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中药补阳还五汤联合针刺治疗中风后遗症的疗效:一项随机对照试验的荟萃分析。

Chinese herbal medicine Buyang Huanwu Decoction combined with acupuncture to treat sequela of apoplexy: a meta-analysis of randomized controlled trials.

机构信息

School of Traditional Chinese Medicine, Macao University of Science and Technology, Macao, China.

Department of Acupuncture and Massage, Yunnan University of Traditional Chinese Medicine, Kunming, China.

出版信息

Ann Palliat Med. 2021 Feb;10(2):1685-1692. doi: 10.21037/apm-20-1092. Epub 2020 Nov 18.

Abstract

BACKGROUND

Buyang Huanwu Decoction combined with acupuncture has a wide range of applications in the treatment of stroke sequelae, and there are many clinical trial reports. We systematically evaluated the clinical efficacy and safety of Buyang Huanwu Decoction combined with acupuncture in treating stroke sequelae, and evaluated overall research quality.

METHODS

We searched 7 databases which includes the Chinese Journal Full-text Database (CNKI), VIP Database (VIP), China Biomedicine (SinoMed), Wanfang Database and PubMed, Cochrane Central, EMBASE from January 2010 to December 2019 Literature references. We selected randomized controlled trials that tested the effects of Buyang Huanwu Decoction combined with acupuncture on stroke sequelae. The authors extracted data and independently assessed quality. We used RevMan 5.3.0 software to analyze the data of randomized trials.

RESULTS

A total of 7 articles were identified, including 902 patients. The overall quality of the included trials was poor, and one of them was moderate. Meta-analysis results showed that the experimental group of Buyang Huanwu decoction combined with acupuncture treatment of stroke sequela compared with the control group clearly improved the clinical efficacy improved the clinical efficacy rate (RR 1.18, 95% CI: 1.12, 1.25), P<0.00001]. Among them, three trials included the incidence of adverse reactions (RR 0.22, 95% CI: 0.09, 0.52, P=0.0006), which also confirmed the safety of its treatment.

CONCLUSIONS

Buyang Huanwu Decoction combined with acupuncture is an effective therapy to ameliorate the clinical symptoms of stroke sequelae. In order to further determine the effectiveness and safety of Buyang Huanwu Decoction combined with acupuncture in treating stroke sequelae, more rigorous design, multicenter and prospective RCT must be carried out.

摘要

背景

补阳还五汤联合针刺治疗中风后遗症应用广泛,临床研究报告较多。我们系统评价补阳还五汤联合针刺治疗中风后遗症的临床疗效和安全性,并评价整体研究质量。

方法

我们检索了 7 个数据库,包括中国期刊全文数据库(CNKI)、维普数据库(VIP)、中国生物医学文献数据库(SinoMed)、万方数据库和 PubMed、Cochrane 中央、EMBASE,检索时间从 2010 年 1 月至 2019 年 12 月。我们纳入补阳还五汤联合针刺治疗中风后遗症的随机对照试验,提取资料并独立评价质量。采用 RevMan 5.3.0 软件进行数据分析。

结果

共纳入 7 篇文献,包含 902 例患者。纳入研究的整体质量较差,其中 1 篇为中等质量。Meta 分析结果显示,补阳还五汤联合针刺组治疗中风后遗症的临床疗效明显优于对照组,临床疗效有效率[RR=1.18,95%CI:1.12,1.25],P<0.00001]。其中 3 篇研究纳入不良反应发生率[RR=0.22,95%CI:0.09,0.52,P=0.0006],提示其治疗安全性。

结论

补阳还五汤联合针刺是改善中风后遗症临床症状的有效疗法。为进一步确定补阳还五汤联合针刺治疗中风后遗症的有效性和安全性,还需要开展更多设计严谨、多中心、前瞻性 RCT 研究。

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