DU Wan-Qing, Jia Min, Wang Min, Zhang Xin-Yang, Jiao Wei-Wei, Chen Qian, Lei Lin, Duan Jia-Yu, Tong Chen-Guang, Shen Wei, Liang Xiao, Chen Xin-Zhi, Wu Da-Hua, Zhang Yun-Ling, Liao Xing
Graduate School,Beijing University of Chinese Medicine Beijing 100029,China Center for Evidence-based Chinese Medicine,Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences Beijing 100700,China Xiyuan Hospital,China Academy of Chinese Medical Sciences Beijing 100091,China.
Xiyuan Hospital,China Academy of Chinese Medical Sciences Beijing 100091,China.
Zhongguo Zhong Yao Za Zhi. 2021 Sep;46(18):4601-4614. doi: 10.19540/j.cnki.cjcmm.20210618.501.
The study aims to analyze the outcome indicators of randomized controlled trial(RCT) of traditional Chinese medicine(TCM) in the treatment of hypertensive intracerebral hemorrhage(HICH) in recent three years, and thus provide suggestions for the future studies in this field. Four English databases, four Chinese databases and two online registration websites of clinical trials were searched. The RCTs published between January 2018 and September 2020 were screened. The risk of bias was assessed and outcome measures were classified. A total of 151 839 articles were retrieved, of which 44 RCTs were included for analysis after screening. The outcome measures of the included RCTs were classified into 7 categories, among which the symptoms/signs category showed the highest reporting rate. National Institute of Health stroke scale(72.73%) was the most frequently reported outcome indicator, while the vo-lume of intracerebral hemorrhage determined by computerized tomography(36.36%) was the most frequently reported lab test outcome. Most studies collect the outcomes at the end of treatment, while 9 studies reported long-term outcomes 3 months or more after onset. Compared with those of international clinical trials, the application of some of the outcomes was reasonable, focusing on patients' symptoms, quality of life and objective outcomes. However, there were still several problems: unclear primary and secondary outcome measures, insufficient attention to long-term prognosis, insufficient attention to social function, few TCM outcomes, lack of measurement blindness and the use of unreasonable composite outcomes. It is recommended that researchers should rationally design the outcome indicators of clinical trials and develop the core outcome set.
本研究旨在分析近三年中医治疗高血压性脑出血(HICH)的随机对照试验(RCT)的结局指标,从而为该领域未来的研究提供建议。检索了四个英文数据库、四个中文数据库以及两个临床试验在线注册网站。筛选2018年1月至2020年9月发表的RCT。评估偏倚风险并对结局指标进行分类。共检索到151839篇文章,经筛选后纳入44项RCT进行分析。纳入的RCT的结局指标分为7类,其中症状/体征类的报告率最高。国立卫生研究院卒中量表(72.73%)是最常报告的结局指标,而计算机断层扫描测定的脑出血量(36.36%)是最常报告的实验室检查结局。大多数研究在治疗结束时收集结局,而9项研究报告了发病后3个月或更长时间的长期结局。与国际临床试验相比,部分结局指标的应用具有合理性,注重患者症状、生活质量及客观结局。但仍存在几个问题:主次结局指标不明确、对长期预后关注不足、对社会功能关注不足、中医结局指标少、缺乏测量盲法以及复合结局指标使用不合理。建议研究者合理设计临床试验的结局指标并制定核心结局集。