系统评价及再评价补阳还五汤治疗缺血性脑卒中。
Systematic evaluation and re-evaluation of buyang huanwu decoction in treating ischemic stroke.
机构信息
Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, FoShan 528200, China.
HuNan University of Traditional Chinese Medicine, ChangSha 410208, China.
出版信息
Complement Ther Med. 2022 Nov;70:102860. doi: 10.1016/j.ctim.2022.102860. Epub 2022 Jul 19.
BACKGROUND
The Buyang Huanwu Decoction (BYHWD) originated from Wang Qingren's "Yi Lin Gai Cuo". It has the effect of tonifying qi and activating blood circulation and dredging collaterals which is recommended for the treatment of Ischemic stroke in China. In recent years, there have been many systematic reviews of Ischemic stroke treated by BYHWD assessing the efficacy of BYHWD in the treatment of Ischemic stroke in the acute, convalescent and sequelae stages. Because of the different methods of analysis, the quality and quality of the evidence obtained in these systematic reviews is different, so a systematic re-evaluation was needed to comprehensively evaluate the strength of these studies.
METHODS
Systematic reviews and meta-analyses of Ischemic stroke treated by BYHWD were identified through the Web of Science, PubMed, CNKI, Weipu, and Wanfang databases. The included studies were selected for literature screening, methodological quality evaluation, and evidence level evaluation by two investigators. The methodological quality was evaluated by the 2020 PRISMA guidelines, Assessing the Methodological Quality of Systematic Reviews (AMSTAR) scale, and the evidence quality was evaluated by the GRADE criteria.
RESULTS
Overall, 12 studies involving 28,594 patients between 2006-2021 were included in this analysis. The methodological quality evaluation based on 2020 PRISMA guidelines results showed that there were many weaknesses in registration and protocol, support, competing interests, competing interests and availability of data, code and other materials. The AMSTAR scale evaluation results showed that the 12 studies were very low quality. The results of the GRADE criteria evaluation showed that the quality of the evidence was scattered, with mainly low-quality evidence.
CONCLUSION
The methodological quality of systematic reviews and meta-analyses of BYHWD in treating Ischemic stroke was generally poor, and the quality of evidence was generally low.
背景
补阳还五汤（BYHWD）源自王清任的《医林改错》，具有补气、活血、通络的功效，推荐用于治疗中国的缺血性中风。近年来，有许多关于 BYHWD 治疗缺血性中风的系统评价，评估 BYHWD 在缺血性中风急性期、恢复期和后遗症期治疗中的疗效。由于分析方法不同，这些系统评价获得的证据质量和质量也不同，因此需要进行系统重新评估，以全面评估这些研究的强度。
方法
通过 Web of Science、PubMed、CNKI、维普和万方数据库，确定了补阳还五汤治疗缺血性中风的系统评价和荟萃分析。由两名研究者对纳入的研究进行文献筛选、方法学质量评价和证据水平评价。方法学质量评价采用 2020 年 PRISMA 指南、评估系统评价方法学质量（AMSTAR）量表和 GRADE 标准评估证据质量。
结果
总体而言，这项分析共纳入了 2006 年至 2021 年间的 12 项研究，共涉及 28594 名患者。基于 2020 年 PRISMA 指南的方法学质量评价结果表明，在注册和方案、支持、利益冲突、数据、代码和其他材料的可用性方面存在许多弱点。AMSTAR 量表评价结果表明，这 12 项研究的质量非常低。GRADE 标准评价结果表明，证据质量参差不齐，主要是低质量证据。
结论
补阳还五汤治疗缺血性中风的系统评价和荟萃分析的方法学质量普遍较差，证据质量普遍较低。
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