Wang Raoqiong, Ren Junhao, Li Shuangyang, Bai Xue, Guo Wubin, Yang Sijin, Wu Qibiao, Zhang Wei
Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China.
National Traditional Chinese Medicine Clinical Research Base of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou, China.
Front Pharmacol. 2022 Oct 14;13:975816. doi: 10.3389/fphar.2022.975816. eCollection 2022.
Buyang Huanwu decoction (BYHWD) is widely used in the treatment of ischemic stroke in the recovery period and many clinical trials have been reported, but its clinical efficacy and safety have not been fully evaluated. In this study, we conducted a systematic review and meta-analysis to evaluate the clinical efficacy and safety of BYHWD in the recovery period. Eight databases, including CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Cochrane Library, EMBASE, and Web of Science, were searched from the establishment of the database to 13 April 2022. We selected all eligible randomized controlled trials of BYHWD in the treatment of ischemic stroke during the recovery period. Systematic review and meta-analysis were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The National Institutes of Health Stroke Score (NIHSS) was the primary outcome, and the Chinese Stroke Scale (CSS), activities of daily living (ADL), and adverse drug reaction (ADR) were the secondary outcomes. A total of 39 randomized controlled trials were included, and 3,683 patients in the recovery period of ischemic stroke were recruited. Compared with conventional treatment alone, BYHWD combined with conventional treatment significantly decreased the NIHSS score (MD = -1.44, 95% CI: 1.75, -1.12, < 0.00001), the CSS score (MD = -1.18, 95% CI: 2.02, -0.34, = 0.006), improved the ADL (MD = 4.33, 95% CI: 3.06, 5.61, < 0.00001), and did not increase the adverse reactions of patients (OR = 0.88, 95% CI: 0.48, 1.61, = 0.67). BYHWD is an effective and safe therapy for the recovery of ischemic stroke. To further determine the efficacy and safety of BYHWD in the treatment of ischemic stroke in the recovery period, more high-quality, multicenter, and prospective RCTs are needed.
补阳还五汤(BYHWD)广泛用于缺血性中风恢复期的治疗,已有许多临床试验报道,但其临床疗效和安全性尚未得到充分评估。在本研究中,我们进行了一项系统评价和荟萃分析,以评估补阳还五汤在恢复期的临床疗效和安全性。检索了8个数据库,包括中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Cochrane图书馆、EMBASE和Web of Science,检索时间从数据库建立至2022年4月13日。我们纳入了所有符合条件的补阳还五汤治疗缺血性中风恢复期的随机对照试验。按照PRISMA(系统评价和荟萃分析优先报告项目)指南进行系统评价和荟萃分析。美国国立卫生研究院卒中量表(NIHSS)为主要结局指标,中国卒中量表(CSS)、日常生活活动能力(ADL)和药物不良反应(ADR)为次要结局指标。共纳入39项随机对照试验,招募了3683例缺血性中风恢复期患者。与单纯常规治疗相比,补阳还五汤联合常规治疗显著降低了NIHSS评分(MD=-1.44,95%CI:-1.75,-1.12,P<0.00001)、CSS评分(MD=-1.18,95%CI:-2.02,-0.34,P=0.006),改善了ADL(MD=4.33,95%CI:3.06,5.61,P<0.00001),且未增加患者的不良反应(OR=0.88,95%CI:0.48,1.61,P=0.67)。补阳还五汤是治疗缺血性中风恢复期的一种有效且安全的疗法。为进一步确定补阳还五汤治疗缺血性中风恢复期的疗效和安全性,需要更多高质量、多中心的前瞻性随机对照试验。