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盐酸氟桂利嗪联合中药汤剂治疗偏头痛的系统评价及 Meta 分析。

Systematic evaluation and meta-analysis of Flunarizine Hydrochloride combined with traditional Chinese medicine decoction in the treatment of migraine headaches.

机构信息

Department of Encephalopathy, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China.

Department of Encephalopathy, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China.

出版信息

Clinics (Sao Paulo). 2024 Jul 3;79:100431. doi: 10.1016/j.clinsp.2024.100431. eCollection 2024.

Abstract

OBJECTIVES

To systematically evaluate the efficacy and superiority of Flunarizine Hydrochloride when combined with Traditional Chinese Medicine (TCM) Decoctions in treating migraine headaches.

METHOD

The authors conducted a comprehensive search for clinical Randomized Controlled Trials (RCTs) investigating the combination of Flunarizine Hydrochloride with Chinese herbal decoctions in treating migraines. The databases searched included CNKI, VIP, Wanfang, PubMed, WOI, Cochrane Library, and Embase, covering the period from January 1, 2019, to November 10, 2023. Two independent researchers meticulously screened, extracted, and assessed the relevant data, employing the Revman 5.3 software for meta-analysis.

RESULTS

The meta-analysis revealed that, in comparison to Flunarizine Hydrochloride used in isolation, the combination with Chinese herbal decoctions markedly enhanced the effective rate (RR = 1.26, 95 % CI [1.18, 1.34], p < 0.0001). Moreover, significant improvements were observed in the TCM symptom score (MD = 4.97, 95 % CI [-6.74, -3.19], p < 0.00001). The observation group demonstrated a statistically significant improvement in endothelin levels compared to the control group (I = 85 %, MD = -13.66, 95 % CI [-17.87, -9.45], p = 0.0001). The observation group showed a significant reduction in NRS scores compared to the control group, indicating better outcomes (I = 95 %, MD = -2.11, 95 % CI [-3.09, -1.12], p < 0.0001). The observation group was superior to the control group in terms of the reduction in the number of episodes (I = 63 %, MD = -1.16, 95 % CI [-1.45, -0.87], p = 0.007).

CONCLUSIONS

The confluence of Flunarizine Hydrochloride with traditional Chinese medicine decoctions in treating migraine patients demonstrated substantial clinical efficacy and improvement in TCM symptom score over the use of Flunarizine Hydrochloride alone.

摘要

目的

系统评价盐酸氟桂利嗪联合中药汤剂治疗偏头痛的疗效和优势。

方法

本研究全面检索了中国知网(CNKI)、维普(VIP)、万方(Wanfang)、PubMed、Web of Science(WOS)、Cochrane 图书馆和 Embase 数据库,检索时间为 2019 年 1 月 1 日至 2023 年 11 月 10 日,纳入盐酸氟桂利嗪联合中药汤剂治疗偏头痛的随机对照试验(RCT)。由 2 名研究员独立筛选、提取和评估相关数据,采用 RevMan 5.3 软件进行荟萃分析。

结果

荟萃分析结果显示,与单独使用盐酸氟桂利嗪相比,联合中药汤剂治疗能显著提高有效率(RR = 1.26,95 % CI [1.18, 1.34],p < 0.0001)。此外,联合治疗组在中医症状评分方面也有显著改善(MD = 4.97,95 % CI [-6.74, -3.19],p < 0.00001)。与对照组相比,观察组内皮素水平有显著改善(I = 85 %,MD = -13.66,95 % CI [-17.87, -9.45],p = 0.0001)。与对照组相比,观察组的 NRS 评分明显降低,表明疗效更好(I = 95 %,MD = -2.11,95 % CI [-3.09, -1.12],p < 0.0001)。观察组在减少发作次数方面优于对照组(I = 63 %,MD = -1.16,95 % CI [-1.45, -0.87],p = 0.007)。

结论

盐酸氟桂利嗪联合中药汤剂治疗偏头痛患者具有显著的临床疗效,可明显改善中医症状评分,优于单独使用盐酸氟桂利嗪。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc2c/11278533/569ab5da036b/gr1.jpg

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