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中药祛风化痰治疗癫痫的疗效和安全性:系统评价和荟萃分析。

Efficacy and safety of traditional Chinese medicine for the treatment of epilepsy by wind quenching and phlegm resolving: A systematic review and meta-analysis.

机构信息

Guilin Hospital of Traditional Chinese Medicine, Guangxi, China.

Guizhou University of Chinese Medicine, Guiyang, China.

出版信息

Medicine (Baltimore). 2024 Oct 25;103(43):e39942. doi: 10.1097/MD.0000000000039942.

Abstract

BACKGROUND

Using wind-quenching and phlegm-resolving (WQPR) therapy for epilepsy has yielded beneficial results in various clinical studies. However, a comprehensive analysis of the WQPR approach to epilepsy has not yet conducted to date. This study aimed to evaluate the effectiveness and safety of the WQPR method in traditional Chinese medicine (TCM) for epilepsy.

METHODS

Eight databases, including The Cochrane Library, Web of Science, PubMed, Embase, Chinese Biomedical Database, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database (VIP), and WanFang Database, were comprehensively searched to include randomized controlled trials (RCTs) investigating the WQPR approach in epilepsy. Quality was evaluated by the Cochrane Handbook for Systematic Reviews of Interventions, and meta-analysis was conducted using the RevMan 5.4 and Stata 14.0 software. For the outcome indicators with the number of studies ≥ 10, funnel chart and Egger test were used to evaluate the bias, and the evidence quality was evaluated according to GRADEpro system.

RESULTS

We included 19 randomized controlled trials with 1475 participants. Compared to the control group, the WQPR approach showed clinical efficacy for epilepsy (odds ratio = 3.23, 95% confidence interval [CI] [2.19, 4.77], Z = 5.90, P < .00001), reduced seizure frequency (standardized mean differences = -1.24, 95% CI [-1.62, -0.85], Z = 6.26, P < .00001), shortened seizure duration (standardized mean differences = -2.07, 95% CI [-2.99, -1.14], Z = 4.39, P < .0001), improved patient's quality of life (mean difference = 2.60, 95% CI [2.16, 3.03], Z = 11.62, P < .00001), and ameliorated TCM syndromes (mean difference = -4.37, 95% CI [-6.19, -2.56], Z = 4.72, P < .00001). The reduced rate of adverse reactions (odds ratio = 0.56, 95% CI [0.37, 0.85], Z = 2.71, P = .007).

CONCLUSION

WQPR therapy appears to be an effective and safe approach for treating epilepsy, increasing clinical efficacy, reducing seizures' frequency and duration, improving patients' quality of life, ameliorating TCM syndromes, and reducing adverse reaction rates.

摘要

背景

风痰祛瘀法治疗癫痫在多项临床研究中取得了有益的结果。然而,迄今为止,尚未对风痰祛瘀法治疗癫痫进行全面分析。本研究旨在评估中医风痰祛瘀法治疗癫痫的有效性和安全性。

方法

全面检索了 Cochrane 图书馆、Web of Science、PubMed、Embase、中国生物医学文献数据库、中国知网、中国科技期刊数据库(VIP)和万方数据库等 8 个数据库,纳入了关于风痰祛瘀法治疗癫痫的随机对照试验(RCT)。采用 Cochrane 干预系统评价手册评价质量,并使用 RevMan 5.4 和 Stata 14.0 软件进行荟萃分析。对于研究数量≥10 的结局指标,采用漏斗图和 Egger 检验评估偏倚,并根据 GRADEpro 系统评价证据质量。

结果

共纳入 19 项 RCT,纳入 1475 名参与者。与对照组相比,风痰祛瘀法治疗癫痫的临床疗效(比值比=3.23,95%置信区间[CI] [2.19, 4.77],Z=5.90,P<.00001)、减少癫痫发作频率(标准化均数差=-1.24,95% CI [-1.62, -0.85],Z=6.26,P<.00001)、缩短癫痫发作持续时间(标准化均数差=-2.07,95% CI [-2.99, -1.14],Z=4.39,P<.0001)、改善患者生活质量(均数差=2.60,95% CI [2.16, 3.03],Z=11.62,P<.00001)和改善中医证候(均数差=-4.37,95% CI [-6.19, -2.56],Z=4.72,P<.00001)均有改善。不良反应发生率降低(比值比=0.56,95% CI [0.37, 0.85],Z=2.71,P=.007)。

结论

风痰祛瘀法治疗癫痫可能是一种有效且安全的方法,可提高临床疗效,减少癫痫发作频率和持续时间,改善患者生活质量,改善中医证候,降低不良反应发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8587/11521077/f67638bacbe3/medi-103-e39942-g001.jpg

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