Ning Baicheng, Zhu Xiaoting, Wu Xiaodong, Zhu Weiyao, Wang Runze, Qi Chang, Li Mingquan
College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, China.
Department of Cardiology, Dujiangyan Traditional Chinese Medicine Hospital, Chengdu, China.
Front Pharmacol. 2024 Nov 1;15:1486458. doi: 10.3389/fphar.2024.1486458. eCollection 2024.
Currently, traditional Chinese medicine (TCM) and its combinations are widely used in the treatment and rehabilitation of patients with ischemic stroke. However, current studies should mainly focus on the therapeutic effects of traditional Chinese medicines alone. This paper will employ a network meta-analysis to compare the efficacy of different TCM decoctions in the treatment of patients with ischemic stroke.
Chinese and English databases including PubMed, Embase, Cochrane Library, and Web of Science were searched to collect randomized controlled trials of TCM decoctions in the treatment of patients with ischemic stroke (IS), with a search time frame until April 2024. A library of references was created using EndNote 21. Quality assessment was performed using the Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). A Bayesian network meta-analysis of data was performed using R4.3.1 and STATA 15.0.
A network meta-analysis was conducted on 119 randomized controlled trials including 12,137 IS patients. The following TCM decoctions were involved: Xinglou Chengqi Decoction (XLCQT), Shenqi Tongluo Decoction (SQTLF), Zhongfeng Jiuxian Decoction (ZFJXT), Yiqi Tongluo Decoction (YQTLT), Tongqiao Huoxue Tang (TQHXT), Tongluo Xifeng Decoction (TLXFT), Tongluo Fuzheng Decoction (TLFZT), Xuefu Zhuyu Decoction (XFZYT), Xiaoxuming Decoction (XXMT), Qufeng Xingxue Tongluo Formula (QFXXTLF), Banxia Baizhu Tianma Decoction (BXBZTMT), Buyang Huanwu Tang (BYHWT),Huatan Tongluo Decoction (HTTLT), Yiqi Huoxue Tongluo Decoction (YQHXTLT), Yiqi Huoxue Decoction (YQHXT), and Yiqi Huoxue Kaiqiao Prescription (YQHXKQP). Of them, XFZYT was most effective in reducing the NIHSS score; SQTLF was most effective in increasing the Barthel Index (BI) score; and HTTLT was most effective in improving activities of daily living (ADL).
This network meta-analysis provided data on the relative efficacy of different TCM decoctions. Of them, XFZYT was most effective in reducing the NIHSS score; SQTLF was most effective in increasing the BI score; and HTTLT was most effective in improving the ADL score. At the same time, overall, XFZYT ranked first with its best efficacy regarding all the three outcome measures above, and SQTLF came second with its impact on two of the outcome measures.
目前，中药及其复方在缺血性脑卒中患者的治疗和康复中被广泛应用。然而，当前研究主要应聚焦于单一中药的治疗效果。本文将采用网状Meta分析比较不同中药汤剂治疗缺血性脑卒中患者的疗效。
检索包括PubMed、Embase、Cochrane图书馆和Web of Science在内的中英文数据库，收集中药汤剂治疗缺血性脑卒中（IS）患者的随机对照试验，检索时间范围至2024年4月。使用EndNote 21创建参考文献库。采用Cochrane随机试验偏倚风险工具第2版（RoB 2）进行质量评估。使用R4.3.1和STATA 15.0对数据进行贝叶斯网状Meta分析。
对119项随机对照试验（涉及12137例IS患者）进行了网状Meta分析。涉及的中药汤剂如下：星蒌承气汤（XLCQT）、参芪通络方（SQTLF）、中风救先汤（ZFJXT）、益气通络汤（YQTLT）、通窍活血汤（TQHXT）、通络熄风汤（TLXFT）、通络扶正汤（TLFZT）、血府逐瘀汤（XFZYT）、小续命汤（XXMT）、祛风醒血通络方（QFXXTLF）、半夏白术天麻汤（BXBZTMT）、补阳还五汤（BYHWT）、化痰通络汤（HTTLT）、益气活血通络汤（YQHXTLT）、益气活血汤（YQHXT）、益气活血开窍方（YQHXKQP）。其中，血府逐瘀汤在降低美国国立卫生研究院卒中量表（NIHSS）评分方面最有效；参芪通络方在提高巴氏指数（BI）评分方面最有效；化痰通络汤在改善日常生活活动能力（ADL）方面最有效。
该网状Meta分析提供了不同中药汤剂相对疗效的数据。其中，血府逐瘀汤在降低NIHSS评分方面最有效；参芪通络方在提高BI评分方面最有效；化痰通络汤在提高ADL评分方面最有效。同时，总体而言，血府逐瘀汤在上述三项结局指标方面疗效最佳排名第一，参芪通络方在两项结局指标方面有影响排名第二。
