摘要
目的 :系统评价补阳还五汤治疗气虚血瘀型一氧化碳中毒迟发性脑病(delayed encephalophathy after acute carbon monoxide poisoning,DEACMP)的有效性。方法 :检索知网、万方、维普、PubMed、EMbase数据库及The Cochrane Library,检索时限从数据库建库至2022年9月30日,搜集补阳还五汤治疗气虚血瘀型DEACMP的随机对照试验,根据纳入和排除标准由2名研究者独立筛选符合标准的文献,提取文献资料并评价纳入文献的文献质量、偏倚风险,应用Revman5.3软件进行Meta分析。结果:共纳入7篇对照试验,包括患者718例。Meta分析结果显示,补阳还五汤联合西医治疗气虚血瘀型DEACMP的总有效率(OR=0.49,95%CI[0.16,0.41],P<0.00001)、脑电图正常率(OR=0.34,95%CI[0.18,0.64],P=0.0009)高于常规西医治疗,且改善认知功能(MD=-3.00,95%CI[-5.54,-0.46],P=0.02)的有效性优于常规西医治疗。亚组分析结果显示,不同疗程亚组的补阳还五汤联合西医治疗总有效率优于常规西医治疗(P<0.05)。结论:与常规西医治疗相比,联合补阳还五汤治疗气虚血瘀型DEACMP在提高整体疗效、脑电图正常率及改善患者认知功能方面有效性更高,但尚需更高质量的随机双盲对照研究进一步验证。
Objective:The purpose of the study is to systematically assess the effectiveness of Buyang Huanwu Tang in the treatment of Qi deficiency and blood stasis pattern delayed encephalopathy after carbon monoxide poisoning(DEACMP).Methods:Randomized controlled trials(RCTs)on the treatment of DEACMP of Qi deficiency and blood stasis pattern with Buyang Huanwu Tang were collected by searching CNKI,Wanfang,VIP,PubMed,EMbase databases and The Cochrane Library,and the retrieval time limit was from database establishment to September 30,2022,two researchers independently selected the literature that met the criteria according to the inclusion and exclusion criteria,extracted literature and evaluated the quality and the risk of bias of the included literature,performed Meta analysis by applying Revman 5.3 software.Results:Seven controlled trials were included,involving 718 patients.The results of Meta analysis displayed that total effective rate(OR=0.49,95%CI[0.16,0.41],P<0.00001),the normal rate of EEG(OR=0.34,95%CI[0.18,0.64],P=0.0009)of Buyang Huanwu Tang combined with Western medicine in the treatment of Qi deficiency and blood stasis pattern DEACMP were higher than these of conventional Western medicine therapy,the effectiveness of improving cognitive function(MD=-3.00,95%CI[-5.54,-0.46])better than that of conventional Western medicine therapy.The results of subgroup analysis showed that total effective rate of Buyang Huanwu Tang and Western medicine in the subgroups with different treatment courses was higher than that of conventional Western medicine therapy(P<0.05).Conclusion:Compared with conventional Western medicine therapy,Buyang Huanwu Tang in the treatment of Qi deficiency and blood stasis pattern DEACMP presents higher effectiveness in raising overall efficacy,the normal rate of EEG and improving the patients'cognitive function,however,higher quality randomized doubleblind controlled study is still needed for further verification.
作者
张谦
ZHANG Qian(Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China)
出处
《西部中医药》
2023年第5期56-60,共5页
Western Journal of Traditional Chinese Medicine
基金
甘肃省自然科学基金(21JR11RA212)
国家中医优势专科建设项目——脑病临床医学中心(甘卫中医函[2023]63号)。
关键词
迟发性脑病
一氧化碳中毒
气虚血瘀型
补阳还五汤
META分析
delayed encephalopathy,carbon monoxide poisoning
Qi deficiency and blood stasis pattern
Buyang Huanwu Tang
Meta analysis
作者简介
张谦(1980-),女,硕士学位,副主任医师。研究方向:脑疾病的中西医结合治疗。
