血府逐瘀汤治疗慢性硬膜下血肿有效性及安全性Meta分析  

Meta-analysis of Effectiveness and Safety of Xuefu Zhuyu Decoction in Treating Chronic Subdural Hematoma

作　　者：张泽舜[1] 秦德芳[1] 霍泳林 卢梓鸿 ZHANG Ze-Shun;QIN De-Fang;HUO Yong-Lin;LU Zi-Hong(Dept. of Neurosurgery, Zhuhai Branch Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, Zhuhai 519015 Guangdong, China)

机构地区：[1]广东省中医院珠海医院神经外科,广东珠海519015

出　　处：《广州中医药大学学报》2018年第4期758-763,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省科技计划项目(编号:2016A020226013)

摘　　要：【目的】采用Meta分析探讨血府逐瘀汤加减治疗慢性硬膜下血肿的有效性及安全性。【方法】计算机检索Cochrane Library,Pub Med,EMBase共3个外文数据库和中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)和万方数据库共4个中文数据库,检索所有血府逐瘀汤加减治疗慢性硬膜下血肿的随机对照文献(RCTs)。由2名评价员分别对检索出的文献进行筛选并提取有效数据,采用Rev Man 5.3软件对数据进行Meta分析。【结果】该研究共纳入6个RCTs,共计396例患者。Meta分析结果显示,与单纯西医常规治疗相比,在西医常规治疗基础上应用血府逐瘀汤加减(治疗组)可提高慢性硬膜下血肿的治疗有效率[RR=1.23,95%CI(1.12,1.36),P<0.000 1],促进血肿消散吸收[MD=3.89,95%CI(2.06,5.72),P<0.000 1],减少病情加重或血肿复发[RR=0.19,95%CI(0.08,0.47),P<0.001];安全性方面,其中仅1篇研究报道不良反应,其结果显示血府逐瘀汤联合西医治疗不良反应发生率低于单纯西医治疗(P<0.05)。【结论】与单纯西医常规治疗相比,在西医常规治疗基础上加减应用血府逐瘀汤治疗慢性硬膜下血肿更能提高有效率、促进血肿吸收、减少病情加重或血肿复发、减少不良反应等。但鉴于纳入本研究的文献数量较少、质量不高,西医常规联合血府逐瘀汤加减治疗慢性硬膜下血肿的有效性和安全性仍需更多大样本、多中心、高质量的研究加以验证。Objective To investigate the effectiveness and safety of Xuefu Zhuyu Decoction（XZD）in treatingchronic subdural hematoma（CSDH）with Meta-analysis. Methods Randomized controlled trials（RCTs）involving XZD for the treatment of CSDH were retrieved from the databases of Cochrane Library, Pub Med,EMBase,CBM, CNKI,VIP,Wanfang with computer retrieval method. The literature screening and data extractwere carried out by 2 individual researchers,and Rev Man 5.3 software was used for Meta-analysis. Results A totalof 6 RCTs involving 396 cases were enrolled into the study. The results of the Meta-analysis showed that XZDcombined with conventional western medicine was more effective on enhancing the therapeutic efficacy rate[RR =1.23,95% CI（1.12,1.36）,P〈0.000 1],promoting the absorption of subdural hematoma [MD = 3.89,95% CI（2.06,5.72）,P 〈 0.000 1],and relieving the exacerbation of illness and reducing the recurrence of subduralhematoma [RR = 0.19,95% CI（0.08,0.47）,P 〈 0.001] than conventional western medicine alone. In respect ofthe adverse reaction, there was one RCT reporting the adverse reaction, and the results showed that XZDcombined with conventional western medicine had lower adverse reaction incidence than conventional westernmedicine alone（P 〈 0.05）. Conclusion In comparison with conventional western medicine alone,XZD combinedwith conventional western medicine for CSDH is more effective on enhancing the therapeutic efficacy rate,promoting the absorption of subdural hematoma,relieving the exacerbation of illness and reducing the recurrence of subdural hematoma,and reducing the adverse reaction. However,for the amount of the included studies issmall and the overall quality is low,the conclusion still needs more large-scale,multiple-center and high-qualityRCTs to verify.

关 键 词：血府逐瘀汤 慢性硬膜下血肿 有效性 安全性 META分析 

分 类 号：R289.5[医药卫生—方剂学]