星蒌承气汤结合西医治疗痰热腑实型脑梗死疗效的Meta分析  

A Meta-analysis on the Therapeutic Effect of Xinglou Chengqi Decoctioncombined with Western Medicine on Stroke at Acute Stage of Phlegm Heatexcess Pattern

作　　者：赵琪 刘勇 ZHAO Qi;LIU Yong(Integrated Chinese and Western Medicine College of Southwest Medical University,Luzhou 646000,Sichuan,Chin)

机构地区：[1]西南医科大学中西医结合学院,四川泸州646000 [2]西南医科大学附属中医医院

出　　处：《中西医结合心脑血管病杂志》2019年第15期2263-2268,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：四川省科技计划基金资助(No.2017LZXNYD-J15)

摘　　要：目的系统评价星蒌承气汤结合西医治疗痰热腑实型脑梗死的临床疗效。方法对中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、EMbase、MedLine等数据库进行综合搜索。检索时间为建库至2019年6月1日。采用主题词与自由词检索相结合的方式进行。统计软件使用Cochrane协作网提供的RevMan5.3。结果检索后得到238篇文献,通过筛选,最后符合纳入标准的文献有5篇,共469例受试者。Meta分析结果表明:相比单独使用西医方法治疗痰热腑实型脑梗死,使用星蒌承气汤结合西医治疗组的总有效率较对照组显著提高[RR=1.19,95%CI(1.10,1.30),P<0.0001];治疗后神经功能缺损评分低于对照组(WMD=-4.30,95%CI(-5.04,-3.57),P<0.00001);治疗后血清超敏C反应蛋白(hs-CRP)低于对照组[WMD=-2.10,95%CI(-2.83,-1.38),P<0.00001];治疗后血浆蛋白含量低于对照组[WMD=-0.22,95%CI(-0.41,-0.04),P<0.05];治疗后低切全血黏度低于对照组[WMD=-3.04,95%CI(-5.26,-0.82),P<0.01];治疗后高切全血黏度低于对照组[WMD=-1.20,95%CI(-1.84,-0.55),P<0.0001]。结论痰热腑实型脑梗死病人通过星蒌承气汤结合西医治疗后,疗效显著,神经功能缺损评分降低,hs-CRP、血浆蛋白含量、低切全血黏度、高切全血黏度均有效改善。Objective To evaluate the clinical effect of combined xinglou chengqi decoction and western medicine in the treatment of phlegm heatexcess pattern stroke at acute stage.Methods A comprehensive search was conducted on CNKI,VIP,wanfang database,CBM,PubMed,EMbase and Medline.The retrieval time is from the establishment of the database to June 1,2019.Subject words and free words are used to search.RevMan 5.3 was provided by the Cochrane collaboration.Results After retrieval,238 references were obtained.After screening,5 references finally met the inclusion criteria,involving 469 subjects.The results of meta-analysis showed that compared with the western medicine alone in the treatment stroke at acute stage of phlegm heatexcess pattern,the total effective rate of the treatment with the xinglou chengqi decoction and western medicine was significantly higher{JP3than that of the control group[RR=1.19,95%CI(1.10,1.30),P<0.000 1].After treatment,the score of neural dysfunction was lower than that of the control group[WMD=-4.30,95%CI(-5.04,-3.57),P<0.000 01].After treatment,hs-CRP was lower that of than the control group[WMD=-2.10,95%CI(-2.83,-1.38),P<0.000 01].After treatment,the plasma protein was lower than that of the control group[WMD=-0.22,95%CI(-0.41,-0.04),P<0.05].After treatment,the viscosity of low-cutting whole blood was lower than that of the control group[WMD=-3.04,95%CI(-5.26,-0.82),P<0.01].After treatment,the viscosity of high-cutting whole blood was lower than that of the control group[WMD=-1.20,95%CI(-1.84,-0.55),P<0.000 1].Conclusion The treatment of patients with stroke at acute stage of phlegm heat by xinglou chengqi decoction has a significant effect,the nerve function deficit scores reduced,hs-CRP,plasma protein,low-cutting whole blood viscosity,high-cutting whole blood viscosity are effectived.

关 键 词：脑梗死 痰热腑实 星蒌承气汤 中西医结合 META分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R289.5[医药卫生—临床医学]