平肝法治疗偏头痛有效性及安全性的系统评价  

Effectiveness and Safety of Pinggan Method in the Treatment of Migraine:A Systematic Review

作　　者：黄石娇 岳文华 李雪[1] 杨静[1] 王凌 Huang Shijiao;Yue Wenhua;Li Xue;Yang Jing;Wang Ling(Shaanxi University of Chinese Medicine,Shaanxi,Xianyang 712046,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西省中医医院,陕西西安710000

出　　处：《中国中医急症》2021年第7期1152-1156,1232,共6页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家重点研发计划项目(2018YFC2002500)。

摘　　要：目的系统评价平肝法治疗偏头痛的有效性及安全性。方法检索建库至2020年10月中国知网(CNKI)、维普网(VIP)、万方数据知识服务平台、中国生物医学文献数据(CBM)、Cochrane图书馆、EMBASE、PUBMED等中英文数据库,按照Cochrane评价手册5.1.0中的偏倚风险评估工具条目进行评价,应用Review Mansger5.4软件对临床有效率、头痛强度、头痛持续时间、头痛次数、颅内动脉平均血流速度(大脑中动脉、大脑前动脉、大脑后动脉、椎动脉、基底动脉)、血液流变学指标(全血高切黏度、全血低切黏度、血浆黏度、血细胞比容、纤维蛋白原)、中医证候疗效、不良反应/事件的发生进行Meta分析或描述性分析。结果纳入22篇文献,包括1970例患者。与对照组相比,试验组临床有效率[RR=1.21,95%CI(1.16,1.25)]、中医证候疗效[RR=1.22,95%CI(1.09,1.35)]、头痛程度[MD=-1.16,95%CI(-1.42,-0.90)]、头痛持续时间[MD=-1.30,95%CI(-2.13,-0.47)]、全血低切黏度[MD=-2.47,95%CI(-2.83,-2.10)]、纤维蛋白原[MD=-1.88,95%CI(-1.98,-1.78)]、血细胞比容[MD=-8.37,95%CI(-9.15,-7.59)]、大脑后动脉平均血流速度[MD=-14.6,95%CI(-16.48,-12.71)]、椎动脉平均血流速度[MD=-3.29,95%CI(-5.33,-1.25)]均优于对照组(P<0.05);各文献间头痛次数、颅内动脉平均血流速度(大脑中动脉、大脑前动脉、基底动脉)、血液流变学指标(全血高切黏度、血浆黏度)统计学异质性过大,进行描述性分析,与对照组相比,试验组治疗后上述指标优于对照组(P<0.05)。两组均未见明显不良反应。结论平肝法治疗偏头痛临床疗效确切,且不良反应相对较小。Objective:To systematically evaluate the effectiveness and safety of Pinggan method in the treatment of migraine.Methods:The Chinese and English databases such as CNKI,VIP,Wanfang Data Knowledge Service Platform,CBM,Cochrane Library,EMBASE,PUBMED were searched from inception to October 2020.The quality of the included documents was evaluated according to the bias risk assessment tool in Cochrane Evaluation Manual 5.1.0,and the clinical effective rate,headache intensity,headache duration,headache frequency,average blood flow velocity of vertebrobasilar artery(middle cerebral artery,anterior cerebral artery,posterior cerebral artery,vertebral artery and basilar artery),hemodynamic index(whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,hematocrit and fibrinogen),curative effect of TCM symptoms and occurrence of adverse reactions/events were analyzed by using Review Manager 5.4 software.Results:A total of 22 literatures were included,including 1970 patients.Compared with the control group,the clinical effective rate[RR=1.21,95%CI(1.16,1.25)],curative effect of TCM symptoms[RR=1.22,95%CI(1.09,1.35)],headache degree[MD=-1.16,95%CI(-1.42,-0.90)],duration of headache[MD=-1.30,95%CI(-2.13,-0.47)],whole blood low shear viscosity[MD=-2.47,95%CI(-2.83,-2.10)],fibrinogen[MD=-1.88,95%CI(-1.98,-1.78)],hematocrit[MD=-8.37,95%CI(-9.15,-7.59)],average blood flow velocity of posterior cerebral artery[MD=-14.6,95%CI(-16.48,-12.71)],average blood flow velocity of vertebral artery[MD=-3.29,95%CI(-5.33,-1.25)]were all better than those of the control group(P<0.05).Statistical heterogeneity of headache frequency,average blood flow velocity of intracranial artery(middle cerebral artery,anterior cerebral artery,basilar artery)and hemorheological indexes(whole blood high shear viscosity,plasma viscosity)was too large among the literatures.Descriptive analysis showed that the experimental group is superior to the control group after treatment(P<0.05).No obvious adverse reactions were found in both groups.Con

关 键 词：偏头痛 平肝法 随机 系统评价 

分 类 号：R747.2[医药卫生—神经病学与精神病学]