中药注射液治疗血管性痴呆有效性与安全性的网状Meta分析  

Network Meta-analysis to Efficacy and Safety of Chinese Medicine Injection for the Treatment of Vascular Dementia

作　　者：史梦龙 赵敏[2] 张杰[2] 孙江燕[2] 孙田烨 李涛[2] 屈楠[2] 冉龙龙 Shi Menglong;Zhao Min;Zhang Jie;Sun Jiangyan;Sun Tianye;Li Tao;Qu Nan;Ran Longlong(The First Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou 450046,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一临床医学院,郑州450000 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《世界科学技术-中医药现代化》2022年第10期3869-3879,共11页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家科学技术部国家重点研发计划(2017YFC1703502):中医临床科研信息共享系统的研发与实施,负责人:赵敏;河南省中医管理局河南省中医药传承与创新人才工程(豫中医[2018]35号):河南省中医药拔尖人才培养项目,负责人:赵敏;国家自然科学基金委员会青年科学基金项目(81904264):补肾通腑方调控肠道菌群介导的LPS/TLR4/NF-KB通路改善痴呆认知障碍作用机制,负责人:张杰。

摘　　要：目的系统评价不同中药注射液联合常规疗法治疗血管性痴呆(VaD)的有效性及安全性。方法计算机检索中文数据库知网(CNKI)、中国生物医学文献数据库(SinoMed)、万方数据(WANFANG DATA)、维普网(VIP)及英文数据库Cochrane Library、EMbase、PubMed收录的中药注射液联合常规疗法治疗VaD的临床随机对照试验(RCTs),检索时限均为建库到2021年4月。由2名研究员依据纳排标准独立进行文献筛选、数据提取及偏倚风险评价,最终用RevMan5.4、Stata/MP15.1进行数据分析。结果最终纳入40项RCTs涉及丹红注射液、参麦注射液、黄芪注射液、舒血宁注射液、血栓通注射液、清开灵注射液、复方丹参注射液、醒脑静注射液、疏血通注射液9种中药注射液。网状Meta分析结果显示,治疗有效率方面最优的前3种方案为常规治疗联合黄芪注射液>联合复方丹参注射液>联合醒脑静注射液;改善认知功能方面(MMSE),前3种方案为常规治疗联合参麦注射液>联合舒血宁注射液>联合黄芪注射液;安全性方面,前3种方案为常规治疗联合丹红注射液>联合舒血宁注射液>联合复方丹参注射液。结论在常规治疗基础上联合中药注射液可提高VaD患者治疗总有效率、改善患者认知功能并降低不良反应发生,但因纳入RCTs方法学质量一般,此研究结论仍需进一步验证。Objective Systematic evaluation of the effectiveness and safety of different traditional Chinese medicine injections combined with conventional therapies in the treatment of vascular dementia(Va D).Methods The RCTs of Chinese medicine injection for Va D were searched from databases such as CNKI,Sino Med,WANFANG DATA,VIP,Cochrane Library,Pub Med and EMbase by computer from the establishment of the database to April 2021.Two investigators conducted independent literature screening,data extraction and RCTs bias risk assessment.The data were analyzed by Rev Man5.4 and Stata/MP15.1.Results Finally included 40 RCTs involving Danhong injection,Shenmai injection,Huangqi injection,Shuxuening injection,Xueshuan Tong injection,Qingkailing injection,compound Danshen injection,Xingnaojing injection,Shuxuening injection 9 kinds of traditional Chinese medicine injection.Network Meta-analysis results show that in term of treatment effective rate,the first three optimal were Conventional treatment combined with Huangqi injection>Dan Sheng injection>Xingnao Jing injection;In terms of improving MMSE,the first three optimal were Conventional treatment combined with Shenmai injection>Shuxue Ning injection>Huangqi injection;In terms of safety,the first three optimal were Conventional treatment combined with Danhong injection>Shuxue Ning injection>Danshen injection.Conclusion Combining traditional Chinese medicine injection on the basis of conventional treatment can increase the total effective rate of Va D patients,improve the cognitive function of patients,and reduce the incidence of adverse reactions.However,due to the general methodological quality of the included RCTs,the conclusions of this study still need to be further verified.

关 键 词：中药注射剂 血管性痴呆 网状Meta分析 疗效 

分 类 号：R2-03[医药卫生—中医学]