水蛭单方制剂治疗缺血性脑血管病的网状Meta分析  

Network Meta-analysis of single Hirudo prescriptions in treatment of ischemic cerebrovascular disease

作　　者：阎早芳 孙瑞华[2] 陈燕芬[2] 虞康达 YAN Zao-fang;SUN Rui-hua;CHEN Yan-fen;YU Kang-da(Beijing University of Chinese Medicine,Beijing 100029,China;China-Japan Friendship Hospital,Beijing 100029,China;Beijing Inruida Pharmaceutical Technology Co.,Ltd.,Beijing 102218,China)

机构地区：[1]北京中医药大学,北京100029 [2]中日友好医院,北京100029 [3]北京因瑞达医药科技有限公司,北京102218

出　　处：《中国中药杂志》2023年第4期1108-1115,共8页China Journal of Chinese Materia Medica

摘　　要：该研究拟运用频率学网状Meta分析和传统Meta分析相结合,对水蛭单方制剂治疗缺血性脑血管病(ICVD)的有效性及安全性进行评价,通过计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、EMbase、Cochrane Library数据库,自建库至2022年5月收录的水蛭单方制剂治疗ICVD的随机对照试验(RCT),同时采用Cochrane偏倚风险评估工具对纳入文献进行质量评价,最终纳入54项RCTs,包括3种水蛭单方制剂,通过RevMan 5.3和Stata SE 15进行统计分析。网状Meta分析结果显示,在临床有效率方面,累计概率排名曲线下面积(SUCRA)排序为活血通脉胶囊+常规治疗>脉血康胶囊+常规治疗>脑血康胶囊+常规治疗>常规治疗;传统Meta分析显示,在治疗ICVD安全性方面,脉血康胶囊+常规治疗>常规治疗。通过网状Meta分析和传统Meta分析,发现常规治疗联合水蛭单方制剂可有效提高ICVD患者临床有效率,且与单纯常规治疗相比,不良反应发生率低,安全性较高,但由于纳入文献方法学质量普遍偏低,且3种联合方式用药的文献量差异较大,故该结论有待后续RCT证实。This study intended to evaluate the efficacy and safety of single Hirudo prescriptions in the treatment of ischemic cerebrovascular disease(ICVD) by frequency network Meta-analysis and traditional Meta-analysis. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library databases were searched to collect the randomized controlled trial(RCT) of single Hirudo prescriptions for ICVD from the inception of the databases to May 2022. The quality of the included literature was evaluated by Cochrane risk of bias tool. Finally, 54 RCTs and 3 single Hirudo prescriptions were included. Statistical analysis was conducted by RevMan 5.3 and Stata SE 15. Network Meta-analysis showed that in terms of the clinical effective rate, the surface under the cumulative ranking curve(SUCRA) of intervention measures was as follows: Huoxue Tongmai Capsules+conventional treatment>Maixuekang Capsules+conventional treatment>Naoxuekang Capsules+conventional treatment>conventional treatment. Traditional Meta-analysis revealed that in terms of the safety of ICVD treatment, Maixuekang Capsules+conventional treatment had higher safety than conventional treatment alone. According to the network Meta-analysis and traditional Meta-analysis, it was found that conventional treatment combined with single Hirudo prescriptions improved the clinical efficacy of ICVD patients, and compared with that of conventional treatment alone, the incidence of adverse reactions of combined treatment was low and the safety was high. However, the methodological quality of the articles included in this study was generally low and there were large differences in the number of articles on the three combined medication. Therefore, the conclusion of this study needed to be confirmed by subsequent RCT.

关 键 词：水蛭单方制剂 缺血性脑血管病 网状Meta分析 传统Meta分析 有效性 安全性 

分 类 号：R277.7[医药卫生—中医学]