基于“脏腑理论-从肝脾论治”的中药治疗儿童抽动障碍的有效性与安全性Meta分析  

A meta-analysis of the effectiveness and safety of traditional Chinese medicine in children with tic disorder:Based on the theory of "zang-fu organs treatment from liver and spleen"

作　　者：李冬梅[1] 沈红岩[2] 王子[2] LI Dongmei;SHEN Hongyan;WANG Zi(Comprehensive Management Office of Rehabilitation Center,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning 110032;Department of Traditional Chinese Medicine Pediatrics,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang,Liaoning 110032)

机构地区：[1]辽宁中医药大学附属医院康复中心综合管理办公室,辽宁沈阳110032 [2]辽宁中医药大学附属医院中医儿科,辽宁沈阳110032

出　　处：《河北中医》2023年第11期1911-1915,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81774363);第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号);辽宁省教育厅2021年度科学研究经费项目(面上项目)(编号:LJKZ0890)。

摘　　要：目的基于Meta分析系统评价基于“脏腑理论-从肝脾论治”的中药治疗儿童抽动障碍的有效性与安全性。方法通过检索中国知网、万方数据知识服务平台、维普中文期刊服务平台、PubMed、The Cochrane Libraryo、Embase国内外的文献库,纳入有关基于“脏腑理论-从肝脾论治”的中药治疗儿童抽动障碍的随机对照试验(RCT)研究,检索时间从建库至2022年3月。按文献纳入、排除标准进行筛选、质量评价及资料提取,对所有数据进行偏倚分析后,采用RevMan 5.3软件进行Meta分析。结果共纳入8篇符合要求的RCT共1047例患者。Meta分析结果显示,治疗组总有效率高于对照组[OR=2.32,95%CI(1.77,3.04),P<0.00001],临床症状积分改善效果优于对照组[OR=0.29,95%CI(0.23,0.34),P<0.00001],不良反应发生率与对照组比较差异无统计学意义[OR=0.67,95%CI(0.41,1.12),P=0.12]。对8篇RCT的总有效率进行偏倚分析,漏斗图结果提示可能存在一定程度的发表偏倚。结论现有的研究证据表明,基于“脏腑理论-从肝脾论治”的中药治疗儿童抽动障碍有效性与安全性较好,但尚需开展更多高质量RCT予以验证。Objective To systematically evaluate the effectiveness and safety of traditional Chinese medicine(TCM)treatment for children with tic disorder based on the theory of"zang-fu organs treatment from liver and spleen".Methods A literature database at home and abroad,including CNKI,Wanfang Data Knowledge Service Platform,VIP Chinese Journal Service Platform,PubMed,The Cochrane Library and Embase were performed,the randomized controlled trials(RCTs)of TCM treatment for tic disorder in children based on the theory of"zang-fu organs treatment from liver and spleen"was included.The retrieval time limit is from the establishment of the database to March 2022.According to the inclusion and exclusion criteria of the literature,the screening,quality evaluation and data extraction were performed,and bias analysis was conducted,and Rev Man5.3 software was used for a Meta-analysis.Results A total of 8 eligible RCTs representing 1047 patients were included.Meta-analysis showed that the total effective rates in the treatment group were significantly higher than those of the control group(odds ratio[OR]=2.32,95%confidence interval[CI]:1.77-3.04,P<0.00001),and the improvement of clinical symptom score in the treatment group was better than that of the control group(OR=0.29,95%CI:0.23-0.34,P<0.00001),but there was no significant difference in the incidence of adverse reactions between the two groups(OR=0.67,95%CI:0.41-1.12,P=0.12).The total effective rate of clinical treatment of 8 RCTs articles was analyzed by bias.The funnel chart showed that there might be a certain degree of publication bias.Conclusion The existing research evidence shows that the treatment of tic disorder in children with TCM based on the theory of"zang-fu organs treatment from liver and spleen"is effective and safe,but more high-quality RCTs are needed to verify it.

关 键 词：抽搐性运动障碍 脏腑治法 肝脾论治 中医药疗法 META分析 

分 类 号：R749.940.531[医药卫生—神经病学与精神病学]