疏肝解郁类经典名方治疗心脏神经官能症的网状Meta分析  

Treatment of Cardiovascular Neurosis with Classical Prescription: a Network Meta-analysis

作　　者：李泰兴 潘健略 郭伟健 何佰程 卢泽声 余昆荣 吴辉[2] LI Taixing;PAN Jianlue;GUO Weijian;HE Baicheng;LU Zesheng;YU Kunrong;WU Hui(The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510000,Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广州510000 [2]广州中医药大学第一附属医院,广州510000

出　　处：《中西医结合心脑血管病杂志》2024年第13期2322-2332,共11页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家重点研发项目(No.2020YFC2006603)。

摘　　要：目的:应用网状Meta分析方法比较与评价疏肝解郁类经典名方治疗心脏神经官能症(CN)的临床疗效及安全性。方法:计算机检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库(WanFang Data)、PubMed、the Cochrane Library、Web of Science数据库中关于柴胡加龙骨牡蛎汤、柴胡疏肝散、丹栀逍遥散、逍遥散单独或联合西医常规治疗CN的随机对照试验(RCT),检索时限为自建库至2022年10月26日。对纳入文献进行评估和筛选,并完成资料提取。运用RevMan 5.4进行文献质量评价、Stata 17.0进行网状Meta分析。结果:纳入35项研究,涉及病人3 094例,研究涉及的干预措施共9种,其中有34项研究以临床总有效率为主要结局指标,9项研究以汉密尔顿焦虑量表(HAMA)评分为次要结局指标,9项研究以不良反应发生率为次要结局指标。网状Meta结果显示,在临床总有效率上,逍遥散治疗效果更佳;在改善HAMA评分上,丹栀逍遥散+西医常规治疗效果更佳。在安全性上,丹栀逍遥散+西医常规治疗不良反应发生率更低。结论:临床上治疗CN,不仅要疏肝解郁,还需辅以健脾益气,且联合西医常规治疗可提高临床疗效,降低不良反应事件发生率。但是,基于本研究的局限性,需要更多高质量、多样本、多结局指标的研究进一步验证。Objective:To compare and evaluate the clinical efficacy and safety of classic prescriptions for the treatment of cardiovascular neurosis(CN)by mesh Meta-analysis.Methods:Randomized controlled trials(RCT)of the treatment of cardiovascular neurosis with conventional western medicine alone or classical prescription(Chaihu Jia Longgu Muli Decoction,Chaihu Shugan Powder,Danzhi Xiaoyao Powder,Xiaoyao Powder)combined with conventional western medicine were searched by computer in China National Knowledge Network(CNKI),China Biomedical Literature Database(CBM),WanFang Data,PubMed,the Cochrane Library,and Web of Science.The search period was from self-established database to October 26,2022.The included literatures were evaluated and screened,and the data extraction was completed.RevMan 5.4 was used for literature quality evaluation and Stata 17.0 was used for mesh Meta-analysis.Results:A total of 35 studies were included,involving 3094 patients.Nine interventions were involved in the study,of which 34 studies took the overall clinical effective rate as the main outcome indicator,9 studies took the post-treatment Hamilton Anxiety Scale(HAMA)score as the secondary outcome indicator,and 9 studies took the incidence of adverse events as the secondary outcome indicator.Mesh meta results showed that Xiaoyao Powder showed better overall clinical effective rate.Danzhi Xiaoyao Powder plus conventional western medicine showed better effect in improving HAMA score.In terms of safety,the probability of adverse events in Danzhi Xiaoyao Powder+conventional western medicine treatment was lower.Conclusion:Clinical treatment of CN,not only to soothe the liver and relieve depression,but also need to strengthen the spleen and tonify Qi.Combined with conventional western medicine treatment can improve clinical efficacy and reduce the incidence of adverse events.However,due to the limitations of this study,more high-quality,multi-sample and multi-outcome studies are needed for further verification.

关 键 词：心脏神经官能症 疏肝解郁 网状Meta分析 

分 类 号：R259[医药卫生—中西医结合]