不同中成药注射液治疗后循环缺血性眩晕效果的网状Meta分析  

Network Meta-analysis of Different Traditional Chinese Medicine Injections for the Treatment of Posterior Circulatory Ischemic Vertigo

作　　者：朱胜杰 刁华琼 杭晓屹 孙文军 ZHU Shengjie;DIAO Huaqiong;HANG Xiaoyi;SUN Wenjun(Department of Encephalopathy,the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100029,China;College of Traditional Chinese Medicine,Beijing University of Traditional Chinese Medicine,Beijing 102488,China)

机构地区：[1]北京中医药大学第三附属医院脑病科,北京市100029 [2]北京中医药大学中医学院,北京市102488

出　　处：《中国全科医学》2025年第14期1795-1808,共14页Chinese General Practice

基　　金：首都卫生发展科研专项项目(首发2022-2-7035);北京市自然科学基金资助项目(NO.7222274);北京市中西医协同旗舰科室建设项目;国家中医药管理局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);北京市朝阳区重点专科建设项目。

摘　　要：背景后循环缺血性眩晕(PCIV)常可作为脑梗死的先兆症状,具有反复发作、缠绵不愈等特点,严重影响患者生命质量,而常规的西医治疗临床疗效有限。目前中成药注射液在控制和缓解眩晕的发作方面具有显著疗效,但鉴于中成药制剂种类繁多,缺乏相关循证医学证据评估各种中成药注射液的优劣。目的运用网状Meta分析对不同中成药注射液联合常规西药治疗PCIV的疗效和安全性进行评价。方法全面检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献服务系统、PubMed、Web of Science、Embase、Cochrane Library数据库建库至2024-05-07有关中成药注射液治疗PCIV的随机对照试验(RCT)。运用Cochrane风险偏倚工具对纳入文献进行质量评价,采用Stata 17.0、RevMan 5.4软件进行统计学分析。结果最终纳入49项RCT,4556例患者,涉及丹参川芎嗪注射液、丹红注射液、参芎葡萄糖注射液、参麦注射液、天麻素注射液、灯盏花素注射液、疏血通注射液、红花黄色素注射液、舒血宁注射液、苦碟子注射液、葛根素注射液、醒脑静注射液、银杏达莫注射液13种中成药注射液。网状Meta分析结果显示,眩晕症状改善[即眩晕障碍量表(DHI)评分]方面:累积排序概率图下面积(SUCRA)排名前3的干预措施为醒脑静注射液(87.2%)、参麦注射液(73.5%)、舒血宁注射液(59.6%)分别联合常规西药;临床总有效率方面:排名前3的干预措施为银杏达莫注射液(88.3%)、天麻素注射液(63.3%)、葛根素注射液(57.6%)分别联合常规西药;左、右椎动脉血流速度改善方面:排名前3的干预措施为醒脑静注射液(96.2%、99.2%)、灯盏花素注射液(90.2%、85.6%)、红花黄色素注射液(69.3%、79.4%)分别联合常规西药;基底动脉血流速度改善方面:排名前3的干预措施为灯盏花素注射液(97.6%)、红花黄色素注射液(85.8%)、醒脑静注射液(80.6%)分别联合常规Background Posterior circulation ischemic vertigo(PCIV)can often be used as a precursor symptom of cerebral infarction.It has the characteristics of recurrent attacks,lingering and non healing,which seriously affects the quality of life of patients.However,the clinical efficacy of conventional western medicine treatment is limited.At present,traditional Chinese patent medicines and simple preparations injection has significant efficacy in controlling and alleviating the onset of vertigo.However,in view of the wide variety of traditional Chinese patent medicines and simple preparations preparations,there is a lack of relevant evidence-based medical evidence to evaluate the advantages and disadvantages of various traditional Chinese patent medicines and simple preparations injections.Objective To evaluate the efficacy and safety of different Chinese herbal injections combined with conventional western drugs in the treatment of PCIV using reticulated Meta-analysis.Methods A comprehensive search was conducted on CNKI,Wanfang Data,VIP,SinoMed,PubMed,Embase,Web of Science,and Cochrane Library up to May 7,2024,for randomized controlled trials involving TCM injections for the treatment of PCIV.Randomized controlled trial(RCT)on the treatment of post-circulatory ischemic dizziness with herbal injections.The Cochrane risk of bias tool was used to evaluate the quality of the included literature,and RevMan 5.4 and Stata 17 software were used for data analysis.Results Forty-nine RCT with 4556 patients were finally included,involving 13 types of traditional Chinese medicine injections,including Danshen Chuanxiongqin injection,Danhong injection,Shenxiong Putaotang injection,Shenmai injection,Tianmasu injection,Dengzhanhuasu injection,Shuxuetong injection,Honghuahuangsesu injection,Shuxuening injection,Kudiezi injection,Gegensu injection,Xingnaojing injection,Yinxingdamo injection.Net Meta-analysis showed that in terms of vertigo symptom improvement[i.e.Dizziness Disorder Inventory(DHI)score]:the top 3 SUCRA-ranked interventions

关 键 词：眩晕 后循环缺血性眩晕 中成药 注射剂 治疗结果 网状Meta分析 

分 类 号：R255.3[医药卫生—中医内科学] R441.2[医药卫生—中医学]