口服中成药联合常规西药治疗高血压头痛的网状Meta分析  

Network meta-analysis of oral Chinese patent medicine combined with conventional Western medicine for hypertensive headache

作　　者：刘可欣 彭涛 李凯[1] 刘韵琳 冯银 刘学 赵晓平 范小璇[1,2] LIU Ke-xin;PENG Tao;LI Kai;LIU Yun-lin;FENG Yin;LIU Xue;ZHAO Xiao-ping;FAN Xiao-xuan(Shaanxi University of Traditional Chinese Medicine,Xianyang Shaanxi 712046;The Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine,Xianyang Shaanxi 712000)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西中医药大学附属医院,陕西咸阳712000

出　　处：《中南药学》2025年第3期819-825,共7页Central South Pharmacy

基　　金：国家中医药管理局高水平中医药重点学科建设项目(No.国中医药人教函[2023]85号);中医药“双链融合”中青年科研创新团队(No.2022-SLRH-LJ-015);陕西省重点研发计划项目(No.2019ZDLSF04-06-01);陕西省首批省级院士专家工作站(陕组通字[2019]49号);陕西省临床医学研究中心(陕科社发[2017]176号)。

摘　　要：目的运用网状Meta分析方法探索不同中成药联合常规西药在治疗高血压头痛方面的疗效与安全性。方法系统检索中国知网(CNKI)、中国生物医学文献服务系统(SinoMed)、维普(VIP)、万方(WanFang Data)、PubMed、EMbase、The Cochrane Library、Web of Science等数据库,收集自建库至2024年9月期间关于中成药治疗高血压头痛的随机对照试验(RCT)相关文献。采用Stata 16软件进行文献的质量评估及网状Meta分析。结果纳入22项RCTs,总样本量2022例,包括4种中成药(养血清脑颗粒、丹珍头痛胶囊、川芎清脑颗粒、麝香保心丸)。网状Meta分析的结果显示,与单纯常规西药治疗相比,采用中成药联合常规西药疗法在治疗高血压头痛的疗效更佳,安全性更高。在临床症状有效率方面,累计概率排名曲线下面积(SUCRA)位列首位的干预措施是麝香保心丸联合常规西药;在降低收缩压、舒张压方面,SUCRA位列首位的干预措施均是丹珍头痛胶囊联合常规西药。结论当前证据表明,口服中成药治疗高血压病头痛在改善头痛症状和调节血压方面具有明显优势,其中麝香保心丸、丹珍头痛胶囊等与常规西药联用可能是较有效的中西医结合方案。但因纳入文献的数量较少、质量不高,因此有待未来能有更多高质量的研究对此进行验证和深入研究。Objective To determine the clinical efficacy and safety of Chinese patent medicine combined with conventional Western medicine for hypertensive headache by network meta-analysis.Methods We searched CNKI,SinoMed,VIP,WanFang Data,PubMed,EMbase,The Cochrane Library,Web of Science and other databases,and collected literatures on randomized controlled trials(RCTs)of traditional Chinese patent medicine and simple preparations for hypertensive headache from the establishment of the database to September 2024.Review Manager 5.4 and Stata 16 software were used for literature quality evaluation and network meta-analysis.Results Twenty-two RCTs were included,involving 2022 patients,and four proprietary Chinese medicines(Yangxue Qingnao granules,Danzhen Toutong capsules,Chuanxiong Qingnao granules,and Shexiang Baoxin pills).The meta-analysis showed that compared with conventional western medicine alone,combination of Chinese patent medicine with Western medicine showed better efficacy and safety.The intervention measure with the highest cumulative area under the probability ranking curve(SUCRA)was combination of Shexiang Baoxin pills and conventional Western medicine.The top intervention measure of SUCRA in reducing systolic and diastolic blood pressure was combination of Danzhen Toutong capsules and conventional Western medicine.Conclusion Oral Chinese patent medicine has advantages in improving headache symptoms and regulating blood pressure for patients with hypertensive headache.Combination of Shexiang Baoxin pills and Danzhen Toutong capsules with conventional Western medicine may be effective combination with Western medicine.Due to few literatures and low quality,more high-quality studies are expected to verify the results.

关 键 词：中成药 高血压头痛 随机对照试验 网状Meta分析 

分 类 号：R259[医药卫生—中西医结合]