中医药治疗成人癫痫的系统评价  

S ystematic Review of Adult Epilepsy Treated by Chinese Herbal Medicine

作　　者：聂莉媛 张青[1] 王潇慧[1] 孙金[1] 张媛[1] 刘金民 

机构地区：[1]北京中医药大学,北京100079 [2]北京中医药大学第三附属医院,北京100029

出　　处：《中国中医急症》2015年第4期569-572,617,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81373586);高等学校博士学科点专项科研基金资助项目(20120013110011)

摘　　要：目的系统评价中医药治疗成人癫痫的临床疗效及安全性。方法采用计算机检索和手工检索文献,纳入以成人癫痫患者为研究对象、中医药治疗的随机/半随机对照试验。采用改良的Jadad量表进行质量评价,运用Rev Man 5.2进行统计学分析。结果最终纳入73项试验,其中72项涉及总有效率,仅有5项涉及症状积分,30项涉及脑电图改善,36项涉及不良反应及副作用。文献质量普遍较低。系统评价结果显示,在减少患者痫性发作频率、提高总有效率方面,辨证论治/经方加减/中成药联合西药组总有效率明显高于西药组(OR=3.47,95%CI为2.70~4.47,P<0.00001),自拟方加减联合西药组总有效率明显高于西药组(RR=1.22,95%CI为1.17~1.28,P<0.00001),中药联合针刺(耳穴压豆)、西药组疗效明显优于西药组(OR=5.26,95%CI为1.97~14.01,P=0.0009);在症状积分改善方面,中药组及辨证论治/经方加减/中成药联合西药组疗效均明显优于西药组;在脑电图改善方面,中药组疗效明显优于西药组(RR=1.33,95%CI为1.14~1.56,P=0003),辨证论治/经方加减/中成药联合西药组疗效明显优于西药组(OR=2.11,95%CI为1.30~3.42,P=0.002);自拟方加减联合西药组疗效明显优于西药组(OR=2.93,95%CI为1.91~4.49,P<0.00001)。结论中医药治疗成人癫痫在提高总有效率、改善症状积分及脑电图等方面,具有明显优势;中医药治疗成人癫痫未发现严重不良反应。在常规西药治疗基础上加用中医药治疗成人癫痫,可以提高临床疗效。但仍需高质量文献提供循证医学的最佳证据。Objective: To assess the efficacy and safety of treatment Adult Epilepsy with Chinese herbal medicine. Methods: RCTs of treating Adult Epilepsy with Chinese herbal medicine were collected comprehensively by computer and manual searches. The trials were assessedby the Jadad scale integral method,and Rev Man5.2 was used for statistical analysis. Results: Seventy-three trials were included,seventy-two trials relating to the total effective rate,only five trials relating to symptom score,thrity trials relating to Electroencephalogram(EEG),thrity-six trials relating to adverse reaction. The methodological quality was generally low. Result of mete-analysis showed that the treatment by differentiation of syndromes(Bianzheng-Lunzhi)/classical prescription/proprietary Chinese medicine combined with anti-epilepsy drugs(AEDs) groups could significantly improve the total effective rate compared with the Western medicine group(OR 3.47,95%CI 2.70-4.47,P < 0.00001),self-made decoction combined with AEDs group could significantly improve the total effective rate compared with the Western medicine group(RR 1.22,95%CI 1.17-1.28,P < 0.00001),Chinese herbal medicine combined with acupuncture and AEDs group was superior to Western medicine group in improving the clinical efficacy(OR 5.26,95% CI1.97-14.01,P = 0.0009);the Chinese herbal medicine/ the treatment by differentiation of syndromes(BianzhengLunzhi)/classical prescription/proprietary Chinese medicine combined with AEDs groups could significantly improve symptom score compared with the Western medicine group;the Chinese herbal medicine group could significantly improve the EEG compared with the Western medicine group(RR 1.33,95%CI 1.14-1.56,P = 0.0003),the treatment by differentiation of syndromes(Bianzheng-Lunzhi)/classical prescription /proprietary Chinese medicine combined with AEDs groups could significantly improve the EEG compared with the Western medicine group(OR2.11,95%CI 1.30-3.42,P = 0.002),self-made decoction combined with AEDs group could significantly improve the

关 键 词：成人癫痫 中医药 系统评价 META分析 

分 类 号：R277.7[医药卫生—中医学]