痰瘀同治法治疗缺血性中风Meta分析
Meta Analysis on Treatment of lschemic Apoplexy by Trealing Both Phlegm and Blood Stasis
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摘要: 目的评价痰瘀同治法治疗缺血性中风的疗效。方法检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)和中文科技期刊全文数据库(维普),并追查所有纳入研究的参考文献。检索年限从1979—2006年。纳入以痰瘀同治法为主要组方依据的临床随机对照试验(RCT)。文献质量评价采用修改后Jadad量表。提取资料采用卡方检验鉴定研究间异质性,根据检验结果选用固定效应模型或随机效应模型,并对对照组、血液流变学和血脂变化分别进行亚组分析。结果纳入9个RCT,纳入文献的质量均较低。疗效评价,治疗组相对于对照组OR值为3.41(95%CI:2.40,4.85);神经功能缺损,治疗组相对于对照组WMD(fixed)值为-5.09(95%CI:-6.46,-3.71);血液流变学变化,仅红细胞压积1项的治疗组相对于对照组WMD(random)值为-4.60(95%CI:-6.54,-2.66),P<0.000 01;血脂变化,治疗组相对于对照组WMD(fixed)值为0.08(95%CI:0.02,0.13)。结论在常规治疗基础上,以痰瘀同治法为组方依据,加用中药方剂,能有效提高临床疗效,尤其有利于恢复中风所造成的神经功能缺损。Abstract: OBJECTIVE To evaluate the therapeutic effect of the treatment of ischemic apoplexy by treating both phlegm and blood stasis.METHOD By studying related medical literature from 1979 to 2006,the authors carried out a randomized clinical trials(RCT) on the treatment of ischemic apoplexy.RESULT Among the 9 RCTs,the corresponding literature materials were all quite poor.In therapeutic effect evaluation,the OR value of treatment group vs.the control group was 3.41 (95%CI:2.40,4.85);in neurofunctional impairment,the WMD(fixed) value of the treatment group vs.the control group was-5.09(95%CI:-6.46,-3.71);in changes in blood rheology,the WMD(random) value of packed cell volume in the treatment group vs.the control group was-4.60(95%CI:-6.54,-2.66)(P<0.000 01); in changes in blood lipid,the WMD(fixed) value of the treatment group vs.the control group was 0.08(95%CI: 0.02,0.13).CONCLUSION In addition to the routine treatment,the method of treating both the phlegm and blood stasis can be used by using some Chinese drugs to enhance the clinical effect,especially the effect of restoring nerve function.
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