养血清脑颗粒联合盐酸氟桂利嗪治疗偏头痛的系统评价

发布时间：2018-12-10 21:50

【摘要】：背景和目的偏头痛是原发性头痛常见的一种类型,属于慢性神经血管共患的疾病,发病机制涉及多个方面。目前关于偏头痛的治疗方法也是多种多样,尤其是随着祖国医学研究的深入,近年来关于中西医结合治疗偏头痛的有效报道层出不穷。养血清脑颗粒作为成都中医药大学附属医院治疗偏头痛的常用药物,其疗效也得到多数病人的认可。本文从循证医学的角度,运用系统评价的方法,研究养血清脑颗粒联合盐酸氟桂利嗪治疗偏头痛的的有效性及安全性。材料和方法按照Cochrane协作网规定的系统评价原则,制定检索策略,全面检索国内外有关养血清脑颗粒联合盐酸氟桂利嗪治疗偏头痛的临床随机对照试验(RCTs),包括计算机检索清华同方CNKI系列数据库、维普期刊全文数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、MEDLEY Cochrane Library,Pubmed,并且手工检索相关的中文医学期刊,依据制定的纳入及排除标准筛选文献,按照改良的Jadad评分表对纳入研究进行质量评分,提取相关数据,采用RevMan5.2软件对数据进行Meta分析。结果12个试验共纳入1412例患者,联合用药组781例,总有效率为93.1%,西药单用组631例,总有效率为81.1%,中成药单用组138例,总有效率为81.9%。但所纳入的RCTs质量普遍不高。对纳入研究进行Meta分析,结果显示联合用药组对照两药单用能提高患者的总有效率,且不增加药物的副作用。结论本次系统评价收集的研究结果提示养血清脑颗粒联合盐酸氟桂利嗪胶囊治疗偏头痛的效果好,但纳入研究的试验方法学质量普遍低下,且存在发表性偏倚,最终结论的可靠性受到影响。因此有必要进行高质量的大样本量、多中心、采用盲法的临床随机对照试验,为这种中西医结合治疗偏头痛的手段提供更多确凿的临床证据。
[Abstract]:Background and objective Migraine is a common type of primary headache. At present, the treatment of migraine is also varied, especially with the in-depth medical research in the motherland, in recent years, there are many effective reports on the treatment of migraine with integrated Chinese and western medicine. Yangxuennao granule is commonly used to treat migraine in affiliated hospital of Chengdu University of traditional Chinese Medicine. In this paper, the efficacy and safety of Yangxuannao granule combined with flunarizine hydrochloride in the treatment of migraine were studied by means of systematic evaluation from the point of view of evidence-based medicine. Materials and methods according to the systematic evaluation principle stipulated by Cochrane Cooperative Network, a search strategy was formulated to search for the clinical randomized controlled trial (RCTs),) of Yangxuannao granule combined with flunarizine hydrochloride in the treatment of migraine at home and abroad. Including computer retrieval of Tsinghua Tongfang CNKI series database, Weipu periodical full-text database (VIP), Wanfang database, Chinese biomedical literature database (CBM), MEDLEY Cochrane Library,Pubmed, and manual retrieval of related Chinese medical journals. According to the criteria of inclusion and exclusion, the quality of the inclusion study was evaluated according to the improved Jadad scoring table, the relevant data were extracted, and the data were analyzed by Meta software. Results 1412 patients were included in 12 trials. The total effective rate was 93.1 in the combined drug group, 631 in the western medicine group, and 81.1 in the traditional Chinese patent medicine group. The total effective rate was 81.9 in the traditional Chinese patent medicine group. But the quality of RCTs included is generally not high. The results of Meta analysis showed that the control group could improve the total effective rate without increasing the side effect of the drug. Conclusion the results of this systematic evaluation suggest that Yangxuannao granule combined with flunarizine hydrochloride capsule is effective in the treatment of migraine, but the quality of the trial methodology involved in the study is generally low, and there is a published bias. The reliability of the final conclusion is affected. Therefore, it is necessary to carry out high quality large sample size, multi-center, blind clinical randomized controlled trial to provide more conclusive clinical evidence for the treatment of migraine with integrated Chinese and western medicine.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R747.2

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