中药补益类方药治疗肌萎缩侧索硬化症的Meta分析

发布时间：2019-05-20 18:23

【摘要】：目的:系统评价中药补益类方药用于治疗肌萎缩侧索硬化(ALS)的疗效及安全性。方法:以"肌萎缩侧索硬化,运动神经元病(MND),中药,中草药,中医,Drugs,Chinese Herbal"为检索词在多个外文网站包括Pubmed,EMBASE医药数据库,Cochrane图书馆,CBM等,以及中文数据库例如CNKI,维普中文科技期刊数据库,万方医学数据平台中进行全面检索,主要检索关于中药治疗ALS的相关随机对照研究,检索时间从建库到2014年12月31日,语言不限。应用Revman Manager 5.2软件进行Meta分析。结果:共筛选出符合纳入条件的随机对照研究7项,涉及病例411例,其中治疗组257例,对照组154例。Meta分析结果显示:治疗组给予补益类方药(不限剂型)进行治疗,在症状改善方面优于对照组[RR=1.42,95%CI(1.11,3.38)];治疗组Norris评分降低的幅度小于对照组,应用补益类方药控制ALS疾病较西药组好,使疾病进展更缓慢[MD=2.1,95%CI(0.65,3.54)];补益类方药在改善ALS患者中医痿证证候方面效果明显优于西药组[MD=3.29,95%CI(1.57,5.01)];差异均有统计学意义。本文所纳入研究有3项研究从胃肠道症状及肝肾功能角度对用药安全性进行评价,结果均未出现严重不良反应。结论:目前有限的证据表明补益类中药具有延缓ALS疾病发展的作用,在延缓疾病进程方面优于西药利鲁唑,但不能显著改善症状及根治肌萎缩侧索硬化。中药相比西药具有价格低廉,保存方便的优点,可以减轻患者的经济负担。但由于本研究所纳入的文献质量总体不高,影响了本研究的可靠性,还有待于进一步大规模高质量的临床研究。
[Abstract]:Objective: to evaluate the efficacy and safety of traditional Chinese medicine (TCM) tonifying prescription in the treatment of amyotrophic lateral sclerosis (ALS). Methods: "amyotrophic lateral sclerosis, motor neuron disease (MND), traditional Chinese medicine, Chinese herbal medicine, traditional Chinese medicine, Drugs,Chinese Herbal" were used as key words in many foreign language websites, including Pubmed,EMBASE Medical Database, Cochrane Library, CBM and so on. As well as Chinese databases such as CNKI, Weipu Chinese Science and Technology Journal Database, Wanfang Medical data platform for comprehensive retrieval, mainly retrieval of ALS related to the treatment of traditional Chinese medicine, retrieval time from the establishment of the database to December 31, 2014. the retrieval time is from the establishment of the database to December 31, 2014. There is no limit to language. Meta analysis was carried out with Revman Manager 5.2 software. Results: a total of 7 randomized controlled studies were selected, involving 411 cases, including 257 cases in the treatment group and 154 cases in the control group. Meta-analysis showed that the treatment group was treated with tonifying prescription (unlimited dosage form). The improvement of symptoms was better than that of the control group [RR=1.42,95%CI (1.11, 3.38)]. The decrease of Norris score in the treatment group was smaller than that in the control group. The use of tonifying drugs to control ALS disease was better than that in the western medicine group, which made the disease progress more slowly [MD=2.1,95%CI (0.65, 3.54)]. The effect of tonifying prescription on improving the syndrome of impotence syndrome in ALS patients was significantly better than that in western medicine group [MD=3.29,95%CI (1.57, 5.01)], and the difference was statistically significant. Three studies included in this study evaluated the safety of drugs from the point of view of gastrointestinal symptoms and liver and kidney function, and the results showed that there were no serious adverse reactions. Conclusion: at present, there is limited evidence that tonifying traditional Chinese medicine can delay the development of ALS disease, and it is superior to the western medicine riruzole in delaying the process of disease, but it can not significantly improve the symptoms and cure amyotrophic lateral sclerosis. Compared with western medicine, traditional Chinese medicine has the advantages of low price and convenient preservation, and can reduce the economic burden of patients. However, the overall quality of the literature included in this study is not high, which affects the reliability of this study, and further large-scale and high-quality clinical research is still needed.
【作者单位】：大连医科大学附属第一医院;牙克石市牙病防治研究所;
【基金】：国家科技部国际科技合作专项(2010DFR30850) 国家自然科学基金项目(81271412,81471308)
【分类号】：R277.7

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