逍遥散治疗心脏神经官能症疗效的系统评价
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摘要
目的回顾分析逍遥散与谷维素、β受体阻滞剂、苯二氮类药物、氟哌噻吨美利曲辛治疗心脏神经官能症的疗效。方法检索1949年至2018年6月期间中国生物医学数据库、中国知网、万方数据库、维普、Pubmed等5个数据库中收录的逍遥散治疗心脏神经官能症的临床随机对照试验,进行筛选、提取资料并进行Cochrane风险偏倚评估、异质性检验、合并效应量及敏感性分析。结果最终纳入15个试验,共计1 244例患者。纳入试验异质性较低但存在一定偏倚风险,效应量合并结果:逍遥散较联合使用β受体阻滞剂、苯二氮类药物、谷维素的疗效较好(P <0.00001);逍遥散较联合使用β受体阻滞剂、谷维素的疗效较好(P <0.0001);逍遥散较联合使用β受体阻滞剂、谷维素、氟哌噻吨美利曲辛的疗效较好(P=0.0006);逍遥散联合β受体阻滞剂、苯二氮类药物、谷维素的疗效优于单纯使用西药(P=0.0010)。结论逍遥散对照西药、逍遥散联合西药对照单纯西药治疗心脏神经官能症在临床总有效率方面具有优势,但尚需更多高质量的随机双盲对照试验加以验证。
Objective: To retrospectively analyze the therapeutic effects of Xiaoyao Powder and Zhaooryzanol,β-receptor blocker,benzodiazepines,Flupentixol and Melitracen on cardiac neurosis. Methods: Randomized controlled clinical trials of Xiaoyao Powder on cardiac neurosis were retrieved from China Biomedical Database,CNKI,Wanfang Database,Weipu and Pubmed databases from 1949 to June 2018. Data was screened,extracted,and Cochrane risk bias assessment,heterogeneity test,combined effects and sensitivity analysis were performed. Results: A total of 15 trials involving 1244 patients were included. Xiaoyao Powder was better than the combination of β-receptor blocker,benzodiazepines and oryzanol(P < 0.00001). Xiaoyao Powder was better than the combination of β-receptor blocker and oryzanol(P < 0.00001). Xiaoyao Powder was more effective than combination of β-receptor blocker,oryzanol and halopethiazide and melitracen(P = 0.0006). The efficacy of Xiaoyao Powder combined with β-receptor blocker,benzodiazepines and oryzanol was better than that of Western medicine alone(P =0.0010). Conclusion: Compared with Western medicine alone,Xiaoyao Powder combined with Western medicine has significant advantages in the treatment of cardiac neurosis. However,more high-quality randomized doubleblind controlled trials are needed to verify the above conclusions.
Objective: To retrospectively analyze the therapeutic effects of Xiaoyao Powder and Zhaooryzanol,β-receptor blocker,benzodiazepines,Flupentixol and Melitracen on cardiac neurosis. Methods: Randomized controlled clinical trials of Xiaoyao Powder on cardiac neurosis were retrieved from China Biomedical Database,CNKI,Wanfang Database,Weipu and Pubmed databases from 1949 to June 2018. Data was screened,extracted,and Cochrane risk bias assessment,heterogeneity test,combined effects and sensitivity analysis were performed. Results: A total of 15 trials involving 1244 patients were included. Xiaoyao Powder was better than the combination of β-receptor blocker,benzodiazepines and oryzanol(P < 0.00001). Xiaoyao Powder was better than the combination of β-receptor blocker and oryzanol(P < 0.00001). Xiaoyao Powder was more effective than combination of β-receptor blocker,oryzanol and halopethiazide and melitracen(P = 0.0006). The efficacy of Xiaoyao Powder combined with β-receptor blocker,benzodiazepines and oryzanol was better than that of Western medicine alone(P =0.0010). Conclusion: Compared with Western medicine alone,Xiaoyao Powder combined with Western medicine has significant advantages in the treatment of cardiac neurosis. However,more high-quality randomized doubleblind controlled trials are needed to verify the above conclusions.
引文
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[2]陈灏珠.心血管病鉴别诊断学[M].合肥:安徽科学技术出版社,1995:416-421.
[3]周仲英.中医内科学[M].北京:中国中医药出版社,2003:131-142.
[4]邓中甲.方剂学[M].北京:中国中医药出版社,2003:85-86.
[5]李静,李幼平.不断完善与发展的Cochrane系统评价[J]中国循证医学杂志,2008,8(9):742-743.
[6]张天嵩,钟文昭,李博.实用循证医学方法学[M].2版.长沙:中南大学出版社,2014.
[7]段慧杰,李楠,李霞,等.逍遥散治疗心脏神经官能症疗效观察[J].四川中医,2004,22(4):39-40.
[8]孙耀先,闫平正,姚培太.逍遥散加减治疗心脏神经症[J]实用医技杂志,2008,15(27):3712-3713.
[9]方居正.疏肝解郁治疗心脏神经官能症83例[J].光明中医,2008,23(10):1493-1494.
[10]庞英华,韦艳燕,Lingyan Xue,等.疏肝健脾养心法治疗心脏神经官能症的疗效分析[J].医药前沿,2012,12(36):177-178.
[11]覃裕旺,陈远平.疏肝健脾法治疗心脏神经官能症疗效观察[J].四川中医,2008,26(6):68-69.
[12]刘国霞.逍遥散合温胆汤加减治疗心脏神经官能症60例[J].健康导报,2015,20(11):4.
[13]王恺.逍遥散合温胆汤加减治疗心脏神经官能症60例[J]中国实验方剂学杂志,2010,16(4):194-195.
[14]杜笑岩,刘东辉.逍遥丸联合归脾丸治疗心脏神经官能症54例[J].陕西中医,2007,28(11):1529.
[15]魏丽萍,祝光礼,方晓江.牡丹养心合剂治疗心脏神经官能症临床观察[J].浙江中西医结合杂志,2013,23(6):448.
[16]孙利群.逍遥安神方治疗心脏神经官能症56例临床分析[J].中国中医药咨讯,2010,2(30):225.
[17]赵俊坡.逍遥散加减对女性心脏神经官能症患者炎症因子的影响[J].河北中医,2016,38(3):412-415.
[18]霍瑞楼.逍遥散联合归脾汤加减对心脏神经官能症患者心脏自主神经功能的影响[J].河北中医,2016,38(4):565-568.
[19]王晓凯.逍遥散治疗心脏神经官能症临床研究[J].中国医学创新,2011,8(19):165-166.
[20]王辉.逍遥丸治疗心脏神经官能症临床研究[J].光明中医,2012,27(9):1767-1768.
[21]朱改针,张三林,张瑞霞,等.逍遥丸治疗心脏神经官能症疗效观察[J].中外健康文摘,2011,8(42):289-290.