补阳还五汤辅助治疗周围神经损伤随机对照试验的Meta分析
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摘要
目的:系统评价补阳还五汤辅助治疗周围神经损伤的临床疗效和安全性。方法:计算机检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献(CBM)等数据库中关于补阳还五汤治疗周围神经损伤的临床随机对照试验(RCT)的文献,对符合纳入标准的文献采用Cochrane评价手册5.1推荐的RCT质量评价工具行方法学质量评价,提取患者一般资料及临床疗效优良率、桡神经功能评分和不良反应发生率,采用RevMan5.3软件对上述数据行Meta分析。结果:共纳入8篇RCT,共849例患者。经Meta分析显示:与对照组相比,试验组临床疗效优良率显著提高[RR=1.28,95%CI(1.19,1.37),Z=6.95,P<0.001];桡神经功能评分显著改善[SMD=1.28,95%CI(1.09,1.47),Z=13.13,P<0.001];不良反应发生率差异无统计学意义[RR=0.90,95%CI(0.41,1.98),Z=0.26,P=0.79]。结论:补阳还五汤辅助治疗周围神经损伤较单纯西医治疗可显著提高临床疗效和桡神经功能评分,且不增加不良反应的发生率。
Objective: To systematically evaluate the clinical efficacy and safety of Buyang Huanwu decoction(BHD)in the adjuvant treatment of peripheral nerve injury. Methods: The computer-based search of CNKI, Wanfang, VIP, and CBM database on the treatment of peripheral nerve injury with BHD, the choice of literature was based on randomized controlled trials(RCT). The tool of RCT quality assessment recommended by the Cochrane Evaluation Manual 5.1 which was used for the methodological quality evaluation with the literature that meets the inclusion criteria. The general dataof the patient and the clinical efficacy rate, the sacral nerve function score and the incidence of adverse reactions are extracted. The RevMan5.3 was used for the Meta-analysis. Results: A total of 8 RCTs were included, for a total of 849 patients. Meta-analysis results showed that the clinical efficacy of the experimental group was significantly improved compared with the control group [RR=1.28, 95% CI(1.19, 1.37), Z=6.95, P<0.001], and the sacral nerve function score was significantly improved[SMD] =1.28, 95% CI(1.09, 1.47), Z = 13.13, P<0.001]; there was no significant difference in the incidence of adverse reactions[RR=0.90, 95% CI(0.41, 1.98), Z=0.26, P= 0.79]. Conclusion: BHD for the adjuvant treatment of peripheral nerve injury can significantly improve the clinical efficacy and sacral nerve function score compared with western medicine treatment alone, and does not increase the incidence of adverse reactions.
Objective: To systematically evaluate the clinical efficacy and safety of Buyang Huanwu decoction(BHD)in the adjuvant treatment of peripheral nerve injury. Methods: The computer-based search of CNKI, Wanfang, VIP, and CBM database on the treatment of peripheral nerve injury with BHD, the choice of literature was based on randomized controlled trials(RCT). The tool of RCT quality assessment recommended by the Cochrane Evaluation Manual 5.1 which was used for the methodological quality evaluation with the literature that meets the inclusion criteria. The general dataof the patient and the clinical efficacy rate, the sacral nerve function score and the incidence of adverse reactions are extracted. The RevMan5.3 was used for the Meta-analysis. Results: A total of 8 RCTs were included, for a total of 849 patients. Meta-analysis results showed that the clinical efficacy of the experimental group was significantly improved compared with the control group [RR=1.28, 95% CI(1.19, 1.37), Z=6.95, P<0.001], and the sacral nerve function score was significantly improved[SMD] =1.28, 95% CI(1.09, 1.47), Z = 13.13, P<0.001]; there was no significant difference in the incidence of adverse reactions[RR=0.90, 95% CI(0.41, 1.98), Z=0.26, P= 0.79]. Conclusion: BHD for the adjuvant treatment of peripheral nerve injury can significantly improve the clinical efficacy and sacral nerve function score compared with western medicine treatment alone, and does not increase the incidence of adverse reactions.
引文
[1]章明星,郭义,刘健卫,等.周围神经损伤研究进展[J].解剖科学进展,2016,22(3):347-350.
[2]张升波,刘海飞,陈峰,等.周围神经损伤修复和治疗研究进展[J].中华显微外科杂志,2016,39(2):204-208.
[3]HOUSCHYAR K S,MOMENI A,PYLES M N,et al.The Role of Current Techniques and Concepts in Peripheral Nerve Repair[J].Plast Surg Int,2017,20(5):417-529.
[4]何新泽,王维,呼铁民,等.周围神经损伤的修复:理论研究与技术应用[J].中国组织工程研究,2016,20(7):1044-1050.
[5]徐绍东,黄东明.补阳还五汤对周围神经断裂吻合术后功能恢复的疗效观察[J].新中医,1998,30(6):20-21.
[6]修忠标,盖秀丽,潘铁军.补阳还五汤治疗周围神经损伤临床观察[J].辽宁中医杂志,2001,28(5):286-287.
[7]徐绍东.周围神经断裂吻合术后功能恢复配合内服补阳还五汤的疗效分析[J].康复学报,2008,18(4):40-43.
[8]张远军,凌宇.补阳还五汤加味治疗低位正中神经损伤术后30例临床研究[J].江苏中医药,2013,58(8):26-28.
[9]姚隽,宋会江.电针手阳明大肠经穴位配合口服补阳还五汤治疗桡神经损伤临床研究[J].新中医,2014,46(3):172-173.
[10]罗贤红,卢敏,李雄,等.加味补阳还五汤治疗外伤性周围神经损伤脉络瘀阻证[J].中国实验方剂学杂志,2016,20(9):167-171.
[11]杨帆,吴敏靓,于淏,等.钢板螺丝钉内固定术联合自拟补阳还五汤治疗肱骨中下段骨折合并桡神经损伤疗效观察[J].现代中西医结合杂志,2017,26(7):720-722.
[12]钟典,戴冀斌.加味补阳还五汤对颈动脉内膜剥脱术致颅神经损伤的影响[J].湖北中医杂志,2017,39(5):29-31.
[13]WU R,WANG L,CHEN F,et al.Evaluation of artificial nerve conduit and autografts in peripheral nerve repair in the rat model of sciatic nerve injury[J].Neurological Research,2016,38(5):461-466.
[14]刘青龙,秦振龙,王绣伯.补阳还五汤和腰交感神经节切除对大鼠坐骨神经损伤的影响[J].中国中西医结合外科杂志,2014,21(1):50-53.
[15]周胜强,肖周华,易健,等.补阳还五汤含药血清对体外缺氧损伤神经干细胞增殖及Notch信号通路相关因子mRNA表达的影响[J].中华中医药杂志,2016,31(11):4515-4519.
[2]张升波,刘海飞,陈峰,等.周围神经损伤修复和治疗研究进展[J].中华显微外科杂志,2016,39(2):204-208.
[3]HOUSCHYAR K S,MOMENI A,PYLES M N,et al.The Role of Current Techniques and Concepts in Peripheral Nerve Repair[J].Plast Surg Int,2017,20(5):417-529.
[4]何新泽,王维,呼铁民,等.周围神经损伤的修复:理论研究与技术应用[J].中国组织工程研究,2016,20(7):1044-1050.
[5]徐绍东,黄东明.补阳还五汤对周围神经断裂吻合术后功能恢复的疗效观察[J].新中医,1998,30(6):20-21.
[6]修忠标,盖秀丽,潘铁军.补阳还五汤治疗周围神经损伤临床观察[J].辽宁中医杂志,2001,28(5):286-287.
[7]徐绍东.周围神经断裂吻合术后功能恢复配合内服补阳还五汤的疗效分析[J].康复学报,2008,18(4):40-43.
[8]张远军,凌宇.补阳还五汤加味治疗低位正中神经损伤术后30例临床研究[J].江苏中医药,2013,58(8):26-28.
[9]姚隽,宋会江.电针手阳明大肠经穴位配合口服补阳还五汤治疗桡神经损伤临床研究[J].新中医,2014,46(3):172-173.
[10]罗贤红,卢敏,李雄,等.加味补阳还五汤治疗外伤性周围神经损伤脉络瘀阻证[J].中国实验方剂学杂志,2016,20(9):167-171.
[11]杨帆,吴敏靓,于淏,等.钢板螺丝钉内固定术联合自拟补阳还五汤治疗肱骨中下段骨折合并桡神经损伤疗效观察[J].现代中西医结合杂志,2017,26(7):720-722.
[12]钟典,戴冀斌.加味补阳还五汤对颈动脉内膜剥脱术致颅神经损伤的影响[J].湖北中医杂志,2017,39(5):29-31.
[13]WU R,WANG L,CHEN F,et al.Evaluation of artificial nerve conduit and autografts in peripheral nerve repair in the rat model of sciatic nerve injury[J].Neurological Research,2016,38(5):461-466.
[14]刘青龙,秦振龙,王绣伯.补阳还五汤和腰交感神经节切除对大鼠坐骨神经损伤的影响[J].中国中西医结合外科杂志,2014,21(1):50-53.
[15]周胜强,肖周华,易健,等.补阳还五汤含药血清对体外缺氧损伤神经干细胞增殖及Notch信号通路相关因子mRNA表达的影响[J].中华中医药杂志,2016,31(11):4515-4519.