摘要
目的:系统评价头痛宁联合氟桂利嗪治疗偏头痛的疗效及安全性。方法:电子检索PubMed、Cochrane library、Embase、CNKI、VIP、万方和CBM,检索时间限定为自建库至2017年7月6日,检出所有头痛宁联合氟桂利嗪治疗偏头痛的有关文献,2名研究员独立严格进行纳入研究的质量评价和资料提取,用Stata 14.0软件进行Meta分析,用TSA v 0.9软件进行试验序贯分析。采用Harbord方法或Egger检验及剪补法进行发表偏倚的检验。结果:共纳入16个RCT包括1 746例患者。Meta分析结果显示总有疗效(RR=1.21,95%CI[1.16,1.26])、CGRP(WMD=-0.25,95%CI[-0.39,-0.12])、VAS评分(WMD=-1.04,95%CI[-1.42,-0.66])、血钾浓度(WMD=-2.05,95%CI[-0.32,-0.18])、血镁浓度(WMD=0.09,95%CI[0.04,0.14])、血管血流速度等比较差异均有统计学意义(P<0.05),治疗组优于对照组。治疗组不良反应发生率为2.27%,对照组为2.89%。试验序贯分析提示头痛宁联合氟桂利嗪治疗偏头痛总有效率证据确切。结论:头痛宁联合氟桂利嗪能显著提高总有疗效,改善VAS评分、CGRP、血钾及血镁浓度、血管血流速度,且不良反应较少,值得临床推广。
OBJECTIVE To systematically review the efficacy and safety of Toutongning capsules combined with flunarizine against migraine.METHODS Such databases as PubMed,Cochrane library,Embase,CNKI,VIP,Wanfang data and CBM were searched in order to collect literatures about Toutongning capsules combined with flunarizine against migraine on the deadline to July 6,2017.Two researchers independently screened literatures according to the inclusion and exclusion criteria,and evaluated the methodological quality of included studies.Meta-analysis and TSA analysis were carried out by using Stata 14 version and TSA v 0.9 respectively.The publication bias was utilized to evaluate by Harbord or Egger test and Trim and Filled method.RESULTS Totally 16 RCT including 1 746 cases were included eventually.The analysis showed that the curative effect of Toutongning capsules combined with flunarizine against migraine in the improvement of total efficiency(RR=1.21,95% CI[1.16,1.26]),CGRP(WMD=-0.25,95% CI [-0.39,-0.12]),VAS score(WMD=-1.04,95%CI[-1.42,-0.66]),serum potassium concentration(WMD=-2.05,95%CI[-0.32,-0.18]),blood magnesium concentration(WMD=0.09,95%CI[0.04,0.14])and blood vessel velocity were better than those of flunarizine alone.The incidence of adverse reactions was 2.27%in the treatment group and 2.89%in the control group.Subgroup analysis showed that the total effective rate was increased in all subgroups(P<0.05).The TSA analysis showed that the evidence of the total effective rate was definite.CONCLUSION Toutongning capsules combined with flunarizine can increase efficacy in the treatment of migraine,and improve VAS score,CGRP,serum potassium and blood magnesium concentration and blood vessel velocity,which is worthy of clinical promotion.
引文
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