天麻钩藤饮与钙通道阻滞剂在预防性治疗偏头痛疗效对比的Meta分析
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摘要
目的:系统评价天麻钩藤饮与钙通道阻滞剂相比预防性治疗偏头痛的疗效及安全性。方法:电子检索Pub Med、Cochrane library、CNKI、VIP、万方和CBM,分别用Stata 14.0和TSA v0.9进行Meta分析和试验序贯分析。结果:共纳入10个RCT包括900例患者。结果显示与钙通道阻滞剂相比,天麻钩藤饮预防性治疗偏头痛的疗效增加31%(RR=1.31,95%CI(1.22,1.40))。试验序贯分析提示天麻钩藤饮治疗偏头痛的疗效显著,证据充分。治疗组不良反应发生率为3.1%,对照组为7.5%。结论:天麻钩藤饮预防性治疗偏头痛的疗效优于钙通道阻滞剂,具有较好的长期疗效,不良反应较少,仍需高质量、大样本的临床随机对照研究进一步支持验证。
Objective: To systematically review the clinical effect and safety of Tianma Gouteng Yin(TGY) for migraine compared to Calcium channel blockers(CCB). Method: Such databases as Pub Med,Cochrane library,CNKI,VIP,Wanfang data and CBM were searched and we carried out meta-analysis and TSA analysis by using Stata 14 version and TSA v0. 9 respectively. Results: Totally 10 RCT including 900 cases were included eventually. The analysis shows that the total effective rate of prophylactic treatment of migraine in TGY increased by 31% compared to CCB(RR = 1. 31,95%CI(1. 22,1. 40)). The TSA analysis shows that the evidence of the total effective rate is definite. The incidence of adverse reactions was 3. 1% in the treatment group and 7. 5% in the control group. Conclusion: The effectiveness and safety of TGY in the treatment of migraine is better than CCB,which has a good long-term effect. But a larger sample,higher quality RCT test are definitely needed for confirming the conclusion.
Objective: To systematically review the clinical effect and safety of Tianma Gouteng Yin(TGY) for migraine compared to Calcium channel blockers(CCB). Method: Such databases as Pub Med,Cochrane library,CNKI,VIP,Wanfang data and CBM were searched and we carried out meta-analysis and TSA analysis by using Stata 14 version and TSA v0. 9 respectively. Results: Totally 10 RCT including 900 cases were included eventually. The analysis shows that the total effective rate of prophylactic treatment of migraine in TGY increased by 31% compared to CCB(RR = 1. 31,95%CI(1. 22,1. 40)). The TSA analysis shows that the evidence of the total effective rate is definite. The incidence of adverse reactions was 3. 1% in the treatment group and 7. 5% in the control group. Conclusion: The effectiveness and safety of TGY in the treatment of migraine is better than CCB,which has a good long-term effect. But a larger sample,higher quality RCT test are definitely needed for confirming the conclusion.
引文
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[12]ZHU HJ.Clinical Observation on 40 Cases of Migraine Treated with Modified Tianma Gouteng Decoction[J].Zhejiang J Tradit Chin Med,2008,43(5):264-265.
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[14]WANG YQ.Tianma Gouteng Decoction for Treatment of 41 Cases of Hepatitis Yang with Migraine[J].Forum on Traditional Chin Med,2012,27(6):29-30.
[15]YAN MX.Clinical Observation on Treatment of Migraine with Modified Tianma Gouteng Decoction[J].J of North Pharmacy,2015,12(1):85-85.
[16]MAO DC.Clinical Efficacy Evaluation of Tianma Gouteng Decoction in the Treatment of Migraine[J].Clin J Chin Med,2016,8(30):17-18.
[17]CHEN HY,DONG H,ZHANG J,et al.Migraine treatment with Chinese medicine[J].J of Changchun University of Chin Med.2014,30(8):751-753.
[18]CUIN YL,HUANG L,CHEN YQ.Prevent migraine from windblister resistance[J].J of Basic Chin Med,2017,23(2):164-165.
[19]YIN NL.Clinical Study on Acupuncture Combined with Tianma Gouteng Decoction in Treatment of Hyperactive Liver Yang Hyperactivity Migraine[D].Nanjing University Of Chin Med,2015.
[2]VOS T,FLAXMAN AD,NAGHAVI M,et al.Years lived with disability(YLDs)for 1160 sequelae of 289 diseases and injuries1990-2010:a systematic analysis for the Global Burden of Disease Study 2010[J].Lancet,2012,380(9859):2163-2196.
[3]YU SY,CHEN M.The strategy of drug therapy for migraine in adults[J].Chin J New Drug,2014,23(14):1631-1636.
[4]HU G.A review of drug treatment for migraine patients[J].Strait Pharm J,2015,27(4):149-151.
[5]Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1[updated September 2008].The Cochrane Collaboration,2008.
[6]WEN H,LI S,ZENG XT,et al.Application of the Trial Sequential Analysis Software for Meta-analysis[J].Chin J EvidBased Med,2016,16(5):604-611.
[7]CHE GX.The Analysis of 58 Examples on Healing Migraine by using Tianma Gouteng Drink Addition or Subtraction[J].J of Practical Tradit Chin Internal Med,2012,26(5):77-78.
[8]HUANG YF,LOU ZH.Clinical Observation of Tianma Gouteng Decoction in Treating Hepatitis Yang Hyperactivity Migraine[J].Zhejiang J of Integrated Tradit Chin and Western Med,2011,21(12):858-859.
[9]JIANG HC.Pinggan Qianyang Therapy for 45 Cases of Migraine[J].Shangxi J of Tradit Chin Med,2009,30(4):423-424.
[10]LIU NQ.Tianma Gouteng Drinks Treating Migraine 68 Cases of Liver Yang hyperactivity Pattern[J].J of Practical Tradit Chin Internal Med,2011,25(10):77-78.
[11]YANG QX.Effect of Tianma Gouteng Decoction on migraine[J].Chin Health Nutrition(Mid-term),2014,7:4526-4527.
[12]ZHU HJ.Clinical Observation on 40 Cases of Migraine Treated with Modified Tianma Gouteng Decoction[J].Zhejiang J Tradit Chin Med,2008,43(5):264-265.
[13]LI WY.Treatment of 38 Cases of Migraine with Modified Tianma Gouteng Decoction[C].Gansu Provincial Academy of Tradit Chin Med Academic Annual Conference Proceedings,2013:137-138.
[14]WANG YQ.Tianma Gouteng Decoction for Treatment of 41 Cases of Hepatitis Yang with Migraine[J].Forum on Traditional Chin Med,2012,27(6):29-30.
[15]YAN MX.Clinical Observation on Treatment of Migraine with Modified Tianma Gouteng Decoction[J].J of North Pharmacy,2015,12(1):85-85.
[16]MAO DC.Clinical Efficacy Evaluation of Tianma Gouteng Decoction in the Treatment of Migraine[J].Clin J Chin Med,2016,8(30):17-18.
[17]CHEN HY,DONG H,ZHANG J,et al.Migraine treatment with Chinese medicine[J].J of Changchun University of Chin Med.2014,30(8):751-753.
[18]CUIN YL,HUANG L,CHEN YQ.Prevent migraine from windblister resistance[J].J of Basic Chin Med,2017,23(2):164-165.
[19]YIN NL.Clinical Study on Acupuncture Combined with Tianma Gouteng Decoction in Treatment of Hyperactive Liver Yang Hyperactivity Migraine[D].Nanjing University Of Chin Med,2015.