文献类型：期刊文献

中文题名：口服中成药联用西药治疗脑卒中后认知障碍的网状Meta分析

英文题名：A network Meta-analysis of oral Chinese patent medicine combined with western medicine in the treatment of post-stroke cognitive impairment

作者：王楠[1];薛安宁[1];高利娜[1];张甜[1];巩婷[2]

第一作者：王楠

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃省中医院,甘肃兰州730050

第一机构：甘肃中医药大学

年份：2023

卷号：15

期号：26

起止页码：8

中文期刊名：中医临床研究

外文期刊名：Clinical Journal Of Chinese Medicine

基金：甘肃省自然科学基金(21JR7RA589);重大疑难疾病中西医临床协作项目(20210140304);中西医结合防治耐药菌研究(20210140305)。

语种：中文

中文关键词：口服中成药;卒中后认知障碍;随机对照试验;网状Meta分析

外文关键词：Oral Chinese patent medicine;Post-stroke cognitive impairment;Randomized controlled trial;Network Meta-analysis

摘要：目的:系统评价口服中成药治疗卒中后认知障碍(Post-stroke Cognitive Impairment,PSCI)的疗效和安全性。方法:计算机检索中国知网、万方、维普等数据库,搜集建库至2022年3月30日所发表的口服中成药联合西药治疗PSCI的临床随机对照试验。由2位研究员独立筛选文献、评价文献质量并提取资料,采用RevMan 5.4、Stata/SE 15.1软件进行数据分析。结果:最终纳入临床随机对照试验研究25项,涵盖患者2040例。试验组共涉及7种口服中成药,分别为天智颗粒、银杏叶片/胶囊、灯盏生脉胶囊、脑心通胶囊、养血清脑颗粒、滋阴健脑片、脑安胶囊/滴丸。网状Meta分析结果显示:在提高临床总有效率方面,排名居前3位的干预措施为银杏叶片/胶囊、养血清脑颗粒、天智颗粒联合西药;在改善简易智力状态检查量表(Mini-Mental State Examination,MMSE)评分方面,排名居前3位的干预措施为脑安胶囊、脑心通胶囊、养血清脑颗粒联合西药;在改善蒙特利尔认知评估量表(Montreal Cognitive Assessment Scale,MoCA)评分方面,排名居前3位的干预措施为天智颗粒、养血清脑颗粒、灯盏生脉胶囊联合西药;在改善日常生活活动能力(Activities of Daily Living,ADL)评分方面,排名居前3位的干预措施为脑心通胶囊、灯盏生脉胶囊、养血清脑颗粒联合西药;在降低美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分方面,与单纯西药治疗相比,脑安胶囊、滋阴健脑片、脑心通胶囊联合西药的疗效较好。所有研究均未发生严重不良反应,且试验组不良反应发生率整体低于对照组。结论:西药联用口服中成药治疗PSCI在提高总有效率、改善认知功能水平和神经功能缺损症状、提高日常生活能力方面均有优势。
Objective:To evaluate the efficacy and safety of oral Chinese patent medicine in the treatment of cognitive impairment after stroke.Methods:CNKI,Wanfang,VIP and other databases were searched by computer,and the clinical randomized controlled trial of oral Chinese patent medicines combined with western medicine for post-stroke cognitive impairment published from the establishment of the database to March 30,2022 was collected.Two researchers independently screened literature,evaluated literature quality and extracted data.RevMan 5.4 and Stata/SE 15.1 software were used for data analysis.Results:A total of 25 RCTs were included,including 2040 patients.The experimental group involved 7 kinds of oral Chinese patent medicine,which were the Tianzhi granules(天智颗粒),Yinxing-leaf tablet/capsules(银杏叶片/胶囊),the Dengzhan Shengmai capsules(灯盏生脉胶囊),the Naoxintong capsules(脑心通胶囊),the Yangxue Qingnao granules(养血清脑颗粒),the Ziyin Jiannao tablet(滋阴健脑片)and the Nao’an capsules/dropping pill(脑安胶囊/滴丸)respectively.The results of reticular Meta-analysis showed that in terms of improving the total clinical effective rate,the top three intervention measures were Yinxing-leaf tablet/capsules,the Yangxue Qingnao granules,the Tianzhi granules combined with western medicine.In terms of improving MMSE score,the top 3 intervention measures were the Nao’an capsules,the Naoxintong capsules,the Yangxue Qingnao granules combined with western medicine.In terms of improving MoCA score,the top 3 intervention measures were the Tianzhi granules,the Yangxue Qingnao granules,the Dengzhan Shengmai capsules combined with western medicine.In terms of improving ADL score,the top 3 intervention measures were the Naoxintong capsules,the Dengzhan Shengmai capsules,the Yangxue Qingnao granules combined with western medicine.In terms of reducing NIHSS score,compared with western medicine alone,the Nao’an capsules,the Ziyin Jiannao tablet,the Naoxintong capsules combined with western medicine had a better effect.In terms of safety,no serious adverse reactions occurred in all studies,and the incidence of adverse reactions in the experimental group was lower than that in the control group.Conclusion:Compared with western medicine alone,oral Chinese patent medicine combined with western medicine has advantages in the total efficiency,improving the level of cognitive function,ameliorating the symptoms of neurological impairment,and improving the ability of daily living.