中国医院用药评价与分析2025，Vol.25Issue(4)：463-468,6.DOI:10.14009/j.issn.1672-2124.2025.04.018
天麻钩藤饮加减治疗后循环缺血性眩晕的 Meta分析及GRADE评价
Meta-Analysis and GRADE Evaluation of Modified Tianma Gouteng Decoction in the Treatment of Posterior Circulation Ischemic Vertigo
摘要
Abstract
OBJECTIVE:To systematically evaluate the clinical efficacy of modified Tianma Gouteng decoction in the treatment of posterior circulation ischemic vertigo.METHODS:CNKI,CBM,VIP,Wanfang Data,the Cochrane Library,PubMed and Embase databases were retrieved to collect randomized controlled trials(RCT)of modified Tianma Gouteng decoction in the treatment of posterior circulation ischemic vertigo(the study group was treated with modified Tianma Gouteng decoction or conventional treatment+modified Tianma Gouteng decoction,while the control group received conventional treatment)up to Mar.10th,2024.Meta-analysis was performed by using RevMan 5.4.1 software,Cochrane risk bias assessment tool,and GRADE system.RESULTS:A total of 23 RCT were enrolled,including 1 902 patients.Meta-analysis showed that compared with control group,the regimen of study group could increase the effective rate of patients with posterior circulation ischemic vertigo(RR=1.22,95%CI=1.17-1.28,P<0.000 01),increase the mean blood flow velocity of posterior circulation arteries(mean blood flow velocity of left vertebral artery:MD=4.33,95%CI=3.44-5.23,P<0.000 01;mean blood flow velocity of right vertebral artery:MD=4.29,95%CI=3.44-5.15,P<0.000 01;mean blood flow velocity of basilar artery:MD=4.42,95%CI=3.62-5.22,P<0.000 01),decrease blood viscosity(plasma viscosity:MD=-0.94,95%CI=-1.28--0.60,P<0.000 01;whole blood low-cut viscosity:MD=-3.39,95%CI=-5.97--0.81,P=0.01;whole blood high-cut viscosity:MD=-1.79,95%CI=-1.95--1.62,P<0.000 01),shorten the disappearance time of tinnitus symptoms(MD=-18.84,95%CI=-21.86--15.83,P<0.000 01),the disappearance time of vertigo(SMD=-1.70,95%CI=-1.93--1.47,P<0.000 01),and decrease the score of vertigo disability scale(MD=-11.97,95%CI=-19.08--4.87,P=0.001),the differences were statistically significant.GRADE was rated as"low quality"and the recommendation was"weak".CONCLUSIONS:Current evidence suggests that modified Tianma Gouteng decoction can improve the clinical effective rate of patients with posterior circulation ischemic vertigo,improve the mean flow rate and blood viscosity of the posterior circulation arteries,shorten the disappearance time and duration of tinnitus symptoms,and reduce the vertigo disorder scale score.However,due to the low quality of evidence and small sample size,the conclusions have certain limitations.关键词
天麻钩藤饮/后循环缺血性眩晕/Meta分析/随机对照试验Key words
Modified Tianma Gouteng decoction/Posterior circulation ischemic vertigo/Meta-analysis/Randomized controlled trial分类
医药卫生引用本文复制引用
高梦霞,宋连英,唐璐,窦海燕,朱陵群,李鹏..天麻钩藤饮加减治疗后循环缺血性眩晕的 Meta分析及GRADE评价[J].中国医院用药评价与分析,2025,25(4):463-468,6.基金项目
河南省中医药科学研究专项项目(No.2024ZY3113) （No.2024ZY3113）
