【摘要】 目的系统评价半夏白术天麻汤联合西药对椎基底动脉供血不足性眩晕(VBIV)的疗效。方法检索PubMed、Cochrane Library、EMbase、CBM、CNKI、VIP、WangFang数据库自建库至2019年10月发表的关于半夏白术天麻汤联合西药治疗VBIV临床研究,采用Stata 13.0软件对纳入的研究进行meta分析及序贯分析。结果共纳入28项研究,2494例患者。试验组临床综合疗效[RR=1.19,95%CI(1.15,1.23),P <0.001];左侧椎动脉平均血流速度[WMD=5.74,95%CI(4.64,6.84),P <0.001];右侧椎动脉平均血流速度[WMD=5.58,95%CI(4.32,6.84),P <0.001];基底动脉平均血流速度[WMD=5.04,95%CI(3.91,6.18),P <0.001];全血黏度(低切)[WMD=-1.30,95%CI (-2.23,-0.38),P <0.001];全血黏度(高切)[WMD=-1.22,95%CI (-1.48,-0.96),P <0.001];血浆黏度[WMD=-0.26,95%CI(-0.33,-0.18),P <0.001];纤维蛋白原[WMD=-0.77,95%CI(-0.99,-0.55),P <0.001]指标均优于对照组。试验序贯分析进一步说明半夏白术天麻汤联合西药治疗VBIV临床效果确切。结论半夏白术天麻汤联合西药能够提高VBIV的临床疗效。该结论有待进一步的高质量、大样本随机对照试验进行验证。更多还原

【Abstract】 Objective To systematically evaluate the clinical efficacy of Banxia Baizhu Tianma Decoction combined with Western medicine on vertebrobasilar ischemic vertigo(VBIV). Methods PubMed database, Cochrane Library database, EMbase database, CBM database, CNKI database, VIP database, and WangFang database were searched to screen clinical study about Banxia Baizhu Tianma Decoction combined with traditional Western medicine in the treatment of VBIV, and the search time was from the establishment to October, 2019. Meta analysis and trial sequential analysis of included studies were carried out using Stata 13.0 software. Results A total of 28 studies involving 2494 patients were included. The comprehensive clinical efficacy of the combination of Banxia Baizhu Tianma Decoction and traditional western medicine(RR = 1.19,95%CI [1.15,1.23], P < 0.001), left vertebral artery average blood flow velocity(WMD = 5.74,95% CI [4.64,6.84], P < 0.001), right vertebral artery average blood flow velocity(WMD = 5.58, 95%CI [4.32, 6.84], P <0.001), mean flow velocity of basilar artery(WMD =5.04, 95%CI[3.91, 6.18], P < 0.001), whole blood viscosity(low cut)(WMD =-1.30, 95%CI[-2.23,-0.38], P < 0.001),whole blood viscosity(high cut)(WMD =-1.22, 95%CI[-1.48,-0.96], P < 0.001), plasma-viscosity(WMD =-0.26,95%CI [-0.33,-0.18], P < 0.001), fibrinogen(WMD =-0.7,95%CI [-0.99,-0.55], P < 0.001) were better than the control group, and the differences were statistically significant(P < 0.01). Trial sequential analysis further indicated that Banxia Baizhu Tianma Decoction combined with Western medicine had a definite clinical effects in the treatment of VBIV.Conclusion Combining with Banxia Baizhu Tianma Decoction has better comprehensive effect for VBIV. This conclusions still need to be verified by high quality and large sample randomized controlled trials.更多还原