【摘要】 目的 运用网状Meta分析的方法系统评价氟桂利嗪联合口服西药治疗偏头痛的效果。方法 计算机检索三大中文数据库(CNKI,VIP,WanFang)、英文数据库(PubMed, Embase, Medline, Cochrane Library),检索时间为2015年1月1日至2020年12月30日，按照预先设定的纳入排除标准，筛选出口服西药联合氟桂利嗪治疗偏头痛的随机对照试验(RCT)。由2名研究者独立进行文献筛选、资料提取。采用“Cochrane偏倚风险评估”工具和Stata16.0软件分别对所纳入的研究进行质量评价及发表偏倚分析，R软件进行数据分析。结果 最终纳入58个RCTs,涉及11种口服西药。网状Meta分析结果显示：减少头痛发作频率方面，涉及的口服西药排序依次为：帕罗西汀(SUCRA=64.28)>尼美舒利分散片(SUCRA=62.12)>布洛芬(SUCRA=58.76)>佐米曲普坦(SUCRA=57.23)>尼莫地平(SUCRA=47.99)>泰必利(SUCRA=45.21)>普萘洛尔(SUCRA=42.18)>盐酸氟西汀(SUCRA=0.09);在减少头痛程度方面，阿司匹林(SUCRA=48.83)>泰必利(SUCRA=30.10),但氟桂利嗪联合尼莫地平的疗效却次于单用氟桂利嗪；在减少头痛持续时间方面，尼莫地平(SUCRA=46.09)>泰必利(SUCRA=37.35)>阿司匹林(SUCRA=5.01)。结论 氟桂利嗪联用口服西药在偏头痛的治疗中，除联用尼莫地平在头痛程度减轻方面次于单用外，其余均联用有效率高；但鉴于纳入研究的数量和质量上存在差异，需要更大样本、更高质量的RCT加以论证。更多还原

【Abstract】 Objective To evaluate the effect of flunarizine combined oral western medicine for the treatment of migraine by network meta-analysis system. Methods Three Chinese computer retrieval database(CNKI,VIP,WanFang)mand four English databases(PubMed,Embase,Medline,Cochrane Library)were employed from January 1,2015 to December 30,2020,according to the preset criteria,to screen out the randomized controlled trial(RCT)of oral western medicine combined flunarizine for the treatment of migraine. Literature screening and data extraction were conducted by two researchers independently. Cochrane bias risk assessment tools were used to evaluate the quality,stata16. 0 was used to analyse publish bias included in the study,R software was selected for data analysis.Results A total of 58 RCTs involving 11 kinds of oral western medicine were finally screened out. Network meta-analysis results showed that in terms of reducing the frequency of headache,the order of oral western drugs involved was as follows:The order was paroxetine(SUCRA = 64. 28) > nimesuride dispersion tablets( SUCRA = 62. 12) > ibuprofen( SUCRA = 58. 76) >Zolmitriptan(SUCRA = 57. 23) > nimodipine(SUCRA = 47. 99) > tiapride(SUCRA = 45. 21) > propranolol(SU) CRA = 42. 18) >fluoxetine hydrochloride(SUCRA = 0. 09);Aspirin(SUCRA = 48. 83)was more effective than tiapride(SUCRA = 30. 10)in reducing headache severity,but flunarizine combined with nimodipine was inferior to flunarizine alone. Nimodipine(SUCRA = 46. 09) > Tiapride(SUCRA = 37. 35) > aspirin( SUCRA = 5. 01) in reducing headache duration.Conclusion Flunarizine combined with oral western medicine in the treatment of migraine,except the combination of nimodipine in alleviating headache degree is inferior to that of nimodipine alone,has higher efficiency than other combinations. However,due to the differences in the quantity and quality of the included studies,larger samples and higher quality RCT are needed to demonstrate this.更多还原