【摘要】：背景和目的偏頭痛是原發(fā)性頭痛常見(jiàn)的一種類(lèi)型,屬于慢性神經(jīng)血管共患的疾病,發(fā)病機(jī)制涉及多個(gè)方面。目前關(guān)于偏頭痛的治療方法也是多種多樣,尤其是隨著祖國(guó)醫(yī)學(xué)研究的深入,近年來(lái)關(guān)于中西醫(yī)結(jié)合治療偏頭痛的有效報(bào)道層出不窮。養(yǎng)血清腦顆粒作為成都中醫(yī)藥大學(xué)附屬醫(yī)院治療偏頭痛的常用藥物,其療效也得到多數(shù)病人的認(rèn)可。本文從循證醫(yī)學(xué)的角度,運(yùn)用系統(tǒng)評(píng)價(jià)的方法,研究養(yǎng)血清腦顆粒聯(lián)合鹽酸氟桂利嗪治療偏頭痛的的有效性及安全性。 材料和方法按照Cochrane協(xié)作網(wǎng)規(guī)定的系統(tǒng)評(píng)價(jià)原則,制定檢索策略,全面檢索國(guó)內(nèi)外有關(guān)養(yǎng)血清腦顆粒聯(lián)合鹽酸氟桂利嗪治療偏頭痛的臨床隨機(jī)對(duì)照試驗(yàn)(RCTs),包括計(jì)算機(jī)檢索清華同方CNKI系列數(shù)據(jù)庫(kù)、維普期刊全文數(shù)據(jù)庫(kù)(VIP)、萬(wàn)方數(shù)據(jù)庫(kù)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM)、MEDLEY Cochrane Library,Pubmed,并且手工檢索相關(guān)的中文醫(yī)學(xué)期刊,依據(jù)制定的納入及排除標(biāo)準(zhǔn)篩選文獻(xiàn),按照改良的Jadad評(píng)分表對(duì)納入研究進(jìn)行質(zhì)量評(píng)分,提取相關(guān)數(shù)據(jù),采用RevMan5.2軟件對(duì)數(shù)據(jù)進(jìn)行Meta分析。 結(jié)果12個(gè)試驗(yàn)共納入1412例患者,聯(lián)合用藥組781例,總有效率為93.1%,西藥單用組631例,總有效率為81.1%,中成藥單用組138例,總有效率為81.9%。但所納入的RCTs質(zhì)量普遍不高。對(duì)納入研究進(jìn)行Meta分析,結(jié)果顯示聯(lián)合用藥組對(duì)照兩藥單用能提高患者的總有效率,且不增加藥物的副作用。 結(jié)論本次系統(tǒng)評(píng)價(jià)收集的研究結(jié)果提示養(yǎng)血清腦顆粒聯(lián)合鹽酸氟桂利嗪膠囊治療偏頭痛的效果好,但納入研究的試驗(yàn)方法學(xué)質(zhì)量普遍低下,且存在發(fā)表性偏倚,最終結(jié)論的可靠性受到影響。因此有必要進(jìn)行高質(zhì)量的大樣本量、多中心、采用盲法的臨床隨機(jī)對(duì)照試驗(yàn),為這種中西醫(yī)結(jié)合治療偏頭痛的手段提供更多確鑿的臨床證據(jù)。
[Abstract]:Background and objective Migraine is a common type of primary headache. At present, the treatment of migraine is also varied, especially with the in-depth medical research in the motherland, in recent years, there are many effective reports on the treatment of migraine with integrated Chinese and western medicine. Yangxuennao granule is commonly used to treat migraine in affiliated hospital of Chengdu University of traditional Chinese Medicine. In this paper, the efficacy and safety of Yangxuannao granule combined with flunarizine hydrochloride in the treatment of migraine were studied by means of systematic evaluation from the point of view of evidence-based medicine. Materials and methods according to the systematic evaluation principle stipulated by Cochrane Cooperative Network, a search strategy was formulated to search for the clinical randomized controlled trial (RCTs),) of Yangxuannao granule combined with flunarizine hydrochloride in the treatment of migraine at home and abroad. Including computer retrieval of Tsinghua Tongfang CNKI series database, Weipu periodical full-text database (VIP), Wanfang database, Chinese biomedical literature database (CBM), MEDLEY Cochrane Library,Pubmed, and manual retrieval of related Chinese medical journals. According to the criteria of inclusion and exclusion, the quality of the inclusion study was evaluated according to the improved Jadad scoring table, the relevant data were extracted, and the data were analyzed by Meta software. Results 1412 patients were included in 12 trials. The total effective rate was 93.1 in the combined drug group, 631 in the western medicine group, and 81.1 in the traditional Chinese patent medicine group. The total effective rate was 81.9 in the traditional Chinese patent medicine group. But the quality of RCTs included is generally not high. The results of Meta analysis showed that the control group could improve the total effective rate without increasing the side effect of the drug. Conclusion the results of this systematic evaluation suggest that Yangxuannao granule combined with flunarizine hydrochloride capsule is effective in the treatment of migraine, but the quality of the trial methodology involved in the study is generally low, and there is a published bias. The reliability of the final conclusion is affected. Therefore, it is necessary to carry out high quality large sample size, multi-center, blind clinical randomized controlled trial to provide more conclusive clinical evidence for the treatment of migraine with integrated Chinese and western medicine.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R747.2

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 毛元潮;周冀英;譚戈;劉博文;;120例偏頭痛患者特質(zhì)應(yīng)對(duì)方式調(diào)查分析[J];重慶醫(yī)學(xué);2009年06期

2 羅國(guó)標(biāo);楊麗;;偏頭痛發(fā)作與血脂異常及血鎂的相關(guān)性[J];廣東醫(yī)學(xué);2012年04期

3 張秀峰,邊建超;偏頭痛的遺傳流行病學(xué)研究進(jìn)展[J];國(guó)外醫(yī)學(xué).遺傳學(xué)分冊(cè);2005年01期

4 方國(guó)華,趙賀秋,周艾青;血清鎂水平對(duì)偏頭痛的影響[J];中國(guó)新藥與臨床雜志;2004年11期

5 錢(qián)迅;;養(yǎng)血清腦顆粒聯(lián)合西比靈治療偏頭痛臨床觀察[J];醫(yī)學(xué)理論與實(shí)踐;2005年12期

6 蘇錦興;;養(yǎng)血清腦顆粒加鹽酸氟桂利嗪膠囊治療偏頭痛療效[J];中國(guó)醫(yī)藥導(dǎo)報(bào);2011年19期

7 蔡松柏;吳國(guó)營(yíng);;2000至2008年中西醫(yī)治療偏頭痛綜述[J];中國(guó)醫(yī)藥指南;2008年24期

8 李金波;張宏旗;;養(yǎng)血清腦顆粒與西比靈合用治療偏頭痛的臨床觀察[J];中國(guó)現(xiàn)代醫(yī)生;2007年08期

9 李會(huì)明;張克忠;侯海林;;養(yǎng)血清腦顆粒加鹽酸氟桂嗪治療偏頭痛臨床分析[J];衛(wèi)生職業(yè)教育;2006年11期

10 楊麗,成敏,郭志良,祝紅,張駿,周曉蘭;偏頭痛患者血漿P物質(zhì)與Mg~(2+)相關(guān)性研究[J];中風(fēng)與神經(jīng)疾病雜志;2004年03期

，

本文編號(hào)：2371256