| Objective: To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of cerebral arterioscl-erosis(CAS)by systematically searching and sorting out randomized controlled clinical studies on the treatment of cerebral arteriosclerosis by using the method of Meta-analysis.To provide evidence-based medical evidence for clinical use of drugs.Method:The computer retrieval database includes:Wanfang Science and Technology Information Database(Wanfang),Chinese Literature selection Chinese Biomedical Literature Database(CBM),China knowledge Web Database(CNKI),Vip database(VIP),English literature selection Pubmed,Embase,Cochrane Library,retrieval deadline from the establishment of each database to the end of December 2018.Manual retrieval: manually searching core medical journals in the library of our university.All magazines were searched for founding to 2018.Grey literature and related conference papers were collected.The language is limited to Chinese and English papers.Documents were collected,screened,incorporated and collated in strict accordance with inclusion and exclusion criteria,and the results were analyzed by Meta using software RevMan5.3.The relative risk degree(RR)or superiority ratio(OR)was used to express the data of two classification variables,and the weighted mean difference(WMD)or standardized mean difference(SMD)was used as the analysis statisticfor continuous variable data.95% confidence interval(confidence intervals,)was calculated between the two variables.CI).According to the results of heterogeneity test,the corresponding effect model was selected for Meta analysis.A funnel diagram is drawn to assess the risk of bias.The outcome indexes included clinical efficacy index,hemorheology index,blood lipid level,Transcranial Doppler(TCD)hemodynamic index,adverse reaction and so on.This study collected and sorted out the published literatures on the treatment of cerebral arteriosclerosis by traditional Chinese medicine,and used the method of Meta analysis,from the aspects of clinical effective rate,blood lipid,TCD improvement,and so on.In order to provide evidence-based medical evidence for the treatment of cerebral arteriosclerosis and to provide a more comprehensive reference for the clinical study and application of cerebral arteriosclerosis,the therapeutic effect of traditional Chinese medicine on cerebral arteriosclerosis was systematically evaluated in order to provide evidence-based medical evidence for the treatment of cerebral arteriosclerosis by traditional Chinese medicine.Search results:According to the search strategy,722 relevant documents were retrieved,and 26 papers were included,all of which were Chinese study in China.In the 26 studies,a total of 3200 patients with cerebral arteriosclerosis were included,with an average sample size of 123.The total effective rate of traditional Chinese medicine in the treatment of cerebral arteriosclerosis was included in 22 literatures involving 758 cases and 7 studies reported whether the drug had adverse reactions or not.The results of Meta analysis :1.The clinical efficacy of traditional Chinese medicine or combinati-on of western medicine in the treatment of cerebral arteriosclerosis was better than that of conventional western medicine.The result of heterogeneity analysis was Chi2=25.84,df=20,P=0.17,I2=23% < 50%,which indicated that the heterogeneity of the included studies was lower than that of the conventional treatment of cerebral arteriosclerosis.The results of Meta analysis with fixed effect model showed that the effective rate of the test group was higher than that of the control group [OR =4.55,95% CI(3.63,5.71),Z = 13.11)(P < 0.00001)].The combined results showed that there was a significant difference between the two groups.2.The incidence of adverse events was reported in 7 studies,including4 cases in the trial group and 7 cases in the control group.The main side effects were gastrointestinal reaction.2 cases of nausea and anorexia were found in the test group,and the symptoms disappeared after taking the medicine.The results of heterogeneity analysis were(II 2? 78%,P< 0.03).There was a high degree of heterogeneity and was not suitable for Meta analysis.The results showed that there was no significant difference between groups.Both the Chinese medicine group and the western medicine group had a low incidence of adverse events and were safe.In addition,a total of 26 Chinese medicine prescriptions were counted,including 84 kinds of Chinese medicine,of which 32 were used more than 3 times and 3 times.According to the classification and analysis of traditional Chinese medicine,it can be seen that the composition of traditional Chinese medicine in treating cerebral arteriosclerosis mainly consists of four kinds of drugs: activating blood circulation and removing blood stasis,calming the liver and eliminating wind,and invigorating qi and blood,tonifying the liver and kidney,.Among them,there are 10 for calming the liver and eliminating wind,13 herbs foractivating blood circulation and removing blood stasis,10 for tonifying qi and blood,and 8 for tonifying the liver and kidney.Conclusion:Traditional Chinese medicine has a good effect on cerebral arteriosclerosis,and the overall effective rate is higher than that treated with western medicine alone.More than half of the randomized controlled trials found that Chinese herbal medicine in the treatment of cerebral arteriosclerosis to improve blood lipid level,reduce blood viscosity and other aspects of obvious curative effect.Most of the adverse reactions to the treatment process are gastrointestinal reaction,and the adverse reaction rate of the traditional Chinese medicine and the western medicine for treating the cerebral arteriosclerosis are low.Through the analysis of traditional Chinese medicine in treating cerebral arteriosclerosis,it was found that the composition of traditional Chinese medicine in treating cerebral arteriosclerosis was mainly composed of four kinds of drugs: activating blood circulation and removing blood stasis,invigorating qi and blood,soothing liver and eliminating wind,and tonifying liver and kidney.The first five commonly used Chinese medicines are Chuanxiong,Astragalus membranaceus,Paeonia lactiflora,Leech,Dilong. |
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