Meta-analysis Of The Clinical Efficacy And Safety Of Tianma Gouteng Decoction In The Treatment Of Postcirculatory Ischemic Vertigo

Objective: In order to prove the effectiveness and safety of Tianma Gouteng Decoction in the treatment of postcirculatory ischemic vertigo,the Meta analysis method was adopted for scientific demonstration and analysis,and to provide evidence-based medical evidence and guidance for further clinical treatment.Methods: The clinical randomized controlled studies related to the treatment of postcirculatory ischemic vertigo with Tianma Gouteng Decoction were searched,including Chinese and English databases;Chinese databases included: China Academic Journal Network Publishing Database(CNKI),Wanfang Data Knowledge Service Platform,Full text of scientific journals(VIP),China Biomedical Literature Service System,China Clinical Trial Registration Center;English databases include: Pubmed,Cochrane Library,Embase,Web of Science,Clinical Trials,assisted by manual retrieval Clinical randomized controlled studies on circulatory ischemic vertigo.The search scope includes all databases from the establishment of the database to December 31,2022.The modified Jadad scoring scale and Cochrane quality evaluation criteria are used to evaluate the quality of the literature that meets the inclusion criteria.And use the computer software Rev Man 5.4 and Stata15.0 software to merge and Meta-analyze the extracted data.Results: This Meta-analysis included 17 clinical randomized controlled trials that met the criteria,including 17 Chinese literatures and 0 English literatures.A total of 1468 patients with posterior circulation ischemic vertigo were included,736 cases in the treatment group and 732 cases in the control group.(1)Total clinical effective rate: RR =1.27,95%CI(1.21,1.34),Z=9.31,P=0.000<0.05;(2)Clinical cure rate: RR =1.61,95%CI(1.33,1.95),Z=4.81,P=0.000<0.05;(3)Mean blood flow velocity of vertebrobasilar artery(Vm): 1.Basilar artery(BA)level: SMD=0.67,95%CI(0.51,0.83),Z=8.21,P=0.000<0.05;2.Right vertebral artery(RVA)level: SMD=1.14,95%CI(0.71,1.56),Z=5.26,P=0.000<0.05;3.Left vertebral artery(LVA)level: SMD=0.97,95%CI(0.60,1.34),Z=5.12,P=0.000<0.05;(4)Plasma viscosity(PV)level:SMD=-2.40,95%CI(-3.60,-1.21),Z =3.94,P=0.000<0.05;(5)Whole blood low shear viscosity level: SMD=-1.01,95%CI(-1.86,-0.17),Z=2.36,P=0.018<0.05;(6)Whole blood High shear viscosity level: SMD=-3.00,95%CI(-4.94,-1.06),Z=3.03,P=0.002<0.05;(7)Whole blood viscosity(LBV)level: SMD=-1.57,95%CI(-1.93,-1.22),Z=8.66,P=0.000<0.05;(8)SMD=-0.7,95%CI(-2.78,-1.38),Z=0.66,P=0.509> 0.05;(9)Vertigo disappearing time(h): SMD=-1.76,95%CI(-1.99,-1.54),Z=15.36,P=0.000<0.05;(10)TCM symptom tinnitus score: SMD=-2.03,95%CI(-6.21,2.16),Z=0.95,P=0.343>0.05;(11)DHI score: SMD=-1.89,95%CI(-3.05,-0.72),Z=3.17,P=0.002<0.05.(12)Recurrence rate and adverse reactions: Only 1 of the included literature reported on the clinical recurrence rate,and 2 studies mentioned adverse reactions during the clinical process,and there were no adverse reactions in the 2 studies reported in the literature.Conclusions:(1)Compared with the control group in the treatment group: Tianma Gouteng Decoction has a significant effect on the total effective rate of clinical curative effect,clinical cure rate,plasma viscosity(PV)level,whole blood low shear viscosity level,whole blood Blood high shear viscosity level,whole blood viscosity(LBV)level,vertigo disappearing time(h),and vertigo impairment scale(DHI)scores are more advantageous;(2)Compared with the control group: Tianma Gouteng Decoction After treatment,circulatory ischemic vertigo has no advantage in average blood flow velocity of basilar artery(BA),right vertebral artery(RVA),left vertebral artery(LVA),vertigo score of TCM syndrome,and tinnitus score of TCM syndrome.(3)There are too few reports of adverse reactions and recurrence rates,which may be due to the short course of treatment,and its safety and recurrence rates need to be further evaluated.The number of documents included in this study is small,and the quality of some documents is low,so the strength of the evidence is low,which has a certain impact on the accuracy of the results of this study.More large-sample,multi-center,high-level clinical randomized controlled studies are needed in the future.More rigorous evaluation and verification.