A Meta-Analysis And Regularity Of Prescirption Of Randomized Controlled Tirals On Vascular Cognitive Impairment By Method Of Invigorating Kidney,Dissipating Phlegm And Removing Blood Stasis

Objective：①To evaluate objectively the efficacy and the safety of the therapy ofinvigorating kidney, dissipating phlegm and removing blood stasis, to provide clinicalevidence of EBM through screening and analyzing of clinical research literature on VCI.②To explore the regularity of prescription and provide the reference for the clinicalpractice. Method：With the method of Cochrane Systematic Review, searching RCTreports from Pub Med, Cochrane, CBM, CNKI, VIP, Wan fang(2001～2011), collectingthe researches met inclusion criteria by two independent evaluators, analyzing the datausing Revman5.1System. Setting up a database of the formulas and drugs from qualifiedliteratures, analyzing compound using cluster analysis. Result：①According to theinclusion criteria, screened out97articles of RCT qualified reports from569of Chinesemedicine treatment on VCI, of which18reports had relative high quality;②The therapy ofinvigorating kidney, dissipating phlegm and removing blood stasis had a better efficacythan the control group in index of general efficacy, MMSE, HDS, ADL, BBS andSDSVD(P＜0.05);③T here was no significant difference shownin index of Barther andCDR(P＞0.05);④The incidence of adverse reaction wasof the experimental group lowerthan the control group;⑤84prescriptions on VCIin97articles of RCT qualified bymethod of invigorating kidney,dissipating phlegm and removing blood stasis treatment,involving94drugs and overall frequency of896times;⑥F requency of use of the top10drugs can be classified into5categories. Conclusion：①M eta-analysis by availableevidences manifests: the therapy has a better efficacy and higher safety than the controlgroup;②The frequency of drugs indicate that treatment principle is invigorating kidney,dissipating phlegm and removing blood stasis; Cluster analysis results indicate thatthe combination of three methods by removing blood stasis,invigorating kidney anddissipating phlegm;and activating blood is the necessary treatment; invigorating kidneyand activating blood supplement and promote each other mutually;③Due to lower overallquality and potential publication bias of included study, we need to promote and developmore randomized controlled trials,which should have the rational design, the executionstrictly, the multi-central and large sample, long time follow-up and hold Chinese medicinecharacteristic;④O n account of defects in the aspects of clinical trials and SystematicReview, TCM clinical evaluation should take syndrome differentiation as the connectionpoint and establish evidence-based medicine system of the combination of disease andsyndrome based on the characteristics of TCM.