| Evidence-Based Medicine is a medicine which the core idea is “Any decision of a health plan, decision-making should be guided by the best available evidence produced by objective clinical research ” to follow the scientific evidence strictly. It can formulate scientific policies and measures of prevention and treatment for the disease to achieve the purpose of improving the quality of life and promoting the health of humans. Evidence-Based Medicine is known as the most important modern clinical medicine in the 21 st century, which emphasizes that the large multicenter randomized controlled trials recognized internationally and the systematic review results are the most reliable standard to evaluate the efficacy and safety of one therapy to treat one disease.The practice has proved that large multicenter randomized controlled trials spend human, financial resources and time, and most single randomized controlled trial can’t make accurate and reliable conclusions because the sample size is not large enough. The main advantage of a systematic review is to merge multiple randomized controlled trials, increase the sample size, and improve the test effectiveness by meta-anlysis. High-quality systematic reviews are similar to multicenter large-scale randomized controlled clinical trials. The high quality, strong scientific credibility, reproducible evidence can be provided by a systematic review as the basis and practice tool of Evidence-Based Medicine.It is necessary to use the standard recognized internationally to measure the efficacy and safety of Traditional Chinese Medicine to take it to the world. It is important that Evidence-Based Medicine was adopted to evaluate the efficacy of Traditional Chinese Medicine by the universal language of western medicine for promoting the Traditional Chinese Medicine culture and international standards. The application of Evidence-Based Medicine is able to perfect the Traditional Chinese Medicine theory, accelerate the development of Traditional Chinese Medicine, set up Traditional Chinese Medicine clinical evaluation system, collect Traditional Chinese Medicine data of clinical evaluation, and build large Traditional Chinese Medicine information database for accelerating the development and the process of internationalization of Traditional Chinese Medicine. The State Administration of Traditional Chinese Medicine also takes the strategy of putting Traditional Chinese Medicine to the word as one of the priorities for future work, and Evidence-Based Medicine approach Specifically is required to be used to research Traditional Chinese Medicine. Syndrome differentiation, safety and efficacy of Traditional Chinese Medicine have been included in the national "fifteen" science and technology research programs by National Ministry Science and Technology. New vitality will be injected into the clinical practice of Traditional Chinese Medicine by the building of Evidence-Based Medicine with Traditional Chinese Medicine characteristic. Within the current, even for a long period of time, Evidence-Based Medicine approach is the only way to help Traditional Chinese Medicine to go to the world.Objective:To evaluate the therapeutic effect and security of Buyang Huanwu Decoction in treatment of the ischemic stroke recovery, and further clarify its role in the clinical treatment of acute cerebrovascular disease and make an objective assessment. The result will provide reliable evidence of Evidence-Based Medicine for Buyang Huanwu Decoction in treatment of the ischemic stroke recovery.Methods:We retrieved the relevant articles of random and quasi-random control trials in treating ischemic stroke recovery with Buyang Huanwu Decoction which were published from May July 2006 to May 2014 by combining computer retrieval and manual retrieval. The articles were screened by two independent reviewers using the inclusion and exclusion criteria, and a data extraction sheet was adopted to extract key information included in the articles. The author was contacted when met the lack of data and information to make a supplement. The included articles were evaluated according to the Cochrane Reviewers’ handbook 5.1. Rev Man5. 3 software was adopted to make meta-analysis for the effect of interventions, and sensitivity analysis is adopted to evaluate the stability of conclusion when necessary. Descriptive analysis was adopted when the meta-analysis can’t be made when heterogeneity is too large or the combined effect of the effect size is meaningless.Results:21 studies finally met the inclusion criteria. All studies are published in Chinese. Altogether 2072 cases of ischemic stroke recovery were enrolled who meet the diagnostic criteria of ischemic stroke recovery. There are 1071 cases in the treatment group, 1001 cases in the control group. The average sample size is 99 cases. Meta-analysis showed that there was no significant differences in reducing the recurrence rate [RR=0.64, 95%CI(0.31,1.32), Z=1.21, P=0.23] of ischemic stroke between Buyang Huanwu Decoction and the control treatment, but Buyang Huanwu Decoction has the superior tendency. In addition, there were significant differences improving activities of daily living [WMD=-9.56,95%CI(-11.48,-7.65),z=9.77,p<0.00001]; There were significant differences improving neurological deficit by subgroup analysis, the sensitivity analysis shows the effect of the evaluation was stable; There were significant differences in improving symptoms improved time [WMD=-5.94, 95%CI(-6.62,-5.27), z=17.20, p<0.00001] and TCM symptom scores [WMD=3.26, 95%CI(2.37, 4.16), z=7.17, p<0.00001] between Buyang Huanwu Decoction and the control treatment; There were significant differences in improving clinical efficacy between Buyang Huanwu Decoction and the control treatment by subgroup analysis, the sensitivity analysis shows the effect of the evaluation was stable. Descriptive statistics show: All the studies had no adverse reactions related description and economic indicators. There were significant differences in improving quality of life and limb fuction, shortening hospitalization time, improving hemorheology, regulating blood lipid levels, superoxide dismutase activity levels and lipid peroxidation content, and improving internal carotid plaque area and thickness, tongue single and main symptoms of the individual symptoms between Buyang Huanwu Decoction and the control treatment.Conclusion:Buyang Huanwu Decoction is safe and effective in the treatment of ischemic stroke recovery. However, due to the limitations of this study, reducing the proof strength of the conclusion. Reasonable design, strict, multi-center large enough sample and follow-up of randomized controlled trials were excepted to be further verified. |
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