Meta Analysis Of Buyang Huanwu Decoction In The Treatment Of Cerebral Infarction With Qi-deficiency And Blood-stasis Syndrome

ObjectiveTo systematically evaluate the clinical efficacy and safety of Buyang Huanwu Decoction(BYHWD)in the treatment of Cerebral Infarction with Qi-deficiency and Blood-stasis syndrome.MethodMake scientific and reasonable retrieval strategy and adopt computer retrieval method combining with artificial retrieval method to retrieve 16 databases such as CNKI,COJ,PubMed and so on and obtain randomized controlled trials(RCTs)literature about Buyang Huanwu Decoction in the treatment of Cerebral Infarction appeared from January 2007 to March 2017,recovering all published and unpublished Journal Papers,dissertations,related conference papers,research reports and various briefings,etc.Select conditional researches in accordance with the criteria of inclusion and exclusion for literature.Extract data and information from the conditional researches and make a quality evaluation of them.Evaluate the risk of bias using the software of Review Manager 5.3 and make an analysis on the clinical total efficiency rate,the curative effect of TCM syndrome,the condition of neural function deficiency,the activities of daily life and safety.ResultsA total of 2276 articles were retrieved and 75 literature were absorbed,including 6904 cases of patients.Among the 55 RCTs those evaluated the clinical total efficiency rate,the Meta analysis of 34 RCTs at acute stage showed that OR [95%CI] =3.89[3.12,4.84],Z=12.16,P﹤0.00001,the Meta analysis of 13 RCTs at convalescence stage showed that OR[95%CI]=3.58[2.51,5.11],Z=7.05,P﹤0.00001,and the Meta analysis of 5 RCTs at sequelae stage showed that OR [95%CI] = 3.89 [2.13,7.11],Z=4.42,P﹤0.00001.The differences were statistically significant.This result showed that the experiment group was superior to the control group in increasing the clinical total efficiency rate no matter which stage the patients were at.There was no analysis on 3 RCTs for the stages of the course of disease are not single.9 RCTs evaluated the curative effect of TCM syndrome,and the Meta analysis showed that OR[95%CI]=3.19 [2.14,4.77],Z=5.67,P﹤0.00001,the difference was statistically significant.This result suggested that the experiment group had higher efficacy than control group.Among the 48 RCTs those evaluated the condition of neural function deficiency,the Meta analysis of 28 RCTs at acute stage showed that SMD [95%CI] =-1.10 [-1.35,-0.85],Z=8.73,P﹤0.00001,the Meta analysis of 15 RCTs at convalescence stage showed that SMD [95%CI] =-0.79 [-0.90,-0.67],Z=13.35,P﹤0.00001.The differences were statistically significant.This result showed that the experiment group had an advantage over the control group in improving the condition of neural function deficiency.There was no analysis on 3 RCTs for the stages of the course of disease are not single.It is not enough for only 2 RCTs at sequelae stage to analyze the data.There was no analysis on 2 RCTs for the stages of the course of disease were not clear,and another one for the stage was not single.Among the 19 RCTs those evaluated the activities of daily life,the Meta analysis of 8 RCTs at acute stage showed that SMD[95%CI]=0.72[0.54,0.90],Z=7.19,P﹤0.00001,the Meta analysis of 11 RCTs at convalescence stage showed that SMD [95%CI] =0.71 [0.56,0.86],Z=9.37,P﹤0.00001.The differences were statistically significant.This result showed that the experiment group was superior to the control group in elevating the activities of daily life.There was no analysis on 1 RCT for the stage of the course of disease was not single.There was no evaluation on the activities of daily life of the sequelae stage in all RCTs.25 RCTs evaluated the safety and 3 researches reported that the patients had symptoms of discomfort.The Meta analysis showed that OR[95%CI]=0.62[0.19,1.96],Z=0.82,P=0.41>0.05.There was no statistical significance in the difference.This result suggested that the treatment of the experiment group and the control group were both of high security and the two groups were in the same proportion on safety.Conclusions(1)In the treatment of Cerebral Infarction with Qi-deficiency and Blood-stasis syndrome,BYHWD can provide obvious effect in increasing the clinical total efficiency rate and the curative effect of TCM syndrome for patients at at acute stage,convalescence stage and sequelae stage.(2)In the treatment of Cerebral Infarction with Qi-deficiency and Blood-stasis syndrome,BYHWD can provide obvious effect in improving the condition of neural function deficiency and the activities of daily life for patients at acute and convalescence stage.(3)BYHWD is of high security in the treatment of Cerebral Infarction with Qi-deficiency and Blood-stasis syndrome,and the experiment group and the control group are in the same proportion on safety.