| Objective: The purpose of this study is to provide evidence-based medical evidence for clinical decision making in the treatment of epilepsy by conducting a Meta-analysis of the clinical efficacy and safety of the TCM phlegm treatment.Methods: The literature on clinical RCTs on epilepsy with TCM phlegm treatment was searched from China Knowledge Network(CNKI),VIP database(VIP),Wanfang database(Wanfang),and Pubmed,The Cochrane Library,and Web of science published from the date of creation to December31,2023,according to the study objectives by specifying the search formula.All literature was screened according to the inclusion and exclusion criteria,and the data of the literature to be included were subsequently extracted.The literature was assessed for risk of bias using Revman 5.4 software,Meta-analysis was performed for outcome indicators,and the results of Meta-analysis were tested for heterogeneity,sensitivity analysis,subgroup analysis and publication bias assessment.Results:A total of 21 publications were included in this study,which included a total of 1683 patients with epilepsy,including a total of 841 patients in the treatment group and a total of 842 patients in the control group.The results of Meta-analysis were as follows:(1)A total of 19 literatures reporting clinical efficacy were included,and the results were as follows: RR=1.25,95%CI[1.19,-1.31],Z=8.85(P<0.00001),indicating that,compared with conventional western medicine,the addition of phlegm treatment can improve the clinical efficacy of epilepsy.(2)A total of 5 literatures reported the abnormal rate of EEG were included,and the results were: RR=0.55,95%CI[0.42,-0.72],Z=4.46(P<0.00001),indicating that the addition of phlegm treatment was superior to conventional western medicine in reducing the abnormal rate of EEG.(3)A total of 9 literatures using QOLIE-31 to evaluate the quality of life of epileptic patients were included,and the results were MD=7.11,95%CI[4.38,9.84],Z=5.11(P<0.00001),indicating that the addition of resolving phlegm was superior to conventional western medicine in improving the quality of life of epileptic patients.(4)A total of 6 literatures reporting the frequency of seizures were included,and subgroup analysis was performed.The results of the treatment duration<6 months group were:SMD=-0.60,95%CI[-0.85,-0.34],Z=4.59(P<0.00001);Results of treatment duration≥6 months: SMD=-1.54,95%CI[-1.82,-1.26],Z=10.80(P<0.00001);The results showed that the addition of phlegm treatment was better than conventional western medicine in reducing the frequency of seizures in epileptic patients.(5)A total of 5 literatures reporting the duration of seizures were included,and the results were: SMD=-1.97,95%CI[-3.11,-0.82],Z=3.36(P=0.0008),indicating that the addition of phlegm treatment was superior to conventional western medicine in reducing the duration of seizures in patients with epilepsy.(6)A total of 5 literatures reporting TCM symptom score were included,and the results were as follows:MD=-2.53,95%CI[-3.09,-1.98],Z=8.96(P<0.00001),indicating that the addition of phlegm treatment was superior to conventional western medicine in reducing TCM symptom score of epilepsy patients.(7)A total of 4literatures on serum MDA were included,and the results were as follows:SMD=-1.04,95%CI[-1.42,-0.65],Z=5.27(P<0.00003),indicating that the addition of phlegm treatment was superior to conventional western medicine in reducing serum MDA level in epilepsy patients.(8)Four literatures on serum IL-6 levels were included,and the results were as follows: SMD=-1.08,95%CI[-1.35,-0.80],Z=7.64,(P<0.00001),indicating that the addition of phlegm treatment was superior to conventional western medicine in reducing serum IL-6 levels in patients with epilepsy.(9)Ten literatures with detailed records of adverse reactions and the number of cases were included,and the results were: RR=0.52,95%CI[0.37,0.73],Z=3.76(P=0.0002<0.05),indicating that the incidence of adverse reactions of treating epilepsy with phlegm was lower than that of conventional western medicine.Conclusion:(1)TCM phlegm treatment combined with Western medicine in the treatment of epilepsy is superior to conventional western medicine in improving clinical efficacy,reducing the abnormal rate of EEG,improving patients’ quality of life,TCM symptom score,reducing the frequency and duration of seizures,and reducing serum MDA and IL-6 levels.(2)The combination of TCM phlegm treatment with Western medicine is better than conventional western medicine in reducing the incidence of adverse reactions,with good safety. |
PDF Full Text Request