通心络胶囊治疗椎-基底动脉供血不足的系统评价

目的评价通心络胶囊治疗椎一基底动脉供血不足的效果和安全性。方法采用Cochrane系统评价方法，检索Cochrane图书馆、MEDLINE、VIP、CNKI等数据库。按纳入和排除标准由2名评价者独立选择试验、提取资料，交叉核对并进行方法学质量评估，对同质研究采用RevMan4．0软件进行Meta分析。结果共纳入11个研究，包括1157例患者。所有研究均未描述具体的随机方法、分配隐藏和盲法。Meta分析结果显示：通心络胶囊联合丹参在治疗椎-基底动脉供血不足的有效率RR=1．35，95％CI（1．24，1．48）]、椎动脉血流速度改善WMD=3．60，95％CI（2．44，4．77），P〈0．00001]和基底动脉血流速度改善WMD=3．46，95％CI（1．89，5．04），P〈0．00001]方面均优于单用丹参；通心络胶囊联合西药在治疗椎-基底动脉供血不足的有效率RR=1．21，95％CI（1．11，1．31）]、椎动脉血流速度改善WMD=3．85，95％CI（2．19，5．51），P〈0．00001]方面均优于单用西药。结论本系统评价结果初步显示，通心络是一种能有效改善椎一基底动脉供血不足的药物，其效果优于单用西药或丹参治疗。但由于纳入研究少、质量普遍不高，上述结果尚有待高质量大样本的随机双盲对照试验加以验证。

Tongxinluo Capsule for Vertebrobasilar Artery Insufficiency: A Systematic Review

Objective To assess the effectiveness and safety of Tongxinluo Capsule in the treatment of vertebrobasilar artery insufficiency. Methods The Cochrane Library, MEDLINE, VIP and CNKI were searched. Two authors independently collected data, including randomized controlled trials that met the inclusion criteria. They evaluated the quality of these trials and performed meta-analysis using The Cochrane Collaboration＇s RevMan 5.0. Results Eleven studies involving 1157 participants were included. All the included studies were inadequate at reporting randomization, concealment of allocation and blinding. Meta-analysis based on the included studies showed that Tongxinluo Capsule with Danshen was better than Danshen alone in vertebrobasilar artery insufficiency （RR= 1.35, 95%CI 1.24 to 1.48） and blood flow velocity ofvertebrobasilar artery （WMD=3.60, 95%CI 2.44 to 4.77 and WMD=3.46, 95%CI 1.89 to 5.04）. Tongxinluo Capsule with simple basic therapy was better than simple basic therapy alone in vertebrobasilar artery insufficiency （RR=1.21, 95%CI 1.11 to 1.31） and blood flow velocity of vertebrobasilar artery （WMD=3.85, 95%CI 2.19 to 5.51）. Conclusion Tongxinluo Capsule is an effective and safe drug for vertebrobasilar artery insufficiency. However, due to the limited quantity and quality of the included studies, we can not draw a firm conclusion about the effectiveness of Tongxinluo Capsule compared to the simple basic therapy or Danshen. The results suggest that further and larger-scale trials using Tongxinluo Capsule for vertebrobasilar artery insufficiency are needed.