黎军宏，翟 阳，刘禹舟，何 帆，胡跃强，郑景辉，唐 农*

（1.广西中医药大学，南宁 530001；2.广西中医药大学第一附属医院，南宁 530023；3.广西中医药大学附属瑞康医院，南宁 530011）

·临床研究·

益气活血法治疗轻中度血管性痴呆临床研究Meta分析

黎军宏1,2，翟 阳1，刘禹舟1，何 帆1，胡跃强2，郑景辉3，唐 农2*

（1.广西中医药大学，南宁 530001；2.广西中医药大学第一附属医院，南宁 530023；3.广西中医药大学附属瑞康医院，南宁 530011）

目的 评价益气活血法治疗轻中度血管性痴呆有效性和安全性。方法 以主题词“益气活血”“益气”“补气”“活血”“通络”“血管性痴呆”“血管性认知障碍”“中风后痴呆”“痴证”“呆病”检索中国期刊全文数据库（CNKI）、万方数据知识服务平台、维普中文期刊数据库(VIP)、Pubmed数据库、Embase数据库、Cochrance Library数据库、Web of science数据库从建库至2014年1月公开发表相关文献。随机对照试验（RCT）或半随机对照试验（CCT），无论是否采用盲法，病历资料完整，文献研究设计及方法相似，组间均衡性好。采用RveMan 5.3软件进行Meta分析。计数资料用比值比(OR)，计量资料用加权均数差(WMD)，计算95%可信区间(CI)。当纳入文献异质性检验结果P＞0.05时，说明结果间具有同质性，采用固定效应模型。反之，采用随机效应模型；采用敏感性分析检测Meta分析结果稳定性。 结果 纳入8篇文献，Meta分析结果：益气活血法可明显改善轻中度血管性痴呆临床疗效[OR=1.68，95% CI（1.18，2.37），（P=0.004）] ；中医证候疗效[OR=2.58，95% CI（1.61，4.13），（P＜0.000 1）] ；MMSE积分[WMD=1.52，95% CI（0.28，2.77），（P=0.002）] ；BBS积分[WMD=-0.54，95% CI（-1.55，0.46），（P=0.29＞0.05）] ；HCY指标[WMD= -2.67，95% CI（-5.52，0.18），（P=0.07＞0.05）] ；ADL[WMD=9.63，95% CI（-12.46，31.73），（P=0.39＞0.05）] 。不良反应发生率较低，安全性较好。结论 益气活血法治疗轻中度血管性痴呆安全有效。

血管性痴呆；血管性认知障碍；中医药疗法；Meta分析

Abstract: Objective To evaluate the effectiveness and safety of replenishing qi and activating blood, a traditional Chinese medcine (TCM) therapy, in the treatment of mild or moderate vascular dementia(VaD).Methods search the keywords ‘replenishing qi and activating blood’ ‘replenishing qi ’ ‘ activating blood’ ‘dredging collaterals’ ‘dementia of wind stroke’ ‘dementia’ of the documents which was published since January 2014 on Pubmed, Cochrane library ,web of science, CNKI, Wanfang data and VIP Chinese Journal Database.The main outcome analyzed was mini mental state examination (MMSE) and secondary outcomes were clinical effect, effect of TCM Syndromes and activities ofdaily living (ADL).Pooled odds ratio(OR) and 95% confidence intervals (CI)were calculated to assess the association.Sensitivity analyses was also conducted.Results Eight eligible studies enrolling 655 patients were identified.TCM Supplementing Qi and activating blood circulation can significantly improve MMSE score(WMD=1.52; 95%confidence interval, 0.28-2.77) and the Effect of TCM Syndromes(OR=2.58; 95% confidence interval, 1.61-4.13).Further analyses showed that TCM Supplementing Qi and activating blood circulation can also ameliorate the clinical efficacy (OR=1.68; 95% confidence interval, 1.18-2.37) and better in ADL(WMD=9.63; 95% confidence interval,-12.46-31.73).The incidence of adverse reactions was low.Conclusion Our present meta-analysis indicates that TCM Supplementing Qi and activating blood circulation can serve as an effective adjuvant therapy for mild and moderate VaD.

Keywords: vascular dementia; vascular cognitive impairment; Chinese medicine; meta analysis

血管性痴呆（VaD）是认知功能障碍为主，或伴有语言视觉空间技能及情感或人格障碍的获得性智能的持续性损害。……