卢文文 郭闫葵

摘要 目的：系統评价补阳还五汤治疗血管性认知障碍的临床疗效与安全性。方法：检索国家知识基础设施数据库（CNKI）、中国学术期刊数据库（CSPD）、中文科技期刊数据库（CCD）、PubMed等数据库，收集建库至2020年5月20日期间发表的补阳还五汤治疗血管性认知障碍的随机对照试验，通过RevMan 5.3软件对数据进行统计分析。结果：纳入文献14篇，含患者1 151例，其中观察组595例，对照组556例。Meta分析结果显示：1）在临床有效率方面，1个月内、2个月、3个月及以上疗程，观察组均优于对照组;2）在改善简易精神智力状态检查量表（MMSE）评分上，单用补阳还五汤或联合西药均优于单用西药;3）在改善日常生活能力量表（ADL）评分上，单用补阳还五汤或联用促智类西药效果优于单用西药，联用改善脑供血类西药与单用西药效果相当。4项研究报告不良事件，均未出现不良反应。结论：补阳还五汤治疗血管性认知障碍有效且安全性良好。但纳入文献的方法学质量较低，需要开展高质量临床试验进一步补充证据。

关键词 补阳还五汤;血管性认知障碍;随机对照;益气活血通络;临床疗效;安全性;系统评价;Meta分析

Systematic Evaluation and Meta-analysis of the Efficacy and Safety of Buyang Huanwu Decoction in the Treatment of Vascular Cognitive Impairment

LU Wenwen1，GUO Yankui2

（1 Shandong University of Traditional Chinese Medicine，Ji′nan 250014，China; 2 Ji′nan Municipal Hospital of Traditional Chinese Medicine，Ji′nan 250012，China）

Abstract Objective：This study aims to systematically evaluate the clinical efficacy and safety of Buyang Huanwu Decoction in the treatment of vascular cognitive impairment（VCI） through Meta-analysis.Methods：Randomized controlled trials（RCTs） on the treatment of VCI with Buyang Huanwu Decoction were searched from China National Knowledge Infrastructure（CNKI），Wanfang Data，VIP，and PubMed（from establishment of the database to May 20，2020）.Then two researchers independently completed literature screening，data collection，result checking，and methodological bias risk assessment according to the inclusion and exclusion criteria.In case of any disagreement，the two discussed or sought for opinions of a third researcher.RevMan 5.3 was employed for Meta-analysis.Results：A total of 14 eligible articles were screened out，involving 1 151 patients.In these trials，the treatment group was given Buyang Huanwu Decoction alone or in combination with western medicine.The control group received western medicine or the blank control was designed.The following conclusions were drawn from these trials. 1）The clinical effective rate in the treatment group was higher than that in the control group within the 1-month，2-month，or>3-month course. 2）Buyang Huanwu Decoction alone or in combination with western medicine can better improve the MMSE score than western medicine alone. 3）Buyang Huanwu Decoction alone or the combination with nootropic western medicine was superior to western medicine alone in the improvement of ADL score and the effect of the decoction combined with western medicine for improving brain blood supply was equivalent to that of western medicine alone.Four studies reported on adverse events，none of which occurred.Thus，the prescription is safe and can be used in clinical settings.Conclusion：Buyang Huanwu Decoction is effective and safe in the treatment of VCI.However，in view of the small quality of the included articles，high-quality clinical trials are still needed for further support.73AA3564-244F-4259-BDF2-5A63E320D57C

Keywords Buyang Huanwu Decoction; Vascular cognitive impairment; Randomized control; Yiqi Huoxue Tongluo; Clinical efficacy; Safety; Systematic evaluation; Meta-analysis

中图分类号：R277.7文献标识码：Adoi：10.3969/j.issn.1673-7202.2022.08.010

血管性认知障碍（Vascular Cognitive Impairment，VCI）是指从轻度认知障碍到痴呆的一大类综合征，多由脑血管病危险因素、明显或不明显的脑血管病引起。VCI分为非痴呆性血管性认知障碍（Vascular Cognitive Impairment-No Dementia，VCIND）和血管性痴呆（Vasculardementia，VD）。当前血管性痴呆发病率仅次于阿尔茨海默病，为痴呆的第二大类型。该病发病率逐年增高且病程较长，严重影响患者自理能力，降低患者及家属生命质量，故其治疗成为当代医学研究重点。V……