浏览全部资源
扫码关注微信
1.中国中医科学院 中医临床基础医学研究所,北京 100700
2.广州中医药大学 第二临床医学院,广州 510405
3.河南中医药大学 第一临床医学院,郑州 450046
姜燕华,在读博士,从事中医临床药理学研究,E-mail:1466102995@qq,com
武红莉,博士,助理研究员,从事中医临床研究,E-mail:holiwu@yeah.net
纸质出版日期:2023-11-20,
网络出版日期:2023-10-07,
收稿日期:2023-06-14,
扫 描 看 全 文
姜燕华,荆志伟,钱真真等.中药治疗眩晕随机对照试验的结局指标分析[J].中国实验方剂学杂志,2023,29(22):136-145.
JIANG Yanhua,JING Zhiwei,QIAN Zhenzhen,et al.Outcome Indicators in Randomized Controlled Trials on Traditional Chinese Medicine Treatment of Vertigo[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(22):136-145.
姜燕华,荆志伟,钱真真等.中药治疗眩晕随机对照试验的结局指标分析[J].中国实验方剂学杂志,2023,29(22):136-145. DOI: 10.13422/j.cnki.syfjx.20231216.
JIANG Yanhua,JING Zhiwei,QIAN Zhenzhen,et al.Outcome Indicators in Randomized Controlled Trials on Traditional Chinese Medicine Treatment of Vertigo[J].Chinese Journal of Experimental Traditional Medical Formulae,2023,29(22):136-145. DOI: 10.13422/j.cnki.syfjx.20231216.
目的
2
分析中药治疗眩晕随机对照试验(RCTs)的结局指标,为后续中药治疗眩晕临床试验的方案设计和核心指标集的构建提供参考。
方法
2
计算机检索中国知网(CNKI)、万方数据知识服务平台(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、医学文摘数据库(PubMed)、医学文摘数据库(Embase)和科学网(Web of Science)数据库中收录的中药治疗眩晕的RCTs,并提取资料。
结果
2
纳入375篇RCTs,33 593例患者,共报告482个结局指标,总频数为2 715次,平均每篇RCT报告7个结局指标,不同研究人群报告的结局指标有一定差异。结局指标按功能属性分为9个指标域:临床症状/体征、中医证候疗效、理化检查、生活质量、精神心理健康、安全性事件、患者满意度、远期预后和经济学评估。使用频数较高的结局指标依次为总有效率、中医证候总积分、不良反应发生情况、眩晕障碍量表评分(DHI评分)、基底动脉平均血流速度、不良反应发生率、左椎动脉平均血流速度、右椎动脉平均血流速度、血浆黏度、眩晕评分等。
结论
2
中药治疗眩晕RCTs所报告结局指标主要存在两方面问题:结局指标报告缺乏统一标准规范、对能够体现中医特色的结局指标关注度不足。建议中药治疗眩晕核心指标集的构建充分突出中医特色优势,在此基础上对结局指标统一标准规范,以提高临床研究水平和二次研究的价值。
Objective
2
This study analyzed the outcome indicators in randomized controlled trials (RCTs) on traditional Chinese medicine (TCM) treatment of vertigo, aiming to provide a reference for clinical trial protocol design and the establishment of core indicator sets for vertigo treatment.
Method
2
CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, and Web of Science were searched for the RCTs on TCM treatment of vertigo, and data extraction was conducted.
Result
2
A total of 375 RCTs involving 33 593 patients were included, from which 482 outcome indicators were extracted, with a frequency of 2 715 and an average of seven outcome indicators used for each RCT. In addition, there were some differences in outcome indicators reported by different study groups. According to the functional properties, the reported outcome indicators were classified into nine domains: clinical symptoms and signs, TCM symptom efficacy, physical and chemical examinations, quality of life, mental health, safety events, patients’ satisfaction degree, long-term prognosis, and economic evaluation. The outcome indicators with higher frequency were clinical total effective rate, total TCM symptom score, occurrence of adverse reactions, dizziness handicap inventory (DHI) score, average flow velocity of the basilar artery, incidence of adverse reactions, average flow velocity of the left vertebral artery, average flow velocity of the right vertebral artery, plasma viscosity, and vertigo score.
Conclusion
2
The outcome indicators reported by RCTs of TCM treatment of vertigo mainly have two problems: lack of unified standards and norms and insufficient attention to outcome indicators that can reflect the characteristics of TCM. The construction of the core indicator set for TCM treatment of vertigo should fully highlight the characteristic advantages of TCM and unify the standards and norms for the outcome indicators on this basis, so as to improve the quality of clinical research and the value of secondary research.
中药眩晕随机对照试验结局指标
Traditional Chinese medicinevertigorandomized controlled trialoutcome indicator
POST R E,DICKERSON L M.Dizziness: A diagnostic approach[J].Am Fam Physician,2010,82(4):361-369.
LEMPERT T,NEUHAUSER H.Epidemiology of vertigo, migraine and vestibular migraine[J].J Neurol,2009,256(3):333-338.
徐霞,卜行宽,邢光前,等.江苏省≥10岁人群的眩晕流行病学调查研究[J].中华耳科学杂志,2006,4(4):250-253.
CHAWLA N,OLSHAKER J S.Diagnosis and management of dizziness and vertigo[J].Med Clin North Am,2006,90(2):291-304.
NEUHAUSER H K.Epidemiology of vertigo[J].Curr Opin Neurol,2007,20(1):40-46.
MAARSINGH O R,DROS J,SCHELLEVIS F G,et al.Causes of persistent dizziness in elderly patients in primary care[J].Ann Fam Med,2010,8(3):196-205.
FERNÁNDEZ L,BREINBAUER H A,DELANO P H.Vertigo and dizziness in the elderly[J].Front Neurol,2015,6:144.
孔令博,王淑燕,廖晓凌,等.中医药治疗神经内科领域临床优势病种的探讨[J].中国实验方剂学杂志,2021,27(13):172-178.
丁心香,王爱国,郑昆仑,等.基于无监督数据挖掘中药内服治疗颈性眩晕的组方用药规律分析[J].中国中药杂志,2016,41(5):955-959.
刘超,陈光,高嘉良,等.中成药治疗眩晕用药规律分析[J].中国实验方剂学杂志,2017,23(11):202-207.
傅景华,陈心智.黄帝内经素问[M].北京:中医古籍出版社,1997:146.
中医研究院研究生班.《黄帝内经·素问》注评[M].北京:中国中医药出版社, 2011:567.
宋金丽,孔晓,李春红.眩晕的中医药治疗概况[J].世界中医药,2023,18(9):1337-1340,1347.
姜燕华,钱真真,朱健,等.中药治疗眩晕的临床研究证据图分析[J].中国中药杂志,2023,48(18):5102-5112.
王新春.眩晕症的病因和中西医结合治疗方法——《眩晕临床诊疗》[J].中国实验方剂学杂志,2022,28(5):76.
WILLIAMSON P R,ALTMAN D G,BAGLEY H,et al.The COMET handbook: Version 1.0[J].Trials,2017,18(Suppl 3):280.
张明妍,张俊华,张伯礼,等.中医药临床试验核心指标集研制技术规范[J].中华中医药杂志,2021,36(2):924-928.
郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002.
国家中医药管理局.中医病证诊断疗效标准:ZY/T001.1~001.9-94[M].南京:南京大学出版社,1994.
佚名.眩晕的诊断依据、证候分类、疗效评定——中华人民共和国中医药行业标准《中医内科病证诊断疗效标准》(ZY/T001.1-94)[J].辽宁中医药大学学报,2016,18(9):167.
中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉头颈外科学分会.良性阵发性位置性眩晕诊断和治疗指南(2017)[J].中华耳鼻咽喉头颈外科杂志,2017,52(3):173-177.
中华耳鼻咽喉头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科学分会.良性阵发性位置性眩晕的诊断依据和疗效评估(2006年,贵阳)[J].中华耳鼻咽喉头颈外科杂志,2007,42(3):163-164.
孙传兴.临床疾病诊断依据治愈好转标准[M].2版.北京:人民军医出版社,2002:410.
中华中医药学会.中医内科常见病诊疗指南:中医病证部分[M].北京:中国中医药出版社,2008.
王子衿,孙伟伟,张颖思,等.中医药治疗子宫内膜异位症随机对照试验结局指标与测量工具的现状分析[J].中国中药杂志,2023,48(16):4521-4528.
王可仪,欧益,刘春香,等.中医药治疗糖尿病足临床研究结局指标分析[J].中国中药杂志,2021,46(15):4008-4015.
强晓钰,季昭臣,生晓迪,等.核心指标集方法学研究进展[J].上海中医药杂志,2022,56(8):113-117.
ANDRADE C.The primary outcome measure and its importance in clinical trials[J].J Clin Psychiatry,2015,76(10):e1320-1323.
SEDGWICK P. Primary and secondary outcome measures[J].BMJ,2010,340:c1938.
邱瑞瑾,魏旭煦,关之玥,等.中医药领域核心指标集研究现状及展望[J].中国循证医学杂志,2023,23(2):211-220.
韩如雪,李庚,陈贤坤,等.中医临床研究中“核心结局指标集”测量工具的选择[J].中药新药与临床药理,2019,30(6):745-749.
MOKKINK L B,TERWEE C B,KNOL D L,et al.Protocol of the COSMIN study: Consensus-based standards for the selection of health measurement instruments[J].BMC Med Res Methodol,2006,6:2.
WILLIAMSON P R,ALTMAN D G,BLAZEBY J M,et al.Developing core outcome sets for clinical trials: Issues to consider[J].Trials,2012,13:132.
殷秀梅,秦懿囡,张曼,等.近7年中医药治疗特发性面神经麻痹随机对照试验结局指标的现状分析[J].世界中医药,2023,doi:11.5529.R.20230427.1345.002http://dx.doi.org/11.5529.R.20230427.1345.002.
眩晕的诊断依据、证侯分类、疗效评定——中华人民共和国中医药行业标准《中医内科病证诊断疗效标准》(ZY/T001.1-94)[J].实用中医内科杂志,2022,36(8):85.
于莉,李楠,于思雨,等.基于文献研究的眩晕中医证型分布特征及病机特点探析[J].中华中医药学刊,2023,doi:21.1546.r.20230321.1615.002http://dx.doi.org/21.1546.r.20230321.1615.002.
杨辉,刘峰,张拓红,等.病人满意度调查研究中存在的问题及建议[J].中华医院管理杂志,2005,21(7):437-441.
曾卫坪,宁德斌.中医防治慢性病经济学评价研究述评与展望[J].中医药导报,2022,28(4):186-191,196.
0
浏览量
21
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构