Efficacy And Safety Of Xuanyunning Pian In The Patients With PCIV: A Systematic Review And Meta-analysis

Objective Systematically evaluating the clinical efficacy and safety of Xuanyunning tablets in the treatment of posterior circulation ischemic vertigo by applying Meta-analysis method and providing certain scientific basis for clinical selection of Xuanyunning Pian.Methods A computer was used to retrieve the controlled trials on posterior circulation ischemia vertigo of Xuanyunning tablets in domestic and foreign databases.The domestic databases include: CNKI,Wanfang Data,VIP,China Biomedical Literature Database(CBM).Foreign databases include: Pub Med,The Cochrane Library,Embase.The searching time is from the start date of each relevant database to December 31,2020.Two researchers,following the inclusion and exclusion criteria established in this study,independently carried out the screening,extraction and quality evaluation of the literature.Using Rev Man 5.4 software to analyze the clinical effective rate,clinical recovery rate,TCD examination results(the average blood flow velocity of the basilar artery),fibrinogen,total cholesterol and hematocrit.Due to little adverse reaction data included in the literature of this study,it is only a description rather than metaanalysis.Results 146 related documents were retrieved from domestic and foreign databases and 16 documents were finally included.,All of which were RCT documents.A total of 1544 subjects were involved,including 493 cases in the Xuanyunning tablet test group and 430 cases in the conven tional western medicine control group.There were 311 cases in the combined western medicine test group and 310 cases in the conventional western medicine control group.(1)Clinical effectiveness:(1)Xuanyunning tablet group and conventional western medicine group: RR=1.18,95%CI [1.12,1.24],P <0.00001,(2)Xuanyunning tablet combined western medicine group and convent ional western medicine group: RR=1.18,95%CI [1.11,1.26],P <0.00001;(2)Clinical recovery rate:(1)Duanyunning tablet group and conventional western medicine group: RR=1.60,95%CI [1.37,1.87],P <0.00001,(2)Xuanyunning tablet combined with western medicine group and conventional western medicine group: RR=1.39,95% CI [1.21,1.59],P <0.00001;(3)TCD examination results(mainly based on the average blood flow velocity of the basilar artery):(1)Xuanyunning tablets group and conventional western medicine group: MD=5.26,95%CI is [3.46,7.05],P <0.00001,(2)Xuanyunning tablets combined with western medicine gro up and conventional western medicine group: MD=5.71,95%CI is [4.51,6.92],P <0.00001;(4)Plasma viscosity:(1)Xuanyunning tablet group and conventional western medicine group: MD=-0.20,95%CI is [-0.39,-0.01],P=0.04,(2)Xuanyunning tablet combined western medicine group and conventional medicine group Western medicine group: MD=-0.20,95%CI is [-0.48,0.08],P=0.17;(5)Fibrinogen: Xuanyunning tablets combined with Western medicine group and conventional Western medicine group MD=-0.46,95%CI is [-0.99,0.07],P=0.09;(6)Total cholesterol: Xuanyuanning tablet group and conventional western medicine group: MD=0.04,95%CI is [-0.26,0.35],P=0.78;(7)Hematocrit : Xuanyunning tablet group and conventional western medicine group: MD=-0.06,95% CI [-0.15,0.03],P=0.17.(8)Adverse reactions: 6 of the 16 documents described adverse reactions,of which 4 documents showed that no adverse reactions occurred and the other 2 documents appeared adverse reactions in the experim ental group and the control group.ConclusionCompared with conventional western medicine,Xuanyunning tablets can improve the clinical effectiveness and recovery rate of patients with circulatory ischemic vertigo after treatment with Xuanyunning tablets,as well as the average blood flow velocity of the basilar artery and reduce the plasma viscosity;and.No advantages were found in the two indica tors of specific volume: total cholesterol and hematocrit.Compared with the conventional western medicine group,the Xuanyunning tablet combi ned western medicine can improve the clinical effective rate,recovery rate,the basis of the circulatory ischemic vertigo and arterial average blood flow velocity;However,no advantages were found in the two indicators of plasma viscosity and fibrinogen;There are fewer cases of adverse reactions,which may be related to the short medication time,also,its safety needs to be further evaluating.