Are Pill And Other Treatment Of Migraine Control Study Of The Meta-analysis

Migraine is a common disorder in clinical practice. The last ten years have seen therapeutic improvement, especially in pain management, associated symptoms treatment and relapse prevention. Results of long term large scale clinical trials, with integrative medicine (TCM, Western Medicine and Chinese herbs) for migraine treatment, designed according to evidence based medicine principles, has shown its efficacy with a reduction of migraine incidence and an upturn in long term prognosis. Nonetheless improvement is still needed necessary.A systematic review of clinical research with meta-analysis on the treatment of migraine with Zheng Tian Wan over the last twenty years is described in this article. Zheng Tian Wan, a patent medicine first produced in 1985, used in the clinical practice for the treatment of migraine, has the action of blood nourishment, liver sedation, wind removal, blood circulatory stimulation and analgesia.This medicine is composed of:Gou Teng, Bai Shao, Chuan Xiong, Dang Gui, Di Huang, Bai Zhi, Fang Feng, Qiang Huo etc.Clinical trialObjective:comparative analysis in the treatment of migraine with Zheng Tian Wan and other medicines.Methods1. We searched the PubMed,Medline, CNKI,Wei Pu and Wan Fang databases for clinical trials literature with the following search type:Medline:Zheng Tian Wan, China Journal database:(search item:abstract) and (search word:Zheng Tian Wan), Wan Fang database: Zheng Tian Wan, migraine. We limited the search from the first period of 1985 to December 2009 in order to widen the research.Bibliography selection was done according to inclusion and exclusion standards; 2. Data gathering and evaluation was made according to their relevance of our specific subject.3. Meta analysis has been the basis for the selection of randomized control trials.Results1.We retrieved 2020 articles without exclusion of similar papers. 2. After excluding irrelevant papers,29 articles were included.3. We found out that trials on the migraine treatment with Zheng Tian Wan were not up to standard showing evident study design inadequacy. Referring to the modified of Jdada evaluation, high quality randomized controlled test (4-7 points) we found only two articles that scored 6 points. In the non-randomized controlled trial quality score, only one article scored 5 points (best score 12 points)4. Finally we entered 21 articles in the meta-analysis, with heterogeneity level (P<0.0001<0.5) showing the probability of confounding factors, random effects models, with the total result being relative risk (RR) 1.94 [1.46,2.60], P<0.00001, the two group heterogeneity showing statistically significant difference. In the evaluation of migraine treatment, diamonds were positioned totally to the right of the vertical line indicating a higher rate of improvement in the treatment group.ConclusionLitterature about migraine treatment with Zheng Tian Wan has shown sustained inconsistency, affecting trials outcomes reliability. Meta-analysis indicates that in controlled comparison trials, Zheng Tian Wan does not reach the favourable response of other drugs. On the other hand our conclusion reliability was affected by Jdada evaluation for study inclusion elegibility being mostly low, with numerous confounding factors and design defects. Based on the present analysis, the effectiveness of Zheng Tian Wan in migraine treatment is not significant. Results confirmation should rely on studies with larger sampling, coherent design and clear prognostic indicators.