Banxia Baizhu Tianma Decoction For The Treatment Of Vertebrobasilar Insufficiency:A Meta-Analysis Of Randomized Controlled Trials

Objective : Vertebral- basilar insufficiency( VBI) is the result of a variety of causes affecting the brain, brain stem, cerebellum, and other parts of the occipital lobe blood supply and finally lead to cerebrovascular ischemic. With the progress of the current aging society, incidence of VBI is ascending. Clinically, vasodilator and symptomatic treatment is usually applied, but only poor efficacy and easily repeated. Many clinical reports confirm that Banxia Baizhu Tianma detection could alleviate vertigo symptoms of VBI, and the purpose of this systematic review is to evaluate the efficacy and safety of Banxia Baizhu Tianma decoction for VBI.Methods :The medical literature was searched in 7 domestic and abroad databases up to May20, 2014 to identify the random controlled trials( RCTs) studying Banxia Baizhu Tianma decoction for VBI, including Pubmed, Excerpt Media Database(EMbase), The Cochrane Library, Chinese National Knowledge Infrastructure databases( CNKI), Chinese Biomedical database( CBM),VIP journal database( VIP), Wanfang Data Knowledge Service Platform. The last time we searched was May20, 2014. We made our best efforts to search possible literature, then two reviewers screened literature according to inclusion and exclusion criteria, and extracted data respectively. The methodological quality assessment was assessed according to criteria of Cochrane Collaboration..Review Manager 5.2 software was used to perform Heterogeneity test, Meta-analysis, and publication bias test.Results:Finally 9 articles were included, through the data collation and analysis, we found that: compared with western conventional medicine, Banxia Baizhu Tianma decoction could better improve the symptoms of VBI patients with vertigo, increase the vertebral artery and basilar artery mean flow velocity, and could better reduce the plasma viscosity, high shear whole blood viscosity and fibrinogen. About Security, only three studies of nine studies included mentioned adverse reactions, while the other 6 studies didn’t report safety information.Conclusion: The Meta analysis showed us that: compared with the western conventional medicine, Banxia Baizhu Tianma decoction could better alleviate the clinical symptoms of VBI patients, increase the vertebral artery and basilar artery mean flow velocity, and improve hemorheology. But with regard to safety, especially long-term safety remains to be further studied. Considering the lower methodological quality of the literatures included, multi-center, large sample, high quality randomized controlled trials are needed in the future.