目的 系統(tǒng)評價半夏白術(shù)天麻湯治療后循環(huán)缺血性眩暈的有效性、安全性。方法 計算機(jī)檢索中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、萬方數(shù)據(jù)知識服務(wù)平臺（Wanfang Data）、維普中文期刊全文數(shù)據(jù)庫（VIP）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、Cochrane Library、PubMed、Embase、Web of Science等數(shù)據(jù)庫，篩選出半夏白術(shù)天麻湯治療后循環(huán)缺血性眩暈的隨機(jī)對照試驗（RCT），檢索時限從建庫至2023年6月30日。應(yīng)用Cochrane Handbook 5.1評價文獻(xiàn)質(zhì)量，RevMan 5.3評價軟件進(jìn)行Meta分析。結(jié)果 共納入22項RCTs，包括患者1 763例患者，試驗組（半夏白術(shù)天麻湯聯(lián)合化學(xué)藥治療或常規(guī)治療） 887例、對照組（單用化學(xué)藥或常規(guī)治療） 876例。Meta分析結(jié)果顯示：在提高總有效率方面［OR＝4.10，95% CI（2.95，5.70），P＜0.000 01］，在改善全血高切黏度方面［SMD＝-0.88，95% CI（-1.30，-0.46），P＜0.000 1］、改善全血低切黏度方面［SMD＝-1.55，95% CI（-1.84，-1.25），P＜0.000 01］，在增加基底動脈平均血流流速方面［SMD＝1.32，95% CI （0.85，1.78），P＜0.000 01］，在增加左/右椎動脈平均血流流速方面［SMD＝2.08，95% CI （1.15，3.00），P＜0.000 1］/［SMD＝2.04，95% CI （1.10，2.98），P＜0.000 1］；在改善惡心嘔吐癥狀評分方面［SMD＝ - 4.18，95% CI（-6.14，-2.21），P＜0.000 1］、頭暈?zāi)垦０Y狀評分方面［SMD＝-1.13，95% CI（-1.87，-0.40），P＝0.002］，試驗組均優(yōu)于對照組。研究中明確為不良反應(yīng)者10例，癥狀為皮疹或胃腸道不適。結(jié)論 半夏白術(shù)天麻湯聯(lián)合化學(xué)藥治療或常規(guī)治療，可以明顯提高后循環(huán)缺血性眩暈的總有效率、改善血流指標(biāo)、改善惡心嘔吐及頭暈?zāi)垦０Y狀評分，并且不良反應(yīng)少且輕微，具有安全性及有效性。但由于此次納入的文獻(xiàn)中樣本量偏小，需采用更多大樣本、設(shè)計嚴(yán)謹(jǐn)?shù)呐R床試驗方案提高證據(jù)質(zhì)量級別。

Objective To systematically evaluate the efficacy and safety of Banxia Baizhu Tianma Decoction for posterior circulation ischemic vertigo. Methods Databases such as CNKI, Wanfang Data, VIP, CBM, Cochrane Library, PubMed, Embase, Web of Science were searched by computer from foundation to June 30, 2023, for the randomized controlled trial (RCT) of Banxia Baizhu Tianma Decoction in the treatment of posterior circulation ischemic vertigo. The Cochrane Handbook 5.1 evaluation of literature quality and RevMan 5.3 evaluation software were used to conduct Meta-analysis. Results A total of 22 RCTs were included in the Meta-analysis, with a total sample size of 1 763 cases, 887 cases in the treatment group (Banxia Baizhu Tianma Decoction combined with western medicine/conventional treatment) and 876 cases in the control group (western medicine/ conventional treatment alone). Meta-analysis results showed: in terms of improving the total efficacy rate [OR = 4.10, 95%CI (2.95, 5.70), P < 0.000 01]; improving whole blood high shear viscosity [SMD = -0.88, 95%CI (-1.30,-0.46), P < 0.000 1], and whole blood low shear viscosity [SMD=-1.55, 95%CI (-1.84, -1.25), P < 0.000 01]; increasing the mean blood flow velocity of basilar artery [SMD = 1.32, 95%CI (0.85, 1.78), P < 0.000 01]; increasing the mean blood flow velocity of left vertebral arteries [SMD = 2.08, 95%CI (1.15, 3.00), P < 0.000 1] and mean blood flow velocity of right vertebral arteries [SMD = 2.04, 95%CI (1.10, 2.98), P < 0.000 1]; improving nausea and vomiting and vertigo symptom score [SMD = - 4.18, 95%CI (- 6.14, - 2.21), P < 0.000 1], dizziness and vertigo symptom score [SMD = -1.13, 95%CI (-1.87, -0.40), P = 0.002], treatment group was better than control group. There were 10 cases reported as adverse reactions in the study, with symptoms such as rash or gastrointestinal discomfort. Conclusion The results showed that Banxia Baizhu Tianma Decoction combined with western medicine/conventional treatment could significantly improve the total efficacy rate of posterior circulation ischemic vertigo, improve blood flow indicators, improve nausea and vomiting and dizziness and vertigo symptom score, and had few and mild adverse reactions, with safety and efficacy. However, due to the small sample size, more large-sample, rigorous design, protocols are needed to improve the quality level of evidence.

R969.3；R286.1

吉林省中醫(yī)藥科技項目（2022168）；吉林省名老中醫(yī)專家傳承工作室建設(shè)項目；第七批全國老中醫(yī)藥專家學(xué)術(shù)經(jīng)驗繼承工作項目