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目的:采用Meta分析方法评价七叶皂苷联合依达拉奉治疗脑出血的有效性与安全性。方法:计算机检索PubMed、Embase、the Cochrane Library、CNKI、Wang Fang Data、SinoMed和VIP,检索时限均从各数据库建库至2016年4月,纳入七叶皂苷联合依达拉奉治疗脑出血的随机对照试验(RCT),进行数据提取和质量评价后,使用Rev Man 5.3软件进行Meta分析。结果以均数差(MD)、相对危险度(RR)、比值比(OR)、95%置信区间(CI)等指标进行分析。结果:共纳入13个RCT,共计1 046例患者。Meta分析结果显示:七叶皂苷联合依达拉奉能够提高临床疗效(RR=1.38,95%CI:1.27~1.49,P<0.000 01),减少NIHSS评分(MD=-4.98,95%CI:-6.85~-3.21,P<0.000 01)和NDS评分(MD=-7.98,95%CI:-12.03~-3.93,P=0.000 1),有效地减少脑水肿体积(MD=-2.61,95%CI:-3.99~-1.22,P=0.000 2)与脑出血体积(MD=-6.03,95%CI:-11.35~-0.70,P<0.03);安全性方面因仅1项研究报道了不良反应发生情况,故无法评价。结论:七叶皂苷联合依达拉奉能够有效地提高临床疗效,减少NIHSS评分或NDS评分缩小患者的脑水肿、脑血肿的体积,但是其安全性仍需要进一步的探讨。
Objective: To evaluate the efficacy and safety of aescinate combined with edaravone in the treatment of cerebral hemorrhage by Meta analysis. METHODS: PubMed, Embase, the Cochrane Library, CNKI, Wang Fang Data, SinoMed and VIP were searched by computer. The retrieval time was from the database of each database to April 2016. The patients were randomized to receive intracerebral hemorrhage with aesculin combined with edaravone Controlled Trials (RCTs), data extraction and quality evaluation were performed using RevMan 5.3 software for meta-analysis. The results were analyzed by mean difference (MD), relative risk (RR), odds ratio (OR), 95% confidence interval (CI) and other indicators. Results: A total of 13 RCTs were enrolled, totaling 1 046 patients. Meta analysis showed that aescine combined with edaravone could improve the clinical efficacy (RR = 1.38, 95% CI: 1.27-1.49, P <0.000 01) and reduce the NIHSS score (MD = -4.98, 95% CI: 6.85 ~ -3.21, P <0.000 01) and NDS score (MD = -7.98,95% CI: -12.03 ~ -3.93, P = 0.0001), effectively reducing the volume of brain edema (MD = -2.61, 95% CI : -3.99 ~ -1.22, P = 0.0002) and the volume of intracerebral hemorrhage (MD = -6.03, 95% CI: -11.35 ~ -0.70, P <0.03); only one study reported the adverse effects Situation, it can not be evaluated. Conclusion: The combination of aescinate and edaravone can effectively improve the clinical curative effect and reduce the volume of cerebral edema and cerebral hematoma in patients with NIHSS score or NDS score reduction, but its safety still needs further exploration.