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目的:采用Meta分析方法评价醒脑静注射剂辅助西医常规治疗急性脑梗死的有效性及安全性。方法:计算机检索the Cochrane Library、PubMed、Embase、SinoMed、中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数据库中有关醒脑静注射剂治疗急性脑梗死的随机对照试验,文献检索年限为各数据库建库至2016年9月。采用Cochrane风险评估表评价其质量,通过Rev Man 5.3软件提取资料并进行Meta分析。结果:共纳入24个随机对照试验,累计2 514名患者。Meta分析结果显示,醒脑静注射剂辅助西医常规治疗与仅用西医常规治疗方法相比,可提高临床总有效率(RR=1.22,95%CI:1.18~1.27,P<0.000 01)。此外,醒脑静注射剂也可改善神经功能缺损情况(MD=-3.93,95%CI:-5.04~-2.82,P<0.000 01),影响血液流变学指标。有8个随机对照试验共报告发生了38例不良反应,7个随机对照试验报告未发生明显不良反应。结论:醒脑静注射剂辅助西医常规治疗急性脑梗死具有较好的疗效,但其安全性需进一步探讨。
OBJECTIVE: To evaluate the effectiveness and safety of Xingnaojing injection in assisting western medicine routine treatment of acute cerebral infarction by Meta-analysis. Methods: The randomized controlled trials of Xingnaojing injection for the treatment of acute cerebral infarction were searched by computer in the Cochrane Library, PubMed, Embase, SinoMed, Chinese Journal Full-text Database (CNKI), Chinese Science and Technology Periodical Full-text Database (VIP) Search for the database for each database until September 2016. The Cochrane Risk Assessment Scale was used to evaluate the quality of the data and data were extracted and Meta-analysis was performed using Rev Man 5.3 software. Results: A total of 24 randomized controlled trials were included, with a total of 2 514 patients. The result of Meta analysis showed that Xingnaojing injection could increase the total clinical effective rate (RR = 1.22, 95% CI: 1.18-1.27, P <0.000 01) compared with conventional western medicine only. In addition, Xingnaojing injection can also improve neurological deficit (MD = -3.93, 95% CI: -5.04 ~ -2.82, P <0.000 01), affecting hemorheological parameters. Eight randomized controlled trials reported a total of 38 adverse reactions, and seven randomized controlled trials reported no significant adverse effects. Conclusion: Xingnaojing injection can ameliorate acute cerebral infarction effectively by Western medicine, but its safety needs to be further explored.