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目的:采用Meta分析方法评价刺五加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、Pub Med、Embase、Sino Med、中国知网、维普期刊数据库和万方数据库有关刺五加注射剂辅助治疗急性脑梗死的随机对照临床试验文献,检索时限为各数据库建库至2016年8月1日。采用Cochrane风险评价表评价其研究质量,提取资料通过Rev Man 5.3进行Meta分析。结果:共纳入11个随机对照试验,累计患者763例。Meta分析结果显示,刺五加注射剂辅助西医常规治疗可提高临床疗效总有效率(RR=1.18,95%CI:1.11~1.26,P<0.000 01);此外,刺五加注射剂也会影响血液流变学指标,如降低患者的红细胞压积、纤维蛋白原值。本研究中3篇文献明确无不良反应,4篇研究报道了共14例不良反应,其他文献均未对安全性进行说明。结论:现有证据表明,西医常规用药的基础上加用刺五加注射剂治疗急性脑梗死可以提高临床疗效及改善血液流变学指标,但其安全性仍需进一步探讨。鉴于纳入研究存在质量及数量上的局限,使结论证据支持力度较弱,因此本研究结论尚需更多大样本、多中心临床试验加以证实。
OBJECTIVE: To evaluate the efficacy and safety of Acanthopanax injection for Western routine treatment of acute cerebral infarction by Meta-analysis. Methods: Randomized controlled clinical trials of Acanthopanax senticosus injection in adjuvant treatment of acute cerebral infarction were searched by computer, and the search period was searched from the database of PubMed, Pub Med, Embase, Sino Med, CNKI, VIP database and Wanfang database Library until August 1, 2016. Cochrane Risk Assessment Scale was used to evaluate the quality of the study, and data were extracted for meta-analysis using Rev Man 5.3. Results: A total of 11 randomized controlled trials were included, with a total of 763 patients. Meta-analysis showed that acanthopanax injection-assisted conventional western medicine can improve the total effective rate of clinical efficacy (RR = 1.18, 95% CI: 1.11-1.26, P <0.000 01); in addition, acanthopanax injection also affects blood flow Variable indicators, such as reducing the patient’s hematocrit, fibrinogen value. The three articles in this study clearly no adverse reactions, 4 studies reported a total of 14 adverse reactions, no other literature on safety. Conclusion: The available evidence shows that the addition of Acanthopanax senticosus injection to acute cerebral infarction can improve the clinical curative effect and improve the hemorheological indexes on the basis of conventional western medicine, but its safety needs further study. In view of the quality and quantity limitations of the included studies and the weak evidence support for the conclusions, the conclusions of this study still need more large sample and multi-center clinical trials to confirm.