醒脑静联合肌氨肽苷治疗急性缺血性脑卒中临床疗效的Meta分析及GRADE质量评价  

CLINICAL EFFICACY OF XINGNAOJING COMBINED WITH MUSCULAR AMINO ACIDS AND NUCLEOSIDES IN THE TREATMENT OF ACUTE ISCHEMIC STROKE:A META-ANALYSIS AND GRADE EVALUATION

作　　者：郭浩 寇佳敏 杨宏昕 Guo Hao;Kou Jiamin;Yang Hongxin(Department of Pharmacy,Inner Mongolia Autonomous Region People’s Hospital,Hohhot 010017,China;College of Pharmacy,Baotou Medical College,Baotou 014040,China)

机构地区：[1]内蒙古自治区人民医院药学处,内蒙古呼和浩特010017 [2]包头医学院药学院,内蒙古包头014040

出　　处：《疾病监测与控制》2022年第6期426-430,434,共6页Journal of Diseases Monitor and Control

基　　金：内蒙古自治区人民医院博士科研启动基金项目(2020BS02)

摘　　要：目的对醒脑静联合肌氨肽苷治疗急性缺血性脑卒中的临床疗效进行Meta分析,并对其进行质量评价,以期为临床实践提供参考。方法计算机检索中国知网、万方以及中国生物医学文献数据库、Pubmed、Embase、Cochrane Library,收集醒脑静联合肌氨肽苷治疗急性缺血性脑卒中的随机对照试验(randomized controlled trial,RCT),检索时限为建库至2021年12月。采用RevMan 5.3软件对符合纳入标准的文献进行Meta分析,同时进行GRADE证据质量评价。结果共纳入6篇符合标准的文献,包括762例患者。Meta分析结果显示:与对照组相比,醒脑静联合肌氨肽苷可进一步提高临床总有效率,显著改善患者神经功能缺损以及日常生活能力,差异均有统计学意义(P<0.05)。其还可显著改善血脂指标与C反应蛋白的水平,差异均有统计学意义(P<0.05)。GRADE证据质量评价结果显示所有结局指标评级均为中级。结论当前证据表明,醒脑静联合肌氨肽苷进一步改善脑卒中患者的神经功能缺损情况与日常生活能力,对血脂异常以及降低CRP水平也有良好的效果,值得临床应用与推广。Objective The clinical efficacy of Xingnaojing combined with carnosine in the treatment of acute ischemic stroke was analyzed by meta-analysis and its quality was evaluated in order to provide reference for clinical practice.Methods Computer search of CNKI,Wanfang,China Biomedical Literature Database,Pubmed,Embase,Cochrane Library,collected the randomized controlled trial(RCT)of Xingnaojing combined with carnosine in the treatment of acute ischemic stroke.The search time limit is from the establishment of the database to December 2021.RevMan 5.3 software was used to conduct meta-analysis of the documents that met the inclusion criteria,and GRADE evidence quality evaluation was also conducted.Results A total of 6 ar-ticles meeting the criteria were included,including 762 patients.Meta-analysis showed that compared with control group,Xingnaojing combined with muscular amino acids and nucleosides can further improve the total clinical effective rate,Significantly improve neurological deficits in patients,and daily life ability,and the differences were statistically significant(P<0.05).It can also significantly improve the level of blood lipid index and C-reactive protein,and the difference is statistically significant(P<0.05).GRADE evaluation results showed that all outcome measures were rated as intermediate.Conclusion Current evidence shows that Xingnaojing combined with carnosine can further improve the neurological deficit and ability of daily living of stroke patients,and has good effects on dyslipidemia and lowering CRP level,which is worthy of clinical application and promotion.

关 键 词：醒脑静 肌氨肽苷 缺血性脑卒中 临床疗效 META分析 GRADE系统 

分 类 号：R775[医药卫生—眼科]