醒脑静注射液治疗急性脑梗死随机对照试验的系统评价  

Systematic review of Xingnaojing injection in random controlled trials for acute cerebral infarction

作　　者：李昶[1,2] 茹雪莹 吴泰相[4] 傅强[5] 

机构地区：[1]天津中医药大学,天津300193 [2]天津市第五中心医院重症医学科,天津300450 [3]天津市永久医院皮肤科,天津300450 [4]四川大学华西医院中国临床试验注册中心,中国循证医学中心,国际临床流行病学网华西培训中心,四川成都610041 [5]天津市第四中心医院重症医学科,天津300140

出　　处：《临床荟萃》2013年第9期1006-1013,共8页Clinical Focus

摘　　要：目的系统评价醒脑静与丹参等不同药物治疗脑梗死的临床疗效。方法计算机检索的数据库包括中文期刊网全文数据库、中国优秀博硕士学位论文全文数据库、中国医用信息资源系统,手工检索初步入选的全文及文献。采用Cochrane协作网提供的RevMan4.2.7进行Meta分析。结果共纳入36个随机对照试验(3 114例患者)。Meta分析结果显示:①总有效率,7个与丹参比较的研究,差异有统计学意义(RR=1.37,95%CI=1.26~1.50,P<0.01);②病死率,3个研究报道了醒脑静与丹参的比较,在病死率方面差异有统计学意义(RR=0.26,95%CI=0.07~1.01,P=0.05);③治愈率,6个与丹参比较的研究,差异有统计学意义(RR=1.90,95%CI=1.24~2.90,P<0.01);3个与胞二磷胆碱比较的研究,两组差异有统计学意义(RR=2.35,95%CI=1.29~4.29,P<0.01);④不良反应,发生数量少且表现轻微;⑤神经功能缺损评分(NDS),6个研究报告了醒脑静与丹参干预前后评分值(WMD=-5.57,95%CI=-6.43^-4.71,P<0.01),NDS评分明显下降。结论目前的证据表明,醒脑静与丹参等药物比较,可降低其病死率、提高总有效率;需要更多设计良好的随机、双盲、安慰剂对照试验予以证实。Objective To assess the clinical efficacy of Xingnaojing with salvia or other different medications for treating cerebral infarction. Methods Randomized controlled trials （RCTs） were identified from Chinese Periodical, Chinese Selected Doctoral Dissertations and Master＇s Theses Full-Text Databases（CDMD）,China Medical Information Resource System. All data related and their references were hand searched. RevMan4. 2. 7 soft was used for data analysis. Results Thirty-six RCTs involving 3 114 patients were included. The results of meta-analysis were listed as the following：① Total effective rate： compared with salvia, 7 studies showed that Xingnaojing was more effective （RR = 1.37,95% CI = 1.26 --1.50, P〈 0.01） ;② Mortality： compared with salvia, 3 studies showed that Xingnaojing decreased the mortality statistically（ RR = 0.26,95 0/60 （7.1 = 0.07-1.01, P = 0.05） ; ③Cure rate ： compared with salvia, 6 studies showed that Xingnaojing was more effective（ RR = 1.90,95 % CI = 1.24-2.90, P 〈0.01） ; compared with citicoline,3 studies showed that Xingnaojing was more effective（ RR = 2.35,95 % CI = 1.29-4.29, P 〈 0.01）;④ Adverse effect： the number of adverse drug reaction was small and the symptoms were moderate; ⑤Neurologic impairment score： compared with salvia, 6 studies showed that Xingnaojing was better（WMD=--5.57,95~ CI -6.43- -4.71, P 〈0.01）. Conclusion Xingnaojing may decrease the mortality and increase the total effective rate of cerebral infarction. More high quality trials are required.

关 键 词：脑梗塞 植物制剂 META分析 

分 类 号：R743.33[医药卫生—神经病学与精神病学]