活血化瘀类中成药联合丁苯酞注射液治疗急性脑梗死疗效与安全性的系统评价  

Systematic Evaluation of Efficacy and Safety of Traditional Chinese Medicine for Promoting Blood Circulation and Removing Phlegm Combined with Butylphthalide Injection in Treatment of Acute Cerebral Infarction

作　　者：李新燕 周霖 李维辰 LI Xinyan;ZHOU Lin;LI Weichen(Dept.of Pharmacy,Shanghai Putuo District Central Hospital,Shanghai 200062,China;Dept.of Pharmacy,Shanghai Putuo District Mental Health Center,Shanghai 200065,China)

机构地区：[1]上海市普陀区中心医院药学部,上海200062 [2]上海市普陀区精神卫生中心药剂科,上海200065

出　　处：《中国医院用药评价与分析》2019年第6期724-728,共5页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:系统评价活血化瘀类中成药联合丁苯酞注射液治疗急性脑梗死的临床疗效与安全性。方法:检索中国知网、万方数据库、维普数据库、PubMed、EMBase和Cochrane图书馆等数据库,纳入活血化瘀类中成药联合丁苯酞注射液治疗急性脑梗死的随机对照研究[在常规治疗基础上,观察组患者联合应用活血化瘀类中成药与丁苯酞注射液;对照组患者单独使用丁苯酞注射液(对照1组)或活血化瘀类中成药(对照2组)],依据Cochrane手册对纳入文献进行质量评价,采用RevMan5.3软件进行文献荟萃分析(Meta分析)。结果:共纳入15篇文献,涉及1330例患者。Meta分析结果显示,观察组患者的总有效率明显高于对照1组(RR=1.20,95%CI=1.11~1.30,P<0.001)、对照2组(RR=1.22,95%CI=1.15~1.31,P<0.001),差异均有统计学意义;随访结束时,观察组患者的美国国立卫生院卒中神经功能缺损评分量表评分明显低于对照1组(MD=-4.11,95%CI=-5.30^-2.92,P<0.001)、对照2组(MD=-2.34,95%CI=-3.34^-1.33,P<0.001),差异均有统计学意义。7篇文献报告了不良反应,仅3篇文献报告对照组患者不良反应发生率明显高于观察组,差异有统计学意义;其余4篇报告观察组患者与对照组患者不良反应发生率的差异无统计学意义。结论:活血化瘀类中成药联合丁苯酞注射液治疗急性脑梗死,在疗效和改善患者神经功能方面优于单独使用丁苯酞注射液或活血化瘀类中成药。OBJECTIVE: To systematically evaluate the efficacy and safety of traditional Chinese medicine for promoting blood circulation and removing phlegm combined with butylphthalide injection in treatment of acute cerebral infarction. METHODS: CNKI, Wanfang database, VIP database, Pubmed, EMBase, Cochrane library were retrieved to collect the randomized controlled trials of traditional Chinese medicine for promoting blood circulation and removing phlegm combined with butylphthalide injection in treatment of acute cerebral infarction [on the basis of conventional treatment, the observation group was additionally treated with the traditional Chinese medicine for promoting blood circulation and removing phlegm combined with butylphthalide injection;the control group was given butylphthalide injection(control group 1) or traditional Chinese medicine for promoting blood circulation and removing phlegm(control group 2)]. The quality of the included literature was evaluated according to the Cochrane Handbook, and meta-analysis(Meta analysis) was performed by using RevMan 5.3 software. RESULTS: Totally 15 randomized controlled trials were enrolled, including 1 330 patients. Meta-analysis showed that the total effective rate of the observation group was significantly higher than that of the control group 1(RR=1.20,95%CI=1.11-1.30,P<0.001), and the control group 2(RR=1.22,95%CI=1.15-1.31,P<0.001), the difference was statistically significant. At the end of follow-up, the scores of the National Institutes of Health Stroke Neurological Deficit Rating Scale in the observation group were significantly lower than those in the control group 1(MD=-4.11,95%CI=-5.30--2.92,P<0.001), and the control group 2(MD=-2.34,95%CI=-3.34--1.33,P<0.001), the difference was statistically significant. Adverse drug reactions were reported in 7 literatures, and only 3 literatures reported that the incidence of adverse drug reactions in the control group was significantly higher than that in the observation group, and the difference was statistically signi

关 键 词：急性脑梗死 丁苯酞注射液 活血化瘀类中成药 META分析 

分 类 号：R932[医药卫生—生药学]