清热活血类中药注射剂治疗急性缺血性脑卒中的网状Meta分析  

Network Meta-analysis of Chinese materia medica injection for resolving heat and promoting blood circulation in treatment of acute ischemic stroke

作　　者：王哲义 孙怿泽 张媛凤 刘碧原 田金洲[3] 卢涛 WANG Zhe-yi;SUN Yi-ze;ZHANG Yuan-feng;LIU Bi-yuan;TIAN Jin-zhou;LU Tao(Beijing University of Chinese Medicine,Beijing 100029,China;School of Life Science,Beijing University of Chinese Medicine,Beijing 100029,China;Dongzhimen Hospital of Beijing University of Chinese Medicine,Beijing 100010,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学生命科学学院,北京100029 [3]北京中医药大学东直门医院,北京100010

出　　处：《中草药》2021年第6期1706-1718,共13页Chinese Traditional and Herbal Drugs

基　　金：北京市双一流高层次人才科研经费(1000041510053)。

摘　　要：目的系统评价清热活血类中药注射剂治疗急性缺血性脑卒中的有效性和安全性。方法计算机检索中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库、PubMed、Cochrane Library,检索起止时间为建库至2020年10月。由2位研究员独立筛选文献、提取资料并按照Jadad量表对文献进行质量评价,采用Stata16.0进行统计分析。结果共纳入66个研究,总样本量7142例,干预措施包括脉络宁注射液、醒脑静注射液、苦碟子注射液共3种中药注射剂。网状Meta分析结果显示,在总有效率方面,累积概率排序为醒脑静注射液+常规治疗(72.8%)>苦碟子注射液+常规治疗(65.6%)>脉络宁注射液+常规治疗(61.6%)>常规治疗(0.0);在改善神经功能缺损评分(NIHSS)方面,累积概率排序为脉络宁注射液+常规治疗(87.8%)>醒脑静注射液+常规治疗(71.9%)>苦碟子注射液+常规治疗(38.6%)>常规治疗(1.7%);在Barthel指数方面,苦碟子注射液+常规治疗(93.3%)>醒脑静注射液+常规治疗(56.6%)>常规治疗(0.0);在降低血清白细胞介素-6(intedeukin-6,IL-6)水平方面,醒脑静注射液+常规治疗(99.6%)>苦碟子注射液+常规治疗(38.3%)>常规治疗(12.1%)。结论醒脑静注射液在总有效率和减少炎症因子方面疗效最佳,脉络宁注射液和苦碟子注射液分别在改善NIHSS评分和Barthel指数方面有优势。但受纳入研究质量所限,存在发表偏倚,该结论仍需开展高质量研究进一步验证。Objective To evaluate the efficacy and safety of chinese medicine injection for resolving heat and promoting blood circulation in treatment of acute ischemic stroke(AIS). Methods CNKI, VIP database(VIP), Wanfang database, PubMed and Cochrane Library were all searched until October, 2020. Two researchers independently screened the literature, extracted the data, and evaluated the quality of the literature according to the Jadad scale. Stata 16.0 was used for statistical analysis. Results A total of 66 studies were included, with a total sample size of 7142 cases. The measures included three Chinese medicine injections, including Xingnaojing Injection(醒脑静注射液, XNJ), Mailuoning Injection(脉络宁注射液, MLN), and Kudiezi Injection(苦碟子注射液, KDZ). On the part of total effective rate, results of network Meta analysis showed that the rank of cumulative probability was: XNJ + CT(72.8%) > KDZ + CT(65.6%) > MLN + CT(61.6%) > CT(0.0%). In terms of NIHSS, the rank of cumulative probability was: MLN + CT(87.8%) > XNJ + CT(71.9%) > KDZ + CT(38.6%) > CT(1.7%). In the aspect of Barthel index, the rank of cumulative probability was: KDZ + CT(93.3%) > XNJ + CT(56.6%) > CT(0.0%). In the aspect of serum levels of IL-6, the rank of cumulative probability was: XNJ + CT(99.6%) > KDZ + CT(38.3%) > CT(12.1%). Conclusion For patients with AIS, XNJ shows better effect in total effective rate and serum levels of IL-6, while MLNI and KSZI show advantages in improving NIHSS score and Barthel index, respectively. However, limited by the quality of the included studies, this conclusion still needs to be further verified by high-quality studies.

关 键 词：清热活血 中药注射剂 急性缺血性脑卒中 网状Meta分析 醒脑静注射液 苦碟子注射液 脉络宁注射液 

分 类 号：R285[医药卫生—中药学]