5种活血类中药注射剂联合化学药治疗急性缺血性脑卒中的贝叶斯网状Meta分析  

Bayesian network Meta-analysis of five kinds of blood revitalizing traditional Chinese medicine injections combined with chemical drugs in treatment of acute ischemic stroke

作　　者：刘会霞 魏丽 陈雪娇 万玉敏 刘耀东 梁玉 刘婷婷 安晓华 齐捧茹 LIU Huixia;WEI Li;CHEN Xuejiao;WAN Yumin;LIU Yaodong;LIANG Yu;LIU Tingting;AN Xiaohua;QI Pengru(Shijiazhuang Wuji Renhe Hospital in Hebei Province,Shijiazhuang 052460,China)

机构地区：[1]河北省石家庄市无极人和医院,河北石家庄052460

出　　处：《药物评价研究》2023年第8期1759-1777,共19页Drug Evaluation Research

基　　金：河北省医学研究重点课题计划项目(20181487)。

摘　　要：目的系统评价中药注射液(注射用丹参多酚酸、丹红注射液、疏血通注射液、银杏二萜内酯葡胺注射液、银杏内酯注射液)联合化学药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学术期刊全文数据库(CNKI)、万方数据知识服务平台(Wanfang Data)、维普中文期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、美国生物医学期刊文献数据库(PubMed)、荷兰医学文摘数据库(Embase)、循证医学图书馆(Cochrane Library)、美国引文数据库(Web of Science),检索时间从建库至2023年5月31日,全面收集相关临床随机对照试验(RCT),使用Cochrane系统评价手册进行纳入研究的质量评价,采用R 4.0.5和Stata 16软件进行网状Meta分析。结果共纳入72项研究,共纳入7343例患者,涉及5种中药注射剂。网状Meta分析结果显示:在临床有效率方面,注射用丹参多酚酸、丹红注射液、疏血通注射液、银杏二萜内酯葡胺注射液、银杏内酯注射液联合化学药的临床有效率均高于化学药对照组,累积概率排序为疏血通注射液+化学药(89.36%)>注射用丹参多酚酸+化学药(87.25%)>丹红注射液+化学药(54.14%)>银杏内酯注射液+化学药(44.48%)>银杏二萜内酯葡胺注射液+化学药(24.77%)>化学药(0.0%);在降低美国国立卫生研究院卒中量表(NIHSS)评分方面,注射用丹参多酚酸、丹红注射液、疏血通注射液、银杏二萜内酯葡胺注射液、银杏内酯注射液联合化学药的NIHSS评分均低于化学药对照组,累积概率排序为丹红注射液+化学药(89.63%)>疏血通注射液+化学药(71.44%)>注射用丹参多酚酸+化学药(65.19%)>银杏内酯注射液+化学药(50.41%)>银杏二萜内酯葡胺注射液+化学药(23.21%)>化学药(0.00%);在提高日常生活能力量表(BI)评分方面,注射用丹参多酚酸、丹红注射液、疏血通注射液、银杏二萜内酯葡胺注射液、银杏内酯注射液联合化学药的BI评�Objective To evaluate the efficacy and safety of traditional Chinese medicine injections[Salvianolic Acids for Injection(SAFI),Danhong Injection(DH),Shuxuetong Injection(SXT),Ginkgo Diterpene Lactone Meglumine Injection(YXETNZ),Ginkgolide Injection(YXNZ)]combined with western medicine in the treatment of acute ischemic stroke.Methods Databases including CNKI,Wanfang Data,VIP,CBM,PubMed,Embase,the Cochrane library,and Web of Science were searched to collect randomized controlled trials from the date of establishment to May 31,2023.ReviewManager 5.3 software was used to make studies quality bias.Network Meta-analysis was performed by R 4.0.5 and Stata 16 software.Results A total of 72 RCTs were included,with a total sample size of 7343 cases.Salvianolic Acids for Injection combined with chemical drugs(SAFI+CM),Danhong Injection combined with chemical drugs(DH+CM),Shuxuetong Injection combined with chemical drugs(SXT+CM),Ginkgo Diterpene Lactone Meglumine Injection combined with chemical drugs(YXETNZ+CM),Ginkgolide Injection combined with chemical drugs(YXNZ+CM)are five interventions.Network Meta-analysis showed that SAFI+CM,DH+CM,SXT+CM,YXETNZ+CM,YXNZ+CM could improve clinical efficiency,and the rank of cumulative probability was SXT+CM(89.36%)>SAFI+CM(87.25%)>DH+CM(54.14%)>YXNZ+CM(44.48%)>YXETNZ+CM(24.77%)>CM(0.00%).SAFI+CM,DH+CM,SXT+CM,YXETNZ+CM,YXNZ+CM could reduce NIHSS scores,and the rank of cumulative probability was DH+CM(89.63%)>SXT+CM(71.44%)>SAFI+CM(65.19%)>YXNZ+CM(50.41%)>YXETNZ+CM(23.21%)>CM(0.00%).SAFI+CM,DH+CM,SXT+CM,YXETNZ+CM,YXNZ+CM could improve BI index,and the rank of cumulative probability was YXETNZ+CM(81.33%)>SXT+CM(71.54%)>DH+CM(64.85%)>SAFI+CM(51.81%)>YXNZ+CM(30.44%)>CM(0.00%).A total of 40 studies reported adverse reactions,of which 19 studies reported no reactions.Others were no serious adverse reactions.The reported types of adverse reactions are all common types of adverse reactions.Meta-analysis results show that there is no statistically significant difference in the incidence of adver

关 键 词：中药注射液 注射用丹参多酚酸 丹红注射液 疏血通注射液 银杏二萜内酯葡胺注射液 银杏内酯注射液 急性缺血性脑卒中 网状Meta分析 

分 类 号：R286.1[医药卫生—中药学]