活血化瘀类中药注射液辅助治疗急性缺血性卒中的网状Meta分析  

Network Meta-analysis of Chinese medicine injections for activating blood and resolving stasis in adjuvant treatment of acute ischemic stroke

作　　者：彭世雄 危聪 雷静颖 张腾[2] 丁砚兵 PENG Shi-xiong;WEI Cong;LEI Jing-ying;ZHANG Teng;DING Yan-bing(College of Clinical Chinese Medicine,Hubei University of Chinese Medicine,Wuhan 430061,China;Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 430060,China)

机构地区：[1]湖北中医药大学中医临床学院,湖北武汉430061 [2]湖北省中医院,湖北武汉430060

出　　处：《中国中药杂志》2023年第15期4215-4230,共16页China Journal of Chinese Materia Medica

基　　金：中医药脑病循证能力提升及平台建设项目(2019XZZX-NB003);国家中医药管理局“凃晋文名老中医药专家传承工作室”建设项目(国中医药人教函[2012]149号)。

摘　　要：运用网状Meta分析,对比活血化瘀类中药注射液联合西医常规治疗急性缺血性卒中(AIS)的疗效,以及对血小板聚集率、纤维蛋白原(FIB)、超敏C反应蛋白(hs-CRP)的影响,旨在为临床用药提供循证医学参考。检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Web of Science、Cochrane Library、EMbase等数据库,搜集丹参川芎嗪注射液、丹红注射液、疏血通注射液、血栓通注射液、舒血宁注射液、红花黄色素注射液、银杏二萜内酯葡胺注射液等联合西医常规治疗AIS的随机对照试验(RCT),检索时间均为建库至2023年3月18日,由2位研究者筛选提取文献并进行质量评价,采用R 4.2.2进行网状Meta分析。最终纳入87项RCTs,样本量8580例。网状Meta分析结果显示,在减少美国国立卫生研究院卒中量表(NIHSS)评分方面,累计概率排名曲线下面积(SUCRA)排序为血栓通注射液+西医常规(88.7%)>丹参川芎嗪注射液+西医常规(73.7%)>疏血通注射液+西医常规(69.7%)>舒血宁注射液+西医常规(51.8%)>丹红注射液+西医常规(43.7%)>红花黄色素注射液+西医常规(36.8%)>银杏二萜内酯葡胺注射液+西医常规(35.3%)>西医常规(1.7%);在提高了临床总有效率方面,SUCRA排序为丹红注射液+西医常规(63.0%)>舒血宁注射液+西医常规(59.0%)>丹参川芎嗪注射液+西医常规(58.9%)>红花黄色素注射液+西医常规(57.1%)>血栓通注射液+西医常规(56.8%)>舒血通注射液+西医常规(54.6%)>银杏二萜内酯葡胺注射液+西医常规(50.5%)>西医常规(0.03%);在提高Barthel指数方面,SUCRA排序为丹红注射液+西医常规(84.7%)>疏血通注射液+西医常规(72.4%)>红花黄色素注射液+西医常规(61.6%)>丹参川芎嗪注射液+西医常规(44.6%)>银杏二萜内酯葡胺注射液+西医常规(43.2%)>舒血宁注射液+西医常规(42.2%)>西医常规(1.4%);在降低血小板聚集率方面,SUCRA排序为丹参川芎Network Meta-analysis was employed to compare the efficacy of Chinese medicine injections for activating blood and resolving stasis combined with conventional western medicine in the treatment of acute ischemic stroke and the effects on platelet aggregation rate,fibrinogen(FIB),and hypersensitive C-reactive protein(hs-CRP),with a view to providing evidence-based medicine reference for clinical medication.CNKI,Wanfang,VIP,SinoMed,PubMed,Web of Science,Cochrane Library,and EMbase were searched for randomized controlled trial(RCT)on the treatment of acute ischemic stroke with Salvia Miltiorrhiza Ligustrazine Injection,Danhong Injection,Shuxuetong Injection,Xueshuantong Injection,Shuxuening Injection,Safflower Yellow Pigment Injection,and Ginkgo Diterpene Lactone Meglumine Injection combined with conventional western medicine.The retrieval time was from database inception to March 18,2023.The articles were extracted by two researchers and their quality was evaluated.R 4.2.2 was used for network Meta-analysis.A total of 87 RCTs involving 8580 patients were included.Network Meta-analysis showed that,in terms of reducing National Institutes of Health stroke scale(NIHSS)scores,the surface under the cumulative ranking curve(SUCRA)showed the order of Xueshuantong Injection+conventional western medicine(88.7%)>Salvia Miltiorrhiza Ligustrazine Injection+conventional western medicine(73.7%)>Shuxuetong Injection+conventional western medicine(69.7%)>Shuxuening Injection+conventional western medicine(51.8%)>Danhong Injection+conventional western medicine(43.7%)>Safflower Yellow Pigment Injection+conventional western medicine(36.8%)>Ginkgo Diterpene Lactone Meglumine Injection+conventional western medicine(35.3%)>conventional western medicine(1.7%).In terms of improving clinical total effective rate,SUCRA showed the order of Danhong Injection+conventional western medicine(63.0%)>Shuxuening Injection+conventional western medicine(59.0%)>Salvia Miltiorrhiza Ligustrazine Injection+conventional western medicine(58.9%)>Safflower Yello

关 键 词：活血化瘀 中药注射液 急性缺血性卒中 网状Meta分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]