疏血通注射液治疗急性缺血性脑卒中的有效性和安全性系统评价  

Efficacy and safety of Shuxuetong Injection in treatment of acute ischemic stroke:a systematic review

作　　者：李强[1] 李博[1,2,3] 王宏 王彦博[4] 王天园 Li Qiang;Li Bo;Wang Hong;Wang Yanbo;Wang Tianyuan(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010,China;不详)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]北京市中医药研究所,北京100010 [3]北京中医药循证医学中心,北京100010 [4]武警北京总队医院,北京100027

出　　处：《中国循证心血管医学杂志》2023年第12期1287-1294,共8页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：国家自然科学基金资助项目(81774146)。

摘　　要：目的对疏血通注射液治疗急性缺血性脑卒中的有效性与安全性进行系统评价。方法计算机检索PubMed、Cochrane Library、EMbase、中国知网(CNKI)、万方医学数据库、维普(VIP)数据库、中国生物医学文献数据库(SinoMed)等数据库,检索时间均从建库至2022年1月28日。检索收集关于疏血通注射液的随机对照试验。采用Cochrane风险偏倚评估工具,对纳入研究进行质量评价。结果检索疏血通注射液治疗急性缺血性脑卒中相关文献命中共1288篇,纳入31个RCT试验,共2781例患者,纳入研究的质量较低。与常规基础治疗相比,疏血通注射液联合常规治疗在临床总有效率、改善NHISS评分、改善血液流变学指标方面具有一定优势。且本次研究纳入的文献中,未报道不良反应情况发生。Meta分析结果显示:①NHISS评分:疏血通注射液联合常规基础治疗和常规基础治疗对患者NHISS评分具有统计学意义(MD=-3.71,95%CI:-4.42~-2.99,P<0.01)。②血液流变学指标全血黏度/血浆黏度/纤维蛋白原:疏血通注射液联合常规基础治疗和常规基础治疗对降低患者全血黏度(MD=-1.49,95%CI:-2.06~-0.92,P<0.01),血浆黏度(SMD=-1.11,95%CI:-1.44~-0.78,P<0.01),纤维蛋白原的作用(MD=-0.61,95%CI:-1.02~-0.20,P<0.01)具有统计学意义。③超敏C反应蛋白(hs-CRP):疏血通注射液联合常规基础治疗和常规基础治疗对降低患者hs-CRP具有统计学意义(SMD=-1.35,95%CI:-1.85~-0.84,P<0.01)。④肿瘤坏死因子α(TNF-α):疏血通注射液联合常规基础治疗和常规基础治疗对降低患者TNF-α具有统计学意义(SMD=-1.07,95%CI:-1.33~-0.82,P<0.01)。⑤临床症状总有效率:疏血通注射液联合常规基础治疗和常规基础治疗的临床有效率具有统计学意义(RR=1.15,95%CI:1.12~1.19,P<0.01)。结论疏血通注射液联合常规基础治疗对缺血性脑卒中的临床疗效可能优于常规基础治疗,可能改善患者NHISS评分,并改善患者血液流变学Objective To systematically review the efficacy and safety of Shuxuetong Injection in treatment of acute ischemic stroke(AIS).Methods The databases of PubMed,Cochrane Library,Embase,CNKI,WanFang Data,VIP and SinoMed were retrieved with computer.The retrieving time was from database establishment time to Jan.28,2022.The randomized controlled trials(RCT)related to Shuxuetong Injection were collected.The quality of included studies was reviewed by using Cochrane risk bias assessment tool.Results There were totally 1288 documents related to AIS retrieved,including 31 RCT and 2781 patients.The quality of included studies was lower.Compared with routine basic therapy,Shuxuetong Injectionv combined with routine therapy had some advantages in total clinical efficacy and improvements of NHISS score and hemorheology indexes.There were no adverse reactions reported in the included studies.The results of Meta-analysis showed that:①NHISS score:there was a statistical significance in NHISS score(MD=-3.71,95%CI:-4.42~-2.99,P<0.01)between Shuxuetong Injectionv combined with routine therapy and routine basic therapy.②Hemorheologic indexes[whole blood viscosity(WBV),plasma viscosity,fibrinogen(FIB)]:there was a statistical significance statistical significance in decreasing WBV(MD=-1.49,95%CI:-2.06~-0.92,P<0.01),plasma viscosity(SMD=-1.11,95%CI:-1.44~-0.78,P<0.01)and FIB(MD=-0.61,95%CI:-1.02~-0.20,P<0.01)between Shuxuetong Injectionv combined with routine therapy and routine basic therapy.③High sensitivity C-reactive protein(hs-CRP):there was a statistical significance statistical significance in decreasing hs-CRP(SMD=-1.35,95%CI:-1.85~-0.84,P<0.01)between Shuxuetong Injectionv combined with routine therapy and routine basic therapy.④Tumor necrosis factor-α(TNF-α):there was a statistical significance statistical significance in decreasing TNF-α(SMD=-1.07,95%CI:-1.33~-0.82,P<0.01)between Shuxuetong Injectionv combined with routine therapy and routine basic therapy.⑤The total clinical efficacy:there was a statistical si

关 键 词：疏血通注射液 急性缺血性脑卒中 有效性 安全性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]