丁苯酞治疗脑梗死后失语的有效性和安全性Meta分析  

Efficacy and safety of butylphthalide in the treatment of aphasia after cerebral infarction:a Meta⁃analysis

作　　者：胡一斌 张立娟[2] 张海旋 马屹峥 徐逸群 王康锋[3] HU Yi-bin;ZHANG Li-juan;ZHANG Hai-xuan;MA Yi-zheng;XU Yi-qun;WANG Kang-feng(First College of Clinical Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250199,China;Clinical Education Management Division,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China;Department of Neurology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China)

机构地区：[1]山东中医药大学第一临床医学院,济南250199 [2]山东中医药大学附属医院临床教育管理科,济南250011 [3]山东中医药大学附属医院神经内科,济南250011

出　　处：《中国新药杂志》2024年第17期1840-1851,共12页Chinese Journal of New Drugs

基　　金：山东省自然科学基金资助项目(ZR2022MH208);济南市科技发展计划资助项目(202019027,202134007);山东省中医药科技项目(2019-0107,2019-0094,Z-2022060,Z-2023020);山东省老年医学学会科技攻关项目(LKJGG2021Y041,LKJGG2021W116)。

摘　　要：目的:评价丁苯酞治疗脑梗死后失语的疗效及安全性。方法:检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库和PubMed,Web of Science,Embase,检索时限为各数据库建库起至2024年3月1日。筛选文献、提取数据,利用RevMan 5.4软件进行质量评价及Meta分析。结果:共纳入25项研究,涉及2248例患者。Meta分析结果显示,干预组的美国国立卫生院卒中量表评分(National Institute of Health Stroke Scale,NIHSS)评分低于对照组[均方差(mean difference,MD)=-3.77,95%置信区间(95%confidence interval,95%CI):(-4.39,-3.24),P<0.00001]、AQ评分高于对照组[MD=9.88,95%CI:(8.70,11.05),P<0.00001]、日常生活能力量表评分(Activity of Daily Living,ADL)高于对照组[MD=4.77,95%CI:(4.32,5.23),P<0.00001]、临床总有效率高于对照组[比值比(odds ratio,OR)=6.03,95%CI:(4.25,8.54),P<0.00001]、不良反应发生率无明显差异[相对危险度(risk ratio,RR)=0.87,95%CI:(0.45,1.67),P=0.68]。推荐分级的评估、制定与评价(grade of recommendations assessment,development and evaluation,GRADE)证据评价显示,证据质量普遍不高。结论:丁苯酞可用于治疗急性期及非急性期脑梗死后失语患者。Objective:To evaluate the efficacy and safety of butylphthalide in the treatment of aphasia after cerebral infarction.Methods:The databases such as CNKI,Wanfang database,VIP database,China biomedical literature database,PubMed,Web of Science,and Embase were searched from the establishment of each database to March 1,2024.The literature was screened,data were extracted,and Revman 5.4 software was used for quality evaluation and Meta⁃analysis.Results:A total of 25 studies involving 2248 patients were included.The results of Meta⁃analysis showed that the NIHSS score of the intervention group was lower than that of the control group[MD=-3.77,95%CI:(-4.39,-3.24),P<0.00001],the AQ score was higher than that of the control group[MD=9.88,95%CI:(8.70,11.05),P<0.00001],the ADL score was higher than that of the control group[MD=4.77,95%CI:(4.32,5.23),P<0.00001],the total clinical effective rate was higher than that of the control group[OR=6.03,95%CI:(4.25,8.54),P<0.00001],and the occurrence of adverse reactions there was no significant difference in the rate[RR=0.87,95%CI:(0.45,1.67),P=0.68].GRADE shows that the quality of evidence is generally not high.Conclusion:Butylphthalide can be used to treat aphasia patients after acute and non⁃acute cerebral infarction.

关 键 词：丁苯酞 脑梗死后失语 美国国立卫生院卒中量表评分 META分析 

分 类 号：R971[医药卫生—药品]