醒脑静注射液联合依达拉奉注射液治疗急性脑出血的有效性的Meta分析  

Meta-Analysis on Efficacy of Xingnaojing Injection Combined with Edaravone Injection in the Treatment of Acute Cerebral Hemorrhage

作　　者：陈文博 陈锐 唐妍妍 刘金响 吴涛 马小兵[5] CHEN Wenbo;CHEN Rui;TANG Yanyan;LIU Jinxiang;WU Tao;MA Xiaobing(Dept.of Encephalopathy,Ankang Hospital of Traditional Chinese Medicine,Shaanxi Ankang 725700,China;Dept.of Acupuncture Rehabilitation Center,Ankang Hospital of Traditional Chinese Medicine,Shaanxi Ankang 725700,China;Dept.of Neurocritical Medicine,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712046,China;Medical Research Experimental Center,Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712046,China;the Second Dept.of Gastroenterology,the Second Affiliated Hospital of Shaanxi University of Chinese Medicine,Shaanxi Xianyang 712046,China)

机构地区：[1]安康市中医医院脑病科,陕西安康725700 [2]安康市中医医院针灸康复中心,陕西安康725700 [3]陕西中医药大学第二附属医院神经重症医学科,陕西咸阳712046 [4]陕西中医药大学医学科研实验中心,陕西咸阳712046 [5]陕西中医药大学第二附属医院消化二科,陕西咸阳712046

出　　处：《中国医院用药评价与分析》2025年第1期76-80,84,共6页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金资助项目(No.81904310)。

摘　　要：目的:系统评价醒脑静注射液联合依达拉奉注射液治疗急性脑出血的临床有效性。方法:检索中国知网、维普数据库、万方数据库、PubMed、Web of Science、CENTRAL、MEDLINE和Embase等文献数据库,收集关于醒脑静注射液治疗急性脑出血的随机对照试验(研究组患者在西医常规治疗基础上使用醒脑静注射液联合依达拉奉注射液,对照组患者使用西医常规治疗或西医常规治疗联合依达拉奉注射液),检索时间为建库2024年7月5日。按照纳入与排除标准,由2名研究者独立进行文献筛选、资料提取和方法学质量评价后,采用RevMan 5.3软件进行Meta分析。结果:纳入20篇文献,共2043例患者。Meta分析结果显示,研究组患者的总有效率(RR=1.21,95%CI=1.16~1.26,P<0.00001)、格拉斯哥昏迷评分(MD=2.83,95%CI=2.23~3.43,P<0.00001)高于对照组,美国国立卫生研究院脑卒中量表评分(MD=-4.43,95%CI=-5.24~-3.63,P<0.00001)、神经元特异性烯醇化酶水平(MD=-4.38,95%CI=-6.73~-2.03,P=0.0003)、白细胞介素6水平(SMD=-3.27,95%CI=-4.30~-2.25,P<0.00001)、肿瘤坏死因子α水平(SMD=-2.84,95%CI=-3.83~-1.85,P<0.00001)、白细胞介素1β水平(SMD=-1.86,95%CI=-2.28~-1.43,P<0.00001)低于对照组,血肿体积小于对照组(MD=-2.77,95%CI=-4.91~-0.64,P=0.01),上述差异均有统计学意义。结论:在西医常规治疗基础上,采用醒脑静注射液联合依达拉奉注射液治疗急性脑出血具有显著疗效,可以提高总有效率,明显减轻患者的脑神经功能损伤和炎症状态。但由于目前的临床研究质量参差不齐,尚需严格的随机、双盲对照研究进行证实。OBJECTIVE:To systematically review the clinical efficacy of Xingnaojing injection combined with edaravone injection in the treatment of acute cerebral hemorrhage.METHODS:Randomized controlled trials on Xingnaojing injection for the treatment of acute cerebral hemorrhage(the research group was given conventional treatment of Western medicine based on Xingnaojing injection combined with edaravone injection,the control group received conventional treatment of Western medicine alone or in combination with edaravone injection)were collected by retrieving databases including CNKI,VIP,Wanfang Data,PubMed,Web of Science,CENTRAL,MEDLINE and Embase,the retrieval time was from the establishment of the database to Jul.5th,2024.According to the inclusion and exclusion criteria,literature screening,data extraction and methodological quality assessment were performed by two researchers independently,and RevMan 5.3 software was adopted to conduct Meta-analysis.RESULTS:A total of 20 studies were enrolled,including 2043 patients.Meta-analysis indicated that the total effective rate(RR=1.21,95%CI=1.16-1.26,P<0.00001)and the Glasgow coma score(MD=2.83,95%CI=2.23-3.43,P<0.00001)in the research group were higher than those in the control group,the National Institutes of Health Stroke Scale score(MD=-4.43,95%CI=-5.24--3.63,P<0.00001),neuron-specific enolase level(MD=-4.38,95%CI=-6.73--2.03,P=0.0003),interleukin-6 level(SMD=-3.27,95%CI=-4.30--2.25,P<0.00001),tumor necrosis factorαlevel(SMD=-2.84,95%CI=-3.83--1.85,P<0.00001)and interleukin-1βlevel(SMD=-1.86,95%CI=-2.28--1.43,P<0.00001)in the research group were lower than those in the control group,the volume of hematoma of the research group was smaller than that of the control group(MD=-2.77,95%CI=-4.91--0.64,P=0.01),the differences were statistically significant.CONCLUSIONS:On the basis of conventional treatment of Western medicine,the combination of Xingnaojing injection and edaravone injection has significant efficacy in the treatment of acute cerebral hemorrhage,which can improve

关 键 词：醒脑静注射液 依达拉奉注射液 急性脑出血 META分析 

分 类 号：R932[医药卫生—生药学]