摘要
目的系统评价依达拉奉联合血栓通治疗急性脑梗死的临床疗效及其安全性。方法检索中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方知识服务平台、中国生物医学文献数据库(CBM)及Pub Med,检索时间从各数据库建库开始至2014年3月发表的依达拉奉联合血栓通治疗急性脑梗死的随机和半随机对照试验(RCT),按Cochrane手册对随机对照试验的质量标准评分对所纳入文献进行质量评价,用Rev Man 5.1软件进行Meta分析。结果最终纳入24个临床研究,共2 204例患者。所纳入研究仅有一个为中等质量文献,16个研究描述了不良反应情况。Meta结果显示,依达拉奉联合血栓通更能提高急性脑梗死患者的总有效率、痊愈率、日常生活能力及改善神经功能,且差异有统计学意义,分别为[OR=4.03,95%CI(3.09,5.25)];[OR=2.07,95%CI(1.68,2.55)];[OR=8.48,95%CI(6.292,10.68)];[OR=6.46,95%CI(4.82,8.10)];[OR=5.03,95%CI(3.67,6.38)];[OR=9.79,95%CI(6.69,12.89)],但在血高敏C反应蛋白(hs-CRP)方面差异无统计学意义[OR=23.00,95%CI(-18.41,64.40)],尚不能表明其可以改善脑梗死患者血hs-CRP。结论目前的研究证据支持依达拉奉联合血栓通更能提高急性脑梗死患者的总有效率、痊愈率及改善神经功能、日常生活能力,其安全性较好,无明显的不良反应,但由于纳入研究的局限性,上述结论仍待更多大规模,高质量的研究加以证明。
Objective To assess the clinical efficacy and safety of edaravone and Xueshuantong in treatment of acute cerebral infarction by conducting a meta-analysis of randomized or quasi controlled trails. Methods The CNKI,Wan Fang Database,VIP and CBM and Pub Med were searched to collect clinical trails of edaravone and Xueshuantong in treatment of acute cerebral infarction that were published from the beginning the databases to January 2014,then assessed the methodological quality with the method in the Cochrane handbook and then made a Meta analysis with the Review Manage 5. 1 software. Results Our study adopted 24 studies,2 204 participants were included in total. Only one of the included studies had moderate quality,and 16 studies described side effect. This meta-analysis showed that edaravone and Xueshuantong can improve the total effective rate,curative rate,neurological function and activities of daily living of the acute cerebral infarction with statistical significance respectively[OR = 4. 03,95% CI（ 3. 09,5. 25） ],[OR = 2. 07,95% CI（ 1. 68,2. 55） ],[OR = 8. 48,95% CI（ 6. 292,10. 68） ],[OR =6. 46,95% CI（ 4. 82,8. 10） ],[OR = 5. 03,95% CI（ 3. 67,6. 38） ],[OR = 9. 79,95% CI（ 6. 69,12.89） ]. However,there was not statistical significance on the improving of high-sensitivity C-reactive protein（ hs-CRP） [OR = 23. 00,95%CI（- 18. 41,64. 40） ]. Conclusion The current evidences show that edaravone combined Xueshuantong is more effective on the total effective rate,curative rate,neurological function and activities of daily living with safety. However,more high quality studies with large-scales and long term follow-up are still needed to verify the above conclusion in the future studies because of the limitations of the included studies.
出处
《中西医结合心脑血管病杂志》
2015年第14期1598-1604,共7页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
