摘要
目的采用网状Meta分析的方法比较不同灯盏花制剂治疗急性脑梗死的疗效。方法计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方全文数据库(Wanfang),以及PubMed、Embase、the Cochrane Library,查找与灯盏花制剂相关的系统评价,检索时限为建库至2019年2月,对合格系统评价中包含的随机对照试验(RCT)进行筛选、数据提取及偏倚风险评价,并采用Stata 13.0软件进行网状Meta分析。结果共纳入74项RCT,包括8803名患者,涉及12种干预措施。网状Meta分析结果显示,在治疗急性脑梗死的总有效率方面,当疗程小于15 d时,不同的灯盏花制剂之间无统计学差异(P>0.05);当疗程大于20 d时,灯盏花素注射液治疗疗效优于灯盏细辛注射液[RR=1.16,95%CI(1.02,1.33),P<0.05],其余不同的灯盏花制剂之间互相比较无统计学差异(P>0.05),累积排序曲线下面积(SUCRA)由高到低排序为灯盏花素注射液、灯盏生脉胶囊、灯盏细辛注射液。在神经功能缺损评分方面,灯盏生脉胶囊组的治疗前后的美国国立卫生研究院卒中量表(NIHSS)变化值大于灯盏细辛注射液组[MD=1.95,95%CI(0.31,1.60),P<0.05],其余不同的灯盏花制剂之间互相比较无统计学差异(P>0.05)。SUCRA由高到低排序为灯盏生脉胶囊、灯盏花素注射液、灯盏细辛注射液。灯盏生脉胶囊的不良事件较其他灯盏花制剂少。结论灯盏花制剂均可在一定程度上提高急性脑梗死患者的有效率及改善神经功能缺损,而不同制剂的优势与疗程长短、结局指标差异有关。综合平衡疗效与安全性,灯盏生脉胶囊对于急性脑梗死的优势最为明显。
Objective To compare the effectiveness of different Erigeron breviscapus preparations as an adjunct therapy for acute ischemic stroke using network meta-analysis.Methods Six databases were searched for relevant systematic reviews including CBM,CNKI,Wanfang,PubMed,Embase and the Cochrane Library from inception to Feb 2019.Randomized controlled trials(RCTs)meeting eligibility in published systematic reviews were identified.Two researchers independently conducted literature screening,data extraction and risk of bias assessment.Network meta-analysis of the data was performed by Stata 13.0.Results A total of 74 RCTs including 12 interventions and8803 patients were included in the analysis.Network meta-analysis suggested that,in terms of improving global effective rate,there is no statistically difference among Dengzhan Shengmai Capsule(DZSM),Breviscapine Injection(DZHS),and Dengzhan Xixin Injection(DZXX)when the therapeutic duration was less than 15 days(P>0.05).However,the total effective rate of DZHS was better than that of DZXX when the therapeutic duration was more than20 days[RR=1.16,95%CI(1.02,1.33),P<0.05];there was no statistically significant difference among other Erigeron breviscapus preparations(P>0.05).In terms of SUCRA,the effect sizes in descending order were DZHS,DZSM and DZXX.In terms of improving neurological deficit scores,the changes of NIHSS from baseline to treatment for DZSM was higher than that of DZXX based on the conventional therapy[MD=1.95,95%CI(0.31,1.60),P<0.05],and there was no statistical difference among other Dengzhan preparations(P>0.05).In terms of SUCRA,the effect size in descending order was as follows,DZSM,DZHS,and DZXX.DZSM had the least adverse events.Conclusion All Dengzhan preparations are effective in increasing the effective rate and improving the neurological deficit for acute ischemic stroke.The dominance of using Dengzhan preparation depends on the therapeutic duration and outcome of interest.However,balancing benefits and harms,DZSM capsule presents the greatest strengt
作者
廖映迪
倪小佳
葛龙
刘博
林嘉辉
张昌林
蔡业峰
LIAO Yingdi;NI Xiaojia;GE Long;LIU Bo;LIN Jiahui;ZHANG Changlin;CAI Yefeng(The Second Clinical School,Guangzhou University of Chinese Medicine,Guangzhou 510120 Guangdong,China;Guangdong Provincial Hospital of Chinese Medicine,Guangdong Provincial Academy of Chinese Medical Science,Guangzhou 510120 Guangdong,China;School of Public Health,Lanzhou University,Lanzliou 730000 Gansu,China)
出处
《中药新药与临床药理》
CAS
CSCD
北大核心
2021年第2期277-286,共10页
Traditional Chinese Drug Research and Clinical Pharmacology
基金
国家中医药管理局中医药循证能力建设项目(2019XZZX-NB002)
广州市临床医学研究与转化中心试点建设项目(201604020003)
广州中医药大学一流学科研究项目(XK2019025)
广东省中医院临床研究专项(1010专项)项目(YN10101901)。
关键词
灯盏花制剂
灯盏花素注射液
灯盏生脉胶囊
灯盏细辛注射液
急性脑梗死
疗效
安全性
网状Meta分析
Erigeron breviscapuspreparations
Breviscapine Injection
Dengzhan Shengmai Capsule
Dengzhan Xixin Injection
acute cerebral infarction
efficacy
safety
network meta-analysis
