摘要
目的:系统评价疏血通注射液联合阿替普酶(rt-PA)静脉溶栓对急性脑梗死病人临床总有效率、神经功能损伤、日常生活能力、血流变、炎性因子的影响。方法:计算机检索中国期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、the Cochrane Library、Web of Science数据库中疏血通注射液联合rt-PA静脉溶栓治疗急性脑梗死的临床随机对照试验(RCTs)研究,检索时限为建库至2022年10月。按照Cochrane系统评价手册进行偏倚风险评价,运用RevMan 5.4软件进行Meta分析。结果:最终纳入文献8篇。Meta分析结果显示,与对照组相比,疏血通注射液联合rt-PA静脉溶栓可明显提高脑梗死病人临床总有效率[OR=3.60,95%CI(2.12,6.10),P<0.00001],降低美国国立卫生研究院卒中量表评分[MD=-2.24,95%CI(-2.92,-1.55),P<0.00001],提高日常生活能力评分[MD=10.28,95%CI(9.94,10.62),P<0.00001],改善全血高切黏度[MD=-0.61,95%CI(-0.74,-0.48),P<0.00001]、全血低切黏度[MD=-1.84,95%CI(-2.06,-1.61),P<0.00001]、纤维蛋白原[MD=-0.72,95%CI(-1.40,-0.04),P=0.04],降低C反应蛋白[SMD=-0.67,95%CI(-0.99,-0.35),P<0.0001]、肿瘤坏死因子-α[SMD=-2.22,95%CI(-4.35,-0.09),P=0.04]水平。安全性方面,与对照组比较,试验组的安全性较高。结论:疏血通注射液联合rt-PA静脉溶栓可提高急性脑梗死的临床总有效率,改善病人神经功能缺损、日常生活能力、血流变及炎性因子指标。
Objective:To evaluate the effects of Shuxuetong injection combined with recombinant tissue plasminogen activator(rt-PA)intravenous thrombolysis on clinical total effective rate,neurological impairment,daily living ability,blood rheology and inflammatory factors in patients with acute cerebral infarction.Methods:The clinical randomized controlled trial(RCTs)of Shuxuetong injection combined with rt-PA intravenous thrombolysis for the treatment of acute cerebral infarction in Chinese Journal Full-text Database(CNKI),VIP database,Wanfang Database,Chinese Biomedical Literature Database(CBM),PubMed,the Cochrane Library,and Web of Science databases were searched.The search time was from self-built database to October 2022.Bias risk assessment was conducted according to Cochrane system assessment manual,and meta-analysis was conducted using RevMan 5.4 software.Results:Eight RCTs were included.Meta analysis showed that Shuxuetong injection combined with rt-PA intravenous thrombolysis could significantly improve the clinical total effective rate of patients with cerebral infarction compared with the control group(OR=3.60,95%CI 2.12-6.10,P<0.00001),reduce the score of National Institutes of Health Stroke Scale(MD=-2.24,95%CI-2.92--1.55,P<0.00001),improve the score of daily living ability(MD=10.28,95%CI 9.94-10.62,P<0.00001),improve whole blood high tangent viscosity(MD=-0.61,95%CI-0.74--0.48,P<0.00001),whole blood with low tangential viscosity(MD=-1.84,95%CI-2.06--1.61,P<0.00001)and fibrinogen(MD=-0.72,95%CI-1.40--0.04,P=0.04),reduce C-reactive protein(SMD=-0.67,95%CI-0.99--0.35,P<0.0001),tumor necrosis factor-α(SMD=-2.22,95%CI-4.35--0.09,P=0.04).In terms of safety,compared with the control group,the safety of experimental group was higher.Conclusion:Shuxuetong injection combined with rt-PA intravenous thrombolysis can improve the clinical total effective rate of acute cerebral infarction,improve nerve function deficit,daily living ability,blood rheology and inflammatory factors.
作者
张丽娜
谭逸海
丁薇
张根明
唐璐
ZHANG Lina;TAN Yihai;DING Wei;ZHANG Genming;TANG Lu(Eye Hospital,China Academy of C.M.S,Beijing 100040,China)
出处
《中西医结合心脑血管病杂志》
2024年第4期607-613,620,共8页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
疏血通注射液临床应用专家共识编制(No.HX-DZM-202209)。
关键词
急性脑梗死
疏血通注射液
阿替普酶
溶栓
META分析
acute cerebral infarction
Shuxuetong injection
recombinant tissue plasminogen activator
thrombolysis
meta-analysis
