脉络宁治疗缺血性脑血管病的临床疗效的Meta分析

Meta-analysis on clinical effects of Mailuoning in treatment of ischemic cerebrovascular disease

目的评价重要中文文献数据库的资料中脉络宁治疗缺血性脑血管病的临床疗效。方法计算机检索中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库、中国医用信息资源系统(维普)(截止至2009年6月)及其参考文献,筛选所有使用脉络宁治疗缺血性脑血管病的随机对照试验(RCT)。采用Jadad7分评分法评价纳入文献质量。采用RevMan4.2软件进行Meta分析。结果共检出符合标准的RCT文献共63篇,筛选出32项研究(治疗组1704例,对照组1655例)进行Meta分析。8篇为阴性对照,其中7篇符合急性期诊断标准(治疗组262例,对照组266例),合并效应值:OR=3.42,95%CI(1.97,5.93),P<0.00001;15篇为维脑路通(曲克芦丁)阳性对照(治疗组858例,对照组906例),效应值合并:OR=4.18,95%CI(2.89,6.05),P<0.00001;另有9篇丹参+低分子右旋糖酐阳性对照(治疗组522例,对照组447例)效应值合并:OR=4.85,95%CI(3.16,67.44),P<0.00001。脉络宁组与各对照组比较,两组之间差异有统计学意义。结论现有的临床资料显示,脉络宁可改善缺血性脑血管病患者神经功能缺损评分和预后。

Objective To assess the clinical curative effect of Mailuoning in treatment of ischemic cerebrovascular disease（ICVD）according to Chinese medical literatures.Methods We searched China National Knowledge Infrastructure（CNKI）,the China Biological Medicine Database,VIP Information（all till Jun.2009）for related randomized controlled trials（RTC）and the reference lists of the related articles.The research objects were limited within ICVD patients.The method of 7 scores was used to review the document quality.The Rev Man 4.2 software was used for statistical analysis.Results We identified 63 RTCs about treating ICVD by Mailuoning complying with the standard and selected 32 RCTs,which included 1704 cases in treatment group and 1655 cases in control group.Among them,7 papers including 262 cases in treatment group and 266 cases in control group were negative control OR=3.42,95%CI（1.97,5.93）,P0.00001.15 papers including 858 cases in treatment group and 906 cases in control group were venoruton（troxerutin）positive control OR=4.18,95%CI（2.89,6.05）,P0.00001.Another 9 papers including 522 cases in treatment group and 447 cases in control group were Danshen with low molecular dextran positive control.OR=4.85,95%CI（3.16,67.44）,P0.00001.Meta-analysis showed that the neurological deficits in treatment group showed significant difference compared with that in control group.Conclusion The Meta-analysis results from databases indicate that Mailuoning injection could provide effective improvements for neurological deficits and prognosis in ICVD.