三七总皂苷注射液治疗急性期脑出血的系统评价

A systemic evaluation of panax notoginseng injections in the treatment of acute cerebral hemorrhage

目的通过已发表文献系统评价三七总皂苷注射液治疗脑出血的有效性及安全性。方法搜集三七总皂苷治疗脑出血随机和半随机对照实验,筛选合格研究,进行质量评价和Meta-分析。结果有21个研究符合纳入标准。Meta-分析结果显示,与常规治疗对照组比较,病死率[Peto OR0.41,95%CI(0.19,0.90)],总有效率[RR 1.20,95%CI(1.14,1.26)],神经功能缺损评分[WMD-5.30,95%CI(-6.03,-4.58)],脑血肿体积[WMD-6.04,95%CI(-7.82,-4.27)],脑水肿体积[WMD-11.49,95%CI(-14.72,-8.26)],日常生活活动Barthel指数[WMD 11.55,95%CI(8.96,14.13)]均优于常规治疗组。敏感性分析显示Meta-分析结果稳定、可靠。结论三七总皂苷注射液治疗脑出血优于常规治疗,但缺乏远期生存质量的终点指标;不良反应情况报道较少。期待更多的大样本、高质量临床随机对照试验,以获得更可靠证据。

Objective To systemicly evaluate the effciency and safety of panax treatment of acute cerebral hemorrhage based on the publised literatures Methods notoginseng injections in the The randomized and semirandomized contol studies of panax notoginseng injections in the treatment of acute cerebral hemorrhage were enrolled in the quality evaluation and in the metaanalysis. Results sis. The metaanalysis results showed that compared to the There were 21 studies enrolling in the meta-analytraditional contrast group, the fataliy rate [Peto OR 0.41, 95 % CI （0.19, 0.90） ], the overall response rate [ （RR1.20, 95 % CI （ 1.14, 1.26） ], nerve function injuries scores [WMD - 5.30, 95 % CI （ - 6.03, - 4.58） ], and the cerebral hemorrhage volume [ WMD - 6.04, 95 % CI （ - 7.82, - 4.27） ], hydrocephalus volume [WMD - 11.49, 95 % CI （ - 14.72, - 8.26） ], and the Barthel indexes [WMD11.55, 95 % CI （8.96, 14.13）] in the panax notoginseng injections group were superior to those in the contrast group. The susceptibility test results indicated that the meta - analysis results were stability and dependence. Conclusion Panax notoginseng injections in the treatment of acute cerebral hemorrhage was superior to the conventional treatment. But lack of end - indexes of long - term survival quality, and less side - effects reports. We expected more evidence by big samples, high quality clinical randomized control trials.