活血化瘀中药复方治疗急性脑出血病死率的系统评价

Systematic Evaluation of Activating Blood to Resolve Stasis for Acute Intracerebral Hemorrhage Mortality

目的评价活血化瘀中药复方治疗急性脑出血的疗效与安全性。方法检索从数据库建库至2009年2月活血化瘀中药复方治疗急性脑出血的随机对照试验。对纳入研究的方法学质量进行评价,并用RevMan软件进行统计分析。结果共纳入25个随机对照试验,均为中文,25个试验质量评分均为C级。绝大多数研究未对远期疗效进行评价。在治疗期间病死率方面,6个研究的Meta分析显示,活血化瘀中药复方组优于对照组。结论活血化瘀中药复方在短期内可能有助于降低急性脑出血的近期病死率,对远期生存率的影响尚不清楚。活血化瘀中药复方在急性脑出血的应用仍需要进行大规模、高质量、随访时间足够的随机对照研究提供证据。

Objective：To evaluate the efficacy and safety of compound Traditional Chinese Medicine with activating blood to resolve stasis for acute intracerebral hemorrhage.Methods：Literatures were reviewed from the full text of the CNKI database,Wanfang data base and full-text database of Chinese scientific and technical journals,Chinese Biomedical Literature Database,Core journals of T.C.M.regarding randomized controlled trials of compound T.C.M.with activating blood to resolve stasis for acute intracerebral hemorrhage.All searches were ended in 2009.Related literatures were selected and analyzed according to different treatment strategies of the trials.The methodological quality of the trials was assessed by the Jadad scale and evaluation was performed with software RevMan 4.2.10.Results：Twenty-five randomized controlled trials meting the inclusion criteria were selected and reviewed.All selected trials were in Chinese.All trials quality scale were C.Most trials were not assessed long-term effect.As compound T.C.M.with activating blood to resolve stasis group（compound T.C.M.with activating blood to resolve stasis plus basic therapy）was compared with the control group（basic therapy）,the meta analysis from six trials indicated that the compound T.C.M.with activating blood to resolve stasis group was superior remakably to that of the control group.Conclusion：Compound T.C.M.with activating blood to resolve stasis may reduce AICH short-term mortality.However,the long-term survival rate is still not clear.THE further high quality trials are needed.