活血化瘀中药复方治疗急性脑梗死的系统评价

Systematic Analysis of Compound Traditional Chinese Medicine with Activating Blood on Acute Cerebral Infarction

目的评价活血化瘀中药复方治疗急性脑梗死(ACI)的疗效与安全性。方法检索从数据库建库至2012年2月活血化瘀中药复方治疗ACI的随机对照试验和半随机对照试验。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 Meta分析结果显示,在近期疗效上,活血化瘀中药复方改善ACI患者的神经功能缺损程度评分优于对照组,治愈率优势比(OR)为2.78,95%可信区间(CI)[1.79,4.32]。疗程28 d的5个研究合并分析显示,活血化瘀中药复方改善ACI患者的神经功能缺损程度评分优于对照组,OR为4.87,95%CI[3.02,7.86]。4个研究中,患者经治疗后活血化瘀中药复方组神经功能缺损程度评分低于对照组,加权均数差(WMD)为-4.56,95%CI[-6.52,-2.60]。1个研究中,患者治疗后活血化瘀中药复方组中医病类疗前积分与疗后积分低于对照组,WMD为-4.62,95%CI[-7.10,-2.14]。检索到1个文献评价活血化瘀中药复方用于ACI的经济学研究。结论活血化瘀中药复方在短期内可能有助于改善ACI的神经功能缺损,对远期依赖率和神经功能缺损的影响尚不清楚。活血化瘀中药复方在治疗ACI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 activat- ing blood on acute cerebral infarction. Methods：Literatures from the full text of databases including the random- ized and the semi-randomized controlled trials of compound traditional Chinese medicine with activating blood to resolve stasis for acute cerebral infarction were reviewed and analysed by the the RevMan 4.2.10 software. Re- suits：The meta-analysis showed that the improvement of the neurologic function deficits in the compound tradi- tional Chinese with activating blood was superior to that in the control therapies. The meta analysis from 7 trials indicated that the OR for the 14 day effect （improvement of the neurological deficit） was 2.78,and 95% CI was [ 1.79,4.323. The meta analysis from 5 trials showed that the OR for the 28 day effect （improvement of the neu- rological deficit ） was 4.87,and 95% CI was[3.02,7.86]. 4 trials outcomes were that stroke patients clinical neu- rological deficit scores with TCM therapy were less than those with control therapy. The weighted mean difference （WMD） of the scale was -4.56,and 95% CI was [-6.52,-2.60]. 1 trial outcome indicator was conversion rate of TCM points before treatment and after treatment. The weighted mean difference （WMD） of the scale was -4.62, and 95% CI was [-7.10,-2.14]. Only one trial elevated the economic index compound traditional Chinese medicine with activating blood to resolve stasis for acute cerebral infarction. Conclusion：Compound traditional Chinese medicine with activating blood to resolve stasis can improve the neurological deficit. The long-term sur- vival rate and the impact of neurological deficit are still not clear. The further high quality trials are needed.