脑苷肌肽佐治新生儿缺氧缺血性脑病的Meta分析

Meta-Analysis of Adjuvant Therapy of Cattle Encephalon Glycoside and Ignotin in Treatment of Neonatal Hypoxic-Ischemic Encephalopathy

目的评价基础治疗加用脑苷肌肽佐治新生儿缺氧缺血性脑病(HIE)的临床疗效和安全性。方法系统检索MEDLINE,EMBase,Cochrane Library,CBM,CNKI,VIP及万方数据库,纳入HIE患儿基础治疗加用脑苷肌肽对比单纯基础治疗的随机对照试验(RCT),对纳入研究进行质量评价,并对同质性研究进行Meta分析。结果共纳入11个RCT,Jadad评分均为3分。Meta分析显示,两组显效率差异有统计学意义[RR=1.81,95%CI(1.53,2.14)];新生儿行为神经评分(NBNA)得分差异有统计学意义[MD=4.30,95%CI(2.24,6.35)];意识障碍、惊厥停止、前囟张力、原始反射、肌张力恢复时间差异均有统计学意义[MD(95%CI)分别为-1.6(-2.15,-1.07),-1.21(-1.84,-0.59),-1.53(-2.07,-0.99),-2.27(-3.10,-1.43),-1.66(-2.42,-0.90)]。结论基于当前临床研究,HIE患儿在基础治疗上加用脑苷肌肽能增加疗效,安全性好。

Objective To evaluate the clinical effect and safety of the basic treatment plus the adjuvant therapy of cattle encephalon glycoside and ignotin in treating neonatal hypoxie-ischemic encephalopathy（ HIE）.Methods MEDLINE,EMBase,Cochrane Library, CBM,CNKI,VIP and Wanfang database were systematically retrieved for collecting the randomized controlled trials（ RCT） of the basic treatment plus the adjuvant therapy of encephalon glycoside and ignotin and simple basic treatment in treating neonatal HIE.The included studies were performed the quality evaluation and the meta-analysis on the homogeneity studies.Results A total of 11 RCTs were included,scoring 3 by the Jadad scoring method.The meta-analysis results indicated that the significantly effective rates had statistical difference between the two groups [ RR = 1.81,95% CI（1.53,2.14） ]; the neonatal behavioral neurological assessment（ NBNA） scores had statistical difference between the two groups [ MD = 4.30,95% CI（2.24,6.35） ]; the differences in the the recovery time of the consciousness disturbance,seizures stop,anterior fontanel tension,primitivie reflex and muscular tension between the study group and the control group had statistical significance,[ MD（ 95% CI） was-1.6（-2.15,-1.07）,-1.21（-1.84,-0.59）,-1.53（-2.07,-0.99）,-2.27（-3.10,-1.43） and-1.66（-2.42,-0.90） respectively ].Conclusion Based on the present clinical studies,adding cattle encephalon glycoside and ignotin on the basic treatment for treating neonatal HIE can increase the effect with good safety.