纤溶酶联合血栓通注射液治疗急性缺血性脑卒中疗效和安全性的Meta分析

Therapeutic Efficacy and Safety of Fibrinolytic Combined with Xueshuantong Injection in the Treatment of Acute Ischemic Stroke:A Meta-analysis

目的:系统评价纤溶酶联合血栓通注射液治疗急性缺血性脑卒中的疗效和安全性,为临床提供循证参考。方法:计算机检索中国期刊全文数据库、万方数据库、Science Direct、ELSEVIER,收集纤溶酶联合血栓通注射液(试验组)对比纤溶酶单用(对照组)治疗急性缺血性脑卒中的随机对照试验(RCT),提取资料并采用改良的Jadad量表评价质量后,采用Rev Man 5.2和Stata 12.0统计软件进行Meta分析。结果:最终纳入14项RCT,合计1 342例患者。Meta分析结果显示,试验组患者总有效率[RR=1.24,95%CI(1.18,1.31),P<0.001]、痊愈率[RR=1.59,95%CI(1.23,2.06),P<0.001]和显效率[RR=1.41,95%CI(1.24,1.60),P<0.001]均显著高于对照组,差异均有统计学意义。两组患者有效率[RR=0.93,95%CI(0.79,1.10),P=0.40]和不良反应发生率[RR=0.63,95%CI(0.17,2.36),P=0.49]比较,差异均无统计学意义。结论:纤溶酶联合血栓通注射液治疗急性缺血性脑卒中疗效和安全性均较好。

OBJECTIVE： To systematically evaluate the therapeutic efficacy and safety of fibrinolytic combined Xueshuantong injection in the treatment of acute ischemic stroke, and to provide evidence-based reference. METHODS： Retrieved from CJFD, Wanfang database, ScienceDirect and ELSEVIER, RCTs about fibrinolytic combined Xueshuantong injection （trial group） vs. fibri- nolytic alone （control group） in the treatment of acute ischemic stroke were collected. After data extraction and quality evaluation according to modified Jadad evaluation, Meta-analysis was conducted by using Rev Man 5.2 and Stata 12.0 statistical software. RE- SULTS： A total of 14 RCTs were included, involving 1 342 patients. The results of Meta-analysis showed that, total response rate [RR= 1.24,95 % CI （ 1.18, 1.31 ）, P〈 0.001], cure rate [RR= 1.59,95 % CI （ 1.23,2.06）, P〈 0.001] and efficiency rate [RR=- 1.41,95 % CI （ 1.24, 1.60）, P〈 0.001 ] of trial group were significantly higher than those of control group. There was no significant difference in the response rate [RR=-0.93,95%CI（0.79,1.10） ,P=-0.40] and the incidence of ADR [RR=-0.63,95%CI（0.17,2.36）, P=0.49] between 2 groups. CONCLUSIONS： Fibrinolytic combined Xueshuantong injection shows good therapeutic efficacy and safety for acute ischemic stroke.