瓜蒌皮注射液治疗急性脑梗死的疗效和安全性Meta分析

Efficacy and Safety of Trichosanthes Cortex Injection in the Treatment of Cute Cerebral Infarction: A Systematic Review

目的:系统评价瓜蒌皮注射液治疗急性脑梗死的疗效及安全性,为其临床应用提供循证依据。方法:选取6项研究,共计1 734例。通过计算机检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方医药期刊数据库、Cochrane、Pub Med,收集瓜蒌皮注射液治疗急性脑梗死的随机对照试验(RCT),通过纳入及排除标准进行文献筛选并对纳入研究进行质量评价,使用Rev Man5.3软件包进行Meta分析。结果:观察组瓜蒌皮注射液在临床症状有效率、心电图有效率、血流动力学指标改善方面优于对照组舒血宁、依达拉奉。治疗急性脑梗的临床症状有效率比较OR=3.57,95%CI(2.81,4.54),P<0.00001,心电图有效率比较RD=0.28,95%CI(0.23,0.33),P<0.00001。血液流变学指标全血黏度高切情况比较MD=-1.86,95%CI(-2.24,-1.48),P<0.00001,血液流变学指标全血黏度低切情况比较MD=-2.46,95%CI(-3.20,-1.73),P<0.00001,且瓜蒌皮注射液不良反应较少,使用较安全。结论,瓜蒌皮注射液治疗急性脑梗死疗效确切,且安全性较高。

Objective： To systematically summarize the clinical application of Trichosanthes Cortex injection and evaluate the clinical effects in the treatment of cute cerebral infarction by using the Meta-analysis. Methods： Such databases as CBM,CNKI and wangfang database,Pub Med and Cochrane were electronically searched to collect relevant randomized controlled trials（ RCT）.According to the inclusion and exclusion criteria,two reviewers independently screened literature,extracted data,and assessed the methodological quality of included studies. Then,Meta-analysis was conducted using Rev Man 5. 3 software. Results： A total of 6 studies was included with 1734 cases. Meta-analysis revealed that Trichosanthes Cortex injection in the experimental group was better than Shuxuening and edaravone in the control group in clinical symptoms efficacy rate,ECG efficacy rate,and hemodynamics improvement. The clinical symptoms efficacy rate was compared in treating acute cerebral infarction（ OR = 3. 57,95% CI（ 2. 81,4. 54）,P 〈0. 00001）. And ECG efficacy rate was compared（ RD = 0. 28,95% CI（ 0. 23,0. 33）,P 〈0. 00001）. The whole blood viscosity at high shearwas of hemorheology was compared（ MD =-1. 86,95% CI（-2. 24,-1. 48）,P 〈0. 00001）.So were the efficacy rate of haemorheology on whole blood viscosity at low shear（ MD =-2. 46,95% CI（-3. 20,-1. 73）,P 〈0. 00001）. The Trichosanthes Cortex injection had few adverse reactions with safety. Conclusion： Trichosanthes Cortex injection is effective in the treatment of cute cerebral infarction with high safety. Due to low quality of included literatures,more RCTs with high quality are still needed for further verification.