醒脑静注射液辅助治疗结核性脑膜炎临床疗效的系统评价

Systematic Review on Clinical Efficacy of Xingnaojing Injection in the Adjuvant Treatment of Tuberculous Meningitis

目的:系统评价醒脑静注射液辅助常规抗结核疗法治疗结核性脑膜炎的临床疗效.方法:检索中国知网、万方数据库、PubMed、中国生物医学文献数据库和维普中文科技期刊全文数据库,收集醒脑静注射液辅助常规抗结核疗法治疗结核性脑膜炎的临床随机对照试验(对照组患者采用常规抗结核疗法治疗,观察组患者采用醒脑静注射液联合常规抗结核疗法治疗),筛选出符合纳入标准的文献,进行基线信息提取与质量评估后,采用RevMan 5.3软件进行文献荟萃分析(Meta分析).结果:共纳入11篇文献,涉及781例患者.Meta分析结果显示,与常规抗结核疗法比较,醒脑静注射液辅助常规抗结核疗法治疗结核性脑膜炎可显著提高临床总有效率(OR=4.19,95%CI=2.74~6.39,P<0.00001),显著改善患者脑脊液中蛋白质(MD=-0.82,95%CI=-0.91^-0.74,P<0.00001)及氯化物(MD=-8.98,95%CI=4.71~13.25,P<0.0001)水平,显著缩短患者意识障碍恢复时间(MD=-1.70,95%CI=-2.12^-1.27,P<0.00001)及住院时间(MD=-7.97,95%CI=-10.06^-5.87,P<0.00001),差异均有统计学意义.结论:醒脑静注射液辅助常规抗结核疗法治疗结核性脑膜炎的临床疗效明显优于单独应用常规抗结核疗法,该联合用药的治疗方案值得推广应用.

OBJECTIVE:To systematically evaluate the clinical efficacy of Xingnaojing injection combined with conventional antituberculosis therapy in the adjuvant treatment of tuberculous meningitis.METHODS:CNKI,Wanfang database,PubMed,CBM and VIP database was retrieved to collect the randomized controlled trials of Xingnaojing injection combined with conventional antituberculosis therapy in the adjuvant treatment of tuberculous meningitis(the control group was treated with conventional antituberculosis therapy,while the observation group received Xingnaojing injection combined with conventional antituberculosis therapy).The literature that met the inclusion criteria were screened.Baseline information extraction and quality assessment were performed on the included literature,and the data of the study were statistically analyzed by using RevMan 5.3 software.RESULTS:Totally 11 literature were collected,including 781 patients.Compared with conventional antituberculosis therapy,Xingnaojing injection combined with conventional antituberculosis therapy for tuberculous meningitis can significantly improve the total clinical effective rate(OR=4.19,95%CI=2.74-6.39,P<0.00001),increase the levels of protein(MD=-0.82,95%CI=-0.91--0.74,P<0.00001)and chloride(MD=-8.98,95%CI=4.71-13.25,P<0.0001)in cerebrospinal fluid,shorten the recovery time of disturbance of consciousness(MD=-1.70,95%CI=-2.12--1.27,P<0.00001)and hospitalization time(MD=-7.97,95%CI=-10.06--5.87,P<0.00001),the differences were statistically significant.CONCLUSIONS:The clinical efficacy of Xingnaojing injection combined with conventional antituberculosis therapy in the adjuvant treatment of tuberculous meningitis is significantly better than conventional antituberculosis therapy.The combination therapy is worthy of popularization and application.