健脾类治法治疗缺血性中风的Meta分析

Meta-Analysis of Spleen-Invigorating Therapy for Ischemic Stroke

目的系统评价健脾类治法治疗缺血性中风的临床疗效和功能恢复效果。方法通过检索中外文数据库,获得所有健脾相关治法为主要治法治疗缺血性中风的临床随机对照试验。采用Rev Man5.2软件进行整理和Meta分析。结果共纳入12个随机对照试验研究,979例受试者。Meta分析结果显示:健脾类治法治疗缺血性中风临床疗效比单用西药治疗效果明显(CSS评分)[RR=1.22,95%CI(1.09,1.37),P<0.01];患者神经功能缺损程度有所改善[MD=-2.83,95%CI(-4.20,-1.46),P<0.001](NIHSS评分),[MD=-4.17,95%CI(-5.35,-3.00),P<0.001](CSS评分);ADL-Barthel指数的积分明显改善[MD=9.39,95%CI(6.50,12.29),P<0.001]。结论相较于常规治疗,健脾类治法能有效提高临床疗效,有利于恢复中风所造成的神经功能缺损,改善患者日常生活活动能力。但由于研究方法学及文献报告质量的限制,仍需进一步开展设计严格的临床试验进行验证。

OBJECTIVE To systematically evaluate the clinical efficacy and functional recovery effects of spleen-invigorating therapy in the treatment of ischemic stroke.METHODS Domestic and foreign databases were searched to obtain clinical randomized controlled trials of invigorating spleen-related therapies to treat ischemic stroke.The Rev Man5.2 software was used for Meta-analysis.RESULTS 12 randomized controlled trials with 979 patients were enrolled.Meta-analysis showed that the clinical efficacy of the spleen-invigorating therapy for ischemic stroke was significantly greater than that of Western medicine alone(CSS score)[RR=1.22,95%CI(1.09,1.37),P<0.01].Patients'neurological deficits was improved[MD=-2.83,95%CI(-4.20-1.46),P<0.001](NIHSS score),[MD=-4.17,95%CI(-5.35-3.00),P<0.001](CSS score).The ADL-Barthel index score was notably ameliorated[MD=9.39,95%CI(6.50,12.29),P<0.001].COCLUSION Compared with conventional treatment,spleen-invigorating treatment can effectively improve clinical efficacy,recover neurological deficits caused by stroke,and improve patients'daily activities.However,due to the limitations of the research methodology and literature quality,this study still needs to be validated by more strictly designed clinical trials.