谷红注射液治疗急性脑梗死的临床疗效及对血液流变学影响的Meta分析

Effect and Hemorheology of Guhong Injection in the Treatment of Acute Cerebral Infarction:a Meta-analysis

目的系统评价谷红注射液治疗急性脑梗死(ACI)的临床效果及对血液流变学的影响。方法检索万方数据库、中国知网(CNKI)、中文科技期刊全文数据库(VIP)、PubMed、Web of Science Core Collection及Cochrane Library等数据库,收集关于谷红注射液治疗ACI的随机对照试验(RCTs)。检索时间为各数据库建库至2019年10月28日。由两名研究者独立完成文献筛选、数据提取、偏倚风险和质量评估。采用Review Manager 5.3软件对纳入文献的数据进行Meta分析。结果共纳入文献12篇,入选病人1403例,谷红注射液组711例,对照组692例。纳入研究的对照组病人均给予常规治疗,包括抗血小板聚集、降颅脑压、改善脑代谢、控制血糖及调节血脂等治疗;谷红注射液组在常规治疗的基础上联合应用谷红注射液治疗。使用美国国立卫生研究院卒中量表(NIHSS)评分评价疗效,Meta分析结果显示:谷红注射液组临床疗效优于对照组[MD=-4.14,95%CI(-5.63,-2.65),P<0.00001];谷红注射液组血液流变学指标全血高切比黏度[MD=-0.96,95%CI(-1.27,-0.65),P<0.00001]、血细胞比容或红细胞比容[MD=-4.19,95%Cl(-6.62,-1.76),P<0.00001]改善优于对照组。结论现有证据表明,谷红注射液治疗ACI的临床效果优于对照组,并可改善血液流变学指标。但由于纳入研究文献的质量不高,影响了结论的可靠性。需要大样本、多中心、高质量的前瞻性RCTs来验证谷红注射液治疗ACI的确切临床效果。

Objective To evaluate the clinical effect and hemorheology of Guhong injection in the treatment acute cerebral infarction.Methods China Journal Full-Text Database(CNKI),Chinese science and technology periodical database(VIP),Wanfang database,PubMed,Web of Science Core Collection and Cochrane Library were searched by computer,to collect randomized controlled trials(RCTs)of Guhong injection in the treatment acute cerebral infarction from the date of the establishment of each database to October 28,2019.The literatures were independently screened by two investigators for date extraction,risk of bias and quality assessment.The included literatures were analyzed by Review Manager 5.3.Results Twelve literatures were included,including 1403 patients,and there were 711 cases in Guhong injection group and 692 cases in control group.National Institutes of Health Stroke Scale(NIHSS)score was ased to evaluated the efficacy of the patient.The results of Meta-analysis showed that the clinical efficacy of Guhong injection group in the treatment of acute cerebral infarction was better than that of control group[MD=-4.14,95%Cl(-5.63,-2.65),P<0.00001],the hemorheologic indexes of Guhong injection group were improved,whole blood high shear viscosity[MD=0.96,95%Cl(-1.27,-0.65),P<0.00001],haematocrit and hematocrit value[MD=-4.19,95%Cl(-6.62,-1.76),P<0.00001]were better in the treatment group.Conclusion Current evidences sows,Guhong injection in the treatment of acute cerebral infarction showed good clinical efficacy and the indexes of hemorheology were improved.However,the quality of literatures in the study was not high,the reliability of Conclusions would be affected.The Conclusions of the study still needed to be verified by large-sample,multi-center,high-quality RCTs.