注射用丹参多酚酸盐联合依达拉奉治疗急性脑梗死疗效及安全性的Meta分析

Efficacy and safety of salvianolate injection combined with edaravone in treatment of acute cerebral infarction: a meta-analysis

目的分析注射用丹参多酚酸盐联合依达拉奉治疗急性脑梗死的疗效及安全性。方法全面检索中国知网、维普、万方、PubMed、Cochrane library和Medline数据库建库至2020年4月的相关文献。基于PRISMA流程图对检索到的文献进行筛查,采用Cochrane风险偏倚评估工具对偏倚风险进行评估,采用RevMan 5.3软件对数据进行Meta分析,比较在常规治疗基础上联合注射用丹参多酚酸盐联合依达拉奉(试验组)与在常规治疗基础上联合注射用丹参多酚酸盐或依达拉奉(二者选一,对照组)的总有效率、美国国立卫生研究院卒中量表(NIHSS)评分变化、日常生活活动能力(ADL)评分变化、血液流变学指标及不良反应。结果共16篇文献纳入本次Meta分析。试验组治疗急性脑梗死的总有效率(OR=3.77,95%CI:2.82~5.04,P<0.01)、NIHSS评分(MD=-4.65,95%CI:-5.83~-3.47,P<0.01)、ADL评分(MD=17.18,95%CI:12.52~21.85,P<0.01)和血液流变学指标均优于对照组。两组患者不良反应比较差异无统计学意义(P>0.05)。结论注射用丹参多酚酸盐联合依达拉奉治疗能明显改善急性脑梗死的临床疗效,且安全性较好。

Objective To systemically evaluate the efficacy and safety of salvianolate injection combined with edaravone in the treatment of acute cerebral infarction.Methods Randomized controlled trials for efficacy and safety of salvianolate injection combined with edaravone(study group)in comparison of salvianolate injection or edaravone alone(control group)in the treatment of acute cerebral infarction were searched from CNKI,VIP,Wanfang,PubMed,Cochrane Library and Medline from incipient to April 2020.Based on the flow chart of PRISMA,the retrieved literature was screened and the risk of bias was assessed by Cochrane risk bias assessment tool,Revman 5.3 software was used for statistical analysis.The total e ffe ctive rate,NIHSS score,ADL score and hemorheological changes were compared between study group and control group.Results Sixteen articles were included for meta-analysis.The total effective rate(OR=3.77,95%CI:2.82-5.04,P<0.01),NIHSS score(HD=-4.65,95%CI:-5.83~-3.47,P<0.01),ADL score(MD=17.18,95%CI:12.52-21.85,P<0.01)and hemorheological changes in the study group were significantly better than those in the control group.Conclusion Salvianolate injection combined with edaravone can significantly improve the clinical e ffe ct of acute cerebral infarction sa fely.