小续命汤治疗急性脑梗死有效性及安全性的Meta分析

Clinical Efficacy and Safety of Modified Xiaoxuming Decoction in the Treatment of Acute Cerebral Infarction:a Meta-analysis

目的系统评价小续命汤加减治疗急性脑梗死的有效性与安全性。方法计算机检索MedLine、PubMed、中国知网、中国生物医学文献数据库、维普及万方数据库中小续命汤加减治疗急性脑梗死的随机对照试验,且辅以手工检索相关核心期刊,并追踪纳入研究的参考文献。检索时间为建库至2020年2月1日,根据纳入与排除标准由两位研究者独立筛选文献、提取资料并评估文献质量。采用RevMan 5.3软件进行Meta分析。结果共纳入17项研究,涉及1327例病人。Meta分析结果显示:与西医常规治疗措施比较,小续命汤加减治疗能有效改善急性脑梗死病人临床总有效率[OR=2.74,95%CI(1.86,4.05),Z=5.06,P<0.00001],美国国立卫生研究院卒中量表(NIHSS)评分[MD=-2.16,95%CI(-2.90,-1.42),Z=5.70,P<0.00001]、Barthel指数评分[MD=7.74,95%CI(6.38,9.09),Z=11.15,P<0.00001]及神经功能缺损评分[MD=-1.91,95%CI(-3.41,-0.40),Z=2.48,P=0.01]。结论现有证据表明:小续命汤加减治疗急性脑梗死临床疗效优于单纯应用西药治疗。

Objective To systematically evaluate the clinical efficacy and safety of modified Xiaoxuming Decoction in the treatment of acute cerebral infarction.Methods Randomized controlled trials in the treatment of chronic heart failure with modified Xiaoxuming Decoction were searched from MedLine,PubMed,China Journal Full-Text Database(CNKI),Chinese Biomedical Literature(CBM),Chinese science and technology periodical database(VIP),and Wanfang database.Manual retrieval of relevant core journals was supplemented,and indepth study of references related to this thesis were tracked from establishment to February 1,2020.Two researchers independently screened the literatures,extracted the data and evaluated the quality of literatures according to the inclusion criteria and exclusion criteria.RevMan 5.3 software was used for Meta-analysis.Results A total of 17 literatures were included,involving 1327 patients.The results of Meta-analysis showed that compared with the conventional treatment of western medicine,modified Xiaoxuming decoction could effectively improve the clinical efficacy of patients with acute cerebral infarction[OR=2.74,95%CI(1.86,4.05),Z=5.06,P<0.00001],National Institute of Health Stroke Scale(NIHSS)score[MD=-2.16,95%CI(-2.90,-1.42),Z=5.70,P<0.00001],Barthel score[MD=7.74,95%CI(6.38,9.09),Z=11.15,P<0.00001]and Neurological Deficit Score[MD=-1.91,95%CI(-3.41,-0.40),Z=2.48,P=0.01].Conclusion Current evidence showed that the clinical efficacy of modified Xiaoxuming Decoction for the treatment of acute cerebral infarction was better than that of western medicine.