三七总皂苷治疗急性脑梗死的系统评价再评价

Overview of systematic reviews of Panax notoginseng saponins in treatment of acute cerebral infarction

研究旨在对三七总皂苷治疗急性脑梗死的系统评价进行再评价。计算机检索CNKI、CBM、Wanfang、VIP、PubMed、Cochrane Library和EMbase数据库,收集三七总皂苷治疗急性脑梗死的系统评价,检索时限均为建库至2021年1月。由2名研究者独立筛选文献、提取资料后,采用AMSTAR-2量表评价纳入系统评价的方法学质量,使用GRADE系统对结局指标进行证据质量分级,并进行疗效评价汇总。共纳入5个系统评价,AMSTAR-2评价结果显示,3个条目报告较为完整,4个条目报告较差,总体质量不高。三七总皂苷联用西药基础治疗在恢复神经功能、提高临床总有效率、改善日常生活能力等方面多优于单用西药基础治疗,GRADE评价结果显示证据质量为低质量到极低质量。三七总皂苷治疗急性脑梗死可提高临床疗效,且安全性较好,但所纳入文献整体方法学质量不高,证据体质量普遍偏低,建议进一步开展高质量临床研究,为三七总皂苷在急性脑梗死治疗中的应用提供循证依据。

To overview the systematic reviews of Panax notoginseng saponins in the treatment of acute cerebral infarction.CNKI,CBM,Wanfang,VIP,PubMed,Cochrane Library and EMbase databases were retrieved to collect the systematic reviews of the efficacy of P.notoginseng saponins in the treatment of acute cerebral infarction.The retrieval time was from the time of database establishment to January 2021.After two researchers independently screened out the literature and extracted the data,AMSTAR-2 scale was used to evaluate the methodological quality of the included systematic reviews,GRADE system was used to grade the quality of evidences of the outcome indicators,and the efficacy evaluation was summarized.A total of 5 systematic reviews were included.AMSTAR-2 evaluation results showed that 3 items were relatively complete,while 4 items had a poor overall quality.P.notoginseng saponins combined with conventional Western medicine therapy was superior to single conventional therapy in the recovery of neurological function,enhancement of the total effective rate in clinic,and improvement of activities of daily living.GRADE evaluation results showed that the quality of evidence was from low quality to very low quality.In conclusion,in the treatment of acute cerebral infarction,P.notoginseng saponins can improve the clinical efficacy,with a good safety but a not high methodological quality and a low evidence quality.It is suggested that high-quality clinical studies shall be further carried out to provide evidence-based basis for the application of P.notoginseng saponins in the treatment of acute cerebral infarction.