醒脑静注射液治疗脑梗死的系统评价/Meta分析再评价

Overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treatment of cerebral ischaemic stroke

目前已有较多临床试验、系统评价/Meta分析证明醒脑静注射液治疗脑梗死有良好的临床效果,证据数量较多,综合性论述较少。该研究通过对醒脑静注射液治疗脑梗死的系统评价/Meta分析进行再评价,为该药物临床实践和决策提供证据概貌和依据。计算机检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、CBM、EMbase、PubMed、Cochrane Library、Web of Science中有关醒脑静注射液治疗脑梗死的系统评价/Meta分析。应用AMSTAR-2量表、GRADE工具对纳入的6篇文献进行质量评价及结局指标的疗效评价。AMSTAR-2方法学质量评价结果显示,6篇文献均为极低质量;GRADE证据质量评价显示,55个结局指标中中等质量证据2个,低质量证据4个,极低质量证据49个。6篇系统评价均得出醒脑静注射液治疗脑梗死有效的结论,在总有效率、神经功能缺损评分、血液流变学、血流动力学方面均有改善作用。方法学质量评估及证据等级评价结构显示,纳入研究方法学质量极低,结局指标证据等级为中、低等,醒脑静注射液治疗脑梗死的有效性和安全性仍需更多高质量研究进一步证实,未来相关临床研究的开展及系统评价/Meta分析的书写应严格遵守相关规范。

There have been many clinical trials,systematic reviews/Meta-analysis proving that Xingnaojing Injection has a good clinical efficacy in treatment of cerebral ischaemic stroke,but with fewer comprehensive descriptions.In this study,an overview of systematic reviews/Meta-analysis of Xingnaojing Injection in treating cerebral ischaemic stroke was performed to provide current situation of evidences and basis for clinical practice.CNKI,Wanfang,VIP,CBM,EMbase,PubMed,Cochrane Library,Web of Science were retrieved through computers.A total of 6 literatures were included in this study.By AMSTAR-2 checklist and GRADE,the quality of included systematic reviews and the efficacy of Xingnaojing Injection were evaluated.The results of AMSTAR-2 checklist showed an extremely low quality for all of the 6 systematic reviews.According to the results of GRADE evaluation,among 55 outcomes,there were 2 outcomes with a medium quality,4 outcomes with a low quality and 49 outcomes with an extremely low quality.The 6 systematic reviews reached a consistent conclusion that Xingnaojing Injection was effective in the treatment of cerebral ischaemic stroke.This therapy could improve the total efficacy,neurological deficit scores,hemodynamic and hemodynamic parameters.However,the methodolo-gical quality of all literatures was extremely low.The evidence levels of outcomes were between extremely low to medium.The effectiveness of Xingnaojing Injection in the treatment of cerebral ischaemic stroke still needs to be further verified by more high-quality studies.In the future,relevant clinical studies and systematic reviews/Meta-analysis shall be carried out in a strict accordance with relevant regulations.