醒脑静联合依达拉奉治疗急性缺血性脑卒中疗效和安全性的Meta分析

Meta-analysis of the efficacy and safety of Xingnaojing combined with edaravone in the treatment of acute ischaemic stroke

目的系统评价醒脑静联合依达拉奉用于急性缺血性脑卒中的疗效及安全性。方法系统检索PubMed、知网、维普、万方和SinoMed数据库,并根据纳入/排除标准对文献进行筛选。两位作者分别独立对纳入文献进行资料提取并核对。使用RevMan软件对结局数据进行合并分析。结果共纳入21项随机对照试验。结果显示,在常规疗法基础上联合使用醒脑静和依达拉奉,在提高神经功能改善率[RR=1.25,95%CI(1.20,1.31),P<0.00001])、提高生活能力[MD=12.40,95%CI(1.56,23.23),P=0.02]、降低美国国立研究院卒中评分(NIHSS)[MD=-3.79,95%CI(-5.34,-2.24),P<0.00001]及减轻昏迷程度[MD=1.77,95%CI(0.77,2.77),P=0.0005]上,均优于未同时联用二者的常规疗法;在全因死亡率[RR=0.60,95%CI(0.08,4.46),P=0.62]及不良事件发生率[RR=0.75,95%CI(0.36,1.56),P=0.44]上,组间比较差异无统计学意义。结论醒脑静联合依达拉奉用于急性缺血性脑卒中患者,在改善神经功能、提高生活能力、提高神经恢复程度(降低NIHSS评分)及减轻昏迷程度方面能够增强疗效,且不会增加安全风险。

Objective To systematically evaluate the efficacy and safety of Xingnaojing combined with edaravone as a therapy for acute ischemic stroke.Methods PubMed,CNKI,VIP,Wanfang and SinoMed databases were systematically searched,and the literature was screened according to the inclusion/exclusion criteria.Two authors independently extracted and checked the data of the included literature.The outcome data were combined and analyzed using RevMan software.Results Twenty-four randomized controlled trials were included.The outcome suggested that combining Xingnaojing and edaravone on the basis of conventional therapy was superior to conventional therapy that did not use both simultaneously in improving the rate of neurological improvement[RR=1.25,95%CI(1.20,1.31),P<0.00001]),improving viability[MD=12.40,95%CI(1.56,23.23),P=0.02],lowering NIHSS scores[MD=-3.79,95%CI(-5.34,-2.24),P<0.00001],and reducing coma degree[MD=1.77,95%CI(0.77,2.77),P=0.0005];there was no statistical difference in the incidence of all-cause mortality[RR=0.60,95%CI(0.08,4.46),P=0.62]and adverse events between groups[RR=0.75,95%CI(0.36,1.56),P=0.44].Conclusion The combination of Xingnaojing and edaravone in patients with acute ischemic stroke can enhance efficacy in improving neurological function,improving viability,improving neurological recovery level(reducing NIHSS score),and reducing coma degree without increasing safety risks.