中药注射液联合丁苯酞治疗脑梗死临床疗效的网状Meta分析

Network Meta-analysis of clinical efficacy of traditional Chinese medicine injection combined with butylphthalide in the treatment of cerebral infarction

目的:通过网状Meta分析的方法评价4种中药注射液联合丁苯酞治疗脑梗死的临床疗效。方法:从Web of Science、万方、PubMed、维普、Cochrane Library、中国知网等中英文数据库检索丹红注射液、复方丹参注射液、血栓通注射液、银杏二萜内酯葡胺注射液4种中药注射液联合丁苯酞治疗脑梗死的临床随机对照试验,用Review Manager 5.4.1软件进行传统Meta分析,并以StataMP 17软件进行网状Meta分析,记录分析结果。结果:最终纳入37篇文献,3488例患者。Meta分析结果显示,在提高总有效率方面,排序第一的干预措施为丹红注射液联合丁苯酞;在降低美国国立卫生研究院卒中量表(NIHSS)评分方面,排序第一的干预措施为血栓通注射液联合丁苯酞;在提高日常生活活动能力量表(ADL)评分方面,排序第一的干预措施为银杏二萜内酯葡胺注射液联合丁苯酞。结论:以上4种中药注射液联合丁苯酞治疗脑梗死均可发挥协同增效作用,优势各有侧重,可结合临床实际情况选择适宜的联用方案以取得更好的临床疗效。

OBJECTIVE To evaluate the clinical efficacy of 4 kinds of traditional Chinese medicine injections combined with butylphthalide in the treatment of cerebral infarction.METHODS Randomized controlled clinical trials of Danhong injection,compound Danshen injection,Xueshuantong injection and ginkgo diterpene lactone meglumine injection combined with butylphthalide in the treatment of cerebral infarction were retrieved from Web of Science,Wanfang,PubMed,VIP,Cochrane Library,CNKI and other Chinese and English databases.Review Manager 5.4.1 software was used for traditional meta-analysis,and StataMP 17 software was used for network meta-analysis,and the analysis results were recorded.RESULTS Finally,37 literatures with 3488 patients were included.The results of meta-analysis showed that in terms of improving total effective rate,Danhong injection combined with butylphthalein ranked first.In terms of reducing the score of the National Institutes of Health Stroke Scale(NIHSS),the first ranked intervention was Xueshuantong injection combined with butylphthalein.In terms of improving the score of Activity Scale of daily living(ADL),the first intervention was ginkgo diterpene lactone meglumine injection combined with butylphthalide.CONCLUSION The above 4 kinds of Chinese medicine injections combined with butylphthalide in the treatment of cerebral infarction have synergistic effect,with different advantages.The appropriate combination scheme can be selected based on the actual clinical situation to achieve better clinical efficacy.