川芎嗪治疗脑梗死:疗效及安全性的系统评价

Systemic evaluation of Security of ligustrazine for treatment of cerebral infarction

目的:评价川芎嗪治疗脑梗死的疗效和安全性。方法:应用国际Cochrane协作网的系统评价方法评价全世界关于川芎嗪治疗脑梗死的随机或半随机临床试验。结果:共收集到有关川芎嗪治疗脑梗死的文献441篇,经筛选共纳入符合标准的7个试验,质量均较低。没有关于川芎嗪治疗脑梗死远期疗效的研究。4个试验报道了不良反应,包括颅内出血、鼻衄,发生率较低。川芎嗪合用某种治疗与单用某种治疗相比,川芎嗪可能降低治疗期末的神经功能缺损评分(RR0.34,95%CI0.25～0.48)。结论:目前尚不能推荐在临床常规使用川芎嗪治疗脑梗死,应开展设计严格的随机双盲安慰剂对照试验。

AIM:To assess the effectiveness and safety of ligustrazine for treatment of cerebral infarction.METHODS:All of the randomized or quasi-randomized trials involving ligustrazine for cerebral infarction were reviewed systemically with the method used in the international Cochrane network.RESULTS:Among 441 pertinent studies,seven trials with poor methodological quality were included.There were no studies on the long-term effect of ligustrazine in treatment of cerebral infarction.Four of the 7 trials reported adverse effect with low incidence,including intracranial hemorrhage and epistaxis.As to the neurologic impairment at the end of treatment period,ligustrazine was associated with a significant improvement(RR 0.34,95%CI 0.25-0.48).CONCLUSION:There is insufficient reliable evidence for treatment of cerebral infarction using ligustrazine due to the low quality of the trials and possible publication bias.Further randomized,double blind,placebo-controlled trials are needed.