目的系统评价远隔缺血适应(remote ischemic conditioning,RIC)干预急性缺血性卒中(acute ischemic stroke,AIS)的效果。方法选取中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Ovid、Cochrane Library、Scopus...目的系统评价远隔缺血适应(remote ischemic conditioning,RIC)干预急性缺血性卒中(acute ischemic stroke,AIS)的效果。方法选取中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Ovid、Cochrane Library、Scopus等数据库建库至2023年12月公开发表的RIC干预AIS的中英文RCT研究。对文献进行整理和分析,采用Cochrane偏倚风险评估工具评价文献质量,采用R 4.1.2软件对提取的数据进行meta分析,评估RIC对AIS的干预效果。结果共检索文献1962篇,纳入有效RCT研究20篇,涉及研究对象4030例。20篇文献中18篇文献质量中等、2篇文献质量较低。Meta分析结果显示,干预后与常规西医治疗组相比,RIC联合常规西医治疗组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分较低(MD=-1.82,95%CI:-2.40~-1.24)、改良Rankin量表(modified Rankin scale,mRs)评分较低(MD=-0.54,95%CI:-0.67~-0.40)、Barthel指数较高(Barthel index,BI)(MD=8.7,95%CI:6.80~10.61),神经功能预后较好(RR=1.08,95%CI:1.04~1.13),差异均有统计学意义(P<0.01)。各项研究均未出现严重不良反应。结论RIC干预AIS的疗效显著,具有较好的安全性,值得临床推广。展开更多
Objective:To systematically evaluate the long-term efficacy of Bushen Huoxue Decoction combined with vertebroplasty(PVP or PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF),in order to provide...Objective:To systematically evaluate the long-term efficacy of Bushen Huoxue Decoction combined with vertebroplasty(PVP or PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF),in order to provide evidence-based reference for clinical application.Methods:To ensure the novelty of research data,a computer search was conducted between 2017 and February 2023 to publicly publish all randomized controlled studies and clinical trials at home and abroad on the treatment of OVCF with Bushen Huoxue Decoction combined with vertebroplasty published in CNKI,Wanfang,Vip,PubMed,CBM,and Cochrane libraries.Two researchers independently conducted literature screening and data extraction,evaluated the quality of randomized controlled trials included one by one according to the Cochrane collaboration network standards,and conducted a meta statistical analysis using RevMan5.3 for studies that met the inclusion criteria.Results:A total of 684 patients were included in 7 randomized controlled trials,including 342 patients in the observation group and 342 patients in the control group,with a ratio of 1:1;The meta-analysis results showed that in the observation group,the overall effective rate[RR=1.30,95%CI(1.14,1.47),P<0.001],visual analog pain(VAS)score[SMD=1.19,95%CI(0.77,1.61),P<0.0001],bone mineral density score[SMD=1.09,95%CI(0.15,2.04),P=0.02],COQOL score[SMD=0.99,95%CI(0.68,1.30),P<0.00001],OPG score[SMD=0.48,95%CI(0.18,0.77),P=0.002]The RANKL score[SMD=1.33,95%CI(1.00,1.65),P<0.0001]was significantly superior to the control group,with statistically significant differences.There was no significant difference in the Oswestry Disability Index(ODI)score[SMD=0.27,95%CI(-0.03,0.57),P=0.08],Cobb score[SMD=1.52,95%CI(-1.05,4.09),P=0.25],and vertebral height score[SMD=0.43,95%CI(-0.14,1.01),P=0.14].Conclusion:The results show that Bushen Huoxue Decoction combined with vertebroplasty has significant advantages in improving bone mineral density and alleviating pain in patients after OVCF,which is significantly superior to using OVCF alone.展开更多
文摘目的系统评价远隔缺血适应(remote ischemic conditioning,RIC)干预急性缺血性卒中(acute ischemic stroke,AIS)的效果。方法选取中国知网、万方数据库、维普数据库、SinoMed、PubMed、Web of Science、Ovid、Cochrane Library、Scopus等数据库建库至2023年12月公开发表的RIC干预AIS的中英文RCT研究。对文献进行整理和分析,采用Cochrane偏倚风险评估工具评价文献质量,采用R 4.1.2软件对提取的数据进行meta分析,评估RIC对AIS的干预效果。结果共检索文献1962篇,纳入有效RCT研究20篇,涉及研究对象4030例。20篇文献中18篇文献质量中等、2篇文献质量较低。Meta分析结果显示,干预后与常规西医治疗组相比,RIC联合常规西医治疗组美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分较低(MD=-1.82,95%CI:-2.40~-1.24)、改良Rankin量表(modified Rankin scale,mRs)评分较低(MD=-0.54,95%CI:-0.67~-0.40)、Barthel指数较高(Barthel index,BI)(MD=8.7,95%CI:6.80~10.61),神经功能预后较好(RR=1.08,95%CI:1.04~1.13),差异均有统计学意义(P<0.01)。各项研究均未出现严重不良反应。结论RIC干预AIS的疗效显著,具有较好的安全性,值得临床推广。
基金National Natural Science Foundation Project of China(No.81904230,82205155)Capital Health Development Research Project(No.2018-2-4162)。
文摘Objective:To systematically evaluate the long-term efficacy of Bushen Huoxue Decoction combined with vertebroplasty(PVP or PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF),in order to provide evidence-based reference for clinical application.Methods:To ensure the novelty of research data,a computer search was conducted between 2017 and February 2023 to publicly publish all randomized controlled studies and clinical trials at home and abroad on the treatment of OVCF with Bushen Huoxue Decoction combined with vertebroplasty published in CNKI,Wanfang,Vip,PubMed,CBM,and Cochrane libraries.Two researchers independently conducted literature screening and data extraction,evaluated the quality of randomized controlled trials included one by one according to the Cochrane collaboration network standards,and conducted a meta statistical analysis using RevMan5.3 for studies that met the inclusion criteria.Results:A total of 684 patients were included in 7 randomized controlled trials,including 342 patients in the observation group and 342 patients in the control group,with a ratio of 1:1;The meta-analysis results showed that in the observation group,the overall effective rate[RR=1.30,95%CI(1.14,1.47),P<0.001],visual analog pain(VAS)score[SMD=1.19,95%CI(0.77,1.61),P<0.0001],bone mineral density score[SMD=1.09,95%CI(0.15,2.04),P=0.02],COQOL score[SMD=0.99,95%CI(0.68,1.30),P<0.00001],OPG score[SMD=0.48,95%CI(0.18,0.77),P=0.002]The RANKL score[SMD=1.33,95%CI(1.00,1.65),P<0.0001]was significantly superior to the control group,with statistically significant differences.There was no significant difference in the Oswestry Disability Index(ODI)score[SMD=0.27,95%CI(-0.03,0.57),P=0.08],Cobb score[SMD=1.52,95%CI(-1.05,4.09),P=0.25],and vertebral height score[SMD=0.43,95%CI(-0.14,1.01),P=0.14].Conclusion:The results show that Bushen Huoxue Decoction combined with vertebroplasty has significant advantages in improving bone mineral density and alleviating pain in patients after OVCF,which is significantly superior to using OVCF alone.
