神经节苷脂治疗急性脑梗死患者的临床研究

目的观察神经节苷脂在促进脑梗死患者神经功能恢复中的效果。方法将脑梗死患者68例,随机分为治疗组和对照组,对照组患者行抗血小板聚集改善微循环等常规治疗,治疗组患者在常规治疗基础上加用神经节苷脂。比较两组治疗前后2w的血清蛋白(S100B)水平和NIHSS评分。结果经2w治疗后,与对照组相比,治疗组患者的NIHSS评分明显低于对照组(P<0.05),且血清蛋白(S100B)水平明显低于对照组,差异具有统计学意义(P<0.05)。结论神经节苷脂能明显促进脑梗死患者神经功能恢复,改善预后。     

神经节苷脂治疗急性脑梗死的疗效观察

目的观察单唾液酸四己糖神经节苷脂钠注射液对急性脑梗死的治疗效果。方法急性脑梗死病人60例,随机分为两组。对照组30例,给予预防、控制脑水肿,抗凝,营养脑细胞等常规治疗;治疗组30例,在给予常规治疗的基础上,加用单唾液酸四己糖神经节苷脂钠注射液40mg肌肉注射,1次／d,连续治疗14d。两组病人治疗前及治疗后第14d,进行神经功能缺损评分,并行疗效评定。结果治疗组治疗后14d神经功能缺损评分与对照组相比,差异有显著性（P〈0．05）,治疗组临床疗效明显优于对照组（P〈0．05）,其神经功能评分明显改善,日常生活活动能力较对照组明显提高。结论单唾液酸四己糖神经节苷脂钠,通过增加酶自由基清除剂超氧化物歧化酶（SOD）的活性,减轻脂质过氧化反应,有效减轻缺氧性脑损伤,有神经保护作用,能提高治愈率,促进神经功能早期恢复,降低致残率,能改善急性脑梗死病人的预后。单唾液酸神经节苷脂在急性脑梗死治疗中早期应用可以获得良好的治疗效果,恢复神经功能,提高生存质量。     

疏血通联合神经节苷脂治疗急性脑梗死的疗效

目的 探讨疏血通联合神经节苷脂治疗急性脑梗死的临床效果.方法 将70例急性脑梗死患者按随机数字表法分为观察组和对照组,每组35例.对照组给予常规治疗;观察组在对照组常规治疗的基础上给予疏血通联合神经节苷脂治疗,疗程结束后评估2组患者的临床效果,记录药物不良反应.结果 观察组总有效率为100.0％,对照组总有效率为80.0％,2组比较差异有统计学意义（P＜0.05）.观察组治疗后的GCS评分高于对照组（14.93：±0.98比14.32±0.46）分、NIHSS评分低于对照组（5.87±1.24比9.93±1.35）分（均P＜0.05）.2组均未见明显的药物不良反应.结论 疏血通联合神经节苷脂治疗急性脑梗死的临床效果显著、安全,是治疗急性脑梗死较好的方法.     

尤瑞克林联合神经节苷脂治疗急性脑梗死临床观察

目的 探讨尤瑞克林联合神经节苷脂(GM1)治疗急性脑梗死的临床疗效.方法 将148例急性脑梗死患者随机分成两组:对照组给予0.9%生理盐水100 mL加疏血通6 mL,1次/d,静滴;甘露醇250 mL,2~3次/d,静滴;神经节苷脂100 mg加0.9%生理盐水100 mL,1次/d,静滴;口服抗血小板聚集药物的常规治疗.治疗组在对照组治疗基础上加用尤瑞克林0.15 PNA单位+0.9%生理盐水100 mL,1次/d,静滴.对照组和治疗组疗程均为21 d,治疗21 d后行疗效评定.结果 治疗组有效率高于对照组(94.6%vs 67.6%),两组比较差异有统计学意义(P<0.05).结论 尤瑞克林联合神经节苷脂治疗急性脑梗死安全且疗效肯定.     

单唾液酸四己糖神经节苷脂治疗急性脑梗死临床疗效观察

目的 观察和评价单唾液酸四己糖神经节苷脂(GM1)钠盐注射液治疗老年急性脑梗死的临床疗效和安全性.方法 选取急性脑梗死患者54例,随机分为治疗组(29例)和对照组(25例).常规予以降纤、抗凝、调脂、降压、降糖等脑血管疾病二级预防,治疗组加用GM1,急性期100 mg/d静脉滴注,14 d后改为40 mg/d维持28 d.结果 治疗组和对照组临床疗效愈显率为58.62%(17/29)与36.00%(9/25),总有效率为82.76%(24/29)与56.00%(14/25);2组总体有效率构成比差异有统计学意义(χ2=4.61,P＜0.05).治疗前2组神经功能残缺积分差异无统计学意义(t=0.477,P＞0.05).治疗14 d后,2组神经功能缺损积分[治疗组(26.41±5.82)分、对照组(23.52±4.13)分],差异有统计学意义(t=2.079,P＜0.05).治疗42 d后,治疗组较对照组神经功能缺损积分[治疗组(36.52±6.21)分与对照组(30.48±5.73)分],差异有统计学意义(t=3.693,P＜0.01).结论 GM1对于老年急性脑梗死患者具有良好的中枢神经保护作用,其疗效明确,可大大改善脑梗死后的神经功能缺损.     

神经节苷脂对急性脑梗死患者神经功能及炎症因子的影响

目的:探讨神经节苷脂对急性脑梗死患者神经功能及血清炎症因子的影响。方法:选取2018年1月～2019年1月神经内科收治的急性脑梗死患者90例,按随机数字法分为对照组和观察组各45例。对照组采用常规治疗,观察组在对照组基础上给予神经节苷脂治疗。比较两组患者神经功能及血清炎症因子水平。结果:观察组治疗后美国国立卫生研究院卒中量表评分(6.34±1.75)分低于对照组的(9.84±1.82)分,差异有统计学意义(P0.05);观察组治疗后C反应蛋白、肿瘤坏死因子-α及白介素-6水平均低于对照组,差异有统计学意义(P0.05)。结论:神经节苷脂可改善急性脑梗死患者神经功能,降低血清炎症因子水平。     

神经节苷脂在促进脑梗死患者神经功能恢复中的效果

68例脑梗死患者随机分为对照组(常规治疗组)和观察组(常规治疗加神经节苷脂组)各34例,将两组治疗前及治疗后2周的NIHSS评分及血清S100B蛋白(S100B)、C反应蛋白(CRP)、丙二醛(MDA)水平进行比较。结果观察组治疗后2周的NIHSS评分低于对照组,血清S100B、CRP、MDA水平也较对照组低,有显著性差异(P<0.05)。     

巴曲酶联合神经节苷脂治疗急性脑梗死的临床研究

目的：探讨巴曲酶联合神经节苷脂治疗急性脑梗死的临床效果。方法76例急性脑梗死患者随机分成单用巴曲酶组（对照组38例）和巴曲酶联合神经节苷脂组（观察组38例）,比较两组用药后的疗效。结果两组患者均无死亡病例,观察组的纤维蛋白原、丙二醛分别为（1．67±0．29）g／L、（5．47±1．49）nmol／mL ,明显低于对照组的（3．75±0．89）g／L、（8．15±2．89）nmol／mL ,差异有统计学意义（P＜0．05）;超氧化物歧化酶、神经功能缺失评分及缺陷程度评分分别为（67．47±6．49）ng／mL、（75．86±6．04）分、（81．86±9．01）分,明显高于对照组的（51．75±8．89）ng／mL、（63．86±5．52）分、（59．86±6．33）分,差异有统计学意义（P＜0．05）。结论巴曲酶联合神经节苷脂后治疗急性脑梗死临床疗效显著提高,且不增加由降纤治疗引起的出血风险。     

依达拉奉联合神经节苷脂治疗急性脑梗死

目的观察依达拉奉联合神经节苷脂治疗急性脑梗死的临床效果及安全性。方法将182例急性脑梗死患者随机分为两组,治疗组采用依达拉奉和神经节苷脂分别加入生理盐水中静脉滴注,1次/d,21 d为1个疗程;对照组采用胞二磷胆碱注射液加入生理盐水中静脉滴注,疗程及用法同治疗组。结果治疗组基本治愈率为32.97%,总有效率为85.71%;明显高于对照组的18.68%、65.93%,两组比较差异有统计学意义(P<0.05)。结论早期应用依达拉奉和神经节苷脂治疗急性脑梗死,可加速神经功能的恢复,提高患者的生存质量,改善预后。     

神经节苷脂治疗脑出血

目的 探讨神经节苷脂(monosialotetrahexosy-1 ganglioside,GM-1)治疗脑出血的临床效果及其机制.方法 脑出血患者146例,随机分为两组,对照组76例,给予常规治疗;GM-1治疗组70例,常规治疗加GM-1治疗21天,观察两组治疗前后肌力变化,并记录治疗前后GCS评分、NDS评分、ADL评分及6个月后GOS评分,来评定两组患者的疗效.结果 GM-1组患者肌力增加一级及一级以上,与对照组相比有显著差异(P＜0.01);治疗后GM-1治疗组中GCS评分、ADS评分的提高和NDS评分的降低与对照组相比有显著性差异(P＜0.01);在脑出血后6个月进行COS评分,GM-1治疗组Ⅴ级病例比例为68.57%.结论 应用GM-1可以明显改善脑出血患者临床症状,促进神经功能的恢复,降低致残率,改善患者的生活质量.     

Caffeine and cerebral palsy: A systematic review of randomized controlled trials and cohort studies

ObjectiveTo systematically review the effects of caffeine on the development of cerebral palsy (CP). Design: Systematic review.SettingA search of five databases was performed to identify randomized controlled trials (RCT) or cohort studies published through May 2022. Studies conducted on newborns at risk of developing CP upon receiving caffeine in the first days of life were included as well. Two independent researchers assessed the screening, data extraction, and methodological quality assessment.Main outcome measures: Percentage of children with CP.ResultsFour studies met our inclusion criteria. The only RCT found a decreased risk (approximately 40 %) of developing CP with 20 mg/kg caffeine citrate (OR 0.59, 95 % CI 0.39, 0.89). In addition, when comparing the period over which caffeine citrate was administered, one retrospective cohort study reported that infants who received caffeine up to the second day of life were also less likely to develop CP.Some methodological issues should be highlighted: in the RCT, the differences between the groups with respect to loss to follow-up were not explored. Similarly, intention-to-treat analyses were not performed. Most cohort studies have not adequately identified the primary confounding factors. Conclusions: Caffeine could be an important intervention in preventing CP. However, few studies have assessed the effects of caffeine on the risk of CP development. Due to methodological differences, no recommendation regarding its use can be safely made. The findings suggest a positive effect of caffeine citrate in the early stages of life with approximately 20 mg/kg of weight; however, well-designed RCTs with adequate sample size and power, randomization process, outcome measurement, and data analysis are still required.     

Tanreqing injection for acute bronchitis disease: A systematic review and meta-analysis of randomized controlled trials

BackgroundAcute bronchitis (AB) is one of the common diseases. Tanreqing injection (TRQ) was widely used to treat patients with acute bronchitis, and many randomized controlled trials have been conducted to investigate its efficacy.ObjectiveThe purpose of this systematic review is to evaluate the efficacy and safety of TRQ for AB.MethodsEight English and Chinese electronic databases, up to October 2014, were searched to identify randomized controlled trials on TRQ for AB. Two reviewers independently extracted data and assessed the quality of each trial by using Cochrane handbook. Meta-analysis was carried out by using Review Manager software.ResultA total of 49 trials with 5131 participants were collected. Data of three main outcomes were pooled and analyzed as following: (1) effective rates: TRQ versus antibiotics (RR 1.12; 95% CI 1.05, 1.18; P = 0.0002); TRQ plus antiviral drugs versus antiviral drugs (RR: 5.12; 95% CI 3.03, 8.66; P < 0.00001); TRQ plus antibiotics versus antibiotics (RR 3.46; 95% CI 2.59, 4.62; P < 0.00001); TRQ versus antibiotics plus antiviral drugs (RR 2.03; 95% CI 1.10, 3.74; P = 0.02); TRQ plus conventional therapy versus conventional therapy alone (RR 1.21; 95% CI 1.15, 1.27; P < 0.00001). (2) Time for fever resolution: TRQ plus antiviral drugs versus antiviral drugs (MD: −1.08; 95% CI −1.59, −0.57; P < 0.00001); TRQ plus antibiotics versus antibiotics (MD −1.33; 95% CI −1.81, −0.86; P < 0.00001); TRQ versus antibiotics plus antiviral drugs (MD −0.88; 95% CI −1.25, −0.51; P < 0.00001); TRQ plus conventional therapy versus conventional therapy alone (MD −1.06; 95% CI −1.13, −0.98; P < 0.00001). (3) Resolution of cough: TRQ plus antiviral drugs versus antiviral drugs (MD: −2.09; 95% CI −3.11, −1.43; P < 0.00001); TRQ plus antibiotics versus antibiotics (MD: −2.65; 95% CI −2.88, −2.42; P < 0.00001); TRQ plus conventional therapy versus conventional therapy alone (MD −1.84; 95% CI −2.85, −0.83; P = 0.0003). Four trials described the adverse drug reactions of TRQ, while no severe adverse drug reactions reported.ConclusionsAs a therapy for AB, TRQ has potentially beneficial effect in improving effective rates, reducing the time to resolution of fever, cough, crackles and absorption of shadows on X-ray. However, due to the limitations of methodological quality of the included trials, it is difficult to make a conclusive recommendation about TRQ treating patients with AB. Further rigorous clinical trials are warranted to evaluate the efficacy and safety of TRQ.     

The acute management of trauma hemorrhage: a systematic review of randomized controlled trials

Introduction  

Worldwide, trauma is a leading cause of death and disability. Haemorrhage is responsible for up to 40% of trauma deaths. Recent strategies to improve mortality rates have focused on optimal methods of early hemorrhage control and correction of coagulopathy. We undertook a systematic review of randomized controlled trials (RCT) which evaluated trauma patients with hemorrhagic shock within the first 24 hours of injury and appraised how the interventions affected three outcomes: bleeding and/or transfusion requirements; correction of trauma induced coagulopathy and mortality.     

Acupuncture for recurrent headaches: a systematic review of randomized controlled trials

Objective : To assess whether there is evidence that acupuncture is effective in the treatment of recurrent headaches. Design :Systematic review. Study selection :Randomized or quasi-randomized clinical trials comparing acupuncture with any type of control intervention for the treatment of recurrent headaches. Data sources : Electronic databases (Medline, Embase, Cochrane Field for Complementary Medicine, Cochrane Controlled Trials Register), personal communications and bibliographies. Data collection and analysis : Information on patients, interventions, methods, and results were extracted by at least two independent reviewers using a pretested form. A pooled estimate of the responder rate ratio (responder rate in treatment group/responder rate in control group) was calculated as a crude indicator of trial results as meta-analysis of more specific outcome data was impossible due to heterogeneity and insufficient reporting. Results :Twenty-two trials, including a total of 1042 patients (median 36, range 10–150), met the inclusion criteria. Fifteen trials were in migraine patients, six in tension-headache patients, and in one trial patients with various headaches were included. The majority of the 14 trials comparing true and sham acupuncture showed at least a trend in favor of true acupuncture. The pooled responder rate ratio was 1.53 (95% confidence interval 1.11 to 2.11). The eight trials comparing acupuncture and other treatment forms had contradictory results. Conclusions :Overall, the existing evidence suggests that acupuncture has a role in the treatment of recurrent headaches. However, the quality and amount of evidence is not fully convincing. There is urgent need for well-planned, large-scale studies to assess effectiveness and efficiency of acupuncture under real life conditions.     

Flavonoid-containing supplements for preventing acute respiratory tract infections: A systematic review and meta-analysis of 20 randomized controlled trials

BackgroundThis systematic review and meta-analysis was conducted to investigate the efficacy and safety of flavonoid-containing supplements in preventing acute respiratory tract infection (ARTI).MethodsRandomized controlled trials (RCTs) investigating the effects of flavonoid-containing supplements on ARTI prevention in the aspects of ARTI incidence, mean ARTI sick days, symptoms, bio-immune markers, and adverse effects were searched in 5 databases. Data were searched from inception to November 26, 2021. Stata 16.0 was used to perform the meta-analysis.ResultsTwenty RCTs (n = 4521) were included in this systematic review and meta-analysis. Pooled results showed that in the flavonoid-containing supplement group, the ARTI incidence and mean ARTI sick days were significantly decreased compared to those in the control group (RR = 0.81, 95% CI: 0.74–0.89, p < 0.001; WMD = −0.56, 95% CI: −1.04 to −0.08, p = 0.021; respectively). In 8 RCTs, flavonoids were singly used for interventions, ARTI incidence in the experimental group significantly decreased compared to that in the control group (RR = 0.85, 95% CI: 0.72–1.00, p = 0.047). In ten RCTs, flavonoid-containing mixtures were applied for interventions, and ARTI incidence in the experimental group significantly decreased compared to that in the control group (RR = 0.79, 95% CI: 0.71–0.89, p < 0.001). Furthermore, the ARTI incidence and mean ARTI sick days were significantly decreased in the experimental group compared to those in the control group in the flavan-3-ols subgroup (RR = 0.79, 95% CI: 0.67–0.92, p = 0.002; WMD = −2.75, 95% CI: −4.30 to −1.21, p < 0.001; respectively) and the multiple subclasses subgroup (RR = 0.75, 95% CI: 0.63–0.88, p = 0.001; WMD = −0.56, 95% CI: −1.11 to −0.01, p = 0.046; respectively). However, the bio-immune markers including interleukin-6, hypersensitive-c-reactive-protein, tumor necrosis factor-α, and interferon-γ did not differ between the flavonoid group and the control group. Moreover, in the flavonoid-containing supplement group, the incidence of adverse reactions did not increase compared to that in the control group (RR = 1.16, 95% CI: 0.78–1.73, p = 0.469).ConclusionsThis systematic review and meta-analysis showed that flavonoid-containing supplements were efficacious and safe in preventing ARTIs. The most important limitations result from the small number of trials, poor quality of some included RCTs, differences in the composition and types of interventions, principal subclasses of flavonoids, methods of administration, and methodology. Moreover, only a few RCTs conducted independent verification of the flavonoid supplements used in the trial in terms of purity and potency, which may lead to a potential source of bias. Thus, larger and better-designed studies are needed to further verify this conclusion.