中西医结合卒中单元治疗急性脑卒中的系统评价

目的系统评价中西医结合卒中单元治疗急性脑卒中的有效性。方法计算机检索CBM(1978～2009)、CNKI(1994～2009)、VIP(1989～2009)、PubMed(1966～2009)、MEDLINE(1978～2009)、Sci nder(1998～2009)、Cochrane Library(2009年第6期),并手工检索辽宁中医药大学图书馆过刊资料库。按照Cochrane系统评价的方法,逐一评价纳入研究的质量,提取有效数据,采用RevMan 5.0.23软件进行Meta分析。结果共纳入12个随机/半随机对照试验,包括2316例患者。Meta分析结果显示:与普通内科治疗相比,中西医结合卒中单元在脑卒中后1个月病死率RR=0.34,95%CI(0.22,0.54)]、出院时NIHSS评分WMD=-1.01,95%CI(-1.52,-0.51)]、出院时OHS评分WMD=-0.48,95%CI(-0.78,-0.18)]较普通内科治疗更有优势(P<0.05)。与西医卒中单元相比,中西医结合卒中单元在脑卒中后1周NIHSS评分WMD=-2.38,95%C(I-4.08,-0.68)]、1个月NIHSS评分WMD=-1.52,95%CI(-2.32,-0.73)]、3个月NIHSS评分WMD=-1.77,95%CI(-2.59,-0.95)]、出入院NIHSS评分差值WMD=-1.94,95%CI(-2.54,-1.34)]、脑卒中后1个月OHS评分WMD=-0.56,95%CI(-0.95,-0.17)]、脑卒中后3个月OHS评分WMD=-1.05,95%CI(-1.44,-0.66)]较西医卒中单元更有优势(P<0.05)。结论现有有限证据表明,中西医结合卒中单元治疗急性脑卒中的疗效与普通内科治疗相比有显著差异,与西医卒中单元相比病死率虽无显著差异,但在改善神经功能缺损及伤残方面有明显优势。尚需更多高质量的随机对照试验来进一步证实中西医结合卒中单元治疗急性脑卒中的疗效。

Stroke Unit of Integrated Traditional Chinese Medicine and Western Medicine for Acute Cerebral Stroke: A Systematic Review

Objective To assess the clinical efficacy of stroke unit(SU) of integrated traditional Chinese medicine and western medicine in the treatment of acute cerebral stroke.Methods Randomized or quasi-randomized controlled trials(RCTs or q-RCTs) were identified from CBM(1978-2009),CNKI(1994-2009),VIP(1989-2009),PubMed(1966-2009),MEDLINE(1978-2009),Scifinder(1998-2009),and The Cochrane Library(Issue 6,2009),and relevant journals from Liaoning University of Traditional Chinese Medicine were also hand searched.Data ...