醒脑静注射液联合阿替普酶治疗急性缺血性脑卒中临床疗效的Meta分析

目的系统评价醒脑静注射液联合阿替普酶治疗急性缺血性脑卒中的临床疗效。方法计算机检索中国知网(CNKI)、中文科技期刊全文数据库(VIP)、万方全文数据库(WanFang)、CBM、PubMed、Embase和Cochrane Library电子数据库,搜集有关醒脑静注射液联合阿替普酶治疗急性缺血性卒中的随机对照试验(RCT),检索时间从建库至2020年8月1日。采用RevMan 5.3软件进行Meta分析。结果共纳入19篇RCT,包括1 768例患者。Meta分析结果显示:醒脑静注射液联合阿替普酶治疗在治疗有效率RR=1.24,95%CI(1.17~1.32),(P <0.001)]、神经功能改善SMD=-1.30,95%CI(-1.70~-0.89),P <0.001]、认知功能改善SMD=0.97,95%CI(0.79~-1.15),P <0.001]、不良反应发生率RR=0.4,95%CI(0.22~0.72),(P=0.002)]、纤溶指标与凝血指标方面均明显优于与单纯阿替普酶治疗。结论当前的证据表明,醒脑静注射液联合阿替普酶可以显著改善急性缺血性卒中患者神经功能缺损。

Clinical Efficacy of Xingnaojing Injection Combined with Alteplase in the Treatment of Acute Ischemic Stroke:A Meta-analysis

Objective:To systematically evaluate the clinical efficacy of Xingnaojing Injection combined with alteplase in patients with acute ischemic stroke.Methods:Databases of CNKI,VIP,CBM,WanFang,PubMed,Embase and Cochrane Library were searched from inception to Aug 1,2020 for randomized controlled trials(RCT)of Xingnaojing Injection combined with alteplase for acute ischemic stroke patients.RevMan 5.3 was used to perform data analysis.Results:A total of 19 RCT studies(1768 patients)were included.Meta-analysis showed that compared with the control group,Xingnaojing Injection combined with alteplase significantly improved the treatment efficiencyRR=1.24,95%CI(1.17~1.32),(P<0.001)],neurological functionSMD=-1.30,95%CI(-1.70~-0.89),(P<0.001)],cognition functionSMD=0.97,95%CI(0.79~-1.15),P<0.001],adverse eventsRR=0.4,95%CI(0.22~0.72),(P=0.002)]and fibrinolysis index and coagulation index.Conclusion:Current evidence suggested that Xingnaojing Injection combined with alteplase could significantly improve the neurological function of patients with acute ischemic stroke.