葛根素治疗缺血性中风急性期随机对照试验的系统评价

目的:系统评价葛根素治疗缺血性中风急性期的疗效及安全性。方法:搜集葛根素治疗缺血性中风急性期随机对照试验文献,筛选合格研究,应用Jadad评分法进行质量评价,统计方法应用异质性检验、Meta-分析、漏斗图分析、敏感性分析。结果:7项研究符合纳入标准,Jadad评分显示所有研究得分均低于3分,属低质量文献。Meta-分析结果显示,总有效率比较的合并相对危险度(RR值)及99%的可信区间(CI值)为1.23(1.08,1.39);日常生活能力评分比较的WMD(99%CI)为9.56(8.78,10.34);病死率、致残率比较的RR(99%CI)分别为1.82(0.40,8.40)、1.15(0.42,3.11);皮肤瘙痒、恶心发生率比较的合并RR(99%CI)分别为5.20(0.10,272.19)、3.13(0.17,59.09)。结论:Meta-分析结果显示,葛根素具有改善缺血性中风急性期患者神经功能缺损状况、提高日常生活能力的趋势,但尚不能确定是否存在导致不良反应的危险性。由于纳入研究质量普遍较低等因素影响,降低了该系统评价结论的可靠性。

A systematic review of puerarin for acute ischaemic stroke

Objective: To systematically evaluate efficacy and safety of puerarin for treating acute ischaemic stroke.Methods: Randomized controlled trails(RCTs) of puerarin for acute ischaemic stroke treatment were identified.Qualification studies for those RCTs were conducted.The qualification assessment was performed by using Jadad scale.Heterogeneity test,Meta-analysis,funnel plot analysis and sensitivity analysis were used to analyze data.Results: Seven RCTs were selected.All RCTs were low methodological quality according to Jadad score index.Meta-analysis indicated that RR of overall effective rate was 1.23[99%CI(1.08,1.39)],weighted mean difference of ability of daily life was 9.56[99%CI(8.78,10.34)].Conclusion: This systematic review showed that puerarin was effective for treating acute ischaemic stroke.However,the evidence was not strong due to the general low methodological quality of RCTs.To determinately evaluate efficacy and safety of puerarin for acute ischaemic stroke treatment,more rationally designed and strictly executed RCTs with large amount of cases are necessary.