金纳多治疗脑梗死的系统评价

目的系统评价金纳多（Ginkgo）治疗脑梗死的疗效及安全性。方法计算机检索中国生物医学文献数据库（China biol-ogy medicine disc,CBM,1978年—2011年）、中国学术期刊全文数据库（China Academic Journal,CAJ,1979年—2011年）、中文科技期刊全文数据库（VIP,1989年—2011年）、万方数据库（1978年—2011年）等,手工检索中华神经科杂志、临床神经病学杂志、中风与神经疾病杂志、中国临床神经科学等相关杂志,收集国内关于金纳多治疗脑梗死的随机或半随机对照试验。按Cochrane系统评价的方法,采用RevMan5.0软件进行Meta分析。结果共纳入50篇已发表文献,包括4 662例脑梗死患者。Meta分析结果：金纳多组病情恶化率低于对照组相对危险度（relative risk,RR）=0.39,95%CI（0.23,0.67）,P〈0.001];金纳多组死亡率与对照组差异无统计学意义RR=0.52,95%CI（0.23,1.18）,P=0.12];金纳多组治疗总有效率高于对照组RR=1.15,95%CI（1.12,1.17）,P〈0.001];神经功能缺损程度评分,金纳多组与对照组差异有统计学意义加权均数差（WMD）=5.07,95%CI（4.19,5.94）,P〈0.001];金纳多不良反应少,程度轻微,不影响治疗。结论金纳多可降低脑梗死患者的恶化率,提高治疗总有效率,改善患者治疗后神经功能缺损评分;金纳多对患者死亡率的影响与对照组无统计学意义;其不良反应发生极少,使用安全。

Ginkgo Therapy for Cerebral Infarction：A Meta Analysis

Objective To assess the efficacy of ginkgo for patients of cerebral infarction.Methods China biology medicine disc（CBMdisc）（1978 to 2011）,CNKI（1979 to 2011）,VIP（1989 to 2011）,and Wanfang Database（1978 to 2011） were searched by electronic database and relevant journals,such as Chinese Journal of Neurology,Journal of Clinical Neurology,Journal of Apoplexy and Nervous Diseases,Chinese Journal of Clinical Neurosciences and so on,by manual searching to collect all randomized controlled trials（RCTs） and quasi-randomized controlled trials（quasi-RCTs） of ginkgo for patients with cerebral infarction.The quality of studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews of Interventions.The data were extracted by two reviewers independently.Meta-analysis was conducted by RevMan 5.0 software.Results Fifty-one studies involving 4 722 patients were included.The results of meta-analysis were as follows：The incidence of aggravated rate in the ginkgo group was lower than that in the control group（RR=0.39,95% CI 0.23 to 0.67,P0.001）;There were no differences between the two groups in the mortality（RR=0.52,95% CI 0.23 to 1.18,P=0.12）;The total effective rate in ginkgo group was higher than that in the control group（RR=1.15,95% CI 1.12 to 1.17,P0.001）.There were significant differences between the two groups in the influence of the clinical nerve function damage degree by the fourth academic conference of national cerebral vascular diseases（WMD=5.07,95% CI 4.19 to 5.94,P0.001）;The adverse reactions of ginkgo were relatively mild and it was safe to use.Conclusion Ginkgo could reduce the incidence of aggravated rate.It could improve the total effective rate and the clinical nerve function damage degree.There were no differences between the two groups in the mortality.The adverse reactions in the ginkgo group were fewer and it is safe to use.