醒脑静治疗急性重症颅脑损伤昏迷患者疗效及安全性的Meta-分析

目的 系统评价醒脑静治疗急性重症颅脑损伤昏迷的疗效和安全性。方法 计算机检索中国学术期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、维普中文期刊全文数据库（VIP）、万方数据库、PubMed及Embase数据库，检索时间均从建库至2019年5月。收集醒脑静治疗急性重型颅脑损伤昏迷的随机对照试验。对符合纳入标准的临床研究进行质量评价和资料提取后，采用Rev Man 5.3软件进行Meta-分析。结果 共纳入15项研究，包括1 173例患者。Meta-分析结果显示：试验组的清醒率（OR=2.50，95%CI=1.79～3.49）、清醒时间（MD=-4.20，95%CI=-5.45～-2.96）、GCS评分变化（MD=2.68，95%CI=2.44～2.93）、NHISS评分变化（MD=-6.12，95%CI=-7.46～-4.77）、APACHE-Ⅱ（MD=-3.61，95%CI=-4.37～-2.86）、预后较好率（OR=2.37，95%CI=1.81～3.10）、预后不良率（OR=0.46，95%CI=0.34～0.62）及血清炎性因子（TNF-a、IL-8、IL-6）均优于对照组，差异均有统计学意义（P<0.01）。结论 现有研究证据显示，醒脑静能显著提高重症颅脑损伤昏迷患者清醒率、缩短清醒时间、提高GCS评分、降低NIHSS评分和APACHE-Ⅱ评分，提高预后良好率。

Meta-analysis of therapeutic efficacy and safety of Xingnaojing in treatment of acute severe craniocerebral injury in patients with coma

Objective To systematically evaluate the efficacy and safety of Xingnaojing in the treatment of acute severe craniocerebral injury in patients with coma. Methods A randomized controlled trial of Xingnaojing in the treatment of acute severe craniocerebral injury in patients with coma were conducted in CNKI, Wanfang, WIP, CBM, PubMed and Embase databases from the database to May 2019. Date were extracted and evaluated by two reviewers independently with designed extraction form. The Rev Man 5.3 software was used to carry out statistic analysis. Results A total of 15 studies were included, including 1173 patients.Metaanalysis results showed: the test group of the awake rate (OR = 2.50, 95%CI = 1.79 ~ 3.49), awake time (MD = -4.20, 95%CI = -5.45 ~ -2.96), GCS score changed (MD = 2.68, 95%CI = 2.44 ~ 2.93), NHISS score changed (MD = -6.12, 95%CI = -7.46 ~ -4.77), APACHE-II score changed (MD = -3.61, 95%CI = -4.37 ~ -2.86), Prognosis rate (OR = 2.37, 95%CI =1.81 ~ 3.10), poor prognosis rate (OR = 0.46, 95%CI = 0.34 ~ 0.62) and serum inflammatory factors (TNF-a, IL-8, IL-6) were better than that in the control group,the difference both had statistically significant (P < 0.01). Conclusion The available research evidence shows that Xingnaojing can significantly improve the wakefulness rate, shorten the awake time, increase the GCS score, decrease the NIHSS score and APACHE-II score and improve the prognosis rate in patients with severe craniocerebral injury.