葛根素治疗急性脑梗死的系统评价

目的系统评价葛根素治疗急性脑梗死的临床疗效和安全性。方法运用系统评价的方法,全面检索2006年2月以前来自MEDLINE、 EMBase、中国生物医学文献光盘数据库、中国脑卒中临床试验数据库的相关文献以及所获文献的参考文献。按Cochrane标准,对纳入研究逐个进行质量评价,而后采用RevMan 4．2软件进行Meta分析。结果共14个研究(1141例)符合纳入标准。仅1个试验报告了6个月时的死亡或残疾率,原试验结果显示两组差异无统计学意义。对提供神经功能缺损改善率的11个研究进行的Meta分析显示,治疗组有效率高于对照组,其差异有统计学意义[OR 3．21,95%CI(2．25,4．59)]。结论本研究所纳入试验的方法学质量均较低,虽然葛根素可改善急性脑梗死近期神经功能缺损,但评价远期功能性结局的研究仅1个,且病例数(98例) 太少,尚不能得出肯定结论。因此进行高质量、大样本的随机对照试验非常必要。

Clinical Efficacy of Pueraria for Acute Cerebral Infarction

Objective To assess the efficacy and safety of pueraria for acute cerebral infarction. Methods We searched MEDLINE, EMBASE, CBM, and the Chinese Stroke Clinical Trials Database. The search was conducted in Feb., 2006. Data were extracted and assessed by two reviewers independently. Revman 4.2 software was used for statistical analysis. Results Nineteen potentially eligible trials were identified, of which 14 (1 141 patients) were included. Only one trial reported the death or disability rate at the end of 6-month follow-up (the difference between the two groups was not significant). Meta-analysis of 11 trials invovling the improvement of neurological deficit indicated that pueraria was significantly more effective than the control group [OR 3.04, 95%CI 2.11, 4.39]. Conclusions Pueraria might improve the short-term neurological deficit of patients with acute cerebral infarction. But the methodological quality of all the included trials is poor, reliable conclusions can not be drawn from the present data. More high-quality randomized controlled trials are required.