脑心通胶囊治疗脑梗死合并颈动脉粥样硬化患者的疗效：随机试验的系统评价与Meta分析
The Effect of Naoxintong Capsule in the Treatment of Patients with Cerebral Infarction and Carotid Atherosclerosis: A Systematic Review and Meta-Analysis of Randomized Trials.
作者信息
Liang Qiuer, Cai Yunfei, Chen Ruixue, Chen Weihao, Chen Liguo, Xiao Ya
机构信息
School of Traditional Chinese Medicine, Jinan University, Guangzhou, China.
The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
出版信息
Evid Based Complement Alternat Med. 2018 Jul 24;2018:5892306. doi: 10.1155/2018/5892306. eCollection 2018.
OBJECTIVE
Naoxintong capsule (NXT) has been widely used to treat patients with cerebral infarction and carotid atherosclerosis. However, it is uncertain whether there is robust evidence on the effects of NXT for cerebral infarction and carotid atherosclerosis. A systematic review and meta-analysis of randomized trials were performed to assess the efficacy of NXT in the treatment of cerebral infarction and carotid atherosclerosis.
METHODS
The Cochrane Library, EMBASE, the Medline database, the Wanfang database, the China National Knowledge Infrastructure, and the VIP database were searched up to January 2018 with no language restrictions. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards.
RESULTS
Eleven studies (N=1141) in total satisfied the inclusion criteria for the meta-analysis. The results of meta-analysis showed that compared with the conventional therapy alone, NXT combined with conventional therapy could significantly improve national institutes of health stroke scale (NIHSS) score (MD= -3.92, 95%CI: -4.31-3.52, <0.00001), plaque area (MD= -0.16, 95%CI: -0.20-0.13, <0.00001), carotid intima-media thickness (IMT) (MD= -0.23, 95%CI: -0.26-0.20, <0.00001), total cholesterol (TC) (MD= -0.16, 95%CI: -0.79-0.42, <0.00001), triglyceride (TG) (MD= -0.69, 95%CI: -0.88-0.51, <0.00001), high-density lipoprotein cholesterol (HDL-C) (MD= 0.23, 95%CI: 0.150.31, <0.00001), and low-density lipoprotein cholesterol (LDL-C) (MD= -0.42, 95%CI: -0.58~-0.25, <0.00001). There were no reported adverse events in the studies.
CONCLUSIONS
NXT is an effective and safe therapy option for patients with cerebral infarction and carotid atherosclerosis. However, due to the high clinical heterogeneity and small sample size of the included trials, further standardized preparation, large-scale and rigorously designed trials are needed.
目的
脑心通胶囊（NXT）已被广泛用于治疗脑梗死和颈动脉粥样硬化患者。然而，关于NXT对脑梗死和颈动脉粥样硬化疗效的有力证据尚不确定。进行了一项随机试验的系统评价和荟萃分析，以评估NXT治疗脑梗死和颈动脉粥样硬化的疗效。
方法
检索截至2018年1月的Cochrane图书馆、EMBASE、Medline数据库、万方数据库、中国知网和维普数据库，无语言限制。根据Cochrane标准进行研究选择、数据提取、质量评估和数据分析。
结果
共有11项研究（N = 1141）符合荟萃分析的纳入标准。荟萃分析结果显示，与单纯常规治疗相比，NXT联合常规治疗可显著改善美国国立卫生研究院卒中量表（NIHSS）评分（MD = -3.92，95%CI：-4.31-3.52，<0.00001）、斑块面积（MD = -0.16，95%CI：-0.20-0.13，<0.00001）、颈动脉内膜中层厚度（IMT）（MD = -0.23，95%CI：-0.26-0.20，<0.00001）、总胆固醇（TC）（MD = -0.16，95%CI：-0.79-0.42，<0.00001）、甘油三酯（TG）（MD = -0.69，95%CI：-0.88-0.51，<0.00001）、高密度脂蛋白胆固醇（HDL-C）（MD = 0.23，95%CI：0.150.31，<0.00001）和低密度脂蛋白胆固醇（LDL-C）（MD = -0.42，95%CI：-0.58~-0.25，<0.00001）。研究中未报告不良事件。
结论
NXT是治疗脑梗死和颈动脉粥样硬化患者的一种有效且安全的治疗选择。然而，由于纳入试验的临床异质性高且样本量小，需要进一步进行标准化制剂、大规模且设计严谨的试验。
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