脑栓通胶囊治疗缺血性脑卒中的疗效与安全性：一项Meta分析

Efficacy and Safety of NaoShuanTong Capsule in the Treatment of Ischemic Stroke: A Meta-Analysis.

作者信息

Zhang Hanlai, Xing Yanwei, Chang Jingling, Wang Liqin, An Na, Tian Chao, Yuan Mengchen, Yang Xinyu, Shang Hongcai, Gao Ying, Gao Yonghong

机构信息

Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China.

Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Front Pharmacol. 2019 Oct 11;10:1133. doi: 10.3389/fphar.2019.01133. eCollection 2019.

Ischemic stroke (IS) is a leading cause of death and long-term disability worldwide. The NaoShuanTong capsule (NSTC), a traditional Chinese patent medicine, has been extensively used in the treatment of stroke in China. However, the clinical efficacy and safety of this treatment has not been statistically and systematically verified by any comprehensive pooled analysis. We therefore performed a meta-analysis to evaluate the efficacy and safety of NSTC in the treatment of IS. Randomized controlled trials (RCTs) of NSTC in the treatment of IS conducted before September 2018 were retrieved from five databases, according to specific inclusion and exclusion criteria. Two investigators independently reviewed the included studies and extracted relevant data. The methodological quality of the included studies was assessed using criteria from the Cochrane Handbook, and analyzed using Review Manager 5.3 software. Thirteen RCTs comprising a total of 1,360 participants were included in this study. NSTC was shown to significantly improve the overall response rate ( = 3.04, 95% CI [1.76, 5.26], < 0.00001), and neurological function (NSTC increased Modified Barthel Index ( = 8.15, 95% CI [3.79, 12.52], = 0.0005), Functional Independence Measure ( = 29.61, 95% CI [10.11, 49.10], = 0.003) and European Stroke Scale scores ( = 8.51, 95% CI [7.00, 10.01], = 0.03). In addition, NSTC significantly increased serum adiponectin level ( = 0.66, 95% CI [0.23, 1.08], = 0.002). Moreover, NSTC reduced atherosclerotic plaque area ( = -2.24, 95% CI [-4.02, -0.46], = 0.01) and intima-media thickness ( = -0.09, 95% CI [-0.13, -0.05], < 0.0001). However, there was no significant difference between NSTC treatment and conventional therapy with respect to Fugl-Meyer Assessment score ( = 10.59, 95% CI [-1.78, 22.96], = 0.09) or Crouse score ( = -0.78, 95% CI [-1.79, -0.22], = 0.13). The results of this meta-analysis showed that NSTC exhibits efficacy in the treatment of cerebral infarction. NSTC can improve the overall response rate and neurological function, increase blood adiponectin, reduce neurological deficits, and decrease atherosclerotic plaque area.

缺血性中风（IS）是全球范围内导致死亡和长期残疾的主要原因。脑栓通胶囊（NSTC）是一种传统中成药，在中国已广泛用于中风治疗。然而，这种治疗方法的临床疗效和安全性尚未经过任何全面的汇总分析进行统计学和系统的验证。因此，我们进行了一项荟萃分析，以评估NSTC治疗IS的疗效和安全性。根据特定的纳入和排除标准，从五个数据库中检索了2018年9月之前进行的NSTC治疗IS的随机对照试验（RCT）。两名研究人员独立审查纳入的研究并提取相关数据。使用Cochrane手册的标准评估纳入研究的方法学质量，并使用Review Manager 5.3软件进行分析。本研究纳入了13项RCT，共1360名参与者。结果显示，NSTC可显著提高总有效率（ = 3.04，95%CI [1.76, 5.26]， < 0.00001），并改善神经功能（NSTC使改良Barthel指数增加（ = 8.15，95%CI [3.79, 12.52]， = 0.0005）、功能独立性测量值（ = 29.61，95%CI [10.11, 49.10]， = 0.003）以及欧洲卒中量表评分（ = 8.51，95%CI [7.00, 10.01]， = 0.03）。此外，NSTC可显著提高血清脂联素水平（ = 0.66，95%CI [0.23, 1.08]， = 0.002）。而且，NSTC可减小动脉粥样硬化斑块面积（ = -2.24，95%CI [-4.02, -0.46]， = 0.01）和内膜中层厚度（ = -0.09，95%CI [-0.13, -0.05]， < 0.0001）。然而，在Fugl-Meyer评估评分（ = 10.59，95%CI [-1.78, 22.96]， = 0.09）或Crouse评分（ = -0.78，95%CI [-1.79, -0.我们进行了一项荟萃分析，以评估NSTC治疗IS的疗效和安全性。根据特定的纳入和排除标准，从五个数据库中检索了2018年9月之前进行的NSTC治疗IS的随机对照试验（RCT）。两名研究人员独立审查纳入的研究并提取相关数据。使用Cochrane手册的标准评估纳入研究的方法学质量，并使用Review Manager 5.3软件进行分析。本研究纳入了13项RCT，共1360名参与者。结果显示，NSTC可显著提高总有效率（ = 3.04，95%CI [1.76, 5.26]， < 0.00001），并改善神经功能（NSTC使改良Barthel指数增加（ = 8.15，95%CI [3.79, 12.52]， = 0.0005）、功能独立性测量值（ = 29.61，95%CI [10.11, 49.10]， = 0.003）以及欧洲卒中量表评分（ = 8.51，95%CI [7.00, 10.01]， = 0.03）。此外，NSTC可显著提高血清脂联素水平（ = 0.66，95%CI [0.23, 1.08]， = 0.002）。而且，NSTC可减小动脉粥样硬化斑块面积（ = -我们进行了一项荟萃分析，以评估NSTC治疗IS的疗效和安全性。根据特定的纳入和排除标准，从五个数据库中检索了2018年9月之前进行的NSTC治疗IS的随机对照试验（RCT）。两名研究人员独立审查纳入的研究并提取相关数据。使用Cochrane手册的标准评估纳入研究的方法学质量，并使用Review Manager 5.3软件进行分析。本研究纳入了13项RCT，共1360名参与者。结果显示，NSTC可显著提高总有效率（ = 3.04，95%CI [1.76, 5.26]， < 0.00001），并改善神经功能（NSTC使改良Barthel指数增加（ = 8.15，95%CI [3.79, 12.52]， = 0.0005）、功能独立性测量值（ = 29.61，95%CI [10.11, 49.10]， = 0.003）以及欧洲卒中量表评分（ = 8.51，95%CI [从五个数据库中检索了2018年9月之前进行的NSTC治疗IS的随机对照试验（RCT）。两名研究人员独立审查纳入的研究并提取相关数据。使用Cochrane手册的标准评估纳入研究的方法学质量，并使用Review Manager 5.3软件进行分析。本研究纳入了13项RCT，共1360名参与者。结果显示，NSTC可显著提高总有效率（ = 3.04，95%CI [1.76, 5.26]， < 0.00001），并改善神经功能（NSTC使改良Barthel指数增加（ = 8.15，95%CI [3.79, 12.52]， = 0.0005）、功能独立性测量值（ = 29.61，95%CI [10.11, 49.10]， = 0.003）以及欧洲卒中量表评分（ = 8.51，95%CI [7.00, 10.01]， = 0.03）。此外，NSTC可显著提高血清脂联素水平（ = 0.66，95%CI [0.23, 1.08]， = 0.002）。而且，NSTC可减小动脉粥样硬化斑块面积（ = -2.24，95%CI [-4.02, -0.46]， = 0.01）和内膜中层厚度（ = -0.09，95%CI [-0.13, -0.05]， < 0.0001）。然而，在Fugl-Meyer评估评分（ = 10.59，95%CI [-1.78, 22.96]， = 0.09）或Crouse评分（ = -0.78，95%CI [-1.79, -0.22]， = 0.13）方面，NSTC治疗与传统疗法之间无显著差异。这项荟萃分析的结果表明，NSTC在治疗脑梗死方面具有疗效。NSTC可提高总有效率和神经功能，增加血液脂联素，减少神经功能缺损，并减小动脉粥样硬化斑块面积。 22]， = 0.13）方面，NSTC治疗与传统疗法之间无显著差异。这项荟萃分析的结果表明，NSTC在治疗脑梗死方面具有疗效。NSTC可提高总有效率和神经功能，增加血液脂联素，减少神经功能缺损，并减小动脉粥样硬化斑块面积。