Xue Ping, Ma Zhuoya, Liu Shuguang
Department of Neurology, Liaocheng People's Hospital, Liaocheng, China.
Department of Intensive Care Unit, Yanggu People's Hospital, Yanggu, China.
Front Pharmacol. 2019 Dec 4;10:1403. doi: 10.3389/fphar.2019.01403. eCollection 2019.
Ginkgo leaf extract and dipyridamole injection (GDI), a kind of Chinese medicine preparation, has been considered as a promising supplementary treatment for ischemic stroke. The aim of this study was to systematically evaluate the clinical efficacy and safety of GDI mediated therapy for ischemic stroke. PubMed, Cochrane Library, Medline, Embase, Web of Science, Wanfang database, Chinese Scientific Journal Database (VIP), China National Knowledge Infrastructure (CNKI) and Chinese Biological Medicine Database (CBM), were searched systematically for clinical trials of conventional treatments combined with GDI for ischemic stroke. The reported outcomes including overall response, hemorrheology and blood lipid indexes, and adverse events were systematically investigated. Data from thirty-nine trials including 3,182 ischemic stroke patients were involved. The results indicated that, compared with conventional treatments alone, the combination of conventional treatments with GDI obviously improved the overall response (odds ratio [OR] = 4.14, 95% confidence interval [CI] = 3.26-5.25, < 0.00001), neurological status (National Institutes of Health Stroke Scale, OR = -3.13, 95% CI = -3.98 to -2.28, < 0.00001) and activity of daily living (Barthel Index score, OR = 14.10, 95% CI = 9.51-18.68, < 0.00001) of patients. Moreover, the hemorheology and blood lipids indexes of ischemic stroke patients were also significantly ameliorated after the combined therapy ( < 0.01). The frequency of adverse events did not differ significantly between the two groups ( > 0.05). Evidence from the meta-analysis suggested that the combination of conventional treatments and GDI is safe and more effective in treating ischemic stroke than conventional treatments alone. Therefore, GDI mediated therapy could be recommended as an adjuvant treatment for ischemic stroke.
银杏叶提取物双嘧达莫注射液(GDI)是一种中药制剂,被认为是缺血性中风一种有前景的辅助治疗方法。本研究旨在系统评价GDI介导治疗缺血性中风的临床疗效和安全性。系统检索了PubMed、Cochrane图书馆、Medline、Embase、科学引文索引、万方数据库、中文科技期刊数据库(维普)、中国知网和中国生物医学数据库(CBM),以查找常规治疗联合GDI治疗缺血性中风的临床试验。系统调查了报告的结果,包括总有效率、血液流变学和血脂指标以及不良事件。纳入了39项试验的数据,涉及3182例缺血性中风患者。结果表明,与单纯常规治疗相比,常规治疗联合GDI明显提高了患者的总有效率(比值比[OR]=4.14,95%置信区间[CI]=3.26-5.25,P<0.00001)、神经功能状态(美国国立卫生研究院卒中量表,OR=-3.13,95%CI=-3.98至-2.28,P<0.00001)和日常生活活动能力(Barthel指数评分,OR=14.10,95%CI=9.51-18.68,P<0.00001)。此外,联合治疗后缺血性中风患者的血液流变学和血脂指标也得到显著改善(P<0.01)。两组不良事件的发生率差异无统计学意义(P>0.05)。荟萃分析的证据表明,常规治疗与GDI联合治疗缺血性中风比单纯常规治疗更安全、更有效。因此,GDI介导的治疗可推荐作为缺血性中风的辅助治疗。