Wang Min, Jia Min, DU Wan-Qing, Zhang Xin-Yang, Jiao Wei-Wei, Chen Qian, Lei Lin, Duan Jia-Yu, Tong Chen-Guang, Zhang Yun-Ling, Liao Xing
Graduate School, Beijing University of Chinese Medicine Beijing 100029, China Center for Evidence-based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences Beijing 100700, China.
Xiyuan Hospital, China Academy of Chinese Medical Sciences Beijing 100091, China.
Zhongguo Zhong Yao Za Zhi. 2021 Sep;46(18):4633-4643. doi: 10.19540/j.cnki.cjcmm.20210622.501.
To overview of systematic reviews/Meta-analysis of Xingnaojing Injection(XNJ) in the treatment of intracerebral hemorrhage(ICH). The systematic reviews concerning XNJ in the treatment of ICH were retrieved from four Chinese databases, four English databases, Chinese Clinical Trial Registry and ClinicalTrail.gov, with the retrieval time set from their inception to September 2020. Following the independent screening and data extraction by two researchers, a measurement tool to assess systematic evaluation 2(AMSTAR 2) and grades of recommendation, assessment, development and evaluation(GRADE) system were used to evaluate the metho-dological, reporting and evidence qualities of the 10 included systematic reviews. The results showed that XNJ was superior to the wes-tern medicine or conventional treatment in improving the effective rate and National Institutes of Health stroke scale(NIHSS) score, Barthel index(BI), and Glasgow coma scale(GCS) score and Chinese stroke scale(CSS) score, and reducing the mortality and cerebral hematoma volume, without inducing obvious adverse reactions. In general, the methodological, reporting and evidence qualities of the 10 included systematic reviews were poor. The AMSTAR 2 scores showed that key items No. 2 and No. 16 failed to meet the stan-dard, resulting in poor methodological quality. There was only one outcome indicator graded by GRADE as intermediate quality, 43% indicators as low quality, 42% indicators as extremely low quality, and none as high quality. These available evidences have suggested that the methodological, reporting and evidence qualities of the systematic evaluation concerning XNJ for the treatment of ICH need to be improved. Most evidences support that XNJ was better than the western medicine or conventional treatment in the treatment of ICH, but the methodological quality and the reliability of outcome indicators in relevant systematic review were low. More high-quality studies are still required for further verification.
醒脑静注射液治疗脑出血的系统评价/荟萃分析概述。从四个中文数据库、四个英文数据库、中国临床试验注册中心和ClinicalTrail.gov检索关于醒脑静注射液治疗脑出血的系统评价，检索时间设定为各数据库建库至2020年9月。由两名研究人员独立筛选和提取数据后，采用系统评价方法学质量评估工具2（AMSTAR 2）和推荐意见、评估、制定与评价（GRADE）系统，对纳入的10篇系统评价的方法学、报告质量和证据质量进行评价。结果显示，醒脑静注射液在提高有效率、美国国立卫生研究院卒中量表（NIHSS）评分、Barthel指数（BI）、格拉斯哥昏迷量表（GCS）评分和中国卒中量表（CSS）评分，以及降低死亡率和脑血肿体积方面优于西药或传统治疗，且未引起明显不良反应。总体而言，纳入的10篇系统评价的方法学、报告质量和证据质量较差。AMSTAR 2评分显示关键条目第2条和第16条未达标，导致方法学质量较差。GRADE分级结果显示，仅有1项结局指标为中等质量，43%的指标为低质量，42%的指标为极低质量，无高质量指标。现有证据提示，醒脑静注射液治疗脑出血的系统评价的方法学、报告质量和证据质量有待提高。多数证据支持醒脑静注射液治疗脑出血优于西药或传统治疗，但相关系统评价的方法学质量和结局指标可靠性较低，仍需更多高质量研究进一步验证。
