依达拉奉联合舒血宁与依达拉奉单药治疗急性脑梗死的系统评价与 Meta 分析。
Edaravone combined with Shuxuening versus edaravone alone in the treatment of acute cerebral infarction: A systematic review and meta-analysis.
机构信息
Department of Neurology, The People's Hospital Affiliated to Ningbo University, Ningbo, Zhejiang Province, China.
Department of Rheumatology, The People's Hospital Affiliated to Ningbo University, Ningbo, Zhejiang Province, China.
出版信息
Medicine (Baltimore). 2023 Mar 3;102(9):e32929. doi: 10.1097/MD.0000000000032929.
BACKGROUND
Shuxuening injection (SXN) is a traditional Chinese medicine used in the treatment of cardiovascular diseases. Whether it can provide better outcomes when combined with edaravone injection (ERI) for the treatment of acute cerebral infarction is not well determined. Therefore, we evaluated the efficacy of ERI combined with SXN versus that of ERI alone in patients with acute cerebral infarction.
METHODS
PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang electronic databases were searched up to July 2022. Randomized controlled trials comparing the outcomes of efficacy rate, neurologic impairment, inflammatory factors, and hemorheology were included. Odds ratio or standard mean difference (SMD) with corresponding 95% confidence intervals (CIs) were used to present the overall estimates. The quality of the included trials was evaluated by the Cochrane risk of bias tool. The study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses.
RESULTS
Seventeen randomized controlled trials were included consisting of 1607 patients. Compared to ERI alone, treatment with ERI plus SXN had a greater effective rate than ER alone (odds ratio = 3.94; 95% CI: 2.85, 5.44; I2 = 0%, P < .00001), a lower National Institute of Health Stroke Scale (SMD= -1.39; 95% CI: -1.73, -1.05; I2 = 71%, P < .00001), lower neural function defect score (SMD= -0.75; 95% CI: -1.06,-0.43; I2 = 67%, P < .00001), and lower level of neuron-specific enolase (SMD= -2.10; 95% CI: -2.85, -1.35; I2 = 85%, P < .00001). ERI plus SXN treatment provided significant improvements in whole blood high shear viscosity (SMD = -0.87; 95% CI: -1.17, -0.57; I2 = 0%, P < .00001), and whole blood low shear viscosity (SMD = -1.50; 95% CI: -1.65, -1.36; I2 = 0%, P < .00001) compared to ERI alone.
CONCLUSION
ERI plus SXN showed better efficacy than ERI alone for patients with acute cerebral infarction. Our study provides evidence supporting the application of ERI plus SXN for acute cerebral infarction.
背景
疏血通注射液（SXN）是一种用于治疗心血管疾病的中药。对于急性脑梗死的治疗，SXN 联合依达拉奉注射液（ERI）是否能提供更好的疗效尚不确定。因此，我们评估了 ERI 联合 SXN 与 ERI 单独治疗急性脑梗死的疗效。
方法
检索 PubMed、Embase、Cochrane 图书馆、中国知网和万方电子数据库，检索时间截至 2022 年 7 月。纳入比较 SXN 联合 ERI 与 ERI 单独治疗急性脑梗死患者的疗效、神经损伤、炎症因子和血液流变学的随机对照试验。使用比值比或标准化均数差（SMD）及其 95%置信区间（CI）表示汇总估计值。采用 Cochrane 偏倚风险工具评估纳入试验的质量。本研究按照系统评价和荟萃分析的 Preferred Reporting Items 进行报告。
结果
共纳入 17 项随机对照试验，包括 1607 例患者。与 ERI 单独治疗相比，ERI 联合 SXN 治疗的有效率高于 ERI 单独治疗（比值比=3.94；95%CI：2.85，5.44；I²=0%，P<0.00001），NIH 卒中量表评分（SMD=-1.39；95%CI：-1.73，-1.05；I²=71%，P<0.00001）、神经功能缺损评分（SMD=-0.75；95%CI：-1.06，-0.43；I²=67%，P<0.00001）和神经元特异性烯醇化酶水平（SMD=-2.10；95%CI：-2.85，-1.35；I²=85%，P<0.00001）均更低。ERI 联合 SXN 治疗还可显著改善全血高切黏度（SMD=-0.87；95%CI：-1.17，-0.57；I²=0%，P<0.00001）和全血低切黏度（SMD=-1.50；95%CI：-1.65，-1.36；I²=0%，P<0.00001）。
结论
与 ERI 单独治疗相比，ERI 联合 SXN 对急性脑梗死患者的疗效更好。本研究为 ERI 联合 SXN 治疗急性脑梗死提供了证据支持。
Zotero 插件