Shanxi Medical University, Taiyuan, 030001, China; Department of Pediatrics, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
Shanxi Medical University, Taiyuan, 030001, China; Department of Neurology, Shanxi Provincial Children's Hospital, Taiyuan, 030013, China.
J Ethnopharmacol. 2024 Jan 30;319(Pt 3):117317. doi: 10.1016/j.jep.2023.117317. Epub 2023 Oct 12.
Although therapeutic hypothermia is currently considered an effective treatment for neonatal hypoxic-ischemic encephalopathy (HIE), neonatal HIE is a disease requiring multiple therapeutic measures. Related Chinese herbal injections (CHIs) have been carried out in Chinese local hospitals for several years, and the outcomes all seem to show positive results. At the same time, other Traditional Chinese medicine (TCM) methods have also shown vigorous vitality.
This study constructed a network meta-analysis (NMA) to investigate the efficacy of CHIs including Shenmai Injection (SMI), Compound musk injection (SXI), Ligustrazine injection (CXI), Compound danshen injection (DSI), Astragalus injection (HQI), Ginkgo biloba extract injection (YXI), and Puerarin injection (GGI) combined with traditional symptomatic treatment (TST) and TST alone in HIE.
A literature review was conducted in several databases from inception to 9 February 2023. The quality of the included studies was assessed by the Cochrane risk of bias tool. Data were analyzed by STATA 17.0 and R 4.2.2 software. Surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the examined treatments. Bayesian network meta-analysis was designed to access the effectiveness of different CHIs.
A total of 46 eligible randomized controlled trials involving 3,448 patients and 7 CHIs were included. The results of the NMA showed that SMI, SXI, CXI, DSI, HQI, YXI, and GGI combined with TST significantly improved treatment performance compared to TST alone. SMI + TST had obvious superiorities in the clinical effective rate and the original reflection recovery time. SXI + TST was the most advantageous in the Cure rate and the Neonatal Behavioral Neurological Assessment (NBNA). CXI + TST was shown to reduce the incidence of sequelae best. All articles reported that there were no obvious adverse drug reactions/adverse drug events (ADRs/ADEs).
This NMA showed that using CHIs in combination with TST improved treatment performance and could be beneficial for patients with HIE compared to using TST alone. Thereinto, SXI + TST showed a preferable improvement in patients with HIE when unified considering the clinical effective rate and other outcomes. As for safety, more evidence is needed to support this hypothesis.
尽管治疗性低温目前被认为是治疗新生儿缺氧缺血性脑病（HIE）的有效方法，但新生儿 HIE 需要多种治疗措施。相关的中药注射剂（CHIs）已在中国当地医院使用了数年，结果似乎都显示出积极的结果。与此同时，其他中医（TCM）方法也显示出了强大的生命力。
本研究构建了一个网络荟萃分析（NMA），以调查包括参麦注射液（SMI）、复方麝香注射液（SXI）、川芎嗪注射液（CXI）、复方丹参注射液（DSI）、黄芪注射液（HQI）、银杏叶提取物注射液（YXI）和葛根素注射液（GGI）在内的 CHIs 与传统对症治疗（TST）联合应用与单独 TST 治疗 HIE 的疗效。
从成立到 2023 年 2 月 9 日，在几个数据库中进行了文献回顾。使用 Cochrane 偏倚风险工具评估纳入研究的质量。使用 STATA 17.0 和 R 4.2.2 软件进行数据分析。应用累积排序曲线下面积（SUCRA）概率值对所检查的治疗方法进行排序。设计贝叶斯网络荟萃分析以评估不同 CHIs 的疗效。
共纳入 46 项符合条件的随机对照试验，涉及 3448 名患者和 7 种 CHIs。NMA 的结果表明，SMI、SXI、CXI、DSI、HQI、YXI 和 GGI 联合 TST 与单独 TST 相比，显著提高了治疗效果。SMI+TST 在临床有效率和原始反射恢复时间方面具有明显优势。SXI+TST 在治愈率和新生儿行为神经评估（NBNA）方面最有利。CXI+TST 显示出最佳的后遗症发生率降低效果。所有文章均报告无明显药物不良反应/药物不良事件（ADRs/ADEs）。
本 NMA 表明，与单独使用 TST 相比，使用 CHIs 联合 TST 可提高治疗效果，对 HIE 患者有益。其中，SXI+TST 在综合考虑临床有效率和其他结局时，对 HIE 患者的改善效果较好。至于安全性，需要更多的证据来支持这一假设。
