Xu Hong, Zeng Li, Liao Li, Li Xiaoxuan, Tang Yan
Department of Pharmacy, The Second People's Hospital of Yibin, Yibin, China.
Department of Pharmacy, The Third People's Hospital of Yibin, Yibin, China.
Front Pharmacol. 2025 Mar 19;16:1554207. doi: 10.3389/fphar.2025.1554207. eCollection 2025.
This meta-analysis aimed to assess the efficacy and safety of ginkgo terpene lactone preparations including diterpene ginkgolides meglumine injection (DGMI) and ginkgolide injection combined with antiplatelet drugs in the treatment of ischemic stroke.
We systematically searched the randomized controlled trials(RCTs) with publication date earlier than 6 November 2024 in PubMed, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (CBM), Wanfang Database, Embase, Web of Science, ClinicalTrials.gov, and Cochrane Library. Studies were screened according to inclusion and exclusion criteria, evaluated according to criteria recommended by the Cochrane Handbook, and data were then analyzed using Stata 17 software.
Of 1,079 identified studies, 27 were eligible and included in our analysis (N = 3,336 patients). The meta-analysis demonstrated that the overall response rate [RR = 1.22, 95% CI(1.17, 1.27), Z = 9.76, < 0.01], as well as the National Institutes of Health Stroke Scale (NIHSS) score and barthel index, were significantly better in the DGMI combined treatment group compared to the antiplatelet therapy alone group. However, there was no significant difference observed between the experimental group and the control group regarding improvements in prognosis and platelet function. The studies included in the analysis reported a total of 419 adverse reactions (ADRs), with 206 occurring in the DGMI combined treatment group; furthermore, there was no significant difference in the incidence of adverse events between the two groups.
Ginkgo terpene lactone preparations, when combined with antiplatelet drugs, can significantly enhance the clinical efficacy of ischemic stroke and demonstrate a favorable safety profile. This combination is a potential treatment strategy that can improve the management of IS patients and has high clinical application value.
本荟萃分析旨在评估银杏萜内酯制剂（包括双萜银杏内酯葡胺注射液（DGMI））和银杏内酯注射液联合抗血小板药物治疗缺血性卒中的疗效和安全性。
我们系统检索了截至2024年11月6日在PubMed、中国知网（CNKI）、维普中文科技期刊数据库（VIP）、中国生物医学文献数据库（CBM）、万方数据库、Embase、Web of Science、ClinicalTrials.gov和Cochrane图书馆中发表的随机对照试验（RCT）。根据纳入和排除标准筛选研究，按照Cochrane手册推荐的标准进行评估，然后使用Stata 17软件进行数据分析。
在1079项检索到的研究中，27项符合纳入标准并纳入我们的分析（N = 3336例患者）。荟萃分析表明，与单纯抗血小板治疗组相比，DGMI联合治疗组的总有效率[RR = 1.22，95%CI（1.17，1.27），Z = 9.76，P < 0.01]以及美国国立卫生研究院卒中量表（NIHSS）评分和巴氏指数均显著更好。然而，在预后改善和血小板功能方面，实验组与对照组之间未观察到显著差异。分析纳入的研究共报告了419例不良反应，其中DGMI联合治疗组发生206例；此外，两组不良事件发生率无显著差异。
银杏萜内酯制剂与抗血小板药物联合使用时，可显著提高缺血性卒中的临床疗效，且安全性良好。这种联合是一种潜在的治疗策略，可改善缺血性卒中患者的治疗管理，具有较高的临床应用价值。
