CAJ | 학술논문

目的：系统评价依达拉奉联合血栓通治疗急性脑梗死的临床疗效及其安全性。方法检索中国期刊全文数据库(CNKI)、中国科技期刊全文数据库(VIP)、万方知识服务平台、中国生物医学文献数据库(CBM)及 PubMed,检索时间从各数据库建库开始至2014年3月发表的依达拉奉联合血栓通治疗急性脑梗死的随机和半随机对照试验(RCT),按 Cochrane手册对随机对照试验的质量标准评分对所纳入文献进行质量评价,用 RevMan 5.1软件进行 Meta 分析。结果最终纳入24个临床研究,共2204例患者。所纳入研究仅有一个为中等质量文献,16个研究描述了不良反应情况。Meta结果显示,依达拉奉联合血栓通更能提高急性脑梗死患者的总有效率、痊愈率、日常生活能力及改善神经功能,且差异有统计学意义,分别为[OR=4.03,95%CI (3.09,5.25)]；[OR=2.07,95%CI(1.68,2.55)]；[OR=8.48,95%CI(6.292,10.68)]；[OR=6.46,95%CI(4.82,8.10)]；[OR=5.03,95%CI (3.67,6.38)]；[OR=9.79,95%CI (6.69,12.89)],但在血高敏 C反应蛋白(hs CRP)方面差异无统计学意义[OR=23.00,95%CI (-18.41,64.40)],尚不能表明其可以改善脑梗死患者血hs CRP。结论目前的研究证据支持依达拉奉联合血栓通更能提高急性脑梗死患者的总有效率、痊愈率及改善神经功能、日常生活能力,其安全性较好,无明显的不良反应,但由于纳入研究的局限性,上述结论仍待更多大规模,高质量的研究加以证明。
목적：계통평개의체랍봉연합혈전통치료급성뇌경사적림상료효급기안전성。방법검색중국기간전문수거고(CNKI)、중국과기기간전문수거고(VIP)、만방지식복무평태、중국생물의학문헌수거고(CBM)급 PubMed,검색시간종각수거고건고개시지2014년3월발표적의체랍봉연합혈전통치료급성뇌경사적수궤화반수궤대조시험(RCT),안 Cochrane수책대수궤대조시험적질량표준평분대소납입문헌진행질량평개,용 RevMan 5.1연건진행 Meta 분석。결과최종납입24개림상연구,공2204례환자。소납입연구부유일개위중등질량문헌,16개연구묘술료불량반응정황。Meta결과현시,의체랍봉연합혈전통경능제고급성뇌경사환자적총유효솔、전유솔、일상생활능력급개선신경공능,차차이유통계학의의,분별위[OR=4.03,95%CI (3.09,5.25)]；[OR=2.07,95%CI(1.68,2.55)]；[OR=8.48,95%CI(6.292,10.68)]；[OR=6.46,95%CI(4.82,8.10)]；[OR=5.03,95%CI (3.67,6.38)]；[OR=9.79,95%CI (6.69,12.89)],단재혈고민 C반응단백(hs CRP)방면차이무통계학의의[OR=23.00,95%CI (-18.41,64.40)],상불능표명기가이개선뇌경사환자혈hs CRP。결론목전적연구증거지지의체랍봉연합혈전통경능제고급성뇌경사환자적총유효솔、전유솔급개선신경공능、일상생활능력,기안전성교호,무명현적불량반응,단유우납입연구적국한성,상술결론잉대경다대규모,고질량적연구가이증명。
Objective To assess the clinical efficacy and safety of edaravone and Xueshuantong in treatment of acute cerebral infarc-tion by conducting a meta analysis of randomized or quasi control ed trails.Methods The CNKI,Wan Fang Database,VIP and CBM and PubMed were searched to col ect clinical trails of edaravone and Xueshuantong in treatment of acute cerebral infarction that were published from the beginning the databases to January 2014,then assessed the methodological quality with the method in the Co-chrane handbook and then made a Meta analysis with the Review Manage 5.1 software.Results Our study adopted 24 studies,2 204 participants were included in total.Only one of the included studies had moderate quality,and 16 studies described side effect.This meta analysis showed that edaravone and Xueshuantong can improve the total effective rate,curative rate,neurological function and activities of daily living of the acute cerebral infarction with statistical significance respectively[OR=4.03,95% CI (3.09,5.25)], [OR=2.07,95% CI (1.68,2.55)],[OR=8.48,95% CI (6.292,10.68)],[OR=6.46,95% CI (4.82,8.10)],[OR=5.03,95% CI (3.67,6.38)],[OR=9.79,95% CI (6.69,12.89)].However,there was not statistical significance on the improving of high sensitivity C reactive protein (hs CRP)[OR=23.00,95% CI (-18.41,64.40)].Conclusion The current evidences show that edaravone combined Xueshuantong is more effective on the total effective rate,curative rate,neurological function and activities of daily living with safety.However,more high quality studies with large scales and long term fol ow up are stil needed to verify the above con-clusion in the future studies because of the limitations of the included studies.