灯盏生脉胶囊佐治缺血性脑卒中的Meta分析

Meta-analysis of Dengzhan Shengmai Capsules as an Adjuvant Treatment for Ischemic Stroke

关键词:  灯盏生脉胶囊  缺血性脑卒中  二级预防  meta分析  系统评价

Key words:  Dengzhan Shengmai capsule  ischemic stroke  secondary prevention  meta-analysis  systematic review

摘要:

目的 系统评价灯盏生脉胶囊佐治缺血性脑卒中的临床疗效及其二级预防作用。方法 计算机检索Pubmed、 EMbase、CochraneLibrary和CNKI、CBM、VIP、Wanfang Data，检索时限为建库至2016年2月，同时手工检索相关杂志和网页搜索谷歌学术，纳入关于灯盏生脉胶囊佐治缺血性脑卒中的随机对照试验。由2名研究者独立地按照纳入和排除标准筛选文献、提取相关数据并进行质量评价，采用RevMan5.3对结局指标进行meta分析。结果 共纳入文献18篇，患者4 416例。Meta分析结果显示，与对照组相比，试验组能降低脑卒中复发率[RR=0.53，95%CI（0.39，0.71），P<0.000 1]和病死率[RR=0.28，95%CI（0.11，0.68），P<0.005]，且在临床疗效[RR=1.22，95%CI（1.15，1.29），P<0.000 01]及日常生活能力[MD=9.19，95%CI（3.41，14.98），P=0.002]上要优于对照组；在残障功能改善程度[MD=-0.04，95%CI（-0.16，0.07），P=0.47] [RR=1.11，95%CI（0.89，1.40），P=0.35]和不良反应发生率[RR=0.68，95%CI（0.34，1.37），P=0.29]上2组间无明显差异。结论 灯盏生脉胶囊佐治缺血性脑卒中与常规治疗相比能够降低脑卒中复发率和病死率，且在临床疗效和日常生活能力上要优于常规治疗。在残障功能改善程度上两者无明显差别。灯盏生脉胶囊联合常规治疗未明显增加不良反应发生。

Abstract:

OBJECTIVE To systematically elevate the clinical efficacy and secondary prevention of Dengzhan Shengmai capsules among the patients with ischemic stroke(IS). METHODS The Cochrane Library, Pubmed, EMbase, CNKI, CBM, VIP, Wanfang Data were used to search for randomized controlled trials(RCTs) regarding the association between Dengzhan Shengmai capsules and ischemic stroke up to February 2016. Hand searching techniques were also used into randomized controlled trial in relevant journals and searching through the Google scholar. According to the inclusion and exclusion criteria, two reviewers screened literature, extracted data and assessed the methodological quality of RCTs independently. The meta-analysis was conducted with RevMan 5.3 software. RESULTS A total of 18 trials involving 4 416 patients were included. The results of the meta-analysis represented that:compared with the control group, the treatment group were associated with decreased the rate of stroke[RR=0.53, 95%CI(0.39, 0.71), P<0.000 1] and the case-fatality rate[RR=0.28, 95%CI(0.11, 0.68), P<0.005], the treatment group had better outcomes in clinical efficacy[RR=1.22, 95%CI(1.15, 1.29), P<0.000 01] and activity of daily living[MD=9.19, 95%CI(3.41, 14.98), P=0.002]. There was no significant difference in the improvement of disability[MD=-0.04, 95%CI(-0.16, 0.07), P=0.47],[RR=1.11, 95%CI(0.89, 1.40), P=0.35] and the rate of adverse reactions[RR=0.68, 95%CI(0.34, 1.37), P=0.29] between the treatment group and the control group. CONCLUSION Compared with conventional treatment, Dengzhan Shengmai capsules combine with conventional treatment can reduce the recurrent rate of stroke and case-fatality rate, the Dengzhan Shengmai capsules group has better outcomes in clinical efficacy and activity of daily living. Therec is no significant difference in the improvement of disability between the two groups. Dengzhan Shengmai capsules combine with conventional treatment do not increase the risk of adverse reaction.