论文部分内容阅读
目的对疏血通注射液联合氯吡格雷治疗缺血性中风临床疗效及安全性进行系统评价。方法计算机检索主要的中英文数据库。全面收集疏血通注射液联合氯吡格雷治疗缺血性中风的随机对照试验。采用偏倚风险评估工具对其进行质量评价,用RevMan5.3软件进行Meta分析,运用Egger检验分析发表性偏倚,并按照国际证据评价与推荐GRADE系统评估证据水平。结果最终纳入8个研究,Meta分析结果显示:(1)总有效率:根据疾病亚类,进行Meta分析,急性脑梗死(OR=3.61,95%CI[2.25,5.79]),脑血栓(OR=6.30,95%CI[2.3,17.26]),疏血通注射液联合氯吡格雷临床疗效均优于单独氯吡格雷。(2)NIHSS(WMD=-3.15,95%CI[-4.66,-1.64]),神经功能缺损评分(WMD=-3.83,95%CI[-5.27,-2.39]),差异均有统计学意义。(3)在改善纤维蛋白原、全血高切黏度、全血低切黏度、全血黏度、血沉方面更具优势。安全性评价缺乏资料,且存在发表性偏倚。根据GRADE方法评价,该证据水平为低级。结论疏血通注射液联合氯吡格雷治疗缺血性中风临床疗效优于单独氯吡格雷,但证据水平低,临床应用宜谨慎。
Objective To evaluate the clinical efficacy and safety of Shuxuetong injection plus clopidogrel in the treatment of ischemic stroke. Methods Computer searches major Chinese and English databases. Comprehensive collection of Shuxuetong injection combined with clopidogrel in the treatment of ischemic stroke randomized controlled trials. Meta-analysis was performed using a risk-based risk assessment tool, Meta-analysis was performed using RevMan 5.3 software, and published bias was assessed using the Egger test. Evidence was assessed using the GRADE system based on international evidence. The results were finally included in 8 studies. The results of Meta-analysis showed that: (1) The total effective rate: according to the disease subgroups, Meta-analysis, acute cerebral infarction (OR = 3.61,95% CI 2.25,5.79) = 6.30, 95% CI [2.3,17.26]), Shuxuetong injection combined with clopidogrel clinical efficacy than clopidogrel alone. (2) NIHSS (WMD = -3.15, 95% CI [-4.66, -1.64]), neurological deficit score (WMD = -3.83, 95% CI [-5.27, -2.39]), the differences were statistically significant . (3) in the improvement of fibrinogen, whole blood high shear viscosity, whole blood low shear viscosity, whole blood viscosity, erythrocyte sedimentation rate more advantages. There is a lack of information on safety assessment and publication bias. According to the GRADE method of evaluation, the level of evidence is low. Conclusion Shuxuetong injection combined with clopidogrel in the treatment of ischemic stroke clinical efficacy superior to clopidogrel alone, but the low level of evidence, the clinical application should be cautious.