摘要
目的系统评价丁苯酞注射液联合阿司匹林和氯吡格雷治疗进展性脑梗死的临床疗效和安全性。方法通过检索PubMed、EmBase及中国知网等数据库,全面收集丁苯酞注射液联合阿司匹林和氯吡格雷治疗进展性脑梗死的随机对照试验,按Cochrane协作网系统评价的方法进行质量评价和Meta分析。结果共纳入17个研究,合计1944例患者。经过Meta分析结果显示:丁苯酞注射液联合阿司匹林和氯吡格雷观察组治疗进展性脑梗死的临床有效率明显高于对照组(OR=3.20,95%CI 2.32~4.42),观察组患者的神经功能缺损评分明显低于对照组(OR=-3.86,95%CI-5.16^-2.56),观察组患者的日常活动能力评分高于对照组(OR=12.61,95%CI 8.58~16.64),观察组患者的睡眠质量较高(OR=4.67,95%CI-7.89^-1.46),两组不良反应发生率差异无统计学意义(RR=1.31,95%CI 0.74~2.31)。结论丁苯酞注射液联合阿司匹林和氯吡格雷能有效改善进展性脑梗死患者的神经功能缺损,不良反应少。
Objective To systematically review the efficacy and safety of butylphthalide injection combined with aspirin and clopidogrel in treatment of progressive cerebral infarction.Methods PubMed,Embase and CNKI were searched for randomized controlled trials about butylphthalide injection combined with aspirin and clopidogrel in treatment of progressive cerebral infarction,the methodological quality of the trials were evaluated by using the Cochrane risk-of-bias criteria and meta-analysis were carried out by using Cochrane RevMan 5.3 software.Results 17 trials involving 1944 patients met the criteria were included.The Meta analysis showed that the NIHSS score of nerve function defect in the butylphthalide injection combined with aspirin and clopidogrel group was lower than that of the control group(OR=-3.86,95%CI-5.16^-2.56)and the barthel index score of daily life ability assessment in the observation group was higher than that of the control group(OR=12.61,95%CI 8.58~16.64).The PSQI score of sleep quality in the observation group was lower than that of the control group(OR=-4.67,95%CI-7.89^-1.46).There was no statistical significance in the difference of incidences of adverse drug reactions between two groups(RR=1.31,95%CI 0.74~2.31).Conclusion Based on the findings from the meta-analysis,butylphthalide injection combined with aspirin and clopidogrel can improve the neurological function deficits after progressive cerebral infarction,and have no obvious adverse reactions.However,further study is needed to confirm its effects.
作者
陈梓斌
李宁虎
姜蔼玲
CHEN Zibin;LI Ninghu;JIANG Ailing(Department of Neurology,the Jiangbin Hospital of Guangxi Province,Nanning 530021,China)
出处
《中国老年保健医学》
2020年第4期50-56,共7页
Chinese Journal of Geriatric Care
关键词
丁苯酞
阿司匹林
氯吡格雷
进展性脑梗死
系统评价
Butylphthalide
Aspirin
Clopidogrel
Progressive cerebral infarction
Meta-analysis
