丁苯酞结合尤瑞克林治疗急性脑梗死的Meta分析

发布时间：2018-11-19 18:31

【摘要】：目的:系统地分析和评价丁苯酞结合尤瑞克林对急性脑梗死的治疗效果和临床安全性,为指导临床合理用药和治疗选择提供依据。方法:计算机检索Pub Med数据库、Cochrane Library、中国生物医学文献数据库(CBMdisc)、西文生物医学期刊文献数据库(FMJS)、中国科技期刊全文数据库(CNKI)、万方数字化期刊全文数据库(Wanfang Data)及维普科技期刊全文数据库(VIP),查询自建库至2016年10月丁苯酞联合尤瑞克林治疗急性脑梗死的随机对照试验(RCT),按Cochrane系统评价手册的方法对检索的文献进行质量评价和数据提取,应用专业数据处理软件Rev Man5.3.5进行统计分析。结果:纳入RCT 18个,患者合计1916例,Meta分析显示:(1)丁苯酞联合尤瑞克林组较常规治疗组,可以显著提高患者的总有效率[RR=1.26,95%CI(1.18,1.35),Z=6.19,P0.00001]、改善神经功能缺损评分(NIHSS)[WMD=-2.83,95%CI(-3.64,-2.02),Z=6.86,P0.00001]及日常生活能力评分(ADL)[WMD=7.33,95%CI(3.43,11.23),Z=3.68,P0.00001],差异均有统计学意义。(2)丁苯酞联合尤瑞克林组较尤瑞克林组,可以显著提高患者的总有效率[RR=1.16,95%CI(1.09,1.24),Z=4.76,P0.00001]、改善神经功能缺损评分(NIHSS)[WMD=-3.26,95%CI(-4.21,-2.31),Z=6.74,P0.00001],差异均有统计学意义。(3)丁苯酞联合尤瑞克林组较丁苯酞组,可以提高患者的总有效率(p0.05)、改善神经功能缺损评分(NIHSS)[WMD=-3.53,95%CI(-5.08,-1.98),Z=4.47,P0.00001],差异均有统计学意义。结论:丁苯酞联合尤瑞克林治疗急性脑梗死相较丁苯酞单药、尤瑞克林单药及常规药物疗效更显著,且未见明显不良反应,可作为脑梗死急性期较为安全有效的治疗方案。但受纳入研究样本及质量所限,需更多严格的大样本随机对照试验提供更科学可靠的依据。
[Abstract]:Objective: to analyze and evaluate the efficacy and safety of butyphthalide combined with eurekline in the treatment of acute cerebral infarction (ACI). Methods: Pub Med database, Cochrane Library, Chinese biomedical literature database (CBMdisc), western language biomedical journal literature database (FMJS), Chinese science and technology journal full-text database (CNKI), Wan-fang Digital Journal Full-text Database (Wanfang Data) and Wiper Sci-tech Journal Full-text Database (VIP),): a Randomized controlled trial (RCT), for the treatment of Acute Cerebral Infarction with Butylphthalide combined with Urethrin until October 2016 According to the method of Cochrane system evaluation manual, the quality evaluation and data extraction of the retrieved documents are carried out, and the statistical analysis is carried out by using the professional data processing software Rev Man5.3.5. Results: 1916 patients were included in 18 patients with RCT. Meta analysis showed that: (1) compared with the routine treatment group, butyphthalide combined with eurexacin group could significantly improve the total effective rate of the patients [RR=1.26,95%CI (1.18 卤1.35), Z _ (6.19)], (P < 0.05). P0.00001, (NIHSS) (-3.644-2.02), (ADL) (WMD=7.33,95%CI (3.43 卤11.23), 3.68), P0.00001, WMD=-2.83,95%CI (-3.644-2.02) and (ADL) (3.43 卤11.23), respectively. The difference was statistically significant (P0.00001). (2) the total effective rate of butyrophthalide combined with eurexacin group was significantly higher than that of eurexacin group [RR=1.16,95%CI (1.09 卤1.24), Z 4.76g / P 0.00001]. The improvement of (NIHSS) [WMD=-3.26,95%CI (-4.21) -2.31], ZT6.74 (P0.00001) was statistically significant. (3) Butylphthalide combined with Urekline was higher than that of butyrophthalein. It can improve the total effective rate (p0.05), improve the neurological function defect score (NIHSS) [WMD=-3.53,95%CI (-5.08U -1.98), ZN 4.47 (P0.00001)], the difference is statistically significant. Conclusion: butyphthalide combined with Urethrin is more effective in the treatment of acute cerebral infarction than butyphthalide alone, eurexacin alone and routine drugs, and there is no obvious adverse reaction. It can be used as a safe and effective treatment for acute cerebral infarction. However, due to the limitation of sample and quality, more strict randomized controlled trials with large samples are needed to provide more scientific and reliable evidence.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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