脑蛋白水解物辅助治疗急性脑梗死疗效与安全性的系统评价

发布时间：2018-01-25 16:46

本文关键词： 脑蛋白水解物急性脑梗死随机对照试验系统评价疗效安全性　出处：《中国药房》2017年30期 　论文类型：期刊论文

【摘要】：目的:系统评价脑蛋白水解物辅助治疗急性脑梗死的疗效与安全性,为临床提供循证参考。方法:计算机检索SCI、Cochrane图书馆、EMBase、Pub Med、相关期刊论文(CJFD)、中文科技期刊数据库(VIP)、万方数据库,收集脑蛋白水解物联合常规方案(试验组)对比单纯常规方案或联合安慰剂(对照组)治疗急性脑梗死的随机对照试验(RCT),提取资料并按照Cochrane系统评价员手册5.1.0评价质量后,采用Rev Man 5.2统计软件对数据进行Meta分析。结果:最终纳入20项RCT,包括3 313例患者。Meta分析结果显示,试验组患者美国国立卫生研究院卒中量表(NIHSS)评分[MD=-1.77,95%CI(-2.33,-1.21),P0.001]、有效率[OR=2.85,95%CI(1.75,4.63),P0.001]、Barthel指数(BI)评分[MD=7.30,95%CI(3.48,11.13),P0.001]显著高于对照组,差异均有统计学意义;两组患者致残率[OR=0.46,95%CI(0.20,1.03),P=0.06]、死亡率[OR=0.79,95%CI(0.52,1.19),P=0.25]、不良反应发生率[OR=1.04,95%CI(0.85,1.27),P=0.72]和严重不良反应发生率[OR=0.01,95%CI(-0.02,0.04),P=0.51]比较,差异均无统计学意义。结论:脑蛋白水解物辅助治疗急性脑梗死疗效较好,可以显著改善患者神经功能缺损状态和生活质量,且不增加不良反应的发生。
[Abstract]:Objective: to evaluate the efficacy and safety of cerebral protein hydrolysates in the treatment of acute cerebral infarction (ACI) and to provide evidence based reference for clinical application. Methods: the SCI Cochrane library was searched by computer. EmBase / Pub Med. Chinese Journal Full-text Database CJFDN, Chinese Sci-tech Journals Database VIPN, Wanfang Database. A randomized controlled trial of brain protein hydrolysate combined with routine regimen (trial group) for the treatment of acute cerebral infarction was conducted compared with conventional regimen or placebo (control group). The data were extracted and the quality was evaluated according to the Cochrane system evaluator's manual 5.1.0. Rev Man 5.2 statistical software was used to analyze the data by Meta. Results: 20 RCTs were included, including 3 313 patients. Meta-analysis results showed. NIHSS score of the National Institutes of Health Stroke scale in the trial Group. [MD-1.77 / 95 CIQ -2.33 ~ 1.21 / P0.001, effective rate. [The score of Barthel Index (BI) was 1.75 / 4.63 / P0.001. [The incidence of disability in the two groups was significantly higher than that in the control group (P 0.001). [Orr 0.46 95 CI 0.20 0. 03 P0.06, mortality rate: 0. 20%, 0. 06%, 0. 06%, 0. 06%, 0. 06%. [The incidence of adverse reactions was 0.72% 1.19% (P < 0.05), and the incidence of adverse reactions was 0.79% (P < 0.05) and 0.52% (P < 0.05). [The incidence of severe adverse reactions and the incidence of severe adverse reactions were 0.85% and 1.27% (P = 0.72) respectively. [There was no significant difference between the two groups. Conclusion: the therapeutic effect of cerebral protein hydrolysate in the treatment of acute cerebral infarction is better. It can significantly improve the state of neurological deficit and quality of life, and does not increase the occurrence of adverse reactions.
【作者单位】：四川大学华西公共卫生学院;四川大学华西医院神经内科;四川大学华西医院国家药物临床试验机构;
【基金】：四川省科技支撑计划项目(No.2013SZ0003)
【分类号】：R743.33
【正文快照】： 610041)急性脑梗死是指因脑部血液循环障碍,缺血、缺氧所致的局限性脑组织缺血性坏死或软化,是成人最常见的致残性疾病。有资料显示,急性脑梗死后3个月的死亡/残疾率约为34.5%~37.1%[1]。目前,急性脑梗死的常规治疗为在一般处理的基础上,改善患者脑循环、保护脑神经(称为特异

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