疏血通注射液联合氯吡格雷治疗缺血性中风的系统评价、Meta分析与证据水平

发布时间：2018-04-20 10:03

本文选题：疏血通注射液 + 氯吡格雷　；参考：《中药新药与临床药理》2017年03期

【摘要】：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。
[Abstract]:Objective to evaluate the efficacy and safety of Shuxuetong injection combined with clopidogrel in the treatment of ischemic stroke. Methods the main Chinese and English databases were searched by computer. A randomized controlled trial of Shuxuetong injection combined with clopidogrel in the treatment of ischemic stroke was collected. Bias risk assessment tools were used to evaluate its quality, Meta analysis was carried out by RevMan5.3 software, publication bias was analyzed by Egger test, and the level of evidence was evaluated according to international evidence evaluation and recommendation GRADE system. Results the results of meta-analysis of 8 studies showed that the total effective rate was: Meta analysis according to the disease subclass. The clinical efficacy of Shuxuetong injection combined with clopidogrel was better than that of clopidogrel alone [-4.66-3.1595CI [-4.66- 1.64], WMD-3.8395CI [-5.27995 CI], WMD-3.8395CI [-5.27395CI]. The difference was statistically significant. Whole blood low shear viscosity, whole blood viscosity, ESR have more advantages. The safety evaluation is lack of data and publication bias. According to the GRADE method, the level of evidence was low. Conclusion Shuxuetong injection combined with clopidogrel is more effective than clopidogrel alone in the treatment of ischemic stroke.
【作者单位】：广州中医药大学第二附属医院;广东省中医院临床研究方法学重点研究室;广州中医药大学DME中心;
【基金】：广东省中医院中医药科学技术研究专项(YK2013B1N05)
【分类号】：R743.3

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