目的:评价豁痰祛瘀法治疗急性脑梗死的临床疗效.方法:在万方数据库、中国生物医学文献数据库、中国知网、维普网、PubMed、Embase中检索建库至2023年5月发表的关于豁痰祛瘀法治疗急性脑梗死的随机对照试验.将文献按照纳排标准进行筛选,再使用Cochrane风险偏倚评估工具对其进行质量评价,将提取到的结局指标运用Revman 5.4.1软件进行Meta分析及敏感性分析.结果:按照纳排标准共筛选出临床试验31项,纳入患者2 998例,采用豁痰祛瘀法治疗急性脑梗死的治疗组Barthel 指数[标准均数差(SMD)=0.65,95％置信区间(CI)[0.53,0.76],P＜0.000 01)]、临床疗效[比值比(OR)=4.05,95％CI[3.17,5.17],P＜0.000 01)]方面高于对照组,差异均具有统计学意义(P＜0.05),治疗组在美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分(SMD=-1.07,95％CI[-1.32,-0.82],P＜0.000 01)、改良的 Rankin 量表(Modified Rankin Scale,MRS)评分(SSMD=-0.67,95％CI[-0.83,-0.52],P＜0.000 01)、全血高切黏度(SMD=-1.80,95％CI[-3.25,-0.34],P=0.02)、全血低切黏度(SSMD=-0.50,95％CI[-0.71,-0.29],P＜0.000 01)、血浆黏度(SMD=-0.87,95％CI[-1.05,-0.69],P＜0.000 01)方面低于对照组,差异均具有统计学意义(P＜0.05).结论:豁痰祛瘀法治疗急性脑梗死在改善神经功能、血液学指标方面具有较好的疗效,值得临床推广.
A Meta-analysis of the therapeutic effect of the eliminating phlegm and removing stasis method in the treatment of acute cerebral infarction
Objective:To evaluate the clinical effect of the eliminating phlegm and removing stasis method in the treatment of acute cerebral infarction.Methods:Randomized controlled trials on the treatment of acute cerebral infarction by the method of eliminating phlegm and removing stasis were searched from Wanfang Database,China Biomedical Database,CNKI,VIP,PubMed and Embase from the establishment of the database to May 2023.The literature data was screened according to the inclusion and exclusion criteria,and then the Cochrane risk bias assessment tool was used for quality assessment.Meta-analysis and sensitivity analysis were performed on the extracted outcome indicators using Revman5.4.1 software.Results:A total of 31 studies on clinical trials with 2 998 patients were screened according to the inclusion and exclusion criteria.The Barthel index(SMD=0.65,95％CI[0.53,0.76],P＜0.000 01)and clinical efficacy in the treatment group was higher than that in the control group(OR=4.05,95％CI[3.17,5.17],P＜0.000 01).The differences were statistically significant(P＜0.05).In the treatment group,the scores of NIHSS(SMD=-1.07,95％CI[-1.32,-0.82],P＜0.000 01),MRS(SMD=-0.67,95％CI[-0.83,-0.52],P＜0.000 01),high whole blood viscosity(SMD=-1.80,95％CI[-3.25,-0.34],P=0.02),low whole blood viscosity(SMD=-0.50,95％CI[-0.71,-0.29],P＜0.000 01),plasma viscosity(SMD=-0.87,95％CI[-1.05,-0.69],P＜0.000 01)were lower than those in the control group,the differences were statistically significant(P＜0.05).Conclusion:The method of eliminating phlegm and removing stasis has a good effect on improving nerve function and hematological indexes in the treatment of acute cerebral infarction,and it is worthy of clinical promotion.
Eliminating phlegm and removing stasis methodAcute cerebral infarctionMeta-analysisClinical effect
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