【摘要】：目的:系統(tǒng)地分析和評(píng)價(jià)丁苯酞結(jié)合尤瑞克林對(duì)急性腦梗死的治療效果和臨床安全性,為指導(dǎo)臨床合理用藥和治療選擇提供依據(jù)。方法:計(jì)算機(jī)檢索Pub Med數(shù)據(jù)庫(kù)、Cochrane Library、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBMdisc)、西文生物醫(yī)學(xué)期刊文獻(xiàn)數(shù)據(jù)庫(kù)(FMJS)、中國(guó)科技期刊全文數(shù)據(jù)庫(kù)(CNKI)、萬(wàn)方數(shù)字化期刊全文數(shù)據(jù)庫(kù)(Wanfang Data)及維普科技期刊全文數(shù)據(jù)庫(kù)(VIP),查詢自建庫(kù)至2016年10月丁苯酞聯(lián)合尤瑞克林治療急性腦梗死的隨機(jī)對(duì)照試驗(yàn)(RCT),按Cochrane系統(tǒng)評(píng)價(jià)手冊(cè)的方法對(duì)檢索的文獻(xiàn)進(jìn)行質(zhì)量評(píng)價(jià)和數(shù)據(jù)提取,應(yīng)用專業(yè)數(shù)據(jù)處理軟件Rev Man5.3.5進(jìn)行統(tǒng)計(jì)分析。結(jié)果:納入RCT 18個(gè),患者合計(jì)1916例,Meta分析顯示:(1)丁苯酞聯(lián)合尤瑞克林組較常規(guī)治療組,可以顯著提高患者的總有效率[RR=1.26,95%CI(1.18,1.35),Z=6.19,P0.00001]、改善神經(jīng)功能缺損評(píng)分(NIHSS)[WMD=-2.83,95%CI(-3.64,-2.02),Z=6.86,P0.00001]及日常生活能力評(píng)分(ADL)[WMD=7.33,95%CI(3.43,11.23),Z=3.68,P0.00001],差異均有統(tǒng)計(jì)學(xué)意義。(2)丁苯酞聯(lián)合尤瑞克林組較尤瑞克林組,可以顯著提高患者的總有效率[RR=1.16,95%CI(1.09,1.24),Z=4.76,P0.00001]、改善神經(jīng)功能缺損評(píng)分(NIHSS)[WMD=-3.26,95%CI(-4.21,-2.31),Z=6.74,P0.00001],差異均有統(tǒng)計(jì)學(xué)意義。(3)丁苯酞聯(lián)合尤瑞克林組較丁苯酞組,可以提高患者的總有效率(p0.05)、改善神經(jīng)功能缺損評(píng)分(NIHSS)[WMD=-3.53,95%CI(-5.08,-1.98),Z=4.47,P0.00001],差異均有統(tǒng)計(jì)學(xué)意義。結(jié)論:丁苯酞聯(lián)合尤瑞克林治療急性腦梗死相較丁苯酞單藥、尤瑞克林單藥及常規(guī)藥物療效更顯著,且未見明顯不良反應(yīng),可作為腦梗死急性期較為安全有效的治療方案。但受納入研究樣本及質(zhì)量所限,需更多嚴(yán)格的大樣本隨機(jī)對(duì)照試驗(yàn)提供更科學(xué)可靠的依據(jù)。
[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 鹵1.35), Z _ (6.19)], (P < 0.05). P0.00001, (NIHSS) (-3.644-2.02), (ADL) (WMD=7.33,95%CI (3.43 鹵11.23), 3.68), P0.00001, WMD=-2.83,95%CI (-3.644-2.02) and (ADL) (3.43 鹵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 鹵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.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R743.3

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