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Meta-Analysis for Clinical Evaluation of Xingnaojing Injection for the Treatment of Cerebral Infarction

机译:醒脑静注射液治疗脑梗死临床评价的Meta分析

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摘要

>Objective: Xingnaojing injection (XNJ) is derived from An-Gong-Niu-Huang pill, a well-known traditional Chinese patent medicine, which is widely used for stroke. To evaluate the therapeutic effect of XNJ on cerebral infarction, an extensive meta-analysis was used.>Methods: Six major electronic databases including the Chinese Biomedical Database (CBM), Wanfang, the VIP medicine information system (VMIS) and the China National Knowledge Infrastructure (CNKI), PubMed, Embase, and the Cochrane Library were examined to retrieve randomized controlled trials designed to evaluate the clinical efficacy of XNJ in treating CI before November 26, 2016.>Results: There were 53 randomized controlled trials with 4915 participants in this study. The results reflected that compared with the conventional therapy (CT) alone, XNJ could significantly improve the overall response rate (OR = 3.56, 95% CI [2.94, 4.32], P < 0.00001), and clinical symptom (including increasing activities of daily living (ADL, MD = 10.23, 95% CI [9.47, 10.99], P < 0.00001), and reduce infarction size (MD = -1.83, 95% CI [-2.49, -1.16], P < 0.00001)). However, there was no significant difference between the XNJ treatment and conventional therapy in Glasgow Coma Scale (GCS, P = 0.32). Neurological deficit score demonstrated that XNJ could significantly reduce the score in two different evaluation criterions as National Institutes of Health Stroke Scale (NIHSS, MD = -3.44, 95% CI [-4.52, -2.36], P < 0.00001), and the Chinese Stroke Scale (CSS, MD = -5.72, 95% CI [-6.94, -4.50], P < 0.00001). Additionally, serum MMPs, including MMP-2 and MMP-9 were significantly reduced by XNJ treatment compared with conventional therapy (MD = -11.24, 95% CI [-20.83, -1.65], P = 0.02; MD = -25.08, 95% CI [-35.49, -14.67], P < 0.00001, respectively). Moreover, XNJ was able to improve hemorrheology in reducing whole blood viscosity, plasma viscosity, and hematocrit (MD = -1.44, 95% CI [-2.18, 0.70], P = 0.001; MD = -0.22, 95% CI [-0.37, -0.07], P = 0.003; MD = -3.63, 95% CI [-6.23, -1.03], P = 0.006, respectively). The therapeutic efficacy of XNJ was found associated with improving hemodynamics (increasing peak-flow rate, and average velocity) (MD = 12.66, 95% CI [10.50, 14.81], P < 0.00001; MD = 9.90, 95% CI [8.63, 11.17], P < 0.00001). XNJ was also related to reducing cholesterol and triglyceride (MD = -1.06, 95% CI [-1.21, -0.92], P < 0.00001; MD = -1.05, 95% CI [-1.12, -0.97], P < 0.00001).>Conclusion: Despite the sample size and the poor quality of the included studies of this review, the results of the research showed that XNJ might be a beneficial therapeutic method for the treatment of cerebral infarction.
机译:>目的:醒脑静注射液(XNJ)来源于著名的中成药安宫牛黄丸,广泛用于中风。为了评估XNJ对脑梗死的治疗效果,使用了广泛的荟萃分析。>方法:六个主要的电子数据库包括中国生物医学数据库(CBM),万方,VIP医学信息系统(VMIS) ),并审查了中国国家知识基础设施(CNKI),PubMed,Embase和Cochrane库,以检索旨在评估XNJ治疗CI的临床疗效的随机对照试验。>结果:本研究共进行了53项随机对照试验,共有4915名参与者。结果表明,与单独使用常规疗法(CT)相比,XNJ可以显着提高总体缓解率(OR = 3.56,95%CI [2.94,4.32],P <0.00001)和临床症状(包括每天增加的活动)生活(ADL,MD = 10.23,95%CI [9.47,10.99],P <0.00001),并减少梗死面积(MD = -1.83,95%CI [-2.49,-1.16],P <0.00001))。但是,在格拉斯哥昏迷量表(GCS,P = 0.32)中,XNJ治疗与常规治疗之间没有显着差异。神经功能缺损评分表明,XNJ可以在两种不同的评估标准(美国国立卫生研究院卒中量表)(NIHSS,MD = -3.44,95%CI [-4.52,-2.36],P <0.00001)和中国人中降低得分。中风评分(CSS,MD = -5.72,95%CI [-6.94,-4.50],P <0.00001)。此外,与传统疗法相比,XNJ治疗可显着降低血清MMP,包括MMP-2和MMP-9(MD = -11.24,95%CI [-20.83,-1.65],P = 0.02; MD = -25.08,95 %CI [-35.49,-14.67],P <0.00001)。此外,XNJ能够改善血液流变学,降低全血粘度,血浆粘度和血细胞比容(MD = -1.44,95%CI [-2.18,0.70], P = 0.001; MD = -0.22,95%CI [-0.37,-0.07], P = 0.003; MD = -3.63,95%CI [-6.23,- 1.03], P = 0.006)。发现XNJ的治疗功效与改善血流动力学(增加峰值流速和平均速度)有关( MD = 12.66,95%CI [10.50,14.81], P <0.00001; MD = 9.90,95%CI [8.63,11.17], P <0.00001)。 XNJ还与降低胆固醇和甘油三酸酯有关( MD = -1.06,95%CI [-1.21,-0.92], P <0.00001; MD = -1.05,95%CI [-1.12,-0.97], P <0.00001)。>结论:尽管样本量大且纳入研究的质量较差审查的结果表明,XNJ可能是治疗脑梗死的一种有益的治疗方法。

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