目的:利用meta分析方法,对川蛭通络胶囊联合西医治疗在脑梗死患者中的临床效果进行全面而系统的评估?方法:检索国内数据库包括中国知网?万方?维普数据库,国外数据库以PubMed为主,并根据纳入及排除标准筛选出合格文献,经质量评价后采用RevMan5.3及stata14.0软件进行科学系统评价?结果:纳入9篇关于川蛭通络胶囊联合西医治疗的随机对照试验(RCT),总共837例脑梗死患者,其中川蛭通络胶囊联合西医常规治疗组420例,单纯西医治疗组417例,以总有效率、神经功能缺损评分(NIHSS评分)?日常生活评分(Barthel指数?ADL评分)及炎症水平(IL-6?超敏C反应蛋白)为结局指标?meta分析结果显示,治疗组总有效率[95%CI,1.19(1.12,1.25),P＜0.00001],神经功能损伤评分[95%CI,-1.49(-2.16,-0.83),P<0.0001]?日常生活评分[95%,0.94(0.63,1.26),P＜0.00001]?炎症水平[95%CI,-0.75(-0.96,-0.53),P＜0.00001]均优于对照组且具有显著差异,不良反应的发生[95%CI,0.85(0.40,1.79),P=0.66],差异与单纯西医治疗无统计学意义。结论:采用川蛭通络胶囊联合西医常规治疗脑梗死的方案,相较于仅使用单纯西医治疗的对照组,其治疗效果更为显著,联合治疗能更有效地改善患者的神经功能,提升日常生活质量,降低的炎症水平?

Objective:To comprehensively and systematically evaluate the clinical effect of Chuan hirudongluo capsule combined with western medical treatment in patients with cerebral infarction by using meta-analysis. Methods:Domestic databases were searched, including China Knowledge Network, Wanfang, and Wipu databases, and foreign databases were mainly PubMed, and qualified literature was screened according to the inclusion and exclusion criteria, and quality evaluation was performed by using RevMan5.3 and Stata14.0. Results: Nine randomized controlled trials (RCTs) on the combination of Chuanhiru Tongluo capsule and western medicine were included, with a total of 837 patients with cerebral infarction, among which 420 cases were in the group of Chuanhiru Tongluo capsule combined with western medicine and 417 cases were in the group of western medicine alone, and the results were analyzed in terms of the total effective rate, neurological deficit score (NIHSS), daily life score (Barthel Index, Barthel Index, Barthel Index, Barthel Index, Barthel Index, Barthel Index, and so on). (Barthel index, ADL score) and inflammation level (IL-6, ultrasensitive C-reactive protein) as the outcome indexes. meta-analysis results showed that the total effective rate [95%CI,1.19(1.12,1.25),P<0.00001], neurological function impairment score [95%CI,-1.49(-2.16,-0.82),P< 0.00001], daily life score [95%,0.69(0.24,1.14),P=0.003], and inflammation level [95%CI,-0.75(-0.96,-0.53),P<0.00001] were better than those of the control group and significantly different, and the incidence of adverse reactions [95%CI,0.85(0.40,1.79),P =0.66], and the difference was not statistically significant compared with that of Western medicine treatment alone. Conclusion: Compared with the control group which only used western medicine, the treatment effect of Chuan hirudongluo capsule combined with western medicine in the treatment of cerebral infarction is more significant, and the combined treatment can improve the neurological function of the patients, enhance the quality of daily life, and reduce the level of inflammation more effectively.

国家中医药管理局第五批全国中医临床优秀人才研修项目（2022年），负责人：李博