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依达拉奉联合银杏叶提取物和双嘧达莫治疗急性脑梗死的疗效和安全性:系统评价和荟萃分析。

Efficacy and safety of edaravone combined with Ginkgo Leaf Extract and Dipyridamole in the treatment of acute cerebral infarction: A systematic review and meta-analysis.

机构信息

Department of Neurology, The Second Affiliated Hospital of Zhejiang University of Chinese Medicine, Hangzhou, Zhejiang, China.

出版信息

Medicine (Baltimore). 2024 Nov 1;103(44):e40223. doi: 10.1097/MD.0000000000040223.

Abstract

BACKGROUND

To evaluate the clinical efficacy and safety of edaravone combined with Ginkgo Leaf Extract and Dipyridamole (GLED) versus edaravone alone in the treatment of acute cerebral infarction (ACI) by the method of meta-analysis.

METHODS

PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WANFANG DATA, and Chinese Scientific Journal Database were searched to identify publications on edaravone combined with GLED for ACI from inception to June 20, 2024. Stata15.0 statistical software was applied for data analysis. The test group was treated with edaravone combined with GLED, while the control group received edaravone alone.

RESULTS

A total of 12 records were involved in this meta-analysis. The combined results exhibited that the effective rate of edaravone combined with GLED was significantly higher than that of edaravone in the treatment of ACI (relative risk = 1.21, 95% confidence interval [CI] = 1.15-1.27, P < .001). The National Institute of Health stroke scale scores of edaravone combined with GLED were significantly lower than those of edaravone alone in the treatment of ACI (standardized mean difference = -1.93, 95% CI = -3.36 to -0.50, P = .008). The incidence of adverse reactions in the edaravone combined with GLED group was significantly lower than that in the edaravone alone group (relative risk = 0.48, 95% CI = 0.33-0.70, P < .001) in the treatment of ACI.

CONCLUSION

The combination of edaravone with GLED for treating ACI has better efficacy and higher safety than edaravone alone. Given the limited number of studies identified and possibility of publication bias, the above findings should be verified by more high-quality trials in the future.

摘要

背景

通过荟萃分析的方法评价依达拉奉联合银杏叶提取物与双嘧达莫(GLED)治疗急性脑梗死(ACI)的临床疗效及安全性。

方法

计算机检索 PubMed、Web of Science、Cochrane Library、中国知网、万方数据知识服务平台、维普中文期刊服务平台,搜集建库至 2024 年 6 月 20 日关于依达拉奉联合 GLED 治疗 ACI 的文献,采用 Stata15.0 统计软件进行数据分析。试验组给予依达拉奉联合 GLED 治疗,对照组给予依达拉奉单药治疗。

结果

共纳入 12 篇文献。Meta 分析结果显示,依达拉奉联合 GLED 治疗 ACI 的有效率明显高于依达拉奉单用(相对危险度=1.21,95%可信区间[CI]为 1.151.27,P<0.001)。依达拉奉联合 GLED 治疗 ACI 的 NIHSS 评分低于依达拉奉单用(标准化均数差=–1.93,95%CI 为–3.36 至–0.50,P=0.008)。依达拉奉联合 GLED 治疗 ACI 的不良反应发生率低于依达拉奉单用(相对危险度=0.48,95%CI 为 0.330.70,P<0.001)。

结论

依达拉奉联合 GLED 治疗 ACI 的疗效优于单用依达拉奉,且安全性更高。鉴于纳入研究数量有限且可能存在发表偏倚,上述结论还需要更多高质量的临床试验加以验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8799/11537593/909e31d1cfdb/medi-103-e40223-g001.jpg

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