The add-on effects of Danhong injection among patients with ischemic stroke receiving Western medicines: A systematic review and meta-analysis.
The add-on effects of Danhong injection among patients with ischemic stroke receiving Western medicines: A systematic review and meta-analysis.
复制标题
丹红注射液对缺血性中风患者西药治疗的附加作用：系统评价与荟萃分析
DOI：
10.3389/fphar.2022.937369
复制
发表时间：
2022
影响因子：
5.6
通讯作者：
Sun, Xin
中科院分区：
文献类型：
--
作者：
Ma, Yu;Deng, Ke;Liu, Jiali;Ma, Bin;Mei, Fan;Hui, Wen;Luo, Xiaochao;Yao, Minghong;Liu, Yanmei;Qin, Xuan;Zhou, Xu;Zou, Kang;Li, Ling;Sun, Xin
背景：丹红注射液在国内广泛用于治疗缺血性脑卒中。然而，当沿着西药（即，附加效应）并没有得到很好的证实。 研究方法：我们检索了PubMed、Embase、科克伦对照试验中心（CENTRAL）和三个中文数据库，从开始到2020年7月20日，以确定评估丹红注射液作为缺血性卒中患者添加治疗的随机对照试验（RCT）。成对经过培训的评审员独立筛选合格的研究，评估偏见风险并提取数据。结果为美国国立卫生研究院卒中量表评分（NIHSS）、Barthel指数、日常生活活动（ADL）、总胆固醇和同型半胱氨酸（Hcy）。 结果：纳入了67项随机对照试验，共纳入6594例患者，偏倚风险各不相同。与单用西药相比，在西药基础上加用丹红注射液明显降低NIHSS评分（45项RCT，4565例患者; MD −4.21，95% CI −4.96至−3.46），总胆固醇（10项试验，1019例患者; MD −1.14 mmol/L，95% CI −1.57至−0.72）和Hcy（4项试验，392例患者; MD −3.54 μmol/L，95% CI −4.38至−2.07）。添加丹红还增加了Barthel指数（14项试验，1270例患者; MD 8.71，95% CI 3.68-13.74）和ADL（12项试验，1114例患者; MD 14.48，95% CI 9.04-19.92）评分。亚组分析显示患者平均年龄对平均脑血流速度的影响不同（<60岁：MD 0.74 cm/s，95% CI 0.29-1.19; ≥60岁：MD 4.09 cm/s，95% CI 2.02-6.16;交互作用p = 0.002）和基线西药类型的NIHSS评分（交互作用p < 0.00001）。 结论：在西药治疗基础上加用丹红注射液可改善缺血性脑卒中患者的神经功能、生活自理能力及血脂水平。然而，考虑到大多数纳入的试验偏倚风险不明确，目前的证据并不确定，需要更仔细设计和进行的试验来证实我们的发现。 系统综述注册：[https：//www.crd.york.ac.uk/PROSPERO/]，标识符[CRD 42022298628]。
Background: Danhong injection is widely used for treating ischemic stroke in China. However, its effects on ischemic stroke patients when given along with Western medicines (i.e., the add-on effect) were not well-established. Methods: We searched PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and three Chinese databases from inception to 20 July 2020 to identify randomized controlled trials (RCTs) that assessed the effects of Danhong injection as add-on therapy in patients with ischemic stroke. Pairs of trained reviewers independently screened for eligible studies, assessed risk of bias, and extracted the data. The outcomes were the National Institutes of Health Stroke Scale Score (NIHSS), Barthel index, activities of daily living (ADL), total cholesterol, and homocysteine (Hcy). Results: Sixty-seven RCTs of 6594 patients with varying risk of bias were included. Compared with Western medicine alone, the addition of Danhong injection to Western medicine significantly lowered the NIHSS score (45 RCTs with 4565 patients; MD −4.21, 95% CI −4.96 to −3.46), total cholesterol (10 trials with 1019 patients; MD −1.14 mmol/L, 95% CI −1.57 to −0.72), and Hcy (four trials with 392 patients; MD −3.54 μmol/L, 95% CI −4.38 to −2.07). The addition of Danhong also increased the Barthel index (14 trials with 1270 patients; MD 8.71, 95% CI 3.68–13.74) and ADL (12 trials with 1114 patients; MD 14.48, 95% CI 9.04–19.92) scores. Subgroup analyses showed differential effects in the average cerebral blood flow rate by mean age of patients (<60 years: MD 0.74 cm/s, 95% CI 0.29–1.19; ≥60 years: MD 4.09 cm/s, 95% CI 2.02–6.16; interaction p = 0.002) and the NIHSS score by type of baseline Western medicines (interaction p < 0.00001). Conclusion: The addition of Danhong injection to Western medicine may improve neurological function, self-care ability, and blood lipid level of ischemic stroke patients. However, given most included trials with unclear risk of bias, current evidence is not definitive, and more carefully designed and conducted trials are warranted to confirm our findings. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022298628].
登录
查看更多内容
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
8.3
作者：
Dawson J;Pierce D;Dixit A;Kimberley TJ;Robertson M;Tarver B;Hilmi O;McLean J;Forbes K;Kilgard MP;Rennaker RL;Cramer SC;Walters M;Engineer N
通讯作者：
Engineer N
影响因子：
2.8
作者：
Boone M;Chillon JM;Garcia PY;Canaple S;Lamy C;Godefroy O;Bugnicourt JM
通讯作者：
Bugnicourt JM
影响因子：
105.7
作者：
Egger, M;Smith, GD;Minder, C
通讯作者：
Minder, C
影响因子：
5.2
作者：
Franks ZG;Campbell RA;Weyrich AS;Rondina MT
通讯作者：
Rondina MT