醒脑静辅助溶栓治疗急性缺血性脑卒中的有效性及安全性的Meta分析OA

Objective To systematically evaluate the effect of Xingnaojing injection on the levels of inflammatory factors in patients with acute ischemic stroke(AIS)as an adjuvant therapy for intravenous thrombolysis with alteplase,and to investigate the neuroprotective significance of Xingnaojing injection.Methods Chinese databases(CNKI,Wan-fang Data,and VIP)and English databases(PubMed,Embase,and the Cochrane Library)were searched for studies on the serum levels of inflammatory factors in the treatment of AIS published up to August 2024,and the patients were di-vided into control group and experimental group based on the method of randomized controlled trial(RCT).The patients in the control group received intravenous thrombolysis with alteplase,while those in the experimental group received intra-venous thrombolysis with alteplase combined with Xingnaojing injection.The Cochrane Collaboration Risk of Bias Tool was used to assess the methodological quality of the studies included for analysis,and RevMan 5.3 software was used to conduct a meta-analysis on NIHSS,response rate,C-reactive protein(CRP),TNF-α,IL-6,IL-8,IL-1,and adverse re-actions for the experimental group and the control group.Results A total of 19 RCTs were included,involving 1 711 pa-tients(856 in the experimental group and 855 in the control group).The meta-analysis showed that there were significant differences between the two groups in NIHSS(SMD=-2.12,95%CI-2.74 to-1.50,P<0.001),response rate(OR=5.22,95%CI 3.44-7.91,P<0.001),CRP(SMD=-1.27,95%CI-1.74 to-0.79,P<0.001),TNF-α(SMD=-2.91,95%CI-3.74 to-2.08,P<0.001),IL-6(SMD=-6.74,95%CI-9.06 to-4.41,P<0.001),IL-8(SMD=-4.85,95%CI-6.49 to-3.20,P<0.001),IL-1(SMD=-4.89,95%CI-6.86 to-2.92,P<0.001),and adverse reactions(OR=0.41,95%CI 0.26-0.64,P<0.001).Conclusion As an adjuvant therapy for thrombolysis with alteplase,Xing-naojing injection significantly reduces the levels of in-flammatory factors in AIS patients and exerts a neuro-protective effect on brain cells,with a high response rate and few adverse reactions,which provides a safe and reliable reference for clinical practice.