依达拉奉右莰醇与神经节苷脂改善急性脑梗死 神经功能的间接比较 Meta 分析.

OBJECTIVE: To compare the improvement effect of edaravone dexborneol and ganglioside in improving neurological function in acute ischemic stroke. METHODS: Clinical randomized controlled trials ( the observation group was intervened by basic treatment combined with edaravone dexborneol or ganglioside, the control group was given basic treatment combined with edaravone) were retrieved from PubMed, the Cochrane Library, Embase, CNKI, VIP, Wanfang Data, SinoMed from base-building to Dec. 2021, systematic review was used to conduct quality assessment on studies met the inclusion criteria, RevMan 5. 4 software was used to perform Meta-analysis on the outcome indicators of the studies, indirect comparison method was used to compare the differences in efficacy of improving neurological function in acute cerebral infarction between edaravone dexborneol and ganglioside. RESULTS: A total of 7 studies were enrolled, including 1 741 patients. Results of direct Meta-analysis indicated that both ganglioside and edaravone dexborneol had better effect in improving National Institutes of Health Stroke Scale (NIHSS) scores than that of edaravone, with statistically significant differences (edaravone dexborneol vs. edaravone: MD= -0. 36,95%CI = -0. 66--0. 07,P = 0. 02; ganglioside vs. edaravone: MD = -0. 85,95%CI = -1. 51--0. 20,P = 0. 001); in terms of improving Barther index, the differences were not statistically significant (edaravone dexborneol vs. edaravone: RR = 1. 44,95% CI = 0. 70-3. 00,P = 0. 32; ganglioside vs. edaravone: MD = 3. 73,95% CI = -3. 80- 11. 27,P = 0. 33). By indirect comparison, it was known that the difference in the effect of improving NIHSS scores in patients with acute cerebral infarction between edaravone dexborneol and gangliosides was not statistically significant (MD= -0. 324 5,95%CI = -1. 203 2-0. 618 2,P>0. 05). In terms of safety, two edaravone dexborneol-related studies reported severe adverse events during treatment, and the difference in the incidence of severe adverse events between edaravone dexborneol and edaravone was not statistically significant (RR = 1. 48,95%CI = 0. 53-4. 17,P = 0. 45); no severe adverse events occurred in the rest studies. CONCLUSIONS: At present, limited evidence suggests that both edaravone dexborneol and ganglioside have better effects in improving neurological function in patients with acute cerebral infarction, and the difference between them is not significant. However, due to the small number of enrolled studies and the low quality, more high-quality direct comparative studies are needed to comprehensively assess the differences. [ABSTRACT FROM AUTHOR]