神经节苷脂治疗急性脑梗死国内随机对照文献的系统评价

背景：目前已有一些文献报道神经节苷脂治疗急性脑梗死的有效性和安全性，但单个研究的样本量均较小，其疗效仍不肯定。 目的：应用偱证医学方法评价神经节苷脂治疗急性脑梗死的有效性和安全性。 方法：采用计算机与手工检索相结合的方法，在中国生物医学光盘数据库(CBM，1990/2010)、清华期刊数据库(CNKI，1990/2010)与维普数据库(VIP，1990/2010)及主要的神经内科相关学术期刊中，检索神经节苷脂治疗急性脑梗死的随机对照试验(RCT)，文献质量评价参照Cochrane协作网推荐的偏倚风险评价工具，统计分析采用RevMan5.0软件，对同质研究进行Meta分析。 结果与结论：初检得到119篇文献，通过阅读标题、摘要和全文，9篇文献满足纳入排除标准，但文献的方法学质量均偏低。以神经功能改善的临床疗效和以中华医学会标准(NDS)评分为结局指标分别进行的Meta分析，均提示神经节苷脂疗效优于对照措施。但由于方法学质量偏低，神经节苷脂治疗中国急性脑梗死患者的有效性和安全性，有待高质量的临床试验证实。 关键词：神经节苷脂；急性脑梗死；神经功能；神经功能；系统评价 doi:10.3969/j.issn.1673-8225.2012.11.041

Gangliosides for acute cerebral infarction: A systematic review based on domestic randomized controlled trials

BACKGROUND: Some studies have reported that gangliosides are safe and effective in the treatment of acute cerebral infarction. However, ganglioside effects on cerebral infarction are still uncertain due to few samples of a single study. OBJECTIVE: To evaluate the efficacy and safety of gangliosides for acute cerebral infarction. METHODS: Literature search was carried out by computer and manual search. We searched for randomized controlled trials about gangliosides for acute cerebral infarction in CBMdisc (1990/2010), VIP (1990/2010), CNKI (1990/2010) and major neurological periodicals. Quality assessment was conducted according to the Cochrane Handbook for Systematic Reviews of Interventions 5.0.1. Meta-analysis was performed for the results of homogeneous studies using RevMan 5.0 software． RESULTS AND CONCLUSION: Totally 119 articles were retrieved, and finally nine randomized controlled trials were included, but the methodological quality was relatively low. Meta analysis showed that the effectiveness of gangliosides was superior to that of control treatment. Due to the low quality of included trials, the effect and safety of gangliosides in the treatment of acute cerebral infarction have to be verified by further high quality evidence.