目的 評價注射用燈盞花素聯(lián)合化學藥治療急性缺血性腦卒中的療效和安全性，為臨床治療提供循證參考。方法 計算機檢索中國期刊全文數(shù)據(jù)庫、中國生物醫(yī)學文獻數(shù)據(jù)庫、萬方數(shù)據(jù)知識服務平臺、維普生物醫(yī)學數(shù)據(jù)庫、PubMed、Cochrane Library、Springer Link、Web of Science等中英文數(shù)據(jù)庫，收集注射用燈盞花素聯(lián)合化學藥在急性缺血性腦卒中治療中的隨機對照（RCTs），檢索時限為建庫至2023年6月。篩選文獻、提取資料、評價文獻質量后，采用Stata 17.0軟件進行網(wǎng)狀Meta分析。結果 共納入29項RCTs，共計2 930例患者；涉及8種干預措施，分別為注射用燈盞花素＋依達拉奉、注射用燈盞花素＋奧扎格雷、注射用燈盞花素＋常規(guī)治療、注射用燈盞花素、依達拉奉、奧扎格雷、常規(guī)治療、復方丹參。網(wǎng)狀Meta分析結果顯示，在臨床療效方面，注射用燈盞花素與3種不同化學藥分別聯(lián)合的干預措施較單獨使用常規(guī)治療、復方丹參、燈盞花素治療急性缺血性腦卒中的總有效率更高；注射用燈盞花素＋依達拉奉、注射用燈盞花素＋奧扎格雷2種干預措施較單獨使用依達拉奉治療急性缺血性腦卒中的總有效率更高；注射用燈盞花素＋奧扎格雷較單獨使用奧扎格雷治療急性缺血性腦卒中的總有效率更高；但注射用燈盞花素與3種不同化學藥分別聯(lián)合的干預措施之間兩兩比較差異無統(tǒng)計學意義（P＞0.05）。累積概率曲線下面積（SUCRA）排名前3的為注射用燈盞花素＋奧扎格雷、注射用燈盞花素＋依達拉奉和注射用燈盞花素＋常規(guī)治療。在不良反應方面，相對于單獨使用化學藥治療，注射用燈盞花素與3種不同化學藥分別聯(lián)合治療急性缺血性腦卒中的不良反應發(fā)生率差異均無統(tǒng)計學意義（P＞0.05），且注射用燈盞花素與3種不同化學藥分別聯(lián)合的干預措施之間兩兩比較差異亦無統(tǒng)計學意義（P＞0.05）。SUCRA排名前3的為復方丹參、注射用燈盞花素＋常規(guī)治療和注射用燈盞花素＋奧扎格雷。結論 相對于單獨使用化學藥治療，注射用燈盞花素聯(lián)合化學藥可顯著提高治療急性缺血性腦卒中的總有效率，且不會增加不良反應發(fā)生的風險，安全性較高。但由于納入文獻量少，文獻質量偏低，未來還需更多大樣本、高質量、隨機雙盲試驗以驗證本研究結果。

Objective To evaluate the efficacy and safety of Breviscapine Injection combined with western medicine in the treatment of acute cerebral infarction, and to provide evidence-based reference for clinical treatment. Methods Chinese and English databases such as CNKI, Chinese Biomedical Literature Database, Wanfang Data Knowledge Service Platform, VIP, PubMed, Cochrane Library, Springer Link, Web of Science were searched by computer. RCTs of Breviscapine Injection combined with western medicine in the treatment of acute cerebral infarction were collected, and the search time was established to June 2023. After literature screening, data extraction and literature quality evaluation, Stata 17.0 software was used to perform mesh Meta-analysis. Results A total of 29 RCTs were included, with a total of 2 930 patients. Eight interventions were involved, namely, breviscapine & edaravone for injection, breviscapine & ozagrel for injection, breviscapine & conventional treatment, edaravone, ozagrel for injection, Breviscapine Injection, compound danshen and conventional treatment. The results of mesh Meta-analysis showed that in terms of clinical efficacy, the total effective rate of Breviscapine Injection combined with three different western medicines was higher than that of conventional treatment alone, compound danshen and breviscapine in the treatment of acute cerebral infarction. The total effective rate of breviscapine & edaravone for injection and breviscapine & ozagrel for injection was higher than that of edaravone alone in the treatment of acute cerebral infarction. The total effective rate of breviscapine plus ozagrel for injection was higher than that of ozagrel alone in the treatment of acute cerebral infarction. However, there was no significant difference between the intervention measures of Breviscapine Injection and three different western medicines (P > 0.05). The top 3 areas under the Cumulative Probability Curve (SUCRA) were Breviscapine Injection & ozagrel, Breviscapine Injection & edaravone and Breviscapine Injection & conventional treatment. In terms of adverse reactions, compared with western medicine alone, there was no statistically significant difference in the incidence of adverse reactions between injection breviscapine and three different western medicines in the treatment of acute cerebral infarction (P > 0.05), and there was no statistically significant difference between pin-wise comparison of intervention measures between injection breviscapine and three different western medicines in the treatment of acute cerebral infarction (P > 0.05). The top 3 areas under the Surface Under the Cumulative Ranking Curve (SUCRA) were compound danshen, Breviscapine Injection & conventional treatment and Breviscapine Injection & ozagrel. Conclusion Compared with western medicine alone, Breviscapine Injection combined with western medicine can significantly improve the total effective rate in the treatment of acute cerebral infarction, and does not increase the risk of adverse reactions, and has high safety.

R971

中央高?；究蒲袠I(yè)務專項（2020-JYB-ZDGG-072）