Xiaojiao Wu, Zelian Chen, Sishi Du, Liming Chang, Jian Zhang
{"title":"胃泌素作为辅助治疗可提高急性中风患者的神经保护效果:随机对照试验的系统回顾与荟萃分析","authors":"Xiaojiao Wu, Zelian Chen, Sishi Du, Liming Chang, Jian Zhang","doi":"10.1016/j.hermed.2024.100895","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Traditionally, gastrodin extracted from Rhizoma Gastrodiae has been used to treat various neurological diseases. The objective of this systematic review with meta-analysis is to evaluate the potential benefits of gastrodin as an adjuvant therapy for the treatment of acute stroke.</p></div><div><h3>Methods</h3><p>Relevant literature from multiple medical databases was searched until October 12, 2023, to identify randomised controlled trials investigating the use of gastrodin as an adjuvant therapy for acute stroke treatment. The total response rate and marked improvement rate were defined as >18% and >45% improvement in National Institutes of Health Stroke Scale score, respectively.</p></div><div><h3>Results</h3><p>A total of 12 randomised controlled trials, including 1 174 stroke patients, were identified. Compared to conventional treatment alone, the combination of gastrodin and conventional treatment significantly improved the total response rate (risk ratio 1.24; 95% CI 1.15–1.34) and marked improvement rate (risk ratio 1.37; 95% CI 1.18–1.59). Adjuvant treatment with gastrodin also resulted in a reduction in the National Institutes of Health Stroke Scale score (weighted mean difference [<strong>WMD</strong>] −3.08 points; 95% CI −3.75 to −2.41), haematoma volume (WMD −3.57 cm<sup>3</sup>; 95% CI −4.26 to −2.87), and blood neuron-specific enolase level (WMD −3.81 μg/l; 95% CI −6.21 to −1.41), as well as an increase in blood brain-derived neurotrophic factor level (WMD 0.81 ng/ml; 95% CI 0.50–1.12).</p></div><div><h3>Conclusions</h3><p>Gastrodin, when used as an adjuvant therapy, may yield additional beneficial effects in patients with acute stroke. However, future high-quality trials are necessary to further support this evidence.</p></div>","PeriodicalId":56077,"journal":{"name":"Journal of Herbal Medicine","volume":"46 ","pages":"Article 100895"},"PeriodicalIF":2.2000,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Gastrodin as Adjuvant Therapy Improves Neuroprotective Effect in Acute Stroke Patients: A Systematic Review With Meta-analysis of Randomised Controlled Trials\",\"authors\":\"Xiaojiao Wu, Zelian Chen, Sishi Du, Liming Chang, Jian Zhang\",\"doi\":\"10.1016/j.hermed.2024.100895\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Traditionally, gastrodin extracted from Rhizoma Gastrodiae has been used to treat various neurological diseases. The objective of this systematic review with meta-analysis is to evaluate the potential benefits of gastrodin as an adjuvant therapy for the treatment of acute stroke.</p></div><div><h3>Methods</h3><p>Relevant literature from multiple medical databases was searched until October 12, 2023, to identify randomised controlled trials investigating the use of gastrodin as an adjuvant therapy for acute stroke treatment. The total response rate and marked improvement rate were defined as >18% and >45% improvement in National Institutes of Health Stroke Scale score, respectively.</p></div><div><h3>Results</h3><p>A total of 12 randomised controlled trials, including 1 174 stroke patients, were identified. Compared to conventional treatment alone, the combination of gastrodin and conventional treatment significantly improved the total response rate (risk ratio 1.24; 95% CI 1.15–1.34) and marked improvement rate (risk ratio 1.37; 95% CI 1.18–1.59). Adjuvant treatment with gastrodin also resulted in a reduction in the National Institutes of Health Stroke Scale score (weighted mean difference [<strong>WMD</strong>] −3.08 points; 95% CI −3.75 to −2.41), haematoma volume (WMD −3.57 cm<sup>3</sup>; 95% CI −4.26 to −2.87), and blood neuron-specific enolase level (WMD −3.81 μg/l; 95% CI −6.21 to −1.41), as well as an increase in blood brain-derived neurotrophic factor level (WMD 0.81 ng/ml; 95% CI 0.50–1.12).</p></div><div><h3>Conclusions</h3><p>Gastrodin, when used as an adjuvant therapy, may yield additional beneficial effects in patients with acute stroke. However, future high-quality trials are necessary to further support this evidence.</p></div>\",\"PeriodicalId\":56077,\"journal\":{\"name\":\"Journal of Herbal Medicine\",\"volume\":\"46 \",\"pages\":\"Article 100895\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-05-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Herbal Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2210803324000526\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"INTEGRATIVE & COMPLEMENTARY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Herbal Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2210803324000526","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
引言传统上,从天麻中提取的天麻素被用于治疗各种神经系统疾病。本系统综述和荟萃分析的目的是评估天麻素作为辅助疗法治疗急性脑卒中的潜在益处。方法检索多个医学数据库中的相关文献,直至 2023 年 10 月 12 日,以确定研究天麻素作为辅助疗法治疗急性脑卒中的随机对照试验。总反应率和明显改善率分别定义为美国国立卫生研究院卒中量表评分的>18%和>45%。与单用常规治疗相比,胃复安和常规治疗联合使用可显著提高总反应率(风险比 1.24;95% CI 1.15-1.34)和明显改善率(风险比 1.37;95% CI 1.18-1.59)。胃复安辅助治疗还可降低美国国立卫生研究院卒中量表评分(加权平均差 [WMD] -3.08分;95% CI -3.75至-2.41)、血肿体积(WMD -3.57立方厘米;95% CI -4.26至-2.87)和血液神经元特异性烯醇化酶水平(WMD -3.57立方厘米;95% CI -4.26至-2.87)。结论胃泌素作为一种辅助疗法,可为急性卒中患者带来额外的益处。结论胃泌素作为辅助疗法可为急性中风患者带来额外的益处,但还需要未来的高质量试验来进一步支持这一证据。
Gastrodin as Adjuvant Therapy Improves Neuroprotective Effect in Acute Stroke Patients: A Systematic Review With Meta-analysis of Randomised Controlled Trials
Introduction
Traditionally, gastrodin extracted from Rhizoma Gastrodiae has been used to treat various neurological diseases. The objective of this systematic review with meta-analysis is to evaluate the potential benefits of gastrodin as an adjuvant therapy for the treatment of acute stroke.
Methods
Relevant literature from multiple medical databases was searched until October 12, 2023, to identify randomised controlled trials investigating the use of gastrodin as an adjuvant therapy for acute stroke treatment. The total response rate and marked improvement rate were defined as >18% and >45% improvement in National Institutes of Health Stroke Scale score, respectively.
Results
A total of 12 randomised controlled trials, including 1 174 stroke patients, were identified. Compared to conventional treatment alone, the combination of gastrodin and conventional treatment significantly improved the total response rate (risk ratio 1.24; 95% CI 1.15–1.34) and marked improvement rate (risk ratio 1.37; 95% CI 1.18–1.59). Adjuvant treatment with gastrodin also resulted in a reduction in the National Institutes of Health Stroke Scale score (weighted mean difference [WMD] −3.08 points; 95% CI −3.75 to −2.41), haematoma volume (WMD −3.57 cm3; 95% CI −4.26 to −2.87), and blood neuron-specific enolase level (WMD −3.81 μg/l; 95% CI −6.21 to −1.41), as well as an increase in blood brain-derived neurotrophic factor level (WMD 0.81 ng/ml; 95% CI 0.50–1.12).
Conclusions
Gastrodin, when used as an adjuvant therapy, may yield additional beneficial effects in patients with acute stroke. However, future high-quality trials are necessary to further support this evidence.
期刊介绍:
The Journal of Herbal Medicine, the official journal of the National Institute of Medical Herbalists, is a peer reviewed journal which aims to serve its readers as an authoritative resource on the profession and practice of herbal medicine. The content areas of the journal reflect the interests of Medical Herbalists and other health professionals interested in the clinical and professional application of botanical medicines. The objective is to strengthen the research and educational base of herbal medicine with research papers in the form of case studies, original research articles and reviews, monographs, clinical trials and relevant in vitro studies. It also publishes policy statements, opinion pieces, book reviews, conference proceedings and profession related information such as pharmacovigilance reports providing an information source for not only the Herbal Practitioner but any Health professional with an interest in phytotherapy.