目的 系統(tǒng)性評價銀杏萜內(nèi)酯類注射液治療缺血性腦卒中的療效及安全性。方法 檢索中國期刊全文數(shù)據(jù)庫（CNKI）、維普中文科技期刊全文數(shù)據(jù)庫（VIP）、中國生物醫(yī)學文獻數(shù)據(jù)庫（CBM）、萬方數(shù)據(jù)庫、EMBASE、Pubmed和The Cochrane Library，檢索截止日期為2017年12月。納入銀杏萜內(nèi)酯類注射液治療缺血性腦卒中的隨機對照試驗研究，采用RevMan5.2軟件對臨床療效及神經(jīng)功能缺損評分進行Meta-分析。結果 最終納入臨床研究13項，涉及患者1 330例。Meta-分析結果顯示，銀杏內(nèi)酯注射液治療缺血性腦卒中患者的臨床療效優(yōu)于對照組[RR=1.14，95%CI（1.03，1.25），Z=2.59，P=0.009]；銀杏內(nèi)酯B注射液治療缺血性腦卒中患者的臨床療效與對照組相當[RR=1.13，95%CI（0.95，1.33），Z=1.36，P=0.17]；銀杏二萜內(nèi)酯葡胺注射液治療缺血性腦卒中患者的臨床療效優(yōu)于對照組[RR=1.17，95%CI（1.08，1.27），Z=3.69，P=0.0002]；銀杏內(nèi)酯注射液改善缺血性腦卒中患者的神經(jīng)功能缺損評分與對照組相當[MD=-0.43，95%CI（-4.32，3.46），Z=0.22，P=0.83]；銀杏內(nèi)酯B注射液改善缺血性腦卒中患者的神經(jīng)功能缺損評分與對照組相當[[MD=-0.87，95%CI（-2.64，0.91），Z=0.96，P=0.34]；銀杏二萜內(nèi)酯葡胺注射液改善缺血性腦卒中患者的神經(jīng)功能缺損評分優(yōu)于對照組[MD=-1.62，95%CI（-2.63，-0.60），Z=3.13，P=0.002]；納入研究均未報道銀杏萜內(nèi)酯類注射液引起嚴重不良反應。結論 銀杏萜內(nèi)酯類注射液治療缺血性腦卒中患者可提高臨床療效、減少神經(jīng)功能缺損，但缺乏臨床意義證據(jù)。尚需更多高質量研究以增加證據(jù)的強度。

Objective To systematically access the effectiveness and safety of bilobalide injections for the treatment of patients with ischemic stroke.Methods The randomized clinical trials (RCTs) were retrieved by searching CBM, CNKI, WanFang Data, VIP Database, EMBASE, PUBMED, and The Cochrane Library until December. Patients with ischemic stroke were included into RCTs research and studies were extracted the feature information. Related journals and conference papers were searched manually. Clinical efficacy and neurological deficit score was Meta-analyzed by RevMan5.2 software.Results Meta-analysis showed that the bilobalide injection was superior to the control group for the treatment of patients with ischemic stroke in improving clinical curative effect[RR=1.14, 95%CI(1.03, 1.25), Z=2.59, P=0.009]; There was no difference between bilobalide B injection and the control group in improving clinical curative effect[RR=1.13, 95%CI(0.95, 1.33), Z=1.36, P=0.17]; While, diterpene ginkgolides meglumine injection were superior to the control group in improving clinical curative effect[RR=1.17, 95%CI(1.08, 1.27), Z=3.69, P=0.000 2]; Meantime, there was no differences between the bilobalide injection and the control group for the treatment of patients with ischemic stroke in improving neurological severity scores[MD=-0.43, 95%CI(-4.32, 3.46), Z=0.22, P=0.83]; Similarly, the same as the bilobalide B injection in improving clinical curative effect[MD=-0.87, 95%CI(-2.64, 0.91), Z=0.96, P=0.34]; While, diterpene ginkgolides meglumine injection were superior to the control group in improving neurological severity scores[MD=-1.62, 95%CI(-2.63, -0.60), Z=3.13, P=0.002]. The serious adverse reactions caused by types of bilobalide injections were not reported in this study.Conclusion Bilobalide injections were superior to the control group in improving clinical curative effect and neurological severity scores in patients with ischemic stroke. More high quality research was needed to increase the strength of the evidence.

國家中醫(yī)臨床研究基地業(yè)務建設科研專項（JDZX2012133）