目的 系統(tǒng)評價醒腦靜治療急性重癥顱腦損傷昏迷的療效和安全性。方法 計算機檢索中國學術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學文獻數(shù)據(jù)庫（CBM）、維普中文期刊全文數(shù)據(jù)庫（VIP）、萬方數(shù)據(jù)庫、PubMed及Embase數(shù)據(jù)庫，檢索時間均從建庫至2019年5月。收集醒腦靜治療急性重型顱腦損傷昏迷的隨機對照試驗。對符合納入標準的臨床研究進行質(zhì)量評價和資料提取后，采用Rev Man 5.3軟件進行Meta-分析。結(jié)果 共納入15項研究，包括1 173例患者。Meta-分析結(jié)果顯示：試驗組的清醒率（OR=2.50，95%CI=1.79～3.49）、清醒時間（MD=-4.20，95%CI=-5.45～-2.96）、GCS評分變化（MD=2.68，95%CI=2.44～2.93）、NHISS評分變化（MD=-6.12，95%CI=-7.46～-4.77）、APACHE-Ⅱ（MD=-3.61，95%CI=-4.37～-2.86）、預(yù)后較好率（OR=2.37，95%CI=1.81～3.10）、預(yù)后不良率（OR=0.46，95%CI=0.34～0.62）及血清炎性因子（TNF-a、IL-8、IL-6）均優(yōu)于對照組，差異均有統(tǒng)計學意義（P<0.01）。結(jié)論 現(xiàn)有研究證據(jù)顯示，醒腦靜能顯著提高重癥顱腦損傷昏迷患者清醒率、縮短清醒時間、提高GCS評分、降低NIHSS評分和APACHE-Ⅱ評分，提高預(yù)后良好率。

Objective To systematically evaluate the efficacy and safety of Xingnaojing in the treatment of acute severe craniocerebral injury in patients with coma. Methods A randomized controlled trial of Xingnaojing in the treatment of acute severe craniocerebral injury in patients with coma were conducted in CNKI, Wanfang, WIP, CBM, PubMed and Embase databases from the database to May 2019. Date were extracted and evaluated by two reviewers independently with designed extraction form. The Rev Man 5.3 software was used to carry out statistic analysis. Results A total of 15 studies were included, including 1173 patients.Metaanalysis results showed: the test group of the awake rate (OR = 2.50, 95%CI = 1.79 ~ 3.49), awake time (MD = -4.20, 95%CI = -5.45 ~ -2.96), GCS score changed (MD = 2.68, 95%CI = 2.44 ~ 2.93), NHISS score changed (MD = -6.12, 95%CI = -7.46 ~ -4.77), APACHE-II score changed (MD = -3.61, 95%CI = -4.37 ~ -2.86), Prognosis rate (OR = 2.37, 95%CI =1.81 ~ 3.10), poor prognosis rate (OR = 0.46, 95%CI = 0.34 ~ 0.62) and serum inflammatory factors (TNF-a, IL-8, IL-6) were better than that in the control group,the difference both had statistically significant (P < 0.01). Conclusion The available research evidence shows that Xingnaojing can significantly improve the wakefulness rate, shorten the awake time, increase the GCS score, decrease the NIHSS score and APACHE-II score and improve the prognosis rate in patients with severe craniocerebral injury.

R944.5