目的 系統(tǒng)評(píng)價(jià)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(jì)算機(jī)檢索中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學(xué)文獻(xiàn)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(shí)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(jī)對(duì)照試驗(yàn)。對(duì)符合納入標(biāo)準(zhǔn)的臨床研究進(jìn)行質(zhì)量評(píng)價(jià)和資料提取后，采用Rev Man 5.3軟件進(jìn)行Meta-分析。結(jié)果 共納入15項(xiàng)研究，包括1 173例患者。Meta-分析結(jié)果顯示：試驗(yàn)組的清醒率（OR=2.50，95%CI=1.79～3.49）、清醒時(shí)間（MD=-4.20，95%CI=-5.45～-2.96）、GCS評(píng)分變化（MD=2.68，95%CI=2.44～2.93）、NHISS評(píng)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(duì)照組，差異均有統(tǒng)計(jì)學(xué)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(shí)間、提高GCS評(píng)分、降低NIHSS評(píng)分和APACHE-Ⅱ評(píng)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