| Objective To assess the efficacy and safety of mNGF for patients with peripheral nerve injury.Methods We searched The Cochrane Library (Issue1,2011), Medline (1950-2011), Embase (1980-2011), CNKI (1979-2011) by electronic database and relevant journals such as Chinese Journal of Orthopaedics, Chinese Journal of Microsurgery and Chinese Journal of Neurosurgery etc. By manual searching to collect all randomized controlled trials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) of mNGF for patients with peripheral nerve injury. The quality of included studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews of Interventions and data were extracted by two reviewers independently. Meta-analysis was conducted by RevMan5.1software. Estimated the comprehensive evaluation index by95%confidence interval, and made a=0.05for the size of test.Results41studies involving3304patients with peripheral nerve injury were included. The results of Meta-analysis showed that:(1) the total rate of peripheral nerve injury treatment in mNGF group was obviously higher than the control group,[(odds ratio, OR)=6.36,95%confidence interval, CI),(4.96,8.15), P<0.00001)];(2) The improvement of sensory nerve conduction velocity in mNGF group was faster than the control group,[(weighted mean difference, WMD)=2.51,95%CI (1.37,3.65), P<0.0001)].(3) The improvement of motor nerve conduction velocity in mNGF group was faster than the control group,[WMD=2.51,95%CI (1.37,3.65), P<0.0001)].(4) The scores of ADL in mNGF group was obviously higher than control group, there were significant differences between two groups,[WMD=1.97,95%CI (1.33,2.61), P<0.00001].(5) The course of treatment was14days, the total rate of peripheral nerve injury treatment that adopted in the regional injection in mNGF group was obviously higher than the muscle injection group,[OR=5.15,95%CI (2.56,10.32), P<0.00001].(6) The dose was2000Au, and the course of treatment was14-30days, the total rate of peripheral nerve injury treatment that adopted in the muscle injection in mNGF group was higher than the regional injection group,[OR=8.63,95%CI(2.72,27.37),P<0.00001].(7) Safety evaluation: Adverse reactions mainly included the pain of injection site, the scleroma of injection site, tickle, tetter, fever, dizziness, headache, nausea and vomiting, and ischemic contracture.①The pain of injection site:the incidence of the pain of injection site in the mNGF group was higher than that in the control group[OR=1.78,95%CI(1.15,2.75), P=0.01];②The scleroma of injection site: The incidence of headache in two groups had no statistically significant [OR=1.01,95%CI(0.26,3.89), P=0.99];③Tickle, tetter, fever The scleroma of injection site: The incidence of headache in two groups had no statistically significant [OR=6.47,95%CI(0.76,54.89), P=0.09];④Dizziness, headache,:The incidence of headache in two groups had no statistically significant [OR=2.73,95%CI (0.56,13.37), P=0.22];⑤nausea and vomiting:The incidence of headache in two groups had no statistically significant [OR=3.88,95%CI (0.42,35.57), P=0.23];⑥ischemic contracture:The incidence of headache in two groups had no statistically significant [OR=0.34,95%CI (0.09,1.36), P=0.13]。Conclusion mNGF therapy for peripheral nerve injury is better than that the control group in efficiency, the improvement of sensory nerve conduction velocity in mNGF group was faster than the control group, the improvement of motor nerve conduction velocity in mNGF group was faster than the control group,it can improve the patient’s (activies of daily living, ADL) obviously, the course of treatment was14days, the total rate of peripheral nerve injury treatment that adopted in the regional injection in mNGF group was obviously higher than the muscle injection group, the dose was2000Au, and the course of treatment was14-30days, the total rate of peripheral nerve injury treatment that adopted in the muscle injection in mNGF group was higher than the regional injection group, adverse reactions mainly included the pain of injection site, the scleroma of injection site, tickle, tetter, fever, dizziness, headache, nausea and vomiting, and ischemic contracture,only the incidence of the pain of injection site in the mNGF group was higher than that in the control group, others have no statistically significant, the degree of all adverse reactions was slighter, no influence in treatment, so it has better safety. |
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