| Objective:In the first part of this study,meta analysis was used to integrate and analyze the randomized controlled trials related to traditional Chinese medicine injection in the treatment of ischemic stroke in the convalescent period,so as to explore the application situation in the real world.In the second part,on the basis of study 1,salvianolic acid injection was used as the research object to observe the convalescent period of ischemic stroke,and the observation content was the clinical efficacy and the safety.And through the observation of the clinical efficacy,analysing different subgroups to determine the optimal patient.Methods:1.Meta-analysis.Using computer to search CNKI and VIP database,according to the database using the corresponding search strategy,and through the query of relevant key words to retrieve the literature,record the relevant literature information.Based on the inclusion and exclusion criteria,the contents of the literature that meet the research conditions were selected.The related indicators were extracted and entered into Rev Man5.3 software was uesd for data processing and analysis.2.Clinical observation.From November 2019 to December 2020,70 cases of ischemic stroke were included in the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin Beichen Traditional Chinese Medicine Hospital,Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital,General Hospital of the Northern Theater of the Chinese People’s Liberation Army and Luoyang Third People’s Hospital.After basic treatment,salvianolic acid for injection was given intravenously for 14 days,and the dosage was 100 mg QD.Before and after treatment,the Modified Rankin Scale(m RS)score,the National Institute of Health Stroke Scale(NIHSS)score,Barthel Index(BI)and the Mini-mental State Examination(MMSE)score were recorded in 70 patients.During the treatment,the adverse reactions and the Main Adverse Cardiovascular And Cerebrovascular Event(MACCE)were recorded.Results:1.Meta analysis: after searching and screening,13 papers were selected in the meta analysis.The clinical efficacy,Fugl-Meyer Assessment,the NIHSS score and BI of the traditional Chinese medicine injection combined with conventional western medicine treatment group were improved compared with the conventional western medicine treatment group,and the differences were statistically significant;the adverse reactions were no significant difference between the two groups.2.Clinical efficacy analysis: main outcome measures: after 90 days of treatment,the proportion of m RS score 0-1 was 42.9%,compared with the objective performance criteria18.4%,P < 0.05,the drug was effective,the difference was statistically significant,and the effective rate was higher than 18.4%.As for the secondary efficacy indicators,the standard before treatment was less than the standard after treatment,P < 0.05,the difference was statistically significant.3.Safety evaluation: No adverse reactions,stroke recurrence and death were observed in the treatment group during treatment and follow-up.4.Subgroup analysis:(1)Previous stroke history: compared with patients with previous stroke history,there was no statistical significance in the difference of index data of each efficacy evaluation for patients with first stroke after treatment.(2)Age: compared with patients over 65 years old,the proportion of 18-65 years old patients had better m RS score 0-1 on 90 days after medication,BI ≥ 75 on 14 days after medication and BI ≥ 75 on 90 days after medication,P < 0.05,the differences were statistically significant;there was no significant difference in other therapeutic indexes between the two groups.(3)Course of disease: compared with patients within 14-90 days of onset(excluding 14,including 90),patients within 14 days of onset had better NIHSS score,P < 0.05,the differences were statistically significant;there was no significant difference in other therapeutic indexes between the two groups.Conclusion:1.In the treatment of ischemic stroke convalescent period,using the injection of salvianolic acid for human body,can effectively improve the degree of neurological deficit,improve the quality of life of patients,clinical curative effect is exact.2.Traditional Chinese medicine injection has certain medical value in the treatment of ischemic stroke convalescent period,combined with conventional treatment can further improve the curative effect.3.During the observation period of this subject,salvianolic acid for injection in the treatment of ischemic stroke recovery period did not find obvious side effects,high safety,worthy of further promotion and application.4.Salvianolic acid for injection in the treatment of 18-65 years old patients,the curative effect is better than 65 years old patients;in the treatment of patients within 14 days of onset,the curative effect is better than 14-90 days patients.In the clinical treatment of convalescent stroke patients,we should focus on young patients and use drugs as soon as possible to increase the curative effect. |
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