Butylphthalide Combined With Urinary Kallidinogenase For Treatment Of Acute Cerebral Infarction: A Meta-analysis

Objective: To systematacially assess the efficacy and safety of butylphthalide combined with urinary kallidinogenase for acute cerebral infarction(ACI),and provide references for clinical rational drug use.Methods: Retrieved from PubMed,Cochrane library,CBM,FMJS,VIP,Wanfang database and CNKI(published until October 2016),randomized controlled trails(RCT)about butylphthalide combined with urinary kallidinogenase for ACI were included.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 independenly.Then statistical analysis of those studies were carried out by Rev Man 5.3.5 software.Results: 18 RCTs involving a total of 1916 cases were included.Results of Meta-analysis showed the outcome of patients in trial group was much better than those in control group: Compared with routine therapeutic group,butylphthalide combined with urinary kallidinogenase could significantly improve total effective rate[RR=1.26,95%CI(1.18,1.35),Z=6.19,P<0.00001],neurological deficit scores precisely National Institutes of Health Stroke Survey(NIHSS)[WMD=-2.83,95%CI(-3.64,-2.02),Z=6.86,P<0.00001] and Barthel Activities of Daily Living Index(ADL)[WMD=7.33,95%CI(3.43,11.23),Z=3.68,P<0.00001].Compared with urinary kallidinogenase-treated group,the total effective rate [RR=1.16,95%CI(1.09,1.24),Z=4.76,P<0.00001],NIHSS [WMD=-3.26,95%CI(-4.21,-2.31),Z=6.74,P<0.00001].Compared with butylphthalide-treated group,significantly,total effective rate(P<0.05),NIHSS [WMD=-3.53,95%CI(-5.08,-1.98),Z=4.47,P<0.00001].Conclusion: Compared with urinary kallidinogenase or butylphthalide or routine therapy,butylphthalide combined with urinary kallidinogenase showed excellent efficacy in the treatment of ACI,and few significant serious adverse reactions were observed.The combination therapy can be a considerably medicable and safe application of ACI treatment.However,due to the limitation of the quality of the included studies,more strict large-scale,multi-center and multicentric randomized double-blind control trials are needed in order to provide more convinced evidence for the above conclusion in future.