Résumé
OBJECTIVE: To evaluate the effectiveness of edaravone for survival of patients with acute cerebral trauma by meta-analysis, in order to give some evidence for dealing acute cerebral trauma. METHODS: Studies that strictly followed and compared the effects of conventional treatments in combination with edaravone and conventional treatments on the survival of patients with acute cerebral trauma were searched. The qualities of the studies were evaluated. Then a meta-analysis was carried out on the qualified studies. The odds ratio (OR) for death of the two treatment regiments was calculate. The effectiveness of edaravone for prolonging the survival of patients with acute cerebral trauma was evaluated. RevMan4.2 software was applied to process data. RESULTS: Totally 7 studies including 427 cases were analyzed. There were 219 patients who received conventional treatments in combination with edaravone, among whom 47 died; while in conventional treatments group there were 208 patients and 70 died. The pooled OR was 0.50 (95% confidence interval 0.32-0.79). CONCLUSION: From the existing clinical evidence, the combination of conventional treatments with edaravone can provide some benefit for the survival of patients with acute cerebral trauma. The overall OR for death decreased by 0.50 in patients receiving combination treatment compared with that for conventional treatments. However, large-scale randomized controlled trials with rigorous design are still needed to verify and support its clinical effectiveness. Copyright 2012 by the Chinese Pharmaceutical Association.
Résumé
<p><b>OBJECTIVE</b>To detect absorbed bioactive compounds of the water extract whose pharmacodynamic effect was craniocerebral protection for quality control assessment.</p><p><b>METHODS</b>Anthraquinones in water extract of rhubarb (WER), in cerebrospinal fluid (CSF) of patients with traumatic brain injury (TBI) and in ipsilateral cortex of TBI rats following oral WER were respectively explored by ultra performance liquid chromatography with photodiode array detector (UPLC-PDA) method developed in the present study. The effects of anthraquinones absorbed into injured cortex on superoxidase dismutase (SOD) activity in TBI rats were detected. The antioxidative anthraquinones absorbed into target organ were evaluated for quality control of WER.</p><p><b>RESULTS</b>Anthraquinones in WER were aloe-emodin, rhein, emodin, chrysophanol, and physcion. Only the last anthraquinone was found in CSF and in ipsilateral cortex under this chromatographic condition. Physcion increased SOD activity in TBI rats significantly.</p><p><b>CONCLUSIONS</b>Physcion was the main active compound of rhubarb against craniocerebral injury via antioxidant pathway. According to our strategy, the exploration of physcion suggested the possibility of a novel quality control of WER in treating TBI injury.</p>