To evaluate the efficacy and safety of butylphthalide sequential therapy in the treatment of acute cerebral infarction.

Internet search in China National Knowledge Infrastructure (CNKI), Wanfang Database (WanFang), VIP Database (VIP), China Biomedical Document Service System (SinoMed), Cochrane Library, PubMed and Web of Science. We collected relevant documents of randomized controlled trials of phthalide sequential therapy in the treatment of acute cerebral infarction. The publish time was from May 1, 2015 to July 1, 2020. After two reviewers independently screened the literature, extracted relevant data, and evaluated the risk of bias in the included studies, meta-analysis was performed through Revman 5.3 software.

Twelve RCTs were finally included, with a total of 1307 patients, including 655 cases of the butylphthalide sequential treatment group, and 652 cases of the control group (conventional treatment or conventional treatment+butylphthalide injection or conventional treatment+edaravone injection). Meta-analysis results showed that there were statistically significant differences between the butylphthalide sequential treatment group and the control group in the NIHSS score (MD=-3.57, 95%CI: -4.56~-2.58, P＜0.001), Barthel index (MD=10.73, 95%CI: 6.14-15.31, P＜0.001) and the total efficacy of treatment (RR=1.19, 95%CI: 1.09-1.31, P＜0.001). During treatment, the two groups had fewer adverse reactions, mainly elevated transaminases, but they were all mild.

Butylphthalide sequential therapy has good efficacy and safety in the treatment of acute cerebral infarction.