OBJECTIVE The objective of this meta-analysis was to assess the efficacy of progesterone (PG) at 1.0 mg kg-1 once every 12 h for 5 consecutive days in patients with moderate-to-severe (Glasgow Coma Score [GCS] 3-12) traumatic brain injury (TBI). METHODS The Cochrane Library, OvidSP, Web of Science, PubMed, CNKI, WFSD, and VIP databases were systematically searched from inception to May 1, 2020. The quality of included studies was evaluated using the bias risk assessment tool from the Cochrane systematic evaluator manual 5.1.0. A pooled analysis of relevant data was conducted using RevMan 5.3 software. The primary outcome was good functional outcome (GFO), and the secondary outcome was mortality. Subgroup analysis was performed to explore the impact of time, administration route, type of injury, and GCS on outcome measures. RESULTS A total of 7 randomized controlled trials involving 504 participants were included in this meta-analysis. The findings indicated a statistically significant difference in terms of GFO (RR, 1.48; 95 % confidence interval [CI], 1.25-1.76; P < 0.00001) and mortality (RR, 0.66; 95 % CI, 0.44-0.84; P = 0.002) between the PG and control groups. Subgroup analyses demonstrated that administration route was an important influencing factor for improving GFO in the PG group, and administration route and follow-up time were important for reducing mortality in the PG group. CONCLUSIONS We conclude that PG, at a dose of 1.0 mg kg-1 via intramuscular injection every 12 h for 5 consecutive days, could significantly improve GFO (1 month, 3 months, 6 months, and 12 months) and reduce the medium-term (3-month and 6-month) mortality rate. Larger studies are needed to support our findings.

中文翻译：

---

黄体酮 1 mg kg-1 每 12 小时 5 天在中度至重度创伤性脑损伤中的疗效：随机对照试验的荟萃分析

目的 本荟萃分析的目的是评估黄体酮 (PG) 1.0 mg kg-1 每 12 小时一次，连续 5 天对中重度（格拉斯哥昏迷评分 [GCS] 3-12 ) 外伤性脑损伤 (TBI)。方法 系统检索 Cochrane 图书馆、OvidSP、Web of Science、PubMed、CNKI、WFSD 和 VIP 数据库，从开始到 2020 年 5 月 1 日。使用 Cochrane 系统评估手册中的偏倚风险评估工具评估纳入研究的质量5.1.0。使用 RevMan 5.3 软件对相关数据进行汇总分析。主要结局是良好的功能结局（GFO），次要结局是死亡率。进行亚组分析以探讨时间、给药途径、损伤类型和 GCS 对结果测量的影响。结果 本荟萃分析共纳入 7 项随机对照试验，涉及 504 名参与者。结果表明 GFO（RR，1.48；95% 置信区间 [CI]，1.25-1.76；P < 0.00001）和死亡率（RR，0.66；95 % CI，0.44-0.84；P = 0.002）存在统计学显着差异) PG 和对照组之间。亚组分析表明，给药途径是PG组改善GFO的重要影响因素，给药途径和随访时间对降低PG组死亡率具有重要意义。结论 我们得出结论，连续 5 天每 12 小时肌肉注射 1.0 mg kg-1 的 PG 可以显着改善 GFO（1 个月、3 个月、6 个月和 12 个月）并减少中期（3 个月和 6 个月）死亡率。