Xuesaitong injection as one adjuvant treatment of acute cerebral infarction: a systematic review and meta-analysis

Xiaomeng Zhang, Jiarui Wu, Bing Zhang, Xiaomeng Zhang, Jiarui Wu, Bing Zhang

Abstract

Background: Xuesaitong Injection (XST) is one of the most commonly used medicines for treating acute cerebral infarction (ACI) in China. However, compared to the conventional therapy with western medicines (WM), the effectiveness and safety of XST as an adjuvant treatment for ACI needs to be systematically reviewed.

Methods: Randomized controlled trials (RCTs) comparing XST & WM with WM for treating ACI were included. Two reviewers independently extracted data. The Cochrane table of Risk of Bias was used to assess the quality of the included studies, and a meta-analysis was conducted using Review Manager 5.2.

Results: 23 RCTs, involving 2196 participants, were included in this study. Methodological quality was not well. The meta-analysis indicated that compared to WM, the combined use of XST and WM was more effective in terms of the total clinical effective rate [RR = 1.21, 95% CI (1.16, 1.25), P < 0.00001], neurological deficit scores [MD = -3.31, 95% CI (-4.10, -2.52), P < 0.00001], and plasma viscosity [MD = -0.13, 95% CI (-0.15, -0.11), P < 0.00001]. The included studies reported 37 adverse events, 17 of which belonged to experimental groups.

Conclusion: XST combined with WM appeared to be effective for ACI. However, the evidence of XST for treating ACI should be carefully interpreted due to the small sample size, limited number of trials, and unsatisfactory quality of research.

Figures

Figure 1
Figure 1
Flow chart of literature search.
Figure 2
Figure 2
Risk of bias.
Figure 3
Figure 3
Funnel plot of the total effective rate of XST in the treatment of ACI. XST: Xuesaitong Injection; ACI: acute cerebral infarction.
Figure 4
Figure 4
Meta-analysis of the total effective rate of XST in the treatment of ACI. XST: Xuesaitong Injection; ACI: acute cerebral infarction.
Figure 5
Figure 5
Meta-analysis of reducing neurological deficit scores of XST for testing ACI. XST: Xuesaitong Injection; ACI: acute cerebral infarction.
Figure 6
Figure 6
Meta-analysis of reducing the content of plasma viscosity of XST for treating ACI. XST: Xuesaitong Injection; ACI: acute cerebral infarction.

References

    1. Luo JN. New progress on treating acute cerebral infarction. Pract J Cardiac Cereb Pneumal Vasc Dis. 2010;18(10):1546–7.
    1. Deng L, Liu XD, Zhang YB, Li JM. Advances in the treatment of acute cerebral infarction. Chin Gen Pract. 2011;14(3B):825–9.
    1. Zhou K. Progress in the treatment of acute cerebral infarction. Pract J Card Cereb Pneumal Vasc Dis. 2010;18(11):1726–8.
    1. Su ZQ, Zhang YX, Yang N, Tao JP, Kang B. Preliminary analysis on TCM pathogenesis of acute cerebral infarction. J Liaoning Univ TCM. 2014;16(3):175–7.
    1. Lin CR. The literature and clinical research of xuesaitong injection to treat acute cerebral infarction. Chinese Medicine: Guangzhou University of; 2007.
    1. Yang ZG, Chen EQ, Yu SD, Sun HX. Recent advances in the research of pharmacological activities of Panax notoginseng saponins. Chin J Vet Drug. 2005;39(1):33–7.
    1. Xiao RM, Qiu XQ, Su JF. New progress of pharmacological study of panax notoginseng saponin for treating cardiovascular disease. China Healthcare Innov. 2009;4(11):30–1.
    1. Yin CQ, Deng HS, Cheng J. Overview of the pharmacological effects of panax notoginseng saponin for blood, cardiovascular and central nervous system. Sci Technol Inf. 2010;29:50–1.
    1. Zhu HC, Guo JJ, Ren Y. Progress of pharmacological researches of panax notoginseng saponin. Henan Tradit Chin Med. 2014;34(3):537–41.
    1. Zhang SS. Comparative efficacy advantage of panax preparations in treating different types of stroke based on a systematic review. J Shandong Univ Tradit Chin Med. 2013;37(2):91–3.
    1. Ding X. Meta analysis of xuesaitong injection for the treatment of acute cerehral infarction. Strait Pharm J. 2009;21(10):93–6.
    1. Wei XC, Zhu LQ. Meta analysis of xuesaitong injection for the treatment of cerehral infarction. Tianjin Pharm. 2010;22(4):25–8.
    1. Chinese society for Neuroscience, Chinese society for neurosurgery Diagnosis of various types of cerebrovascular disease. Chin J Neurol. 1996;29(6):379.
    1. Higgins JPT, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, et al. The cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ. 2011;343:d5928. doi: 10.1136/bmj.d5928.
    1. Li F, Gu DX, Li YJ, Shi JM. Observation on curative effects of treatment with panax notoginsenoside injection combined with batroxobin for acutely cerebral infarction in 31 patients. Chin J Integr Tradit Western Med Intensive Crit Care. 1999;6(10):470–2.
    1. Zhang LJ, Zhang SS. Observation on effect of 60 cases of Luotai in the treatment of cerebral infarction. J Huaihai Med. 2003;20(1):79.
    1. Yuan L. Observation on 34 cases of xuesaitong injection in the treatment of acute cerebral infarction. J Emerg Tradit Chin Med. 2003;12(2):133–45.
    1. Li YS. Effect of 48 cases of xuesaitong injection on treating acute cerebral infarction. China Hydropower Med. 2003;15(5):293.
    1. Li K, Qing XH. Observation on effect of xuesaitong injection on treating acute cerebral infarction. J Clin Med Pract. 2005;9(11):93–4.
    1. He RZ. Effect of xuesaitong injection on treating 40 patients with acute cerebral infarction. Hebei Med. 2006;12(8):756–8.
    1. Wang WC. Xuesaitong injection in the treatment of acute cerebral infarction. J Med Forum. 2006;27(15):56.
    1. Yuan QD, Jiang JL. Observation on 49 cases of xuesaitong injection combined with defibrase in treating with acute cerebral infarction. J Snake. 2006;18(1):20–1.
    1. Zhao BR. Observation on 40 cases of xuesaitong injection combined with defibrase and qinger injection in the treatment of acute cerebral infarction. Chin Med Guides. 2006;3(11):63–4.
    1. Li MF, Jiang YB. Clinical observation on xuesaitong injection in treatment of patients with acute cerebral infarction. Mod Med J China. 2007;9(10):93–4.
    1. Wang QR. Xuesaitong injection on treating acute cerebral infarction. J Med Forum. 2007;28(20):59.
    1. Wang W, Li HJ. Observation on the effect of xuesaitong injection in the treatment of acute cerebral infarction. J Med Forum. 2007;28(14):63.
    1. Rong Z, Zhi HP. Case control study of treatment of acute cerebral infarction with xuesaitong injection. J Neurol Neurorehabil. 2008;5(2):85–6.
    1. Zhang A, Zhang XR. Clinical study on xuesaitong injection in the treatment of acute cerebral infarction. J Pract Med Tech. 2008;15(19):2508–9.
    1. Zi JF, Yue YL, Ma FS. Clinical observation on xuesaitong injection in treating acute cerebral infarction. Chin J Misdiagnostics. 2008;8(30):7353–4.
    1. Duan H, Ai M. Observation on the effect of 69 cases of xuesaitong injection in treatment of acute cerebral infarction. Pract J Card Cereb Pneumal Vascular Dis. 2009;17(3):192.
    1. Ma CC, Wang RG. Observation on the effect of 100 cases of xuesaitong injection in the treatment of acute cerebral infarction. Chin J Coal Ind Med. 2009;12(4):595–6.
    1. Cai SL. Observation on effect of xuesaitong injection in the treatment of acute cerebral injection. Chin Foreign Med Res. 2011;9(24):50–1.
    1. Fu FC, Yang MY, Li JL, Cheng B, Li WJ. 122 cases of xuesaitong combined with sodium ozagrel on treating acute cerebral infarction. Guangming J Chin Mede. 2011;26(10):2087–8.
    1. He Q, Tan CB, Zhao Q. Clinical observation of xuesaitong injection combined with conventional treatment on patients with cerebral infarction. Drugs Clin. 2011;26(3):234–6.
    1. Wang GY, Mao QL, Zhou ZP. Effect of xuesaitong injection on treating acute cerebral infarction and the influence on high sensitive C-reactive protein. J Emerg Tradit Chin Med. 2011;20(4):639–40.
    1. Yang M, Cheng YJ. 30 cases of xuesaitong injection combined with sodium ozagrel on treating acute cerebral infarction. China Mod Med. 2012;19(10):124.
    1. Song Y. Observation on the effect of 80 cases of xuesaitong in the treatment of acute cerebral infarction. Chin J Urban Rural Ind Hyg. 2013;28(5):40–1.
    1. Huang JS, Zhang ZM. Clinical studies on the relations of acute cerebral infarction and lipid. China Foreign Med Treat. 2011;30(15):45–6.
    1. Stroke prevention guidelines writing group of Cerebrovascular Disease Study Group of Chinese Medical Association neuropathy credits Primary prevention of stroke guide in Chinese 2010. Chin J Neurol. 2011;44(4):282–8.
    1. Zhang X, Patel A, Horibe H, Wu Z, Barzi F, Rodgers A, et al. Cholesterol, coronary heartdisease, and stroke in the Asia Pacific region. Int J Epidemiol. 2003;32(4):563–72. doi: 10.1093/ije/dyg106.
    1. Kenarova B, Neychev H, Hadjiivanova C, Petkov VD. Immunomodulating activity of ginsenoside Rg1 from Panax ginseng. Jpn J Pharmacol. 1990;54(4):447–54. doi: 10.1254/jjp.54.447.
    1. Chen WQ. Clinical value of detection FIB, CRP for elderly patients with acute cerebral infarction. For All Health. 2013;7(3):49–50.
    1. Chen HY, Zhang LB, Jin RM. Meta-analysis of adverse reaction induced by xuesaitong injection. Pharmacol Clin Chin Materia Medica. 2012;28(2):163–6.
    1. Duan CY. Systemic review on adverse reaction induced by xuesaitong injection. Jilin Med J. 2013;34(30):6264.

Source: PubMed

3
Iratkozz fel