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

Zhang X, Wu J, Zhang B - BMC Complement Altern Med (2015)

Bottom Line: 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.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].XST combined with WM appeared to be effective for ACI.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 100102, China. fensexiaomao@sina.com.

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.

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Related in: MedlinePlus

Funnel plot of the total effective rate of XST in the treatment of ACI. XST: Xuesaitong Injection; ACI: acute cerebral infarction.
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Fig3: Funnel plot of the total effective rate of XST in the treatment of ACI. XST: Xuesaitong Injection; ACI: acute cerebral infarction.

Mentions: Three trials used a random number table to generate random sequence [26,32,34], two grouped according to the time of admission [21,35], and one grouped according to odd and even numbers [24]. And there were two trials may be used non-random sequence [16,36]. Only one trail performed single-blinding [18]. Others in the included trials in this meta-analysis were judged as unclear random sequence generation, inadequate allocation concealment, and inadequate blinding. None of the included trials had incomplete outcome data or selective reporting. Therefore, the quality of the included studies was not well. More details of the trials were presented in Figure 2. Funnel plot analysis showed that there was some significant publication bias in the comparison, as shown in Figure 3.Figure 2


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

Zhang X, Wu J, Zhang B - BMC Complement Altern Med (2015)

Funnel plot of the total effective rate of XST in the treatment of ACI. XST: Xuesaitong Injection; ACI: acute cerebral infarction.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4355548&req=5

Fig3: Funnel plot of the total effective rate of XST in the treatment of ACI. XST: Xuesaitong Injection; ACI: acute cerebral infarction.
Mentions: Three trials used a random number table to generate random sequence [26,32,34], two grouped according to the time of admission [21,35], and one grouped according to odd and even numbers [24]. And there were two trials may be used non-random sequence [16,36]. Only one trail performed single-blinding [18]. Others in the included trials in this meta-analysis were judged as unclear random sequence generation, inadequate allocation concealment, and inadequate blinding. None of the included trials had incomplete outcome data or selective reporting. Therefore, the quality of the included studies was not well. More details of the trials were presented in Figure 2. Funnel plot analysis showed that there was some significant publication bias in the comparison, as shown in Figure 3.Figure 2

Bottom Line: 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.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].XST combined with WM appeared to be effective for ACI.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Chinese Pharmacy, School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing, 100102, China. fensexiaomao@sina.com.

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.

Show MeSH
Related in: MedlinePlus