Chinese herbal medicine Dengzhan Xixin injection for acute ischemic stroke: A systematic review and meta-analysis of randomised controlled trials

• Published in: Complementary therapies in medicine Vol. 34; pp. 74 - 85
• Main Authors: Li, Jin-gen, Wang, Li-qiong, Yang, Xiao-ying, Chen, Zhuo, Lai, Lily Y.W., Xu, Hao, Liu, Jian-ping
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.10.2017; Elsevier Limited
• Subjects: Acute ischemic stroke; Adverse events; Aged; Aged, 80 and over; Anticoagulants; Bias; Brain; Brain Ischemia - complications; Brain Ischemia - drug therapy; Chinese herbal medicine; Clinical trials; Dengzhan xixin; Drug dosages; Drugs, Chinese Herbal - therapeutic use; Erigeron; FDA approval; Female; Herbal medicine; Humans; Injection; Injections; Ischemia; Kinases; Male; Meta-analysis; Middle Aged; Palliative care; Performance evaluation; Phytotherapy; Quality assessment; Quality of life; Randomised controlled trials; Software; Stroke; Stroke - drug therapy; Stroke - etiology; Systematic review; China; RR; NIHSS; NFDS; Randomised controlled trials; CI; BI; Dengzhan xixin; Systematic review; Meta-analysis; CT; Acute ischemic stroke; DZXX; MD; Chinese herbal medicine; vs
• ISSN: 0965-2299; 1873-6963
• DOI: 10.1016/j.ctim.2017.08.004

•The effectiveness and safety of DZXX injection for AIS was analysed.•It appears that DZXX can additionally improve neurological function for AIS patients.•The addition of DZXX injection to CT appears to be safe for patients with AIS.•More large, rigorous and adequately reported trials are needed to confirm our findings. To evaluate the effectiveness and safety of Chinese herbal medicine Dengzhan Xixin (Erigeron breviscapus) injection for acute ischemic stroke. Systematic review and meta-analysis (CRD42016038413, http://www.crd.york.ac.uk/PROSPERO). Six electronic databases were searched from inception to March 2016 for randomised controlled trials (RCTs) of Dengzhan Xixin (DZXX) injection for acute ischemic stroke. The methodological quality of RCTs was assessed by the Cochrane risk of bias tool. was performed using RevMan 5.3 and was presented with mean difference (MD) or relative risk (RR) and their 95% confidence interval (CI). A summary of finding table was generated by GRADEpro (version 3.6). Twenty-five RCTs with 2498 participants were included and all trials adopted conventional therapy (CT) in both arms. Most of the studies had high risk of bias. The addition of DZXX to CT showed no significant benefit on death (RR 0.27, 95% CI 0.05–1.63) within the treatment period (14–35 d), but showed higher Barthel index score (MD 10.20, 95% CI 8.16–12.25), lower neurological function deficit score (MD −3.99, 95% CI −5.68 to −2.30, by NFDS; MD −1.67, 95% CI −2.59 to −0.76, by NIHSS), and lower treatment failure (RR 0.40, 95% CI 0.31–0.52). Thirteen trials (52%) reported the outcome of adverse events, but no serious adverse events were reported. Low quality evidence implied that DZXX injection appeared to improve neurological function in patients with acute ischemic stroke. However, this potential benefit should be further studied in large, rigorous trials.