scholarly journals The Clinical Efficacy of Ginkgo biloba Leaf Preparation on Ischemic Stroke: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Shuang Zhao ◽  
Hong Zheng ◽  
Yawei Du ◽  
Runlei Zhang ◽  
Peilin Chen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Clinical Efficacy ◽  
Ginkgo Biloba ◽  
Meta Analysis ◽  
Plasma Viscosity ◽  
Biomedical Literature ◽  
Fibrinolytic System ◽  
Therapeutic Effects ◽  
Ginkgo Biloba Leaf

Background. Ginkgo biloba leaf preparations (GLPs) are widely used in ischemic stroke, and uncertainty remains regarding their clinical efficacy. To evaluate systematically the clinical efficacy and safety of GLPs in the treatment of ischemic stroke, we examine evidence from randomized controlled trials (RCTs). Methods. We examine studies published prior to November 2021 that were found from searching the following sources: PubMed, China National Knowledge Infrastructure (CNKI), WANFANG DATA, Chongqing VIP (CQVIP) databases, and Chinese Biomedical Literature (CBM). We evaluated the quality of the included references according to the Cochrane Manual of Systematic Evaluation and Meta-analysis (MA) performed using RevMan 5.2 software. Results. We included a total of 13 RCTs with clinical therapeutic effects, the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), hemorheology index, and adverse reaction index as evaluation criteria. There were 631 cases in the observation group and 629 cases in the control group. MA results showed the following: NIHSS WMD = −3.89, 95% CI: [−4.22, −3.56], I2 = 19%, P  < 0.00001. This index is often used with nerve injury and can also be used to judge the recovery of nerve function. A lower score means less nerve damage and a better chance of recovery. The BI results were WMD = 11.30, 95% CI: [9.83, 12.77], I2 = 7%, P  < 0.00001. This index was used to assess patients’ ability to take care of themselves, with a higher score indicating a stronger ability to live independently. Clinical effective rate results were WMD = 3.79, 95% CI: [2.49, 5.78], I2 = 0%, P  < 0.00001, and this measure can be used to evaluate the effect of treatment clearly and objectively. Hemorheological index results show that plasma viscosity has WMD = −0.16, 95% CI: [−0.20, −0.12], I2 = 40%, P  < 0.00001 and fibrinogen (FIB) has WMD = −1.13, 95% CI: [−1.23, −1.04], I2 = 0%, P  < 0.00001. Plasma viscosity is mainly related to the amount of fibrinogen, and fibrinogen degradation is an important function of the fibrinolytic system. The imbalance of the fibrinolytic system plays an important role in the pathogenesis of cerebral infarction. Fibrinogen is a risk factor of ischemic cerebrovascular disease. Studies have shown that the infarct size of patients with secondary cerebral infarction after CEREBRAL infarction is correlated with their FIB level. In addition, FIB elevation is also one of the risk factors for early infarction after thrombolysis. Therefore, FIB can be used as a detection index for the prevention of cerebral infarction recurrence adverse reactions. Our MA results for FIB show WMD = 0.81, 95% CI: [0.38, 1.73], I2 = 0%, P  = 0.58, and RR < 1. Conclusion. The existing clinical evidence shows that GLP has a good therapeutic effect on patients with ischemic stroke and can improve their hemorheology indices. In addition, GLP is shown to be relatively safe.

scholarly journals Effect of Tongqiao Huoxue Decoction Combined with Western Medicine on Ischemic Stroke: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Da-yuan Zhong ◽  
Hao-yue Li ◽  
Lan Li ◽  
Ruo-meng Ma ◽  
Cheng-ting Jiang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Western Medicine ◽  
Meta Analysis ◽  
Plasma Viscosity ◽  
Biomedical Literature ◽  
Serum Triglycerides ◽  
Reactive Protein ◽  
Hs Crp

Objective. We conducted a systematic review and meta-analysis to systematically evaluate the curative effect of Tongqiao Huoxue Decoction (TQHXD) combined with Western medicine treatment (WMT) on Ischemic Stroke (IS). Methods. Randomized controlled trials (RCTs) of TQHXD in the treatment of IS by computer retrieval of PubMed, Embase, Web of Science, Chinese Biomedical Literature Service System, CNKI, Wanfang Database, and Weipu Database. The retrieval time was taken from the establishment of the database to July 30, 2020. Two researchers, respectively, conducted a strict evaluation of the quality of the literature and extracted the data which were then entered in the RevMan5.3 software for meta-analysis. Results. 40 articles were listed, which involved 3260 patients. Meta-analysis results show that TQHXD combined with WMT can significantly reduce patients’ NIHSS score, serum hypersensitivity C-reactive protein (hs-CRP), plasma viscosity, serum fibrinogen, serum total cholesterol, and serum triglycerides and improve patients’ ADL-Barthel scoring and treatment efficiency. However, there is no evidence that TQHXD combined with the WMT  group can significantly decrease the incidence of adverse events. Conclusion. The therapeutic effect of TQHXD combined with the WMT  group was significantly better than that of the WMT  alone group. For the treatment of patients with IS, TQHXD combined with WMT is worthy of application and promotion.

scholarly journals Efficacy and Safety of Brucea javanica Oil Emulsion Injection in the Treatment of Gastric Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Xinmiao Wang ◽  
Heping Wang ◽  
Luchang Cao ◽  
Jingyuan Wu ◽  
Taicheng Lu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Conventional Therapy ◽  
Meta Analysis ◽  
Performance Status ◽  
Biomedical Literature ◽  
Therapeutic Effects ◽  
Efficacy And Safety ◽  
Oil Emulsion ◽  
Brucea Javanica

Background: Gastric cancer (GC) is one of the most common digestive tract cancers and ranks fifth in the incidence of malignant tumors worldwide. Brucea javanica oil emulsion injection (BJOEI), a Chinese patent medicine extracted from Brucea javanica (Yadanzi in Chinese Pinyin), is widely used as an adjuvant treatment for GC in China. This systematic review and meta-analysis aimed to evaluate the available data on the efficacy and safety of BJOEI in the treatment of GC and assess the quality of the synthesized evidence.Methods: A comprehensive search was performed on PubMed, EMBASE, CENTRAL, Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database and Chinese Scientific Journals Database (VIP database), and other potential resources, such as the Chinese Clinical Trial Registry (ChiCTR) and ClinicalTrials.gov from their inception to July 31, 2021. Randomized controlled trials (RCTs) comparing the therapeutic effects of BJOEI combined with conventional therapy to those of conventional therapy alone were included. We used RevMan 5.3 for data analysis and quality evaluation of the included studies and assessed the evidence quality based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria.Results: Eighteen RCTs involving 1,210 patients were included, and the meta-analysis results demonstrated that compared with the control group (conventional therapy), the experimental group (BJOEI combined with conventional therapy) showed a significantly improved overall response rate (ORR) (risk ratio [RR] = 1.52, 95% CI: 1.36–1.69, P &lt; 0.00001), clinical benefit rate (CBR) (RR = 1.17, 95% CI: 1.11–1.23, P &lt; 0.00001), performance status (RR = 1.72, 95% CI: 1.46–2.01, P &lt; 0.00001), and reduced incidence of the following adverse drug reactions (ADRs): neutropenia, leukopenia, nausea and vomiting, diarrhea, liver damage, hand-foot syndrome, and peripheral sensory nerve toxicity. Subgroup analysis showed that the BJOEI intervention could significantly improve the ORR and CBR in patients with GC when combined with FOLFOX4, XELOX, and other chemotherapeutics.Conclusion: The evidence presented in this study supports the fact that BJOEI combined with conventional chemotherapy provides a statistically significant and clinically important effect in the improvement of ORR, CBR, performance status, and ADR reduction in patients with GC. To further support this conclusion, more rigorously designed, large-scale, and multicenter RCTs are needed in the future.

scholarly journals Efficacy of Longdan Xiegan Decoction on the Treatment of Eczema: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Ziteng Hu ◽  
Lidong Gao ◽  
Chengxian Li ◽  
Alberto Cucco ◽  
Shang Wang ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Total Effective Rate ◽  
Meta Analysis ◽  
Effective Rate ◽  
Biomedical Literature ◽  
Cure Rate ◽  
Quality Of Evidence ◽  
Moderate Quality ◽  
Quality Evidence

Background. Longdan Xiegan decoction (LDXGD) has been widely used in the treatment of eczema. In recent years, randomized controlled trials (RCTs) of LDXGD for the treatment of eczema have gradually increased. Most of the results show that LDXGD is effective in treating eczema. However, whether these conclusions are reliable or not requires meta-analysis. Objective. This study aimed to systematically evaluate the clinical efficacy of LDXGD in the treatment of eczema. Materials and Methods. Seven electronic databases, including PubMed, Excerpta Medica Database (EMBASE), Cochrane Library, Chinese Biomedical Literature on Disc (CBM), China National Knowledge Infrastructure (CNKI), WanFang, and Chinese Science and Technology Periodical Database (VIP) were systematically searched from their inception until January 2021. Risk of bias was assessed using criteria from the Cochrane Collaboration and meta-analysis was conducted on the screened literature data using Review Manage (RevMan 5.3). Then, to assess the quality of evidence, the GRADE criteria was adopted. Results. 14 RCTs with 1080 participants were identified. Meta-analysis indicated that compared with western medicine (WM), the cure rate and the total effective rate of LDXGD in treating eczema were higher. Meanwhile, the recurrence rate and the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF-α) after treatment were lower. The adverse reaction was reported in 5 out of 14 studies without significant statistical difference. According to GRADE criteria, the quality of evidence was low for all outcomes except for the cure rate (moderate-quality evidence) and the total effective rate (moderate-quality evidence). Conclusion. The clinical efficacy of LDXGD in the treatment of eczema was more effective compared with the one of conventional WM alone. However, due to the limitation of the quality of the included studies, additional studies are required to further confirm these results.

scholarly journals Treatment of Polycystic Ovary Syndrome-Related Infertility Using a Combination of Compound Xuanju Capsules and Hormone Therapy: A Meta-Analysis

2021 ◽  
Author(s):  
Qianwen Ma ◽  
Yong Tan
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Hormone Therapy ◽  
Polycystic Ovary ◽  
Therapy Group ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Therapeutic Effects ◽  
Ovary Syndrome

Abstract Objective To compare the therapeutic effects of compound Xuanju capsules combined with hormone therapy versus hormone therapy alone on polycystic ovary syndrome (PCOS)-related infertility using a meta-analysis. Methods Electronic databases including PubMed, The Cochrane Library, Web of science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP database were manually searched. The quality of included studies was evaluated based on the Cochrane systematic review standards, and the valid data were extracted for meta-analysis using Revman 5.3 software. Results A total of 14 randomized controlled trials accounting for 1249 patients were included. Meta-analysis showed that patients in the compound Xuanju capsule + hormone therapy group had higher estradiol levels and overall rates of effective treatment than those in the hormone therapy alone group. Moreover, they also exhibited lower levels of luteinizing hormone and follicle-stimulating hormone as well as lower Kupperman scores than the hormone therapy alone group. Conclusions The combination of compound Xuanju capsules and hormone therapy is more effective than hormone therapy alone in the treatment of PCOS-related infertility. However, the quality of current studies is low, and high-quality clinical trials are warranted.

scholarly journals Efficacy of Danshen Class Injection in the Treatment of Acute Cerebral Infarction: A Bayesian Network Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Shi Liu ◽  
Kaihuan Wang ◽  
Xiaojiao Duan ◽  
Jiarui Wu ◽  
Dan Zhang ◽  
...  
Keyword(s):  
Cerebral Infarction ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Acute Cerebral Infarction ◽  
Tanshinone Iia ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Psychological Burden ◽  
Randomized Controlled

Introduction. As a common chronic disease with high morbidity and recurrent rate, acute cerebral infarction (ACI) affects the life quality of patients and gives them heavy psychological burden. And Danshen class injections (DSCIs) are commonly adopted in treating ACI. So, this network meta-analysis (NMA) was designed to assess the clinical efficacy of eight kinds of DSCIs. Methods. A systematic literature search was performed in PubMed, the Cochrane Library, Embase, the China National Knowledge Infrastructure Database, the China Biomedical Literature Service System, the Chinese Scientific Journals Full-text Database, and Wanfang database from their inception to 16th Dec. 2017 aiming to collect related randomized controlled trials (RCTs). And then data were analyzed through Stata and WinBUGS software based on the Bayesian statistical model. The results were reported as odds ratio (OR) and mean difference (MD) with 95% credible intervals (CIs). The consistency test between direct and indirect comparisons was also evaluated and inconsistency factor was presented to manifest the heterogeneity among them. Meanwhile, the surface under the cumulative ranking probabilities (SUCRA) was utilized to rank the treatments in different outcomes. Results. Finally, 157 RCTs with 15570 patients were included. A total of eight types DSCIs were identified. Based on the results, Sodium Tanshinone IIA Sulfonate injection (STS) plus western medicine (WM) had better effect on the clinical effectiveness rate, neurological impairment, and activities of daily living function than others. Meanwhile, Danhong injection (DS) and Danshen Salvianolic Acids injection (DSSA) had excellent performance in perfecting hemorheological indexes. Conclusions. In conclusion, STS plus WM may be the optimum treatment for ACI. The following therapies were DS plus WM and DSSA plus WM. Nevertheless, in terms of the limitations of the study, more large samples, multicenter, and double-blind RCTs are still needed for validating our findings.

scholarly journals Effect of Buyang Huanwu decoction for the rehabilitation of ischemic stroke patients: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Li Gao ◽  
Zhuoran Xiao ◽  
Chunhua Jia ◽  
Wei Wang
Keyword(s):  
Ischemic Stroke ◽  
Randomized Controlled Trials ◽  
Clinical Efficacy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Stroke Patients ◽  
Buyang Huanwu Decoction ◽  
Randomized Controlled ◽  
Clinical Recommendation

Abstract Purpose Buyang Huanwu decoction (BHD) is a widely used traditional Chinese medicine for the rehabilitation of ischemic stroke patients in China, but its clinical efficacy and safety have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of BHD. Methods We searched seven electronic databases from inception to 31 March 2019. The language was limited to Chinese and English. Randomized controlled trials evaluating the efficacy and safety of BHD for the rehabilitation of ischemic stroke patients were included in the meta-analysis. Reviewers independently performed the screening, data extraction, bias assessment, and data analysis. The treatment efficacy was pooled in a meta-analysis using RevMan 5.3 software with a random-effect model. Any disagreement was resolved by discussion among all reviewers. The PRISMA statement was used in the review process. Results A total of 11 studies with 1084 patients were included in the meta-analysis. The results suggested that BHD was superior to other treatments in terms of clinical efficacy in symptoms and daily activities (n = 684, RR = 1.12, 95% CI: 0.99 to 1.27), clinical efficacy in TCM symptoms (n = 280, RR = 1.45, 95% CI: 1.03 to 2.03), National Institute of Health stroke scale (n = 192, MD = 1.66, 95% CI: -1.08 to 4.40), and activities of daily living (n = 200, MD = 8.20, 95% CI: -3.95 to 20.35). Conclusions The results supported the clinical use of BHD for the rehabilitation of ischemic stroke patients. However, the methodological qualities of the included studies were relatively low, and there were limited reports on adverse events. The clinical efficacy and safety of BHD need to be further confirmed by more well-designed and high-quality randomized controlled trials to warrant the clinical recommendation of BHD for the rehabilitation of ischemic stroke patients.

scholarly journals Clinical Efficacy Evaluation and Potential Mechanism of Zhishe Tongluo Capsule in the Treatment of Cerebral Infarction by Meta-Analysis Associated with Network Pharmacology

2022 ◽  
Vol 2022 ◽  
pp. 1-13
Author(s):  
Zhi Xin Geng ◽  
Feng Gao ◽  
Junjing Guo ◽  
Bingzhou Guo ◽  
Chunyu Liu ◽  
...  
Keyword(s):  
Treatment Group ◽  
Cerebral Infarction ◽  
Clinical Efficacy ◽  
Large Scale ◽  
Chemical Constituents ◽  
English Literature ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Network Pharmacology ◽  
Control Group

Objective. By integrating meta-analysis and network pharmacology strategy, the clinical efficacy of Zhishe Tongluo capsule in the treatment of cerebral infarction was evaluated, and the intervention mechanism was preliminary explored. Methods. Through meta-analysis, the Chinese and English literature of the randomized controlled trial (RCT) of Zhishe Tongluo capsule in the treatment of cerebral infarction was comprehensively searched. Based on the standard of Na Pai, the quantitative literature was determined and the Review Manager data were statistically analyzed. Results. A total of 10 RCTs literatures were included. These literatures included a total of 1278 subjects, of which 670 were in the treatment group and 608 were in the control group. In terms of indicators of efficiency and adverse reaction rate, the treatment group was better than the control group. There was a statistical difference P < 0.05 ; a total of 559 chemical constituents and 2306 potential targets were obtained from the online database. Of these, 201 components, 145 targets, and 185 pathways were closely related to cerebral infarction. Conclusions. The available evidence indicates that the addition of Zhishe Tongluo capsule to the conventional treatment of Western medicine can improve the clinical efficacy of cerebral infarction and has some advantages in regulating blood lipids and hemorheology, but the overall evidence level is low, which still needs to be further supported by large-scale and multicenter RCTs; intervention of brain infarction by Zhishe Tongluo capsule is a comprehensive result of multicomponent and multi-target interactions. On the basis of the combined meta-analysis and network pharmacology in scientific attempts, it also provides a reference for the clinical evaluation of other drugs and mechanism research.

scholarly journals Meta-Analysis of the Clinical Effectiveness and Safety of Ligustrazine in Cerebral Infarction

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Tian Yu ◽  
Xiaoheng Guo ◽  
Zhen Zhang ◽  
Rong Liu ◽  
Liang Zou ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cerebral Infarction ◽  
Clinical Efficacy ◽  
Large Scale ◽  
Meta Analysis ◽  
Blood Rheology ◽  
Secondary Outcome ◽  
Control Group ◽  
Secondary Outcome Measure ◽  
Clinical Effects

Objectives. To evaluate the efficacy and safety of ligustrazine in the treatment of cerebral infarction.Methods. A systematic literature search was conducted in 6 databases until 30 June 2016 to identify randomized controlled trials (RCTs) of ligustrazine in the treatment of cerebral infarction. The quality of all the included studies was evaluated. All data were analyzed by Review Manager 5.1 Software.Results. 19 RCTs totally involving 1969 patients were included. The primary outcome measures were Neurological Deficit Score (NDS) and clinical effective rate. The secondary outcome measure was adverse events. Meta-analysis showed that ligustrazine could improve clinical efficacy and NDS of cerebral infarction with [OR = 3.60, 95% CI (2.72, 4.78),P<0.00001] and [WMD = −3.87, 95% CI (−4.78, −2.95),P<0.00001]. Moreover, ligustrazine in treatment group exerted better clinical effects in improving the Blood Rheology Index (BRI) in patients compared with control group. Ten trials contained safety assessments and stated that no obvious side effects were found.Conclusions. Ligustrazine demonstrated definite clinical efficacy for cerebral infarction, and it can also improve NDS in patients without obvious adverse events. However, due to the existing low-quality research, more large-scale and multicentric RCTs are required to provide clear evidence for its clinical efficacy in the near future.

Abstract WP12: Endovascular Thrombectomy for Acute Ischemic Stroke Associated With Cervical Artery Dissection: A Systematic Review and Meta-Analysis

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam A Dmytriw ◽  
Julian Maingard ◽  
Kevin Phan ◽  
Rajph J Mobbs ◽  
Mark Brooks ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Meta Analysis ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Endovascular Thrombectomy ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Cervical Artery

Objectives: Strokes associated with cervical artery dissection have been managed primarily with antithrombotics with poor outcomes. The additive role of endovascular thrombectomy remains unclear. The objective was to perform systematic review and meta-analysis to compare endovascular thrombectomy and medical therapy for acute ischemic stroke associated with cervical artery dissection. Methods: Studies from six electronic databases included outcomes of patient cohorts with acute ischemic stroke secondary to cervical artery dissection who underwent treatment with endovascular thrombectomy. A meta-analysis of proportions was conducted with a random-effects model. Modified Rankin score at 90 days (mRS 0-2) was the primary outcome. Other outcomes included proportion of patients with thrombolysis in cerebral infarction (TICI) 2b-3 flow, 90-day mortality rate, and 90-day symptomatic intracerebral hemorrhage (sICH) rate. Results: Six studies were included, comprising 193 cases that underwent thrombectomy compared with 59 cases that were managed medically. Successful recanalization with a pooled proportion of thrombolysis in cerebral infarction (TICI) 2b-3 flow in the thrombectomy group was 74%. Favorable outcome (mRS 0-2) was superior in the pooled thrombectomy group (62.9%, 95% CI 55.8-69.5%) compared medical management (41.5%, 95% CI 29.0-55.1%, P=0.006). The pooled rate of 90-day mortality was similar for endovascular vs medical (8.6% vs 6.3%). The pooled rate of symptomatic intracranial haemorrhage (sICH) did not significantly differ (5.9% vs 4.2%, P=0.60). Conclusions: Current data suggest that endovascular thrombectomy may be an option in patients with acute ischemic stroke due to cervical artery dissection. This requires further confirmation in higher quality prospective studies.

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