Effectiveness and safety of ShenXiong glucose injection for acute ischemic stroke: a systematic review and GRADE approach.

Xue-Ting Liu,Qi Hong,De-Ying Kang,Shu Wen,Peng-Wei Ren,Wen-Jie Yang,Le Peng,Tian-Le Zhang

doi:10.1186/s12906-016-1038-8

Abstract

BackgroundTo appraise critically whether published trials of ShenXiong glucose injection for patients with acute ischemic stroke (AIS) are of sufficient quality, and in addition to rate the quality of evidence by using the GRADE approach (grading of recommendations, assessment, development, and evaluation, GRADE).MethodsA literature search was performed in the Cochrane Library, MEDLINE, EMBASE, CBM, Chinese TCM (traditional Chinese medicine) Database, CNKI, VIP, WanFang Databases until January 2015. The limits were patients with AIS and randomized controlled trials (RCTs) or quasi-RCTs. Studies by which patients suffering intracerebral haemorrhage were excluded.ResultsTwelve studies fulfilled the inclusion criteria. We found significant benefits of ShenXiong glucose injection compared with conventional treatment in improving activities of daily living function at 4 weeks (MD = 34.12, 95 % CI: 29.07, 39.17), neurological function deficit at 2 weeks (MD = −5.39, 95 % CI: −6.90, −3.87), 4 weeks (MD = −5.16, 95 % CI: −6.49, −3.83), and clinical effects at 4 weeks (RR = 1.17, 95 % CI: 1.10, 1.24). No trials reported the effects of ShenXiong glucose injection on the risk of early, deterioration, or quality of life. No adverse events were reported within the whole follow-up period.ConclusionsThe use of ShenXiong glucose injection may improve rehabilitation for patients with acute ischemic stroke, however, as the GRADE approach indicated low to moderate quality of available evidence as well as insufficient information about harm and patients preference, the recommendations were not provided for ShenXiong glucose injection taking as a therapeutic intervention to patients with acute ischemic stroke.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1038-8) contains supplementary material, which is available to authorized users.

Highlights

To appraise critically whether published trials of ShenXiong glucose injection for patients with acute ischemic stroke (AIS) are of sufficient quality, and in addition to rate the quality of evidence by using the GRADE approach
This systematic review has shown that ShenXiong glucose injection given as a treatment in the acute stage of ischemic stroke significantly effect on improving activities of daily living function at 7 days, 14 days and 28 days whilst on treatment, but a meta-analysis of this outcome using data from the five studies was not performed due to obvious heterogeneity among the study estimates
None of the included studies reported the pre-specified primary outcome of death during the follow-up period, it may be explained that authors attempted to emphasize short-term effect of ShenXiong glucose injection, or that there were no deaths during the short-term follow up period

Summary

Introduction

To appraise critically whether published trials of ShenXiong glucose injection for patients with acute ischemic stroke (AIS) are of sufficient quality, and in addition to rate the quality of evidence by using the GRADE approach (grading of recommendations, assessment, development, and evaluation, GRADE). The lack of effective and widely applicable pharmacological treatments for acute ischemic stroke patients leads to a growing interest in Chinese traditional medicine [13, 14], Liu et al BMC Complementary and Alternative Medicine (2016) 16:68 for which extensive observational and anecdotal experience has accumulated over the past one thousand years [14, 15]. Traditional Chinese medicine have proven to be effective complementary intervention for AIS, of which Chinese herb products are still prevailing well and make a significant difference [12, 14, 15]. The overall treatment concept for Chinese traditional medicine is different from Western medicine, and herb medicines were always used to treat acute ischemic stroke. ShenXiong glucose injection is one of the most widely used Chinese herb medicine

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