Abstract
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. MethodsA 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. ConclusionsIn 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.
Highlights
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
A total of 10,007 citations were initially detected by the search strategy, and 157 articles were qualitatively analyzed and included in the current network meta-analysis (NMA). They were all published in China from 2005 to 2016
The results indicated that the interventions of Danhong injection (DH)+western medicine (WM) (MD=-1.09, 95% credible intervals (CIs): -1.37∼-0.80), Sodium Tanshinone IIA Sulfonate injection (STS)+WM (MD=-1.13, 95% credible intervals (95% CIs): -1.95∼0.29), and Danshen Salvianolic Acids injection (DSSA)+WM (MD=-1.79, 95% CIs: -3.51∼-0.06) were associated with improving fibrinogen than WM alone
Summary
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. Danshen class injections (DSCIs) are commonly adopted in treating ACI. 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. As a common chronic disease with high morbidity and recurrent rate, ACI affects the life quality of patients and gives them heavy psychological burden [3]. Some stroke patients have no access to appropriate management because of the lack of available experts (especially in nonurban areas), financial factors, healthcare knowledge, and delayed hospital admission. The lack of effective and widely applicable pharmacological treatments for patients with ACI has led to a growing interest in traditional Chinese medicine [7]
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