Safety and Clinical Efficacy of Yangxue Qingnao Granules in the Treatment of Chronic Cerebral Circulation Insufficiency: A Systematic Review and Meta-Analysis.

Yukun Ding,Yu Cao,Xingjiang Xiong,Jianbo Guo,Qingyong He

doi:10.1155/2019/8484263

Abstract

To evaluate the safety and clinical efficacy of Yangxue Qingnao (YXQN) granules in the treatment of chronic cerebral circulation insufficiency (CCCI), electronic databases—PubMed, Embase, CNKI, VIP, and Wangfang—were searched for randomized controlled trials (RCTs) published up to January 2019. GRADE and RevMan 5.3.0 were used for grading and analysis, respectively. Fifteen trials involving 1211 CCCI patients were included. Subgroup analysis was performed owing to study heterogeneity. Compared to nimodipine plus routine treatment, YXQN granules plus routine treatment were more effective in increasing basilar artery (BA) blood flow velocity (mean difference (MD) = 3.34, 95% confidence interval (CI) = [2.31, 4.37], P < 0.00001), vertebral artery (VA) blood flow velocity (MD = 0.52, 95% CI = [0.27, 0.76], P < 0.0001), and internal carotid artery (ICA) blood flow velocity (MD = 7.46, 95% CI = [2.01, 12.90], P=0.007). In improving the clinical efficacy of traditional Chinese medicine (TCM) for symptoms such as headache, dizziness, and insomnia, YXQN granules plus routine treatment were shown to be superior to the following control treatments: nimodipine plus routine treatment (mean difference (M-H) = 4.21, 95% CI = [2.49, 7.12], P < 0.00001), flunarizine plus routine treatment (mean difference (M-H) = 3.92, 95% CI = [1.36, 11.29], P=0.01), troxerutin plus routine treatment (mean difference (M-H) = 4.79, 95% CI = [2.20, 10.42], P < 0.00001), and routine treatment (mean difference (M-H) = 6.13, 95% CI = [1.48, 25.34], P=0.01). Risk of bias was assessed in 15 trials. One analysis was graded using GRADE and showed poor results. Adverse events were not reported explicitly in all but one trial. Thus, this meta-analysis suggests that YXQN granules may be beneficial for patients with CCCI. However, owing to the poor quality of the clinical trials and small sample sizes, a definite conclusion on the efficacy and safety of YXQN granules cannot be drawn from existing information.

Highlights

Chronic cerebral circulation insufficiency (CCCI) is a common and frequently occurring ischemic cerebrovascular disease, with a complex etiology and recurrent symptoms
Search Strategies. is meta-analysis of clinical trials was conducted in accordance with the guidelines [17, 18] set out in the PRISMA Statement (PRISMA Checklist S1) and was registered on PROSPERO (CRD42019121368). e study retrieved all articles published before January 2019 by searching five electronic databases: the PubMed Database, the Chinese Science and Technology Periodical Database (Embase), the Chinese National Knowledge Infrastructure (CNKI) Database, the China Scientific Journal Database (VIP), and the Wangfang Database. e search words and MeSH terms used were “chronic cerebrovascular insufficiency” or “chronic cerebral circulation insufficiency” or “cerebral circulation insufficiency” or “cerebrovascular insufficiency” or “CCCI” and “Yangxue qingnao” or “yangxueqingnao” or “Yangxue Qingnao (YXQN)” or “Yang-Xue-Qing-Nao” and “random” and “groups” and “trial.”
The main purpose of these treatments is to protect the remaining nerve function and improve and restore the damaged nerve function. In this meta-analysis, we investigated the efficacy of YXQN granules in the treatment of CCCI. e clinical

Summary

Introduction

Chronic cerebral circulation insufficiency (CCCI) is a common and frequently occurring ischemic cerebrovascular disease, with a complex etiology and recurrent symptoms. According to a recent report, two-thirds of the over-65-yearold population in China suffer from CCCI [1]. It is mostly caused by hypertension, arteriosclerosis, hyperlipidemia, and diabetes [1,2,3,4]. Western medicine treats CCCI by interventions targeting the risk factors (including hypertension, hyperlipidemia, diabetes, and smoking), etiology (cranial artery stenosis, cerebrovascular lesions, and leukoporosis), cerebral microcirculatory perfusion (using betahistine, flunarizine, and nimodipine), and cognitive deficits (with agents such as cytidine diphosphate choline, compound cerebral peptide ganglioside injection, and compound triglyceride injection) [6, 7].

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Results

Conclusion