Abstract
Objective. Xingnaojing injection (XNJ) is a well-known traditional Chinese patent medicine (TCPM) for stroke. The aim of this study is to assess the efficacy of XNJ for stroke including ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH). Methods. An extensive search was performed within using eight databases up to November 2013. Randomized controlled trials (RCTs) on XNJ for treatment of stroke were collected. Study selection, data extraction, quality assessment, and meta-analysis were conducted according to the Cochrane standards, and RevMan5.0 was used for meta-analysis. Results. This review included 13 RCTs and a total of 1,514 subjects. The overall methodological quality was poor. The meta-analysis showed that XNJ combined with conventional treatment was more effective for total efficacy, neurological deficit improvement, and reduction of TNF-α levels compared with those of conventional treatment alone. Three trials reported adverse events, of these one trial reported mild impairment of kidney and liver function, whereas the other two studies failed to report specific adverse events. Conclusion. Despite the limitations of this review, we suggest that XNJ in combination with conventional medicines might be beneficial for the treatment of stroke. Currently there are various methodological problems in the studies. Therefore, high-quality, large-scale RCTs are urgently needed.
Highlights
Stroke is the second most common cause of death worldwide and a major global cause of disability
Advances in the pharmaceutical industry have led to the development of traditional Chinese patent medicine (TCPM), which has been routinely used for treating stroke patients in hospitals practicing either Western medicine or traditional Chinese medicine [6, 10, 11]
Xingnaojing injection (XNJ), which is composed of four medicinal herbs including artificial musk, synthetic borneol, Curcuma aromatica Salisb, and Gardenia jasminoides J.Ellis, Evidence-Based Complementary and Alternative Medicine is an effective TCPM, that is extracted using modern biotechnology according to Traditional Chinese medicine (TCM) named An Gong Niu Huang Wan [12]
Summary
Stroke is the second most common cause of death worldwide and a major global cause of disability. Traditional Chinese medicine (TCM), including herbal medicines and other nonmedication therapies, has been used to treat stroke in China during the past 2,000 years [5,6,7,8,9]. Xingnaojing injection (XNJ), which is composed of four medicinal herbs including artificial musk, synthetic borneol, Curcuma aromatica Salisb, and Gardenia jasminoides J.Ellis, Evidence-Based Complementary and Alternative Medicine is an effective TCPM, that is extracted using modern biotechnology according to TCM named An Gong Niu Huang Wan [12]. Several previous systematic reviews published in Chinese academic journals have reported the effects of XNJ for ischemic stroke or ICH [17,18,19,20,21,22,23]. New clinical trials have been published recently, and these data have not been included in a systematic meta-analysis of XNJ treatment for stroke
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