| Objective: To assess the clinical efficacy and safety of Naoxintong Capsule in the treatment of cerebral infarction and provide the highest level of evidence-based evidence for clinical members and decision makers by strict and standardized meta-analysis.Methods: According to the principles of PICOS,we establish the document inclusion and exclusion criteria.Randomized controlled trials related to Naoxintong Capsule in the treatment of cerebral infarction were searched in CNKI,VIP,Wanfang,Pubmed,Embase,the Cochrane Library and Web of Science by August 2017.Quality of included RCTs was evaluated by the Cochrane Risk of Bias Assessment Table,and then the data were analyzed by RevMan5.3 software.Results: A total of 107 RCTs with 13073 particle Pants were included,which are all Chinese articles,and no foreign articles that meet the inclusion criteria.The trials enrolled in the study have common characteristics of low methodological quality.In the Meta analysis,Naoxintong Capsule combined with conventional medicine can achieve a better effect than conventional medicine treatment in respect of total effective rate(OR=4.15,95%CI(3.52,4.89),P<0.00001),the TCM syndrome(OR=2.64,95%CI(1.76,3.97),P<0.00001),the National Institutes of Health Stroke Scale(MD=-2.83,95%CI(-3.32,-2.35),P<0.00001),and the activity of daily living(MD=11.19,95%CI(8.85,13.54),P<0.00001),mortality rate(OR=0.46,95%CI(0.14,1.47),P=0.19>0.05),recurrence rate(OR=0.45,95%CI(0.32,0.64),P<0.00001),and the rate of adverse reactions(OR=0.90,95%CI(0.68,1.19),P=0.47>0.05).After further analysis by disease Staging,the results show that Naoxintong Capsule for acute cerebral infarction patients have a better effect than conventional medicine in respect of total effective rate(OR=4.92,95%CI(3.85,6.29),P<0.00001),the National Institutes of Health Stroke Scale(MD=-2.63,95%CI(-3.07,-2.20),P<0.00001),and the activity of daily living(MD=9.59,95%CI(4.94,14.24),P<0.00001),and recurrence rate(OR=0.28,95%CI(0.13,0.60),P=0.001<0.05),and the rate of adverse reactions(OR=1.06,95%CI(0.34,3.35),P=0.0.92>0.05);Naoxintong Capsule for the period of recovery cerebral infarction patients have a better effect than conventional medicine in respect of total effective rate(OR=1.82,95%CI(1.08,3.07),P=0.03<0.05),and the TCM syndrome(OR=2.32,95%CI(1.44,3.72),P=0.0005<0.05).Naoxintong Capsule for the period of sequelae cerebral infarction patients have a better effect than conventional medicine in respect of the activity of daily living(MD=12.99,95%CI(11.51,14.47),P<0.00001),and the rate of adverse reactions(OR=0.59,95%CI(0.29,1.22),P=0.15>0.05).Conclusion: The sample included in this study is abundant.Naoxintong Capsule may decrease the mortality,the National Institutes of Health Stroke Scale,and recurrence rate,and increase the total effective rate,the TCM syndrome,the activity of daily living of cerebral infarction.However,there are fewer RCTs for the recovery phase of cerebral infarction and important outcomes such as mortality and relapse rate,and restricted by the low methodological quality of the trials enrolled in the study,its clinical efficacy and safety and questions we find shall be further confirmed and resolved by some high-quality RCTs. |
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