Reticular Meta-analysis Of 6 Chinese Herbal Injections In The Treatment Of Acute Ischemic Stroke

Objective:The mesh meta-analysis method was used to evaluate and compare the differences of 6 TCM in J combined with conventional Western medicine in the treatment of acute ischemic stroke in terms of effective rate,neurological deficit score,hemorheological changes and safety,and provide some reference for clinical practitioners and decision makers through objective data.Methods : Randomized controlled trials involving 6 TCM injections in the treatment of acute ischemic stroke were searched by computer from seven domestic and foreign databases,and the injections were:Shuxuetong injection(SXT),Breviscapus asarum injection(DZXX),Honghua injection(HH),Xuesaitong injection(XST),Danshen injection(DS),Shuxuening injection(SXN).Retrieved from May 1,2017 to May 1,2022.Two evaluators independently screened,sorted and extracted data from the articles.Literature quality was evaluated using Cochrane bias risk assessment tool,and data were analyzed using Revman5.3,Ge MTC0.14.3 and Stata14.2.Result:1.A total of 3300 literatures were retrieved,of which 1691 were retrieved in English database,1609 were retrieved in Chinese database,and 69 articles were finally included,all of which were Chinese literatures.There were 6 intervention methods,including 13 literatures related to DS,6 literatures related to DZXX,4literatures related to HH,13 literatures related to SXN,and 28 literatures related to SXT.There are 8 articles on XST,1 article on the comparison between SXT and DZXX,1 article on the comparison between SXN and DS,and 1 article on the comparison between HH and DS.2.The results of traditional meta-analysis showed that,in comparison with the effective rate of different interventions in acute ischemic stroke,except DZXX,the effective rate of other 5 kinds of Chinese medicine in J(SXT,HH,XST,DS,SXN)was better than that of conventional Western medicine.To reduce the U.S.national institutes of health stroke scale(National Instituteof Healthstrokescale,NIHSS)scores,SXT,HH,XST,DS,DZXX,SXN is superior to conventional western medicine treatment,DZXX combined with conventional Western medicine is better than SXT combined with conventional Western medicine,DS combined with conventional Western medicine is better than HH combined with conventional Western medicine.In terms of improving plasma viscosity(PV),6 kinds of TCM in J(SXT,HH,XST,DS,DZXX,SXN)were better than conventional Western medicine.XST,HH,DS,DZXX and SXN were superior to conventional Western medicine in reducing the high tangential viscosity of whole blood.Except XST,the other 5 in J(SXT,HH,DS,DZXX,SXN)were better than conventional Western medicine in reducing whole blood hypoviscosity.In terms of fibrinogen(FIB)improvement,XST,HH,DS,DZXX and SXN were superior to conventional Western medicine.The above differences were statistically significant(P < 0.05).3.Mesh meta-analysis:Comparison of the effective rate of different interventions for acute ischemic stroke showed that the effective rate of SXT,HH,XST,DS,DZXX and SXN was better than that of conventional Western medicine(P < 0.05).In terms of reducing NIHSS score,SXT,HH,XST,DS,DZXX and SXN were better than conventional Western medicine(P < 0.05).In terms of reducing PV score,DS,DZXX and SXN combined with conventional Western medicine is better than SXT combined with conventional Western medicine,SXN and DS combined with conventional Western medicine is better than XST combined with conventional Western medicine,DS combined with conventional Western medicine is better than DZXX combined with conventional Western medicine,except HH,The other 5 in J(SXT,XST,DS,DZXX,SXN)were better than conventional Western medicine(P < 0.05).There was no significant difference in the improvement of whole blood high tangential viscosity(P > 0.05).SXN combined with conventional Western medicine was better than SXT,DS,DZXX combined with conventional Western medicine,and SXT,HH,DS,DZXX,SXN was better than conventional Western medicine(P < 0.05).In terms of improving FIB,SXT,DS and SXN combined with conventional Western medicine was superior to conventional Western medicine(P < 0.05).4.Ranking of efficacy:In terms of improving effective rate,SXN combined with conventional treatment was the most likely to be the best treatment,followed by HH,DS,SXT,XST,DZXX combined with conventional Western medicine and conventional Western medicine,respectively.In terms of reducing NIHSS score,HH combined with conventional western medicine may have the best effect,followed by XSN,XST,SXT,DZXX and DS combined with conventional Western medicine and conventional Western medicine,respectively.In terms of PV improvement,DS combined with conventional western medicine was the most likely to become the first place,followed by HH,SXN,SXT,DZXX and XST combined with conventional Western medicine and conventional Western medicine,respectively.In terms of improving the high viscosity of whole blood,SXT combined with conventional western medicine may be the best treatment measure,followed by SXT,HH,DS,DZXX combined with conventional Western medicine and conventional Western medicine respectively.In terms of improving low tangent viscosity,SXN,DZXX,DS,SXT,HH combined with conventional western medicine and conventional Western medicine,respectively.In terms of improving FIB,SXN,HH,DS,SXT,DZXX combined with conventional Western medicine and conventional Western medicine respectively were ranked in order of efficacy from high to low.Conclusions:Based on the results of 69 randomized controlled trials of different Chinese medicine in J combined with conventional Western medicine in the treatment of acute ischemic stroke,the efficacy of 6 Chinese medicine in J combined with Western medicine is better than that of Western medicine alone,and Shuxuening injection combined with conventional treatment can be used as the preferred drug treatment.