Meta Analysis Of Buyang Huanwu Decoction On Cerebral Infarction At Different Stages With Qi-deficiency And Blood-stasis Syndrome

Cerebral Infarction is a common cerebrovascular disease, especially in the elderly. It belongs to the category of "stroke" in traditional Chinese medicine, which considers that Qi-deficiency and Blood-stasis is the main pathogenesis of cerebral infarction and put forward the treatment method of benefiting qi and activating blood circulation. Buyang Huanwu Decoction(BHD) is the representative prescription of this treatment method. At present, there are many clinical trials about BHD on cerebral infarction,and most of which make a certain curative effect, but no systematical evaluation of BHD on cerebral infarction patients at different stages is retrieved.In order to make clear the clinical efficacy and safety of BHD on cerebral infarction at different stages, this study adopts the method of Meta Analysis to systematically evaluate the randomized controlled trials of BHD on cerebral infarction at different stages with Qi-deficiency and Blood-stasisSyndrome, providing more scientific and reliable evidence for the future clinical application.ObjectiveTo systematically evaluate the clinical efficacy and safety of Buyang Huanwu Decoction(BHD) on cerebral infarction at different stages with Qi-deficiency and Blood-stasis Syndrome.MethodTo collect randomized controlled clinical trials(RCTs) literatures of Buyang Huanwu Decoction(BHD) on cerebral infarction at different stages with Qi-deficiency and Blood-stasis Syndrome according to the inclusion and exclusion criteria for Meta Analysis.ResultsA total of eighty-three literatures(involving 7524 patients) were included. Among all the literatures, there were fifty-five literatures about acute stage, twenty-two literatures about convalescence and six literatures about sequelae stage.Among the fifty-five literatures on cerebral infarction at acute stage, thirty-seven RCTs evaluated the clinical total effective rate, and the result of this Meta Analysis showed that the BHD group was superior to the control group in elevating the clinical total effective rate(RR[95%CI]=1.23[1.19, 1.27], P<0.00001, the difference was statistically significant); thirty-four RCTs evaluated the neural function defect score, and the result of this Meta Analysis showed that the BHD group was superior to the control group in ameliorating neural function defect(SMD[95%CI]=-1.07[-1.30,-0.84], P<0.00001, the difference was statistically significant); nine RCTs evaluated the activities of daily life,and the result of this Meta Analysis showed that the BHD group was superior to the control group in improving activities of daily life(SMD[95%CI]=1.24[0.77, 1.70],P<0.00001, the difference was statistically significant); thirteen RCTs evaluated the total effective rate of Chinese medical syndromes, and the result of this Meta Analysis showed that the BHD group was superior to the control group in elevating the total effective rate of Chinese medical syndromes(RR[95%CI]=1.16[1.10, 1.22], P<0.00001, the differencewas statistically significant).Among the twenty-two literatures on cerebral infarction reconvalescents, fifteen RCTs evaluated the clinical total effective rate, and the result of this Meta Analysis showed that the BHD group was superior to the control group in elevating the clinical total effective rate(RR[95%CI]=1.20[1.14, 1.26], P<0.00001, the difference was statistically significant); fifteen RCTs evaluated the neural function defect score,and the result of this Meta Analysis showed that the BHD group was superior to the control group in ameliorating neural function defect(SMD[95%CI]=-0.93[-1.17,-0.69], P<0.00001, the difference was statistically significant); eleven RCTs evaluated the activities of daily life,and the result of this Meta Analysis showed that the BHD group was superior to the control group in improving the activities of daily life(SMD[95%CI]=0.73[0.56, 0.90],P<0.00001, the difference was statistically significant); five RCTs evaluated the total effective rate of Chinese medical syndromes, the result of Meta Analysis showed that the BHD group was superior to the control group in elevating the total effective rate of Chinese medical syndromes(RR[95%CI]=1.23[1.10, 1.37], P=0.0002, the difference was statistically significant).Among the six literatures on cerebral infarction at sequelae stage, six RCTs evaluated the clinical total effective rate. The Meta Analysis result showing:compared with the control group, the BHD group was superior in elevating the clinical total effective rate(RR[95%CI]=1.19[1.11, 1.28], P<0.00001, the difference was statistically significant).ConclusionBuyang Huanwu Decoction(BHD) can provide obvious effect on cerebral infarction at different stages with Qi-deficiency and Blood-stasis Syndrome, and has a high security at acute stage and convalescence stage, but the security of sequelae stage is still need further research.