Article type
Year
Abstract
Background: Controversy exists regarding the potential role of specific ShenXiong glucose injection (SGI) as a therapeutic intervention for patients with acute ischemic stroke (AIS).
Objectives: To critically appraise the effectiveness and safety of SGI for patients with AIS.
Methods: A literature search was performed in the Cochrane Library, MEDLINE, EMBASE, CBM, Chinese TCM Database, CNKI, VIP, WanFang Database up to July 2014. The limits were randomized controlled trial, participants aged over 40 years with AIS, studies by which patients suffering intracerebral haemorrahage were excluded. Two reviewers identified clinical trials for inclusion, assessed quality, and extracted data independently.
Results: Twelve trials involving 970 patients were included in this review. Meta-analysis indicated that SGI is more effective for AIS in terms of neurological function deficit scores (NFDS), Barthel Index and has fewer adverse effects. Among those, SGI improved the neurological function at two weeks (mean difference (MD) = -5.39, 95% confidence interval (CI) -6.90 to -3.87), four weeks (MD = -5.16, 95% CI -6.49 to -3.83), as well as activity of daily living after two weeks (MD = 12.14, 95% CI 0.47 to 23.82), four weeks (MD = 28.09, 95% CI 15.12 to 41.07). No adverse events were reported in included trials. No obvious publication bias was verified by funnel plot. Applying the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach, the overall quality of evidence in this review was graded as less confident.
Conclusions: The strength of recommendation is weak for use of SGI in patients with AIS, due to moderate quality and considerable heterogeneity among included trials. This weak recommendation implies that the decision to use SGI for a patient with AIS should be approached carefully from an individualized standpoint considering the potential for benefit compared with the potential for harm and burden. Regarding the limitations of this review, further well-designed high quality trials are required for verification. Moreover, the safety as well as long-term outcomes of SGI for AIS should take priority in further trials.
Objectives: To critically appraise the effectiveness and safety of SGI for patients with AIS.
Methods: A literature search was performed in the Cochrane Library, MEDLINE, EMBASE, CBM, Chinese TCM Database, CNKI, VIP, WanFang Database up to July 2014. The limits were randomized controlled trial, participants aged over 40 years with AIS, studies by which patients suffering intracerebral haemorrahage were excluded. Two reviewers identified clinical trials for inclusion, assessed quality, and extracted data independently.
Results: Twelve trials involving 970 patients were included in this review. Meta-analysis indicated that SGI is more effective for AIS in terms of neurological function deficit scores (NFDS), Barthel Index and has fewer adverse effects. Among those, SGI improved the neurological function at two weeks (mean difference (MD) = -5.39, 95% confidence interval (CI) -6.90 to -3.87), four weeks (MD = -5.16, 95% CI -6.49 to -3.83), as well as activity of daily living after two weeks (MD = 12.14, 95% CI 0.47 to 23.82), four weeks (MD = 28.09, 95% CI 15.12 to 41.07). No adverse events were reported in included trials. No obvious publication bias was verified by funnel plot. Applying the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach, the overall quality of evidence in this review was graded as less confident.
Conclusions: The strength of recommendation is weak for use of SGI in patients with AIS, due to moderate quality and considerable heterogeneity among included trials. This weak recommendation implies that the decision to use SGI for a patient with AIS should be approached carefully from an individualized standpoint considering the potential for benefit compared with the potential for harm and burden. Regarding the limitations of this review, further well-designed high quality trials are required for verification. Moreover, the safety as well as long-term outcomes of SGI for AIS should take priority in further trials.