Effectiveness and safety of ShenXiong glucose injection for acute ischemic stroke: a systematic review and GRADE approach

Abstract

BackgroundTo appraise critically whether published trials of ShenXiong glucose injection for patients with acute ischemic stroke (AIS) are of sufficient quality, and in addition to rate the quality of evidence by using the GRADE approach (grading of recommendations, assessment, development, and evaluation, GRADE).MethodsA literature search was performed in the Cochrane Library, MEDLINE, EMBASE, CBM, Chinese TCM (traditional Chinese medicine) Database, CNKI, VIP, WanFang Databases until January 2015. The limits were patients with AIS and randomized controlled trials (RCTs) or quasi-RCTs. Studies by which patients suffering intracerebral haemorrhage were excluded.ResultsTwelve studies fulfilled the inclusion criteria. We found significant benefits of ShenXiong glucose injection compared with conventional treatment in improving activities of daily living function at 4 weeks (MD = 34.12, 95 % CI: 29.07, 39.17), neurological function deficit at 2 weeks (MD = −5.39, 95 % CI: −6.90, −3.87), 4 weeks (MD = −5.16, 95 % CI: −6.49, −3.83), and clinical effects at 4 weeks (RR = 1.17, 95 % CI: 1.10, 1.24). No trials reported the effects of ShenXiong glucose injection on the risk of early, deterioration, or quality of life. No adverse events were reported within the whole follow-up period.ConclusionsThe use of ShenXiong glucose injection may improve rehabilitation for patients with acute ischemic stroke, however, as the GRADE approach indicated low to moderate quality of available evidence as well as insufficient information about harm and patients preference, the recommendations were not provided for ShenXiong glucose injection taking as a therapeutic intervention to patients with acute ischemic stroke.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1038-8) contains supplementary material, which is available to authorized users.

Influence of Shenxiong Glucose Injection on the Activities of Six CYP Isozymes and Metabolism of Warfarin in Rats Assessed Using Probe Cocktail and Pharmacokinetic Approaches

“…Shenxiong glucose injection (SGI) is a preparation containing the water extracts of Salvia miltiorrhiza Bunge and ligustrazine hydrochloride. The injection is widely used in China for the treatment of cardiovascular and cerebrovascular diseases, such as angina pectoris [ 1 , 2 ], coronary heart disease [ 3 ], myocardial infarction [ 4 , 5 ], acute cerebral infarction [ 6 , 7 ], and ischemic stroke [ 8 ]. The randomized controlled trial studies showed that the total efficiency was greater than 79% [ 8 , 9 , 10 ].…”

Cardioprotective effect of Shenxiong glucose injection on acute myocardial infarction in rats via reduction in myocardial intracellular calcium ion overload

“…SGI, consisted of two effective ingredients ligustrazine hydrochloride and tanshinol, has shown multiple effects on cerebral disease, but the cardioprotective effect and mechanisms of SGI has been rarely reported [8]. The objective of our present study is to examine whether SGI plays a protective role in AMI injury and explore its potential mechanisms.…”

“…Previous studies have shown that SGI possesses protective effects on cerebral, and its potential mechanisms are involved in antiinflammation, anti-oxidation and anticoagulation [8]. And what's more, clinical applications and animal experimental studies have demonstrated that there are seldom adverse effects after administration of SGI [8,9].…”

“…And what's more, clinical applications and animal experimental studies have demonstrated that there are seldom adverse effects after administration of SGI [8,9]. However, the cardioprotective effect and mechanisms of SGI has been rarely reported.…”

Evidence‐based practice guideline on integrative medicine for stroke 2019

“…A higher score indicates severe neurological impairment, and its minimum clinically important difference is 2 points 30,31 . The systematic reviews 32‐40 suggested that the use of Chinese herbal medicine (Table 1) in addition to conventional care and treatment in the 2 weeks after onset resulted in less neurological impairment in patients with ischemic stroke. Chinese herbal medicines that activate blood and resolve stasis were widely used, and they were often administered for 3‐30 days.…”