The Effect of Naoxintong Capsule in the Treatment of Patients with Cerebral Infarction and Carotid Atherosclerosis: A Systematic Review and Meta‐Analysis of Randomized Trials

Abstract

Objective Naoxintong capsule (NXT) has been widely used to treat patients with cerebral infarction and carotid atherosclerosis. However, it is uncertain whether there is robust evidence on the effects of NXT for cerebral infarction and carotid atherosclerosis. A systematic review and meta-analysis of randomized trials were performed to assess the efficacy of NXT in the treatment of cerebral infarction and carotid atherosclerosis. Methods The Cochrane Library, EMBASE, the Medline database, the Wanfang database, the China National Knowledge Infrastructure, and the VIP database were searched up to January 2018 with no language restrictions. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results Eleven studies (N=1141) in total satisfied the inclusion criteria for the meta-analysis. The results of meta-analysis showed that compared with the conventional therapy alone, NXT combined with conventional therapy could significantly improve national institutes of health stroke scale (NIHSS) score (MD= -3.92, 95%CI: -4.31~-3.52, P<0.00001), plaque area (MD= -0.16, 95%CI: -0.20~-0.13, P<0.00001), carotid intima-media thickness (IMT) (MD= -0.23, 95%CI: -0.26~-0.20, P<0.00001), total cholesterol (TC) (MD= -0.16, 95%CI: -0.79~-0.42, P<0.00001), triglyceride (TG) (MD= -0.69, 95%CI: -0.88~-0.51, P<0.00001), high-density lipoprotein cholesterol (HDL-C) (MD= 0.23, 95%CI: 0.15~0.31, P<0.00001), and low-density lipoprotein cholesterol (LDL-C) (MD= -0.42, 95%CI: -0.58~-0.25, P<0.00001). There were no reported adverse events in the studies. Conclusions NXT is an effective and safe therapy option for patients with cerebral infarction and carotid atherosclerosis. However, due to the high clinical heterogeneity and small sample size of the included trials, further standardized preparation, large-scale and rigorously designed trials are needed.

Effect of Naoxintong Capsules on the Activities of CYP450 and Metabolism of Metoprolol Tartrate in Rats Evaluated by Probe Cocktail and Pharmacokinetic Methods

“…NXT has been widely used in the clinical treatment of cerebral infarction and carotid atherosclerosis [37]. It has become increasingly popular to be used in combination with other prescription drugs.…”

The Effects of Naoxintong Capsule on the Vascular Endothelial Function and Inflammatory Factors in Spontaneously Hypertensive Rats

“…Naoxintong (NXT) capsule is a traditional Chinese herb compound according to the theory of traditional Chinese medicine. It could activate the blood circulation, clear collaterals, improve endothelial function and plays a pivotal role in anti-atherosclerosis [12,13]. In recent years, more and more clinical studies indicated that NXT could reduce the plaque area and carotid intima-media thickness [14], and it could relieve the symptoms of hypertension as well.…”

Evaluation of the anti-inflammatory and antioxidant pharmcodynamic compoents of naoxintong capsules as a basis of broad spectrum effects

“…NXT also can reduce the NO level and the expression of inducible nitric oxide synthase (iNOS) in the vessel wall to treat atheromatous (Zhong et al 2013). In clinics, NXT can be used for carotid atherosclerosis and cerebral infarction (Liang et al 2018), partly abrogate the impaired protective effect of high-density lipoprotein (HDL) on endothelial function (Lv et al 2016), and improve adverse cardiovascular events, atherosclerosis, and the expression of inflammatory factors in patients with acute coronary syndrome undergoing PCI, when combined with Danhong injection (Lv et al 2015;Zhao et al 2018).…”