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Meta-Analysis
. 2007 Apr 18;2007(2):CD004295.
doi: 10.1002/14651858.CD004295.pub3.

Dan Shen agents for acute ischaemic stroke

B Wu, M Liu, S Zhang
Meta-Analysis

Dan Shen agents for acute ischaemic stroke

B Wu et al. Cochrane Database Syst Rev. .

Abstract

Background: Based mainly on experimental data that indicates improvement to the cerebral microcirculation, Dan Shen, a herbal medicine, is widely used in the treatment of acute ischaemic stroke in China.

Objectives: To assess the effects of Dan Shen agents in patients with acute ischaemic stroke.

Search strategy: We searched the Cochrane Stroke Group Trials Register (last searched July 2006), the register of the Cochrane Complementary Field (last searched July 2006) and the Chinese Stroke Trials Register (last searched August 2006). In addition, we searched the following bibliographic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 2, 2006), MEDLINE (1996 to August 2006), EMBASE (1980 to August 2006), CINAHL (1982 to August 2006), AMED (1985 to August 2006), and the China Biological Medicine Database (CBM-disc) (1979 to August 2006). We handsearched 10 Chinese journals, searched clinical trials and research databases, scanned reference lists and contacted the pharmaceutical company manufacturing Dan Shen. We also attempted to contact trial authors to obtain further data.

Selection criteria: Randomised or quasi-randomised controlled trials comparing Dan Shen agents with placebo or open control in patients with acute ischaemic stroke.

Data collection and analysis: Two review authors independently selected trials for inclusion, assessed trial quality, and extracted the data.

Main results: Six trials involving 494 patients were included. Three trials are awaiting assessment. Numbers of deaths and dependent patients at the end of follow up of at least three months were not reported in the six included trials. Only two trials reported adverse events. All trials measured the outcome 'significant improvement in neurological deficit at the end of treatment'. Dan Shen agents were associated with a significant increase in the number of patients with the outcome (Peto odds ratio 3.02, 95% confidence interval 1.73 to 5.26). No deaths were reported within the first two weeks of treatment or during the whole follow-up period. The trials did not include any assessment of quality of life.

Authors' conclusions: The methodological quality of all included studies was poor, and reliable conclusions could not be drawn from the present data. Further high-quality randomised controlled trials should be performed.

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Conflict of interest statement

None known

Figures

1.1
1.1. Analysis
Comparison 1 Dan Shen agents versus control, Outcome 1 Improvement of neurological deficit at the end of treatment.
2.1
2.1. Analysis
Comparison 2 Subgroup analysis: Compound Dan Shen injection versus Compound Dan Shen Dropping pill, Outcome 1 Improvement of neurological deficit at the end of treatment.
3.1
3.1. Analysis
Comparison 3 Subgroup analysis: Compound Dan Shen agents (injection plus pill) versus Dan Shen injection, Outcome 1 Improvement of neurological deficit at the end of treatment.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

Cao 1994 {published data only}
    1. Cao P, Feng R, Feng Z. Observation of Compound Dan Shen injection and snake venom for cerebral infarction. Chinese Traditional Medicine of Guangxi 1994;17(4):3‐4,8.
Mao 2001 {published data only}
    1. Mao J, Gan Z. Observation of Compound Dan Shen dropping pill for cerebral infarction. Pharmacological Magazine of People's Liberation Army 2001;17(1):49‐50.
Min 2004 {published data only}
    1. Min LQ, Yuan J, Li X, Ding ZY, Ma WY, Tian BX, et al. Influence of composite salvia miltiorrhiza on vascular endothelial cell function in patients with cerebral infarction. Chinese Journal of Clinical Rehabilitation 2004;8(16):3090‐1.
Pan 1992 {published data only}
    1. Pan C, Chen N, Huo J. 187 cases of Compound Dan Shen injection and snake venom for cerebral infarction. Chinese Traditional Medicine of Shanxi 1992;13(2):157‐8.
Zhai 2001 {published data only}
    1. Zhai ZL, Sun JH, Zhang J. A large dose of Dan Shen for acute ischaemic stroke.. HeBei Medicine 2001;7(12):1110‐1.
Zhang 2002 {published data only}
    1. Zhang LJ, Zhang BF, Tian F. Compound Dan Shen combined with heparin for acute ischaemic stroke. Zhejiang Journal of Integrated Traditional Chinese and Western Medicine 2002;12(7):423.

References to studies excluded from this review

Geng 2000 {published data only}
    1. Geng Z, Yao J. Compound Dan Shen for acute ischaemic stroke. Research of Traditional Chinese Medicine 2000;16(4):30‐1.
Xu 1995 {published data only}
    1. Xu M. Observation of effect of Compound Dan Shen injection and XueShuangtong injection on cerebral infarction. Chinese Traditional Medicine of Guangxi 1995;18(5):4‐5,7.

References to studies awaiting assessment

Gao 1998 {unpublished data only}
    1. Gao Y, Mao L, Zhao W, Guo J. Clinical research of Compound Dan Shen dropping pill for cerebral infarction. Proceedings of Forum of Internationalized Chinese Materia Medica. 1998:65‐6.
Liang 1996 {published data only}
    1. Liang Z. Observation of effect of Compound Dan Shen injection on ischaemic cerebrovascular diseases. Medicine of Guangdong 1996;17(9):626‐7.
Luo 1998 {published data only}
    1. Luo S. Clinical observation on 78 cases of cerebral vascular accident treated by acupoint injection and acupuncture. Shanghai Journal of Acupuncture and Moxibustion 1998;2:12‐3.

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