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Review
. 2021 Nov 22:12:761722.
doi: 10.3389/fphar.2021.761722. eCollection 2021.

Efficacy of Ligustrazine Injection as Adjunctive Therapy in Treating Acute Cerebral Infarction: A Systematic Review and Meta-Analysis

Huikai Shao  1   2 , Xia He  1   2 , Lijuan Zhang  1   2 , Shan Du  1   2 , Xiaoqing Yi  1   2 , Xiaojiao Cui  1   2 , Xinxia Liu  1   2 , Shengfeng Huang  3 , Rongsheng Tong  1   2
Affiliations
Review

Efficacy of Ligustrazine Injection as Adjunctive Therapy in Treating Acute Cerebral Infarction: A Systematic Review and Meta-Analysis

Huikai Shao et al. Front Pharmacol. .

Abstract

Background: Ligustrazine injection has been widely used as adjunctive therapy in the treatment of acute cerebral infarction (ACI) during the past decades in China, but its clinical efficacy is not yet well confirmed. This study aims to evaluate the efficacy of ligustrazine injection as adjunctive therapy for ACI. Methods: Databases including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), PubMed, Medline, Google Scholar, Chinese Biomedical Literature Database, Cochrane Library, Embase, Sino-Med, Wanfang Database, and Chinese Science Citation Database were systematically searched for the published randomized controlled trials (RCTs) on ligustrazine injection in the treatment of ACI until November 2020. Meta-analysis was performed on the primary outcome measure (i.e., clinical effective rate) and the secondary outcome measure [i.e., neurological deficit score (NDS), fibrinogen, low shear blood viscosity (LBV), and high shear blood viscosity (HBV)]. The quality of the included RCTs was assessed according to the M scoring system (the refined Jadad scale). Sensitivity analysis and subgroup analysis were conducted according to the methodological quality, years of publication, and sample size. Results: Nineteen RCTs, containing 2022 patients, were included in this study. Meta-analysis indicated that ligustrazine injection combined with Western medicine could achieve a better effect in the treatment of ACI than using Western medicine alone in terms of clinical effective rate (RR = 1.24; 95% CI, 1.19-1.29), NDS (MD = -3.88; 95%CI, -4.51 to -3.61), fibrinogen (MD = -0.59; 95% CI, -0.76 to -0.42), LBV (MD = -2.11; 95% CI, -3.16 to -1.06), and HBV (MD = -0.88; 95% CI, -1.20 to -0.55). Conclusions: This research indicated that ligustrazine injection as adjunctive therapy seemed to be more effective than using western medicine alone in treating ACI. However, more evidence is required to confirm the efficacy of ligustrazine injection due to the low methodological quality of the included RCTs.

Keywords: acute cerebral infarction; adjunctive therapy; ligustrazine injection; meta-analysis; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow diagram of study selection process. LSI is ligustrazine injection; CNKI is China National Knowledge Infrastructure; WF is Wangfang Data; VIP is Chinese Scientific Journal Database; Other sources are Medline, Chinese Biomedical Literature. Database, Cochrane Library, Embase, Google Scholar, Sino-Med, and Chinese Science Citation Database.
FIGURE 2
FIGURE 2
Forest plot of clinical effective rate of ligustrazine injection in treating ACI. LSI is ligustrazine injection and WM is Western medicine.
FIGURE 3
FIGURE 3
Funnel plots of the clinical effective rate of ligustrazine injection for ACI. LSI is ligustrazine injection and WM is Western medicine.
FIGURE 4
FIGURE 4
Forest plot of NDS of ligustrazine injection in treating ACI. LSI is ligustrazine injection and WM is Western medicine.
FIGURE 5
FIGURE 5
Forest plot of fibrinogen of ligustrazine injection in treating ACI. LSI is ligustrazine injection and WM is Western medicine.
FIGURE 6
FIGURE 6
Forest plot of LBV of ligustrazine injection in treating ACI. LSI is ligustrazine injection and WM is Western medicine.
FIGURE 7
FIGURE 7
Forest plot of HBV of ligustrazine injection in treating ACI. LSI is ligustrazine injection and WM is Western medicine.
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