Intervention Review

Acanthopanax for acute ischaemic stroke

  1. Weizheng Li1,
  2. Ming Liu1,*,
  3. Shejun Feng1,
  4. Bo Wu1,
  5. Shihong Zhang1,
  6. Weimin Yang1,
  7. Guan Jian Liu2

Editorial Group: Cochrane Stroke Group

Published Online: 8 JUL 2009

Assessed as up-to-date: 19 JAN 2008

DOI: 10.1002/14651858.CD007032.pub2

Database Title

Additional Information

How to Cite

Li W, Liu M, Feng S, Wu B, Zhang S, Yang W, Liu GJ. Acanthopanax for acute ischaemic stroke. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD007032. DOI: 10.1002/14651858.CD007032.pub2.

Author Information

  1. 1

    West China Hospital, Sichuan University, Department of Neurology, Chengdu, Sichuan Province, China

  2. 2

    West China Hospital, Sichuan University, Chinese Cochrane Centre, Chinese EBM Centre, Chengdu, Sichuan, China

*Ming Liu, Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, Sichuan Province, 610041, China. wyplmh@hotmail.com.

Publication History

  1. Publication Status: New
  2. Published Online: 8 JUL 2009

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Acute ischaemic stroke is a common cause of death and disability. A number of studies published in China have shown that acanthopanax is beneficial for acute ischaemic stroke.

Objectives

To assess the efficacy and safety of acanthopanax in patients with acute ischaemic stroke.

Search methods

We searched the Cochrane Stroke Group Trials Register (last searched January 2008), the Chinese Stroke Trials Register (last searched March 2008), and the Trials Register of the Cochrane Complementary Medicine Field (last searched January 2008). In addition, we searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2008), MEDLINE (1966 to March 2008), EMBASE (1980 to March 2008), CINAHL (1982 to March 2008), AMED (1985 to March 2008), and nine Chinese databases, including the China Biological Medicine Database (CBM-disc) (1979 to March 2008). We handsearched three Chinese journals and searched reference lists, relevant clinical trials registers and research databases. In an attempt to identify further published, unpublished, and ongoing trials, we contacted a pharmaceutical company, researchers and study authors.

Selection criteria

We included randomised controlled trials comparing acanthopanax with placebo or open control (no placebo) in patients with acute ischaemic stroke.

Data collection and analysis

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

Main results

We included 13 trials (962 participants); the period of follow up in all included trials ranged from 10 to 30 days. None of the trials reported the pre-specified primary outcome death or dependency during the follow-up period. The outcome measure in all included trials was the improvement of neurological deficit after treatment; acanthopanax was associated with a significant increase in the number of participants whose neurological impairment improved (risk ratio (RR) 1.22, 95% confidence interval (CI) 1.15 to 1.29). Two trials reported adverse events; five trials reported no adverse events.

Authors' conclusions

The risk of bias in all the included trials was high, and hence the data were not adequate to draw reliable conclusions about the efficacy of acanthopanax in acute stroke. Much larger trials of greater methodological quality are needed.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Acanthopanax for acute ischaemic stroke

Most strokes take place when a blood clot blocks a blood vessel leading to the brain. Without a proper blood supply, the brain quickly suffers damage, which can be permanent. The damage from a stroke can cause arm or leg weakness, or difficulties with language or vision. Data from some experimental and human studies have suggested acanthopanax, a traditional Chinese medicine, may be beneficial for people with acute ischaemic stroke. It has been used in China for many years to treat stroke. To obtain a reliable assessment of the effects of acanthopanax in acute ischaemic stroke, we reviewed data from 13 studies involving 962 participants. The quality of the trials was poor, and there was not enough evidence to support the routine use of acanthopanax in the treatment of acute ischaemic stroke. More high-quality trials are needed.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

五加對急性缺血性中風之療效

急性缺血性中風是常見造成死亡及殘障的原因。在中國有數個已發表的研究顯示五加對治療急性缺血性中風是有幫助的。

目標

評估五加對急性缺血性中風之功效及安全性。

搜尋策略

我們搜尋了Cochrane Stroke Group Trials Register(最後搜尋2008年一月)，Chinese Stroke Trials Register(最後搜尋2008年三月)以及Trials Register of the Cochrane Complementary Medicine Field(最後搜尋2008年一月)。此外，我們搜尋了Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2008), MEDLINE (1966 to March 2008), EMBASE (1980 to March 2008), CINAHL (1982 to March 2008), AMED (1985 to March 2008)，還有九個中文資料庫，包括了China Biological Medicine Database (CBMdisc) (1979 至2008年三月)，我們也用人工搜尋三本中文期刊及其參考文獻，相關的臨床試驗，和研究型的資料庫。為了找出更多已發表文獻、未發表及正在進行的臨床試驗，我們也嘗試聯繫了藥廠、研究者及論文作者。

選擇標準

我們納入比較五加、安慰劑或開放式對照組(無安慰劑)來治療急性中風病患的隨機對照臨床試驗

資料收集與分析

二位檢閱的作者獨立挑選納入的臨床試驗，評估試驗的品質和摘錄資料。

主要結論

我們納入了13個臨床試驗(962個受試參與者)，其追蹤的時間是10天至30天。在追蹤期間沒有任何一個試驗在初期結果出爐前有死亡事件發生。結果所要估量的是在接受治療之後神經缺陷的改善情況。所有納入的臨床試驗結果是在接受五加治療後神經缺損皆有改善；而接受五加治療後神經損傷有進步的人數也有顯著的增加(相對危險比 1.22，95%信賴區間1.15至1.29)。二個臨床試驗有不良事件報告，五個臨床試驗沒有不良事件報告。

作者結論

偏差的風險在所納入的臨床試驗是相當高的，所以五加對急性中風功效在現有資料中無法取得可信賴的結論。更大型及有高品質的試驗研究方法是必需的。

翻譯人

本摘要由臺北榮民總醫院鄭博斌翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

大部分中風的發生是由於血塊阻擋了通往腦部的血管，沒有足夠的血液供應，腦部會遭受永久性的損傷。中風的腦部損傷可造成手或腳的無力，語言或視力功能喪失。一些實驗及人體研究顯示了中國傳統中藥五加或許對患有急性缺血性中風的人有幫助。它在中國被用於治療中風已有許多年。為了獲得五加對急性腦中風的功效的信賴評估，我們檢閱了13個研究資料，包含了962個受試參與者。由於臨床試驗的品質不良，以致於沒有足夠證據能夠支持常規使用五加於治療急性缺血性中風。更多高品質的臨床試驗是必需的。

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