Portal de Periódicos da CAPES

Sanchi for Acute Ischemic Stroke

2009; Lippincott Williams & Wilkins; Volume: 40; Issue: 5 Linguagem: Inglês

10.1161/strokeaha.108.536102

1524-4628

Xiaohong Chen, Muke Zhou, Qifu Li, Jie Yang, Yun Zhang, Dongping Zhang, Shuangyan Kong, Dong Zhou, Li He,

Parkinson's Disease Mechanisms and Treatments

HomeStrokeVol. 40, No. 5Sanchi for Acute Ischemic Stroke Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBSanchi for Acute Ischemic Stroke Xiaoyan Chen, Muke Zhou, Qifu Li, Jie Yang, Yun Zhang, Dongping Zhang, Shuangyan Kong, Dong Zhou and Li He Xiaoyan ChenXiaoyan Chen From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. , Muke ZhouMuke Zhou From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. , Qifu LiQifu Li From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. , Jie YangJie Yang From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. , Yun ZhangYun Zhang From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. , Dongping ZhangDongping Zhang From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. , Shuangyan KongShuangyan Kong From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. , Dong ZhouDong Zhou From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. and Li HeLi He From the Neurology Department of West China Hospital, Sichuan University, Chengdu, China. Originally published5 Mar 2009https://doi.org/10.1161/STROKEAHA.108.536102Stroke. 2009;40:e394–e395Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: March 5, 2009: Previous Version 1 Currently, very few drugs are supported for routine use for acute ischemic stroke. Sanchi may be a potential remedy, which acts through several mechanisms. We aimed to assess the efficacy and safety of sanchi for acute ischemic stroke within 30 days of onset.MethodsA comprehensive data search was performed according to the search strategy of the Cochrane Collaboration Stroke Review Group. Only randomized, controlled clinical trials were eligible for inclusion. The interventions were sanchi compared with placebo or no treatment, whereas equal cointerventions were allowed. Two review authors independently extracted data and assessed trial quality.ResultsEight trials involving 660 participants were included. Seven of the 8 studies were of poor quality. Follow-up time was less than 1 month in 6 trials. Only 2 trials provided data for the number of participants who were dead or dependent at the end of 28 days of treatment, indicating a significantly lower rate of death and dependency in the sanchi group than in the control group (relative risk, 0.63; 95% CI, 0.45 to 0.88). One trial reported higher Barthel Index scores in the sanchi group. Pooled analysis of 7 trials indicated that sanchi might improve neurological deficit more than control with a significant difference (relative risk, 0.29; 95% CI, 0.18 to 0.47). Few adverse events were reported. Data were limited in respect of stroke recurrence and quality of life.ConclusionsImplications for PracticeThe effect of treatment with sanchi is implausibly large in our review, but the methodology of the studies is poor (the trials were either not double-blind or not balanced for prognostic factors) and the results are hardly credible. There is no clear evidence to suggest benefit of sanchi in acute ischemic stroke.Implications for ResearchThere is a need for more randomized clinical trials with high methodological quality, large numbers of participants, and good reporting to provide stronger evidence. In particular, such trials should assure adequate randomization and allocation concealment, blinding of participants, drug providers and outcome assessors, good reporting of methodology, and losses of participants using intention-to-treat analysis. In addition, they should have appropriate control interventions using placebo or no treatment. No confounded medicine should be added to the treatment intervention. Cointervention should be concordant in the 2 groups in a trial. Basic drug therapy for ischemic stroke such as aspirin may be given to both groups. Follow-up should be longer. Functional outcome such as death or dependency at the end of follow-up over 2 months should be measured as the primary outcome. Sample size should be large enough to provide adequate statistical power. Finally, we recommend all clinical trials are appropriately registered before they start, for example, on the Chinese Clinical Trial Register's web site. Download figureDownload PowerPointFigure. Comparison: Sanchi vs control. Outcome: Proportion of patients with no improvement of neurological deficit (different constituents).We acknowledge the Chinese Evidence-Based Medicine Centre and the Cochrane Stroke Group Editorial Board for their helpful comments.DisclosuresNone.FootnotesCorrespondence to Li He, MD, Neurology Department of West China Hospital, Sichuan University, Chengdu, China 610041. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited By Wang L, Yu Y, Yang J, Zhao X and Li Z (2015) Dissecting Xuesaitong's mechanisms on preventing stroke based on the microarray and connectivity map, Molecular BioSystems, 10.1039/C5MB00379B, 11:11, (3033-3039) Sucher N and Carles M (2013) Chinese Herbal Medicines for Neuroprotection in Ischemic Stroke: Promise and Reality Evidence and Rational Based Research on Chinese Drugs, 10.1007/978-3-7091-0442-2_9, (363-395), . Gao L, Zhao H, Liu Q, Song J, Xu C, Liu P, Gong W, Wang R, Liu K and Luo Y (2012) Improvement of hematoma absorption and neurological function in patients with acute intracerebral hemorrhage treated with Xueshuantong, Journal of the Neurological Sciences, 10.1016/j.jns.2012.09.028, 323:1-2, (236-240), Online publication date: 1-Dec-2012. May 2009Vol 40, Issue 5 Advertisement Article InformationMetrics https://doi.org/10.1161/STROKEAHA.108.536102 Manuscript receivedAugust 31, 2008Manuscript acceptedOctober 1, 2008Originally publishedMarch 5, 2009 Keywordsacute ischemic meta-analysessanchistrokesystematic reviewPDF download Advertisement