First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Office of Academic Affairs, Shandong University of Traditional Chinese Medicine, Jinan, China.
PLoS One. 2024 Jul 24;19(7):e0307663. doi: 10.1371/journal.pone.0307663. eCollection 2024.
Traditional Chinese medicine (TCM) injections are extensively utilized for the treatment of transient ischemic attack (TIA). However, it remains unclear which specific TCM injection exhibits superior efficacy. In this study, we conducted a network meta-analysis to compare the clinical efficacy and safety of various TCM injections in the treatment of TIA, with the aim of identifying the optimal treatment regimen.
We searched seven databases to collect information on nine TCM injections for the treatment of transient randomized controlled trials (RCTs) for the treatment of transient ischemic attacks were collected from the establishment to August 2023. The methodological quality and risk of bias were assessed using the RoB 2.0 evaluation tool, and reticulated Meta-analysis was performed using R software and Stata software.
We ultimately included 58 RCTs involving 5502 patients and comprising 9 TCM injections. In terms of improving the total effective rate, Shuxuetong injection (P-score = 0.69) was the most effective. In addition, Shuxuetong injection was most effective in lowering total cholesterol (P-score = 1.00) and triglyceride (P-score = 1.00) levels. Notably, Shuxuetong injection remained the most prominent in reducing fibrinogen (P-score = 0.91). However, among other blood hemorheology indicators, Dengzhanhuasu injection was the best regimen in reducing plasma viscosity (P-score = 1.00), whole blood viscosity (high shear rate) (P-score = 0.87), and whole blood viscosity (low shear rate) (P-score = 0.90). It was found that Yinxingyetiquwu injection (P-score = 0.72) was the most effective in reducing the incidence of cerebral infarction. In terms of safety, 22 studies reported adverse effects and descriptive analyses showed that the number of adverse effects of combination therapy was comparable to that of conventional therapy and that the safety profile was good.
TCM injections in combination with CT may be a safe and effective intervention for patients with TIA, of which Shuxuetong injection, Dengzhanhuasu injection, and Yinxingyetiquwu injection may be more noteworthy. The quality of the literature included in the study was low, so further validation is needed with larger sample sizes, higher quality, and more rigorously designed RCTs.
[PROSPERO], identifier [CRD42023443652].
中药注射液在治疗短暂性脑缺血发作（TIA）中被广泛应用。然而，哪种具体的中药注射液疗效更优仍不明确。本研究通过网状 Meta 分析比较了各种中药注射液治疗 TIA 的临床疗效和安全性，旨在确定最佳治疗方案。
我们检索了七个数据库，收集了 2023 年 8 月前建立的 9 种中药注射液治疗短暂性随机对照试验（RCT）的信息。采用 RoB 2.0 评价工具评估方法学质量和偏倚风险，并使用 R 软件和 Stata 软件进行网状 Meta 分析。
最终纳入 58 项 RCT，共 5502 例患者，涉及 9 种中药注射液。在提高总有效率方面，疏血通注射液（P 评分=0.69）效果最佳。此外，疏血通注射液在降低总胆固醇（P 评分=1.00）和甘油三酯（P 评分=1.00）水平方面效果最为显著。值得注意的是，疏血通注射液在降低纤维蛋白原方面也最为突出（P 评分=0.91）。然而，在其他血液流变学指标方面，灯盏花素注射液在降低血浆黏度（P 评分=1.00）、全血黏度（高切率）（P 评分=0.87）和全血黏度（低切率）（P 评分=0.90）方面效果最佳。结果显示，银杏叶提取物注射液（P 评分=0.72）降低脑梗死发生率的效果最佳。在安全性方面，有 22 项研究报告了不良反应，描述性分析表明，联合治疗的不良反应数量与常规治疗相当，安全性良好。
中药注射液联合 CT 可能是 TIA 患者安全有效的干预措施，其中疏血通注射液、灯盏花素注射液和银杏叶提取物注射液可能更为突出。本研究纳入文献的质量较低，因此需要进一步进行更大样本量、更高质量和更严格设计的 RCT 验证。
[PROSPERO]，标识符[CRD42023443652]。
