• 1. Qilu Hospital, Shandong University, Jinan 250012, P. R. China;
  • 2. Beijing University of Chinese Medicine, Beijing 100029, P. R. China;
  • 3. China Traditional Chinese Medicine Science and Technology Development Center, Beijing 100027, P. R. China;
  • 4. Talent Exchance Center of National Administration of Traditional Chinese Medicine, Beijing 100027, P. R. China;
  • 5. Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing 100010, P. R. China;
  • 6. School of Life Science, Beijing University of Chinese Medicine, Beijing 100029, P. R. China;
TIAN Jinzhou, Email: jztian@hotmail.com; LU Tao, Email: taolu@bucm.edu.cn
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Objective To systematically review the efficacy and safety of Salvia miltiorrhiza injection in the treatment of acute ischemic stroke (AIS). Methods PubMed, EMbase, The Cochrane Library, Web of Science, VIP, WanFang Data, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of Salvia miltiorrhiza injection in treatment of AIS from inception to February 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was then performed using Stata 16.0 software and RevMan 5.3 software. Results A total of 160 RCTs were included. The measures included 7 Chinese medicine injections and 8 treatment measures, covering Danhong injection combined with conventional treatment (DH+CT), Danshen injection combined with conventional treatment (DS+CT), Danshen ligustrazine injection combined with conventional treatment (DSCXQ+CT), Danshen polyphenolic acid for injection combined with conventional treatment (DSDFS+CT), compound Danshen injection combined with conventional treatment (FFDS+CT), Danshen polyphenolate for injection combined with conventional treatment (SI+CT), and Sodium Tanshinone ⅡA Sulfonate injection combined with conventional treatment (STS+CT) and conventional treatment (CT). Results of network meta-analysis showed that for the total effective rate, the rank of cumulative probability was: DSDFS+CT (93.0%) > DH+CT (80.5%) > STS+CT (66.7%) > DSCXQ+CT (66.4%) > SI+CT (50.0%)> DS+CT (26.7%)> FFDS+CT (16.7%)> CT (0.1%). In terms of NIHSS, the rank of cumulative probability was: STS+CT (95.5%) >DH+CT (80.9%)> DSCXQ+CT (70.1%) > SI+CT (64.7%) > DSDFS+CT (42.0%) > FFDS+CT (24.4%) > DS+CT (20.1%) > CT (2.4%). In the aspect of Barthel index, the rank of cumulative probability was: DH+CT (76.2%) > DSCXQ+CT (74.3%) > STS+CT (64.1%) > DSDFS+CT (62.2%) > FFDS+CT (51.8%) > SI+CT (46.0 %) > DS+CT (21.7%)> CT (3.8%). Conclusion Current evidence shows that, for patients with AIS, DSDFS has an improved effect on the total effective rate, while STS and DH show advantages in NIHSS score and Barthel index. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.

Citation: WANG Zheyi, SUN Yize, ZHANG Yuanfeng, TIAN Jinzhou, LU Tao. Efficacy and safety of salvia miltiorrhiza injection classes in treatment of acute ischemic stroke: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(2): 217-231. doi: 10.7507/1672-2531.202107133 Copy

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