Clinical Efficacy and Safety of Xingnaojing Injection for Cerebral Infarction: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

XU Fenglei ¹ , GAO Lixia ¹ , WU Taixiang ² , DINGJinhui ¹

1.The Central Hospital of Karamay; Karamay 834000; China2.Chinese Evidence-Based Medicine Centre/Clinical Epidemiology Resource and Training Centre; West China Hospital; Sichuan University; Chengdu 610041;

Corresponding author：

Keywords：

Xingnaojing; Cerebral infarction; Systematic review

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Objective　 To assess the clinical efficacy and safety of Xingnaojing for treating cerebral infarction.
Methods 　Randomized controlled trials (RCTs) were identified from MEDLINE (1966 to April 2005), EMBASE (1984 to April 2005), Cochrane Controlled Trials Register (Issue 2, 2005), CBMdisc (1978 to April 2005). We handsearched the related published and unpublished data and their references. All trials about Xingnaojing injection for cerebral infarction were included. Data were extracted and evaluated by two reviewers independently with designed extraction from RevMan 4.2.7 software was used for data analysis.
Results 　Thirteen RCTs involving 1203 patients were include .The results of meta-analysis were listed as the following:①Mortality:Compared with danshen ,2 studies showed that Xingnaojing decreased mortality statistically (RR 0.31 and 95% CI 0.14 to 0.70).Compared with cerebrolysin ,1 study showed Xingnaojing didn’t decrease the mortality (RR 0.92 ,95%CI 0.14 to 6.27);②Total effective rate: Compared with Danshen ,4 studies showed that Xingnaojing were more effective (RR 0.92,95% CI 1.12 to 1.42 ); ③ Cure rate: Compared with each control , Xingnaojing had the same cure rate ;④ Adverse effect: The number of adverse drug reaction was small and the symptoms were moderate;⑤Neurologic impairment score:Compared with Danshen ,3 studies showed that Xingnaojing had better improvement (WMD 3.78 ,95%CI 2.30 to 5.26).
Conclusions 　xingnaojing may decrease the mortality and increase the total effective rate of cerebral infarction .More high quality trials are required.

Citation： XU Fenglei,GAO Lixia,WU Taixiang,DINGJinhui. Clinical Efficacy and Safety of Xingnaojing Injection for Cerebral Infarction: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2005, 05(7): 549-554. doi: Copy

1.	程学铭. 脑血管病的流行病学[M]. 北京: 中国科学技术出版社; 1993. 4, 11～13.
2.	彭南生. 急性脑出血1000例预后研究[J]. 中国急救医学杂志, 1996; 16 (5): 32～33.
3.	罗侃, 刘苏中, 徐润,刘迎,王宝玉. 临床应用醒脑静注射液的综合总结[J]. 中国中西医急症, 1997; 6(3):119.
4.	梁黔生, 杨光田, 郑智. 醒脑静治疗镇静催眠药中毒的临床观察[J]. 中国急救医学, 1999; 19(12):742.
5.	各类脑血管疾病诊断要点(1995 年中华医学会全国第四届脑血管病学术会议通过) [J]. 中华神经科杂志, 1996; 29 (6):379.
6.	翁超明. 芳香开窍法对脑梗塞患者神经元保护作用的研究[J]. 北京中医药大学学报,2001; 24(6):58～60.
7.	陈坚, 张素平, 王慕真, 梁瑞华. 醒脑静对急性脑梗塞患者血浆内皮素和一氧化氮含量的影响[J]. 国际医药卫生导报, 2004; 10 (20):11～13.
8.	周永炜, 王文安, 陈伟,王根发,姚革,浦政. 醒脑静对脑梗死急性期患者智能障碍的改善作用[J]. 中国临床康复,2004; 8(28):6137～39.
9.	刘英, 胡新平. 醒脑静治疗急性脑梗塞38例疗效观察[J]. 南华大学学报(医学版),2003; 31(3):336～337.
10.	雷奕祺, 袁明远, 史东葵. 醒脑静注射液与安宫牛黄丸治疗脑梗塞急性期临床对照研究[J]. 中国中医急症. 2002; 11(5):359～360.
11.	庄伟端, 欧利民, 郑俊忠, 醒脑静注射液治疗急性脑梗死的临床疗效及CT观察[J]. 现代中西医结合杂志. 2000; 9(24):2446～47.
12.	庄伟端, 欧利民, 郑俊忠等. 醒脑静注射液对急性脑梗死意识障碍患者的影响[J]. 中国中西医结合急救杂志, 2001; 8(6):381～382.
13.	吴玉生, 姜立平, 王占奎, 赵玉武. 醒脑静注射液对急性大灶性脑梗塞患者血清肿瘤坏死因子、可溶性血管细胞粘附分子-1的影响[J]. 中药药理与临床.1999; 15 (5):45～46.
14.	刘纪铁. 醒脑静注射液治疗脑卒中的疗效观察[J]. 华夏医药. 2002; 6(6):52～54.
15.	金家宝. 醒脑静与脑活素治疗急性脑梗塞疗效比较-附96例报告[J]. 临床医学. 1999; 19(9):53～54.
16.	蔡定芳,赵剑华,阮晴珉,俞军,沈思钰,徐东飞,赵钢,刘静. 醒脑静注射液治疗急性缺血性中风的临床与实验研究[J]. 中国中医急症. 2000; 9(2):45～46.
17.	卓安民. 醒脑静注射液治疗脑梗死的临床观察[J]. 中国实用乡村医生杂志. 2005; 12(2):39～40.
18.	魏江磊, 邵念方. 醒脑静注射液治疗缺血性卒中临床疗效的研究[J]. 中西医结合实用临床急救. 1999; 6(5): 197～200.
19.	Cheng XM. Epidemiology of Cerebrovascular Disease[M]. Beijing: Chinese science and technique publishing company;1993. 4, 11-13.
20.	Peng NS. Prognosis of 1000 cute brain hemorrhage cases[J]. Chinese Journal of Emergency, 1996; 16 (5):32-33.
21.	Luo K, Liu SZ, Xu R, Liu Y, Wang BY. Clinical summary of xingnaojing injection[J]. Journal of Chinese and Western Emergency, 1997; 6 (3):119.
22.	Liang QS, Yang GT, Deng Z. Xingnaojing clinical observation of treatingsedativehypnotics[J]. Chinese Journal of Critical Medicine, 1999; 19(12) :742.
23.	Main points of diagnosis of cerebrovascular disease[J]. Chinese Journal of Neurology, 1996; 29 (6):379.
24.	Juni P, Altman DG, Eger M. Assessing the quality of controlled clinical trails[J]. BMJ, 2001; 323(7 303):42-46.
25.	Weng CM. Study of the protective effect s of TCM aromatic resuscitation therapy on the neurons in patients with acute cerebral infarction[J]. Journal of Beijing University of TCM, 2001; 24(6):58-60.
26.	Chen J, Zhang SP, Wang MZ, Liang RH. The effects of xin-nao-jing injection on endothelins and nitric qxide of acute intracerebral hemorrhagic patients[J]. Internal medicine & Hralth Guidance News, 2004;10(20):11-13.
27.	Zhou YW, Wang WN, Chen W, Wang GF, Yao G, Pu Z. The improving effect of xinnaojing on disturbance of intelligence of acute stage of cerebral infarction[J]. Chinese Journal of Clinical Rehabilitation, 2004; 8(28):6137-39.
28.	Liu Ying, Hu Xinping, Effect of xingnaojing treatment on acute cerebral infarction[J]. Journal of Nanhua University(Medical Edition). 2003; 31(3):336-337.
29.	Lei YQ, Yuan MY, Shi DK, Clinical controlled trail of xingnaojing and angongniuhuangwai treating acute cerebral infaraction[J]. Journal of Emergency in Traditinal Chinese Medine. 2002; 11(5):359-360.
30.	Zhuang WD, Ou LM, Zheng JZ. The clinical efficacy and CT evaluation for treatmen t of acute cerebral in infarction with Xingnaoj ing in jection[J]. Morden Journal of Integrated Traditional Chinese and Western Medicine, 2000; 9(24):2446-47.
31.	Zhuang WD, Ou LM, Zheng JZ Influences of Xingnaojing injection on restoring consciousness in acute cerebral infarction[J]. Chinese Journal of Intergrated Traditional and Western Medicine in intersive and Critical Care, 2001; 8(6):381-382.
32.	Wu YS, Jiang LP, Wang ZK, Zhao YW. Effect on serum tumor necrosis actor and soluble vascular cell adhesion molecule-1 of xingnaojing injection in treating acute large cerebral infarction cases[J]. Chinese Journal of Pharmacology and Clinical Medicine, 1999; 15 (5):45-46.
33.	Liu JT. Therapeutic effect of xingnaojing injection in human stroke[J]. Acta Medicinae Sinica,2002; 6(6):52-54.
34.	Jin JB. Efficacy of treating cerebral apoplexy of xingnaojing compared with cerebrolysin, a report of 96 cases[J]. Clinical Medicine, 1999; 19(9):53-54.
35.	Cai DF, Zhao JH, Ruan QM, Yu J, Shen SY, Xu DF, Zhao G, Liu J. Clinical and experimental study on xingnaojing injection in treating acute ischemic cerebral apoplexy[J]. Journal of Emergency in Traditional Chinese Medicine, 2000; 9(2):45-46.
36.	Zhu AM. Clinical observation of xingnaojing treating cerebral faraction[J]. Chinese Practical Journal of Rural Doctor, 2005; 12 (2):39-40.
37.	Wein JL, Shao NF. Studies of Xingnaoj ing In jection on clinically curative effects on treating ischem ic stroke[J]. Chinese Journal of Intergrated Traditional and Western Medine in Practical Clinical emergercy, 1999; 6(5): 197-200.
38.	Song Zhen, Gao JF. Therapeutic effect of xingnaojing injection in Human Stroke[J]. Chinese Jounal of Traditional Chinse Medicine and Pharmacy, 2003; 3(8):698-699.宋镇, 高锦凤等. 醒脑静治疗缺血性脑卒中临床疗效观察[J]. 中华医药杂志2003; 3(8): 698～699.
39.	Moher D, MSc. The CONSORT Guidelines: improving the quality of research. Consolidated standards of reporting trials. Interview by Bonnie Horrigan[J]. Altern Ther Health Med, 2002; 8(3):103-108.

1. 程学铭. 脑血管病的流行病学[M]. 北京: 中国科学技术出版社; 1993. 4, 11～13.
2. 彭南生. 急性脑出血1000例预后研究[J]. 中国急救医学杂志, 1996; 16 (5): 32～33.
3. 罗侃, 刘苏中, 徐润,刘迎,王宝玉. 临床应用醒脑静注射液的综合总结[J]. 中国中西医急症, 1997; 6(3):119.
4. 梁黔生, 杨光田, 郑智. 醒脑静治疗镇静催眠药中毒的临床观察[J]. 中国急救医学, 1999; 19(12):742.
5. 各类脑血管疾病诊断要点(1995 年中华医学会全国第四届脑血管病学术会议通过) [J]. 中华神经科杂志, 1996; 29 (6):379.
6. 翁超明. 芳香开窍法对脑梗塞患者神经元保护作用的研究[J]. 北京中医药大学学报,2001; 24(6):58～60.
7. 陈坚, 张素平, 王慕真, 梁瑞华. 醒脑静对急性脑梗塞患者血浆内皮素和一氧化氮含量的影响[J]. 国际医药卫生导报, 2004; 10 (20):11～13.
8. 周永炜, 王文安, 陈伟,王根发,姚革,浦政. 醒脑静对脑梗死急性期患者智能障碍的改善作用[J]. 中国临床康复,2004; 8(28):6137～39.
9. 刘英, 胡新平. 醒脑静治疗急性脑梗塞38例疗效观察[J]. 南华大学学报(医学版),2003; 31(3):336～337.
10. 雷奕祺, 袁明远, 史东葵. 醒脑静注射液与安宫牛黄丸治疗脑梗塞急性期临床对照研究[J]. 中国中医急症. 2002; 11(5):359～360.
11. 庄伟端, 欧利民, 郑俊忠, 醒脑静注射液治疗急性脑梗死的临床疗效及CT观察[J]. 现代中西医结合杂志. 2000; 9(24):2446～47.
12. 庄伟端, 欧利民, 郑俊忠等. 醒脑静注射液对急性脑梗死意识障碍患者的影响[J]. 中国中西医结合急救杂志, 2001; 8(6):381～382.
13. 吴玉生, 姜立平, 王占奎, 赵玉武. 醒脑静注射液对急性大灶性脑梗塞患者血清肿瘤坏死因子、可溶性血管细胞粘附分子-1的影响[J]. 中药药理与临床.1999; 15 (5):45～46.
14. 刘纪铁. 醒脑静注射液治疗脑卒中的疗效观察[J]. 华夏医药. 2002; 6(6):52～54.
15. 金家宝. 醒脑静与脑活素治疗急性脑梗塞疗效比较-附96例报告[J]. 临床医学. 1999; 19(9):53～54.
16. 蔡定芳,赵剑华,阮晴珉,俞军,沈思钰,徐东飞,赵钢,刘静. 醒脑静注射液治疗急性缺血性中风的临床与实验研究[J]. 中国中医急症. 2000; 9(2):45～46.
17. 卓安民. 醒脑静注射液治疗脑梗死的临床观察[J]. 中国实用乡村医生杂志. 2005; 12(2):39～40.
18. 魏江磊, 邵念方. 醒脑静注射液治疗缺血性卒中临床疗效的研究[J]. 中西医结合实用临床急救. 1999; 6(5): 197～200.
19. Cheng XM. Epidemiology of Cerebrovascular Disease[M]. Beijing: Chinese science and technique publishing company;1993. 4, 11-13.
20. Peng NS. Prognosis of 1000 cute brain hemorrhage cases[J]. Chinese Journal of Emergency, 1996; 16 (5):32-33.
21. Luo K, Liu SZ, Xu R, Liu Y, Wang BY. Clinical summary of xingnaojing injection[J]. Journal of Chinese and Western Emergency, 1997; 6 (3):119.
22. Liang QS, Yang GT, Deng Z. Xingnaojing clinical observation of treatingsedativehypnotics[J]. Chinese Journal of Critical Medicine, 1999; 19(12) :742.
23. Main points of diagnosis of cerebrovascular disease[J]. Chinese Journal of Neurology, 1996; 29 (6):379.
24. Juni P, Altman DG, Eger M. Assessing the quality of controlled clinical trails[J]. BMJ, 2001; 323(7 303):42-46.
25. Weng CM. Study of the protective effect s of TCM aromatic resuscitation therapy on the neurons in patients with acute cerebral infarction[J]. Journal of Beijing University of TCM, 2001; 24(6):58-60.
26. Chen J, Zhang SP, Wang MZ, Liang RH. The effects of xin-nao-jing injection on endothelins and nitric qxide of acute intracerebral hemorrhagic patients[J]. Internal medicine & Hralth Guidance News, 2004;10(20):11-13.
27. Zhou YW, Wang WN, Chen W, Wang GF, Yao G, Pu Z. The improving effect of xinnaojing on disturbance of intelligence of acute stage of cerebral infarction[J]. Chinese Journal of Clinical Rehabilitation, 2004; 8(28):6137-39.
28. Liu Ying, Hu Xinping, Effect of xingnaojing treatment on acute cerebral infarction[J]. Journal of Nanhua University(Medical Edition). 2003; 31(3):336-337.
29. Lei YQ, Yuan MY, Shi DK, Clinical controlled trail of xingnaojing and angongniuhuangwai treating acute cerebral infaraction[J]. Journal of Emergency in Traditinal Chinese Medine. 2002; 11(5):359-360.
30. Zhuang WD, Ou LM, Zheng JZ. The clinical efficacy and CT evaluation for treatmen t of acute cerebral in infarction with Xingnaoj ing in jection[J]. Morden Journal of Integrated Traditional Chinese and Western Medicine, 2000; 9(24):2446-47.
31. Zhuang WD, Ou LM, Zheng JZ Influences of Xingnaojing injection on restoring consciousness in acute cerebral infarction[J]. Chinese Journal of Intergrated Traditional and Western Medicine in intersive and Critical Care, 2001; 8(6):381-382.
32. Wu YS, Jiang LP, Wang ZK, Zhao YW. Effect on serum tumor necrosis actor and soluble vascular cell adhesion molecule-1 of xingnaojing injection in treating acute large cerebral infarction cases[J]. Chinese Journal of Pharmacology and Clinical Medicine, 1999; 15 (5):45-46.
33. Liu JT. Therapeutic effect of xingnaojing injection in human stroke[J]. Acta Medicinae Sinica,2002; 6(6):52-54.
34. Jin JB. Efficacy of treating cerebral apoplexy of xingnaojing compared with cerebrolysin, a report of 96 cases[J]. Clinical Medicine, 1999; 19(9):53-54.
35. Cai DF, Zhao JH, Ruan QM, Yu J, Shen SY, Xu DF, Zhao G, Liu J. Clinical and experimental study on xingnaojing injection in treating acute ischemic cerebral apoplexy[J]. Journal of Emergency in Traditional Chinese Medicine, 2000; 9(2):45-46.
36. Zhu AM. Clinical observation of xingnaojing treating cerebral faraction[J]. Chinese Practical Journal of Rural Doctor, 2005; 12 (2):39-40.
37. Wein JL, Shao NF. Studies of Xingnaoj ing In jection on clinically curative effects on treating ischem ic stroke[J]. Chinese Journal of Intergrated Traditional and Western Medine in Practical Clinical emergercy, 1999; 6(5): 197-200.
38. Song Zhen, Gao JF. Therapeutic effect of xingnaojing injection in Human Stroke[J]. Chinese Jounal of Traditional Chinse Medicine and Pharmacy, 2003; 3(8):698-699.宋镇, 高锦凤等. 醒脑静治疗缺血性脑卒中临床疗效观察[J]. 中华医药杂志2003; 3(8): 698～699.
39. Moher D, MSc. The CONSORT Guidelines: improving the quality of research. Consolidated standards of reporting trials. Interview by Bonnie Horrigan[J]. Altern Ther Health Med, 2002; 8(3):103-108.

Chinese Journal of Evidence-Based Medicine

Clinical Efficacy and Safety of Xingnaojing Injection for Cerebral Infarction: A Systematic Review

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