Promoting blood circulation for removing blood stasis therapy for acute intracerebral hemorrhage: a systematic review and meta-analysis
Meta-analysis published in Acta Pharmacol Sin (2015)
Abstract
AIM: To conduct a systematic review and meta-analysis to assess the current evidence available regarding the promoting blood circulation and removing blood stasis (PBCRBS) therapy for Chinese patients with acute intracerebral hemorrhage (ICH). METHODS: Six databases were searched from their inception to November 2013. The studies assessed in ≥ 4 domains with 'yes' were selected for detailed assessment and meta-analysis. The herbal compositions for PBCRBS therapy for acute ICH patients were also assessed. RESULTS: From the 6 databases, 292 studies claimed randomized-controlled clinical trials (RCTs). Nine studies with 798 individuals were assessed in ≥ 4 domains with 'yes' by using the Cochrane RoB tool. Meta-analysis showed that PBCRBS monotherapy and adjuvant therapy for acute ICH could improve the neurological function deficit, reduce the volume of hematoma and perihematomal edema, and lower the mortality rate and dependency. Moreover, there were fewer adverse effects when compared with Western conventional medication controls. Xueshuantong Injection and Fufang Danshen Injection, Buyang Huanwu Decoction and Liangxue Tongyu formula, and three herbs (danshen root, sanqi and leech) were the most commonly used Chinese herbal patent injections, herbal prescriptions and single herbs, respectively. CONCLUSION: Despite the apparently positive findings, it is premature to conclude that there is sufficient efficacy and safety of PBCRBS for ICH because of the high clinical heterogeneity of the included studies and small number of trials in the meta-analysis. Further large sample-sizes and rigorously designed RCTs are needed.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Nine RCTs (n=798) of PBCRBS therapy including leech for acute intracerebral hemorrhage; meta-analysis showed improvement in neurological deficit and lower mortality vs Western controls.
Why This Matters for Hirudotherapy
This systematic review and meta-analysis assessed promoting blood circulation and removing blood stasis (PBCRBS) therapy for acute intracerebral hemorrhage in Chinese patients, evaluating nine studies with 798 individuals. Meta-analysis suggested PBCRBS monotherapy and adjuvant therapy improved neurological deficit, reduced hematoma and perihematomal edema volume, and lowered mortality and dependency versus Western conventional controls. Among the most commonly used single herbs were danshen root, sanqi, and leech. This provides indirect relevance to ASH's domain by documenting the traditional medicinal use of leeches within Chinese herbal formulations for hematoma resolution. However, the leech is only one of several components in multi-herb preparations, the studies exhibited high clinical heterogeneity and small sample sizes, and the authors conclude the evidence is insufficient to establish efficacy and safety. No isolated leech effect can be attributed.
Citation
Promoting blood circulation for removing blood stasis therapy for acute intracerebral hemorrhage: a systematic review and meta-analysis.
Li HQ et al. · Acta Pharmacol Sin, 2015
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