Meta-analysis Of Efficacy And Safety Of Tongqiao Huoxue Decoction Combined With Conventional Western Medicine In The Treatment Of Ischemic Stroke

Objective: To evaluate the efficacy and safety of Tongqiao Huoxue Decoction combined with conventional western medicine in the treatment of ischemic stroke.Methods: Randomized controlled clinical trials(RCTs)of Tongqiao Huoxue Decoction combined with conventional Western medicine in the treatment of ischemic stroke were retrieved from CNKI,VIP Chinese Periodicals,Wanfang Data Knowledge Service Platform,Pub Med and Embase databases from the establishment of the database to December 2022.According to the inclusion and exclusion criteria,the literature meeting the requirements was screened,and then the literature data was extracted.Finally,the clinical efficacy,NIHSS score,Barthel index,hs-CRP,adverse reactions,blood viscosity,fibrinogen,triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C)and other outcome indicators were analyzed by Rev Man5.3 software.Results:1.There were 43 literatures meeting the requirements of this study,involving a total of 3574 patients,including 1788 patients in the treatment group and 1786 patients in the control group.2.A total of 34 of the 43 studies included compared the clinical efficacy of the treatment group and the control group,and the results of meta-analysis were as follows: OR=4.85,95%CI(3.79,6.21),P < 0.05.3.There were 26 literatures that compared the neurological deficit score before and after treatment.The results of meta-analysis were as follows: MD=-3.46,95%CI(-4.02,-2.89),Z=11.97,P < 0.05.4.Seven literatures evaluated the change of Barthel index score before and after treatment,and the results of meta-analysis were as follows: MD=10.54,95%CI(5.49,15.58),P < 0.05.5.hs-CRP was mentioned in 7 literatures,and the results of meta-analysis were as follows: MD=-1.26,95%CI(-1.86,-0.67),P < 0.056.Among all the included literatures,11 literatures mentioned blood viscosity,which was analyzed by meta-analysis Results: MD=-0.45,95%CI(-0.73,-0.17),P <0.05.7.The outcome index of 12 literatures included was fibrinogen,and the results of meta-analysis were as follows: MD=-1.05,95%CI(-1.28,-0.82),P<0.05.8.Triglyceride was used as the observation index in 5 literatures.Results of meta-analysis were as follows: MD=-0.45,95%CI(-0.62,-0.28),P<0.059.Total cholesterol was analyzed in 4 literatures,and the results of metaanalysis were as follows: MD=-0.54,95%CI(-0.65,-0.43),P<0.05.10.Meta-analysis of four literatures using low density lipoprotein cholesterol as outcome index showed that MD=-0.23,95%CI(-0.31,-0.16),P<0.05.11.Adverse reactions were used as outcome indicators in 11 literatures.Results of meta-analysis were as follows: OR=1.04,95%CI(0.58,1.87),P>0.05.Conclusions:(1)Compared with the conventional western medicine group,Tongqiao Huoxue Decoction combined with conventional Western medicine in the treatment of ischemic stroke has more significant effects on improving clinical efficacy,improving patients’ ability of daily independent living and reducing neurological symptoms.(2)Compared with the conventional western medicine group,Tongqiao Huoxuxue Decoction combined with conventional Western medicine in the treatment of ischemic stroke has a prominent effect on reducing serum fibrinogen,triglyceride,total cholesterol,low density lipoprotein cholesterol,hs-CRP and plasma viscosity.(3)There was no difference in the safety of Tongqiaohuoxuesis decoction combined with conventional Western medicine in the treatment of ischemic stroke compared with the control group,and there was no statistical significance in adverse reactions between the two groups(P > 0.05).