[Clinical comprehensive evaluation of Danhong Injection in treatment of stroke with blood stasis syndrome]

Efficacy and safety of Danhong injection for treating myocardial infarction: a systematic review and meta-analysis of randomized controlled trials

Objective

Danhong injection (DHI) is widely used in the treatment of myocardial infarction (MI). We aimed to systematically review the efficacy and safety of DHI in a randomized controlled experiment on MI.

Methods

We searched the randomized controlled trials (RCTs) of DHI for MI published before 2 April 2023 in China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang database, China Science and Technology Journal Database (VIP), PubMed, Web of Science, Cochrance Library, and Embase databases. The methodological quality of the included studies was evaluated using the Cochrane Handbook 5.3 criteria using the RevMan software, and meta-analysis was performed and a forest map was drawn.

Results

A total of 38 trials included 3877 patients, including 2022 cases in the DHI treatment group and 1855 cases in the control group. Meta-analysis showed that the total effective rate (RR = 1.18%, 95% CI [1.14-1.12]) during treatment with DHI was higher than that of the control group. The prevalence of cardiac arrhythmia (RR = 0.55%, 95% CI [0.46-0.65]) was lower than that of the control group. The incidence of heart rate failure (RR = 0.45%, 95% CI [0.30-0.70]) was lower than that of the control group. The prevalence of cardiogenic shock (RR = 0.33%, 95% CI [0.11-1.04]) was p > 0.05, and the difference was not statistically significant. There was no statistically significant difference in LVEF between the two groups (MD = 0.00%, 95% CI [0.00-0.00]). CK-MB (MD = -0.81%, 95% CI [-0.92∼ -0.69]) was lower than the control group. hs-CRP (MD = -1.09, 95% CI [-1.22∼ -0.97]) was lower than the control group. The incidence of adverse reactions (RR = 0.37, The 95% CI [0.17-0.82]) was lower than that in the control group.

Conclusion

Basing on our study, the use of DHI in the treatment of myocardial infarction patients is effective, can improve cardiac function, reduce the incidence of adverse reactions, and improve the overall quality of life.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023390973.

Comparative efficacy of Honghua class injections for treating acute ischemic stroke: A Bayesian network meta-analysis of randomized controlled trials

Background: Acute ischemic stroke (AIS) is associated with high morbidity, mortality, and disability. Clinical trials have shown that Honghua class injections (HCIs) combined with WM achieve better clinical efficacy than WM alone. In this study, we performed a Bayesian network meta-analysis (NMA) of randomized controlled trials (RCTs) to evaluate the efficacy of different HCIs combined with WM in treating AIS.

Methods: First, the inclusion and exclusion criteria were established. From inception to 1 June 2022, a systematic literature search was conducted in multiple databases for the treatment of AIS with HCIs, including Honghua injection (HI), Safflower Yellow injection (SYI), Guhong injection (GHI), and Danhong injection (DHI). Subsequently, OpenBUGS 3.2.3 was applied to conduct a Bayesian algorithm, and Stata 16.0 was used to prepare the graphs. Multidimensional cluster analysis was performed using the “scatterplot3d” package in R 3.6.1 software.

Results: In this NMA, a total of 120 eligible RCTs were included, involving 12,658 patients, and evaluating the clinical effectiveness rates, activities of daily living (ADL), hemorheological indexes, and adverse reactions (ADRs). DHI + WM was the best intervention for improving the clinical effectiveness rate. Moreover, cluster analysis demonstrated that DHI + WM and SYI + WM had better comprehensive therapeutic effects. As most of the included RCTs did not monitor ADRs, the safety of the HCIs remains to be further explored.

Conclusion: DHI + WM and SYI + WM probably have a better clinical efficacy on AIS patients. Nevertheless, due to the limitation of this NMA, this conclusion may be biased. High-quality RCTs should be performed to validate our findings.

Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021229599