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 We handsearched the related published and unpublished data and their references.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.	程學銘. 腦血管病的流行病學[M]. 北京: 中國科學技術出版社; 1993. 4, 11～13.
2.	彭南生. 急性腦出血1000例預后研究[J]. 中國急救醫學雜志, 1996; 16 (5): 32～33.
3.	羅侃, 劉蘇中, 徐潤,劉迎,王寶玉. 臨床應用醒腦靜注射液的綜合總結[J]. 中國中西醫急癥, 1997; 6(3):119.
4.	梁黔生, 楊光田, 鄭智. 醒腦靜治療鎮靜催眠藥中毒的臨床觀察[J]. 中國急救醫學, 1999; 19(12):742.
5.	各類腦血管疾病診斷要點(1995 年中華醫學會全國第四屆腦血管病學術會議通過) [J]. 中華神經科雜志, 1996; 29 (6):379.
6.	翁超明. 芳香開竅法對腦梗塞患者神經元保護作用的研究[J]. 北京中醫藥大學學報,2001; 24(6):58～60.
7.	陳堅, 張素平, 王慕真, 梁瑞華. 醒腦靜對急性腦梗塞患者血漿內皮素和一氧化氮含量的影響[J]. 國際醫藥衛生導報, 2004; 10 (20):11～13.
8.	周永煒, 王文安, 陳偉,王根發,姚革,浦政. 醒腦靜對腦梗死急性期患者智能障礙的改善作用[J]. 中國臨床康復,2004; 8(28):6137～39.
9.	劉英, 胡新平. 醒腦靜治療急性腦梗塞38例療效觀察[J]. 南華大學學報(醫學版),2003; 31(3):336～337.
10.	雷奕祺, 袁明遠, 史東葵. 醒腦靜注射液與安宮牛黃丸治療腦梗塞急性期臨床對照研究[J]. 中國中醫急癥. 2002; 11(5):359～360.
11.	莊偉端, 歐利民, 鄭俊忠, 醒腦靜注射液治療急性腦梗死的臨床療效及CT觀察[J]. 現代中西醫結合雜志. 2000; 9(24):2446～47.
12.	莊偉端, 歐利民, 鄭俊忠等. 醒腦靜注射液對急性腦梗死意識障礙患者的影響[J]. 中國中西醫結合急救雜志, 2001; 8(6):381～382.
13.	吳玉生, 姜立平, 王占奎, 趙玉武. 醒腦靜注射液對急性大灶性腦梗塞患者血清腫瘤壞死因子、可溶性血管細胞粘附分子-1的影響[J]. 中藥藥理與臨床.1999; 15 (5):45～46.
14.	劉紀鐵. 醒腦靜注射液治療腦卒中的療效觀察[J]. 華夏醫藥. 2002; 6(6):52～54.
15.	金家寶. 醒腦靜與腦活素治療急性腦梗塞療效比較-附96例報告[J]. 臨床醫學. 1999; 19(9):53～54.
16.	蔡定芳,趙劍華,阮晴珉,俞軍,沈思鈺,徐東飛,趙鋼,劉靜. 醒腦靜注射液治療急性缺血性中風的臨床與實驗研究[J]. 中國中醫急癥. 2000; 9(2):45～46.
17.	卓安民. 醒腦靜注射液治療腦梗死的臨床觀察[J]. 中國實用鄉村醫生雜志. 2005; 12(2):39～40.
18.	魏江磊, 邵念方. 醒腦靜注射液治療缺血性卒中臨床療效的研究[J]. 中西醫結合實用臨床急救. 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.宋鎮, 高錦鳳等. 醒腦靜治療缺血性腦卒中臨床療效觀察[J]. 中華醫藥雜志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. 程學銘. 腦血管病的流行病學[M]. 北京: 中國科學技術出版社; 1993. 4, 11～13.
2. 彭南生. 急性腦出血1000例預后研究[J]. 中國急救醫學雜志, 1996; 16 (5): 32～33.
3. 羅侃, 劉蘇中, 徐潤,劉迎,王寶玉. 臨床應用醒腦靜注射液的綜合總結[J]. 中國中西醫急癥, 1997; 6(3):119.
4. 梁黔生, 楊光田, 鄭智. 醒腦靜治療鎮靜催眠藥中毒的臨床觀察[J]. 中國急救醫學, 1999; 19(12):742.
5. 各類腦血管疾病診斷要點(1995 年中華醫學會全國第四屆腦血管病學術會議通過) [J]. 中華神經科雜志, 1996; 29 (6):379.
6. 翁超明. 芳香開竅法對腦梗塞患者神經元保護作用的研究[J]. 北京中醫藥大學學報,2001; 24(6):58～60.
7. 陳堅, 張素平, 王慕真, 梁瑞華. 醒腦靜對急性腦梗塞患者血漿內皮素和一氧化氮含量的影響[J]. 國際醫藥衛生導報, 2004; 10 (20):11～13.
8. 周永煒, 王文安, 陳偉,王根發,姚革,浦政. 醒腦靜對腦梗死急性期患者智能障礙的改善作用[J]. 中國臨床康復,2004; 8(28):6137～39.
9. 劉英, 胡新平. 醒腦靜治療急性腦梗塞38例療效觀察[J]. 南華大學學報(醫學版),2003; 31(3):336～337.
10. 雷奕祺, 袁明遠, 史東葵. 醒腦靜注射液與安宮牛黃丸治療腦梗塞急性期臨床對照研究[J]. 中國中醫急癥. 2002; 11(5):359～360.
11. 莊偉端, 歐利民, 鄭俊忠, 醒腦靜注射液治療急性腦梗死的臨床療效及CT觀察[J]. 現代中西醫結合雜志. 2000; 9(24):2446～47.
12. 莊偉端, 歐利民, 鄭俊忠等. 醒腦靜注射液對急性腦梗死意識障礙患者的影響[J]. 中國中西醫結合急救雜志, 2001; 8(6):381～382.
13. 吳玉生, 姜立平, 王占奎, 趙玉武. 醒腦靜注射液對急性大灶性腦梗塞患者血清腫瘤壞死因子、可溶性血管細胞粘附分子-1的影響[J]. 中藥藥理與臨床.1999; 15 (5):45～46.
14. 劉紀鐵. 醒腦靜注射液治療腦卒中的療效觀察[J]. 華夏醫藥. 2002; 6(6):52～54.
15. 金家寶. 醒腦靜與腦活素治療急性腦梗塞療效比較-附96例報告[J]. 臨床醫學. 1999; 19(9):53～54.
16. 蔡定芳,趙劍華,阮晴珉,俞軍,沈思鈺,徐東飛,趙鋼,劉靜. 醒腦靜注射液治療急性缺血性中風的臨床與實驗研究[J]. 中國中醫急癥. 2000; 9(2):45～46.
17. 卓安民. 醒腦靜注射液治療腦梗死的臨床觀察[J]. 中國實用鄉村醫生雜志. 2005; 12(2):39～40.
18. 魏江磊, 邵念方. 醒腦靜注射液治療缺血性卒中臨床療效的研究[J]. 中西醫結合實用臨床急救. 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.宋鎮, 高錦鳳等. 醒腦靜治療缺血性腦卒中臨床療效觀察[J]. 中華醫藥雜志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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