Sanchi for acute ischaemic stroke.
BACKGROUND
Currently very few drugs are supported for routine use for acute ischaemic stroke. Sanchi is one of the most widely used herbal medicines for ischaemic stroke in China.


OBJECTIVE
To assess the effectiveness and safety of sanchi in the treatment of acute ischaemic stroke.


METHODS
We searched the Cochrane Stroke Group Trials Register (last searched January 2008), the Chinese Stroke Trials Register (searched February 2007), the Cochrane Complementary Medicine Field trials register (searched February 2007), the Chinese Cochrane Centre Controlled Trials Register (last searched February 2007). We also searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 1, 2007), MEDLINE (1966 to February 2007), EMBASE (1980 to February 2007), CINAHL (1982 to February 2007), AMED (1985 to February 2007), CNKI (1979 to February 2007), CBM-disc (1979 to February 2007), Chinese scientific periodical database of VIP INFORMATION (1989 to February 2007), Wanfang Data (1982 to February 2007), CISCOM (1980 to February 2007), and TCMLARS (1984 to February 2007).


METHODS
Randomised controlled trials comparing sanchi with placebo or no treatment for acute ischaemic stroke within 30 days of onset.


METHODS
Two review authors extracted data and assessed trial quality.


RESULTS
Eight trials involving 660 participants were included. Seven of the eight studies were of poor quality. Follow-up time was less than one month in six trials. Only two trials provided data for the number of participants who were dead or dependent at the end of 28 days of treatment, indicating a significantly lower rate of death and dependency in the sanchi group than in the control group (relative risk (RR) 0.63, 95% confidence interval (Cl) 0.45 to 0.88). One trial reported higher Barthel index scores in the sanchi group. Pooled analysis of seven trials indicated that sanchi might improve neurological deficit more than control with a significant difference (RR 0.29, 95%Cl 0.18 to 0.47). The total case fatality rate was lower than 1% indicating that participants probably had mild strokes. Few adverse events were reported. Data were limited in respect of stroke recurrence and quality of life.


CONCLUSIONS
Sanchi appears to be beneficial and safe for acute ischaemic stroke in this review, but the small sample and inferior quality of studies prevented a definite conclusion. More well-designed randomised controlled trials are required.
Department of Neurology, West China Hospital, Sichuan University, Wai Nan Guo Xue Xiang #37, Chengdu, Sichuan, China, 610041.
Xiaoyan
X
Chen
Muke
M
Zhou
Qifu
Q
Li
Jie
J
Yang
Yun
Y
Zhang
Dongping
D
Zhang
Shaugyan
S
Kong
Dong
D
Zhou
Li
L
He
D002545:Brain Ischemia / Q000188:drug therapy; D036145:Ginsenosides / Q000627:therapeutic use*; D006801:Humans; D053723:Panax notoginseng; D008517:Phytotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D012503:Saponins / Q000627:therapeutic use*; D020521:Stroke / Q000188:drug therapy*
D036145:Ginsenosides; C079995:Panax quinquefolium saponin; D012503:Saponins; C004563:panaxatriol