title: Wen Dan Decoction for hemorrhagic stroke and ischemic stroke.
abstract: OBJECTIVE
  The use of traditional Chinese medicine (TCM) in stroke is increasing worldwide. Here we report the existing clinical evidence of the Pinellia Ternata containing formula Wen Dan Decoction (WDD) for the treatment of ischemic stroke and hemorrhagic stroke.
  
  
  METHODS
  PubMed, CNKI, Wan Fang database, Cochrane Library and online Clinical Trial Registry were searched up to 26 February 2013 for randomized, controlled clinical trials (RCTs) using WDD as intervention versus Western conventional medicine as control to treat stroke. Clinical outcomes were improvement of the Neurological Functional Deficit Scores (NFDS) and overall therapeutic efficacy rates including rate of cure. Meta-regression analysis using Hedges'g was performed for RCTs with significant heterogeneity.
  
  
  RESULTS
  A total of 22 RCTs of ischemic stroke and 4 RCTs of hemorrhagic stroke, involving 2214 patients (1167 used WDD), met our inclusion criteria. Meta-analysis of the 13 RCTs reporting NFDS improvement favored WDD over the control (mean difference=-3.40, 95% confidence intervals [CI]=[-4.64, -2.15]). Rate of overall therapeutic efficacy (odds ratio [OR]=3.39, 95%CI=[1.81, 6.37]) for hemorrhagic stroke were significantly higher in WDD treated patients than the control subjects. In the 1898 patients with ischemic stroke, WDD medication also achieved higher rates of cure (OR=2.22, 95%CI=[1.66, 2.97]) and overall therapeutic efficacy (OR=3.31, 95%CI=[2.54, 4.31]) than the conventional treatment.
  
  
  CONCLUSIONS
  WDD displays benefits on improvement of neurological function and overall therapeutic efficacy in post-stroke patients. TCM such as WDD may serve as a therapeutic tool of dual actions to explore the common mechanisms underlying cerebral hemorrhage and ischemia.
authors.affiliation: Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China; Fangchenggang Hospital of Traditional Chinese Medicine, Guangxi 538021, China.
authors.forename: Jia-Hua
authors.initials: JH
authors.lastname: Xu
authors.affiliation: Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China.
authors.forename: Yan-Mei
authors.initials: YM
authors.lastname: Huang
authors.affiliation: Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Ling
authors.affiliation: Department of Gastroenterology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Li
authors.affiliation: Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China.
authors.forename: Min
authors.initials: M
authors.lastname: Wang
authors.affiliation: Division of Neurology, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region.
authors.forename: Xiang-Yan
authors.initials: XY
authors.lastname: Chen
authors.affiliation: Department of Endocrinology, Guangdong Hospital of Traditional Chinese Medicine, Guangzhou 510120, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Sui
authors.affiliation: Center for Diabetic Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin 541004, China. Electronic address: zhaohailu9@126.com.
authors.forename: Hai-Lu
authors.initials: HL
authors.lastname: Zhao
mesh_terms: D002545:Brain Ischemia / Q000188:drug therapy / Q000503:physiopathology; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000188:drug therapy / Q000503:physiopathology; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000188:drug therapy* / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal
keywords: Chinese herbal medicine; Hemorrhagic stroke; Ischemic stroke; Meta-analysis; Meta-regression analysis; Systematic review; Traditional Chinese medicine; Wen Dan Decoction