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Journal of Chinese Integrative Medicine ›› 2010, Vol. 8 ›› Issue (5): 417-426.doi: 10.3736/jcim20100504

• Original Clinical Research • Previous Articles     Next Articles

Outcome and safety assessment of an herbal medicine treatment protocol for yin pattern of acute ischemic stroke

the Project Group for Demonstration Study of Syndrome Differentiation Protocol Effect Evaluation of Acute Ischemic Stroke ,Yan Huanga, Jian-wen Guoa   

  1. a The First Department of Neurology, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, Guangdong Province, China
  • Received:2009-07-06 Accepted:2010-02-05 Online:2010-05-20 Published:2010-05-15
  • Contact: Yan Huang E-mail:stroketcm15@yahoo.com.cn

Background

The morbidity of stroke is high. Traditional Chinese medicine is commonly used for patients with ischemic stroke in China, but the efficacy need be further proved.
Objective

To assess the efficacy and safety of an herbal medicine treatment regimen integrating traditional Chinese medicine and Western medicine for ischemic stroke patients with yin pattern syndrome. Design, setting, participants and interventions: A multicenter, randomized and controlled clinical trial was adopted. A total of 537 patients with acute ischemic stroke were enrolled in 22 hospitals from July 2005 to October 2006, among whom 274 were assigned to group A (herbal group) and administered with Western medicine plus herbal medicine treatment, and the other 263 in group B (control group) with Western medicine plus placebo. The patients in two groups were all treated for 21 days.Main outcome measures: The primary endpoint of outcome measures was Barthel index. The secondary endpoints included National Institutes of Health Stroke Scale, the modified Rankin criteria, Stroke Specific Quality of Life, and Stroke Scale of Traditional Chinese Medicine. The adverse effects of the treatment were also observed.
Results

A total of 622 randomization numbers were applied by the centers and 16 numbers were lost for mishandling, so a total of 606 patients were included. Fifteen patients were excluded (5 in group A, and 10 in group B), and 54 (25 in group A, and 29 in group B) lost in follow-up. A total of 537 patients completed the trial and a per-protocol set analysis was conducted. There were no statistical differences in age, sex, pulse rate, heart rate, respiratory rate, blood pressure, medical history, neurological deficit scores, scores on Glasgow Coma Scale, and lesion size of intracerebral ischemia between the two groups at baseline (P>0.05). Twelve patients, including 5 in group A and 7 in group B, died during the 90 days of research period, and no significant difference was found between the two groups. Compared with Western medicine alone, herbal medicine treatment could improve the neurological deficit at day 21, activities of daily living at day 90 of follow-up, and the patient-reported outcome at days 21, 60, and 90 (P< 0.05). Independent living ability of the patients was also improved (67.9% of group A vs 59.3% of group B, 0-1 at modified Rankin criteria). Moreover, the herbal medicine treatment showed a tendency in improving quality of life at a time-dependent manner. Adverse events, including gastrointestinal adverse events, skin symptoms, hemorrhagic tendency, and aminotransferase increase, happened in 76 cases from both groups, and no significant difference was found between the two groups. Correlation analysis showed that aminotransferase increase was not related to the herbal medicine treatment, but to the lipid-lowering drugs.
Conclusion

The present research demonstrates that the herbal medicine treatment shows effects on neurological deficit and patient-reported outcome at day 21, activities of daily living and handicap at day 60, and handicap, activities of daily living and patient-reported outcome at 3-month follow-up.

Key words: Stroke, Yin syndrome, Treatment outcome, TCM WM therapy, Safety, Randomized controlled trail, Multicenter study

Figure 1

Flow diagram of this randomized trial"

"

Number of cases Cause of death Random number (group)
1 Intracerebral hemorrhage breaking into the ventricals led to hernia 612 (B)
1 Mixed-type shock 562 (A)
1 Upper gastrointestinal bleeding and infection 141 (B)
1 Heart failure, dysfunction of circulation 604 (B)
1 Recurrence of stroke, asking for discharge and died during the course 250 (B)
1 Large area infarction led to hernia; family members abandoned rescue 033 (A)
1 Auricular fibrillation led to large area infarction 415 (B)
1 Pulmonary infection and died of respiratory failure 120 (B)
1 Sudden infarction in the brain stem 200 (A)
1 Unclear cause 541 (B)
1 Myocardial infarction possible 010 (A)
1 Sudden cardiac arrest 418 (A)

"

Group Survival patients Dead patients Total
Group A 269 (51.2) 5 (41.7) 274
Group B 256 (48.8) 7 (58.3) 263
Total 525 12 537

"

Time point Group A Group B t P 95% confidence interval
n Score (x±s) n Score (x±s) Lower Upper
Day 7 271 5.97±3.69 262 6.34±4.39 –1.052 0.293 –1.06 0.32
Day 14 270 4.63±3.63 260 5.28±4.79 –1.780 0.076 –1.39 0.07
Day 21 269 3.65±3.42 260 4.52±4.81 –2.397 0.017 –1.59 –0.16

"

Time point Group BI [Case (%)] χ2 P OR 95% confidence interval
<75 ≥75 ower Upper
Day 21 Group A 103 (38.3) 166 (61.7) 0.73 0.39 0.86 0.61 1.22
Group B 109 (41.9) 151 (58.1)
Day 60 Group A 72 (26.8) 197 (73.2) 1.22 0.27 0.81 0.55 1.18
Group B 80 (31.1) 177 (68.9)
Day 90 Group A 50 (18.6) 219 (81.4) 4.79 0.03 0.63 0.42 0.96
Group B 68 (26.6) 188 (73.4)

"

Time point Group Patients with different GOS scores [Cases (%)] Total number R Z P
1 2 3-4 5
Day 21 Group A 125 (45.8) 94 (34.4) 50 (18.3) 4 (1.5) 273 257.74 –1.760 0.078
Group B 96 (36.5) 111 (42.2) 53 (20.2) 3 (1.1) 263 279.67
Day 60 Group A 150 (54.7) 85 (31.0) 34 (12.4) 5 (1.8) 274 251.81 –2.857 0.004
Group B 114 (43.3) 92 (35.0) 51 (19.4) 6 (2.3) 263 286.91
Day 90 Group A 163 (59.5) 78 (28.5) 28 (10.2) 5 (1.8) 274 253.69 –2.596 0.009
Group B 130 (49.4) 83 (31.6) 43 (16.3) 7 (2.7) 263 284.95

"

Time point Group Patients with different mRS scores [Cases (%)] Total number R Z P
0-1 2-3 4-5 Dead
Day 21 Group A 144 (52.7) 86 (31.5) 39 (14.3) 4 (1.5) 273 262.04 –1.078 0.281
Group B 123 (46.8) 99 (37.6) 38 (14.4) 3 (1.1) 263 275.21
Day 60 Group A 162 (59.1) 85 (31.0) 22 (8.0) 5 (1.8) 274 260.63 –1.438 0.150
Group B 141 (53.6) 87 (33.1) 29 (11.0) 6 (2.3) 263 277.72
Day 90 Group A 186 (67.9) 66 (24.1) 17 (6.2) 5 (1.8) 274 256.90 –2.169 0.030
Group B 156 (59.3) 75 (28.5) 25 (9.5) 7 (2.7) 263 281.60

"

Time point Group A Group B t P 95% confidence interval
n Score (x±s) n Score (x±s) Lower Upper
Day 14 270 169.94±42.29 260 168.04±43.44 0.512 0.609 –5.41 9.22
Day 21 269 183.65±42.30 260 179.82±45.48 1.004 0.316 –3.67 11.33
Day 60 269 195.54±39.06 257 190.72±42.78 1.350 0.178 –2.19 11.83
Day 90 268 202.19±37.65 256 195.75±42.07 1.849 0.065 –0.40 13.29

"

Time point Group A Group B t P 95% confidence interval
n Score (x±s) n Score (x±s) Lower Upper
Baseline 274 11.00±5.76 263 9.99±5.47 2.085 0.038 0.06 1.96
Day 7 271 9.02±5.64 262 8.98±5.29 0.087 0.931 –0.89 0.97
Day 14 270 6.86±5.20 260 7.55±5.35 –1.516 0.13 –1.59 0.21
Day 21 269 5.44±4.30 260 6.28±5.23 –2.027 0.043 –1.66 –0.03
Day 60 269 4.13±3.61 257 5.17±4.94 –2.75 0.006 –1.79 –0.30
Day 90 269 3.30±3.06 256 4.47±4.04 –3.717 0.001 –1.78 –0.55

"

Time point Group A Group B t P 95% confidence interval
n Score (x±s) n Score (x±s) Lower Upper
Baseline 274 10.09±5.95 263 9.51±5.55 1.17 0.242 –0.39 1.56
Day 7 271 8.37±5.57 262 8.46±5.34 –0.188 0.851 –1.02 0.84
Day 14 270 6.25±5.00 260 7.05±5.44 –1.768 0.078 –1.69 0.09
Day 21 269 4.94±4.31 260 5.77±5.09 –2.042 0.042 –1.64 –0.03
Day 60 269 3.72±3.53 257 4.78±4.96 –2.794 0.005 –1.79 –0.31
Day 90 269 2.86±3.06 256 4.05±4.06 –3.787 0.001 –1.81 –0.57

"

Time point Regression coefficient Model checking CMH test
β0 β1 β2 β3 β4 χ2 P χ2CMH P
Day 21 0.76 -0.15 14.5 0.00 0.17 0.68
Day 60 1.31 -0.09 8.39 0.00 2.10 0.15
Day 90 1.51 -0.09 7.99 0.01 4.23 0.04

"

ID Name of the hospital Person in charge N Group A Group B
n Drop-off Exclude Death PPS n Drop-off Exclude Death PPS
(1) Guangdong Provincial Hospital of Traditional Chinese Medicine Yan HUANG,
Ye-feng CAI
60 21 1 1 1 18 39 2 2 1 34
(2) The First Affiliated Hospital of
Henan College of Chinese Medicine
Xin-zhi WANG, Bao-liang WANG 46 24 0 1 0 23 22 2 0 0 20
(3) People's Hospital of Sichuan
Province
You-song YANG 47 21 3 0 0 18 26 4 1 2 19
(4) Longhua Hospital, Shanghai Jian PEI 52 29 4 0 2 23 23 2 0 0 21
(5) Zhejiang Provincial Hospital of
Chinese Medicine
Mei CHEN 10 1 0 0 9 11 2 0 0 9
(6) Dongzhimen Hospital, Beijing Yi-huai ZOU 21 8 3 0 0 5 13 3 1 0 9
(7) Huashan Hospital, Shanghai Qiang DONG 14 7 4 1 0 2 7 2 0 0 5
(8) Zhongshan Hospital, Shanghai Wei FAN 19 7 0 0 0 7 12 0 0 1 11
(9) The Affiliated Hospital of Hubei
College of Chinese Medicine
Ming-jiu DONG 30 17 1 0 0 16 13 0 0 0 13
(10) Fuoshan Hospital of Traditional
Chinese Medicine
Wei GU 32 12 0 0 0 12 20 3 0 0 17
(11) The First Affiliated Hospital, Guangxi University of Chinese Medicine Shao-long DONG 17 8 0 1 0 7 9 0 1 1 7
(12) Jinan TCM Hospital of Shandong
Province
Xiao-lan CAO,
Shi-ke ZHAO
31 17 2 0 0 15 14 1 0 0 13
(13) Shanghai Hospital of Traditional
Chinese Medicine
Yi LIU 11 9 0 0 0 9 2 0 0 0 2
(14) Shuguang Hospital, Shanghai Jiang-lei WEI 28 21 0 0 1 20 7 0 1 0 6
(15) Yueyang Hospital of Integrated
Traditional Chinese and Western
Medicine, Shanghai
Tao WANG 24 13 0 0 0 13 11 1 1 0 9
(16) The Affiliated Hospital of Shaanxi
College of Chinese Medicine
Jun LI 33 18 2 0 1 15 15 2 0 0 13
(17) Xinjiang District Hospital of Traditional Chinese Medicine Dong-qing AN 20 7 2 0 0 5 13 1 1 1 10
(18) The Second Affiliated Hospital of Sun Yat-sen University Jun LIU 24 10 0 0 0 10 14 1 1 0 12
(19) Zhongshan City Hospital of Traditional Chinese Medicine Ji-lin TAN 37 25 2 1 0 22 12 1 1 0 10
(20) Ruikang Hospital, Guangxi
University of Chinese Medicine
Ding REN 12 6 0 0 0 6 6 1 0 0 5
(21) The Second Affiliated Hospital of
Wenzhou Medical School
Xiao-tong WANG 16 10 0 0 0 10 6 1 0 0 5
(22) Taizhou City Hospital of
Traditional Chinese Medicine Total
Yuan-tao CHEN 11 4 0 0 0 4 7 0 0 1 6
606 304 25 5 5 269 302 29 10 7 256

"

Name of the department Person in charge
(1) DME Center, Guangdong Provincial Hospital of Traditional Chinese Medicine Ai-hua OU
(2) DME Center, Guangzhou University of Chinese Medicine Wei-xiong LIANG
(3) Jiangsu Provincial Hospital of Chinese Medicine Ning-ning XIONG, Jian-dong ZOU
[1] Rao ML , Bureau for Disease Control of Chinese Ministry of Health, Branch Society of Neurology of Chinese Medical Association. China guidelines for prevention and treatment of cerebrovascular diseases(2nd ed)[M]. Beijing: People’s Medical Publishing House, 2005,( 2nd ed):1-3
饶明俐 , 卫生部疾病预防控制局, 中华医学会神经病学分会. 中国脑血管病防治指南(第2版)[M]. 北京: 人民卫生出版社, 2005,( 第2版):1-3
[2] Diagnostic essentials of all kinds of cerebral vascular diseases[J]. Zhonghua Shen Jing Ke Za Zhi, 1996,29(6):379
各类脑血管疾病诊断要点[J]. 中华神经科杂志, 1996,29(6):379
[3] Coordinating Group of the State Administration of Traditional Chinese Medicine. Criteria for diagnosis and treatment effect evaluation of stroke[J]. Beijing Zhong Yi Yao Da Xue Xue Bao, 1996,19(1):55-56
国家中医药管理局脑病急症协作组. 中风病诊断与疗效评定标准(试行)[J]. 北京中医药大学学报, 1996,19(1):55-56
[4] Huang PX, Huang Y, Lu M, Du BX, Liang WX, Ou AH, Cai YF, Guo JW, Xi ZQ, Chen M, Dong SL, Lu H, Li J, Dong GR, Li HC, Zhao JJ, Liu MC . Treatment of acute intracerebral hemorrhage with a comprehensive protocol of integrated Chinese and Western medicine[J]. Zhongguo Zhong Xi Yi Jie He Za Zhi, 2006,26(7):590-593
黄培新, 黄燕, 卢明, 杜宝新, 梁伟雄, 欧爱华, 蔡业峰, 郭建文, 奚肇庆, 陈眉, 董少龙, 陆晖, 李军, 东贵荣, 李海聪, 赵建军, 刘茂才 . 急性脑出血中西医结合综合治疗方案研究[J]. 中国中西医结合杂志, 2006,26(7):590-593
[5] Cai YF, Jia Z, Zhang XC, Zhao YQ, Wang LX, Guo JW, Ou AH, Liang WX, Pei J, Huang Y, Huang PX . Study on multi-center investigation of the Chinese version of National Institutes of Health Stroke Scale[J]. Beijing Zhong Yi Yao Da Xue Xue Bao, 2008,31(7):494-501
蔡业峰, 贾真, 张新春, 招远祺, 王立新, 郭建文, 欧爱华, 梁伟雄, 裴建, 黄燕, 黄培新 . 美国国立卫生院卒中量表(NIHSS)中文版多中心测评研究——附537例缺血中风多中心多时点临床测评研究[J]. 北京中医药大学学报, 2008,31(7):494-501
[6] Teasdale G, Jennett B . Assessment of coma and impaired consciousness[J]. A practical scale. Lancet, 1974,2(7872):81-84
[7] Adams HP Jr, Adams RJ , Brott T, del Zoppo GJ, Furlan A, Goldstein LB, Grubb RL, Higashida R, Kidwell C, Kwiatkowski TG, Marler JR, Hademenos GJ ; Stroke Council of the American Stroke Association. Guidelines for the early management of patients with ischemic stroke: a scientific statement from the Stroke Council of the American Stroke Association[J]. Stroke, 2003,34(4):1056-1083
doi: 10.1161/01.STR.0000064841.47697.22
[8] Cai YF, Zhang XC, Guo JW, Ou AH, Ling WX, Huang Y, Huang PX . Meta-analysis of randomized controlled studies of Erigeron breviscapus injection for treatment of cerebral infarction[J]. Guangdong Yi Xue, 2007,28(8):1335-1337
蔡业峰, 张新春, 郭建文, 欧爱华, 梁伟雄, 黄燕, 黄培新 . 灯盏细辛注射液治疗缺血性中风急性期随机对照试验的Meta分析[J]. 广东医学, 2007,28(8):1335-1337
[9] Loewen SC , Anderson BA. Predictors of stroke outcome using objective measurement scales[J]. Stroke, 1990, 21(): 78-81
[10] Bonita R, Beaglehole R . Recovery of motor function after stroke[J]. Stroke, 1988,19(12):497-1500
Bonita R, Beaglehole R . Recovery of motor function after stroke[J]. Stroke, 1988,19(12):1497-1500
[11] Jennett B . Development of Glasgow coma and outcome scales[J]. Nepal J Neuroscience,2005, 2: 24-28
doi: 10.3126/njn.v2i1.19978
[12] Cai YF, Jia Z, He CX, You JS, Bai XX, Guo JW, Ou AH, Liang WX, Pei J, Huang Y, Huang PX . Study on multi-center investigation of the Chinese version of SSQOL[J]. Zhongguo Zhong Yi Ji Chu Yi Xue Za Zhi, 2007,13(7):551-553
蔡业峰, 贾真, 何春霞, 尤劲松, 白小欣, 郭建文, 欧爱华, 梁伟雄, 裴建, 黄燕, 黄培新 . 卒中专门生存质量量表(SSQOL)中文版多中心测评研究——附537例缺血中风多中心多时点临床测评研究[J]. 中国中医基础医学杂志, 2007,13(7):551-553
[13] Zhao YQ, Wen LL, Cai YF . Multi-central evaluation on stroke syndrome of TCM[J]. Henan Zhong Yi, 2008,28(7):38-40
招远祺, 文龙龙, 蔡业峰 . 中风中医症征积分表多中心测评[J]. 河南中医, 2008,28(7):38-40
[14] Xiao SP, Huang PX, Luo XD . Controlled study on combined treatment of TCM in treating acute cerebral infarction[J]. Zhongguo Zhong Yi Ji Zheng, 2002,11(3):160-161
肖书平, 黄培新, 雒晓东 . 脑梗塞急性期中医综合治疗对比研究[J]. 中国中医急症, 2002,11(3):160-161
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