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急性脳卒中に対するTongxinluo(中国伝統医薬品)カプセル

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Abstract

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Background

Tongxinluo capsules are a compound of Chinese traditional medicine which contain substances that are thought to have vasodilatory, antiplatelet, anticoagulant, thrombolytic and even lipid‐lowering properties, and therefore may improve outcome after acute ischaemic stroke. To date the evidence of its effect has not been systematically reviewed, making it difficult to derive robust conclusions about its actual benefits, and indeed, possible harms.

Objectives

To assess the effectiveness and possible harms of tongxinluo capsule for acute cerebral infarction compared with control.

Search methods

We searched the Cochrane Stroke Group trials register (last searched on 24 January 2008) the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 4, 2007), MEDLINE (1995 to 2006), EMBASE (1995 to 2006), China National Knowledge Infrastructure (CNKI, 1994 to 2006), CBM (Chinese Biomedical Database) (1995 to 2006), Current Controlled Trials (www.controlled‐trials.com), National Research Register (http://www.update‐software.com/national/). We handsearched 30 journals (1995 to 2006), and contacted drug companies and the principal of included trials.

Selection criteria

Randomised controlled trials comparing tongxinluo with placebo or open control (or tongxinluo plus standard therapy versus standard therapy alone) in people with definite acute stroke. We excluded trials if they sought to recruit patients with transient ischaemic attacks (TIA), intracerebral haemorrhage, heart failure, or renal failure.

Data collection and analysis

Two review authors extracted data and assessed trial quality.

Main results

Only two poor quality studies with a total of 232 participants were included in this review. Neither study reported any of our pre‐specified outcomes, so no reliable estimate of the effect of treatment on major clinical outcomes could be obtained.

Authors' conclusions

It was not possible to reliably determine whether tongxinluo has a favourable or unfavourable effect in acute ischaemic stroke. High quality trials are required to assess the efficacy and safety of tongxinluo capsule for acute ischaemic stroke.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

一般語訳

急性脳卒中に対するTongxinluo(中国伝統医薬品)カプセル

中国伝統医学は、しばしば急性虚血性脳卒中患者の治療に使用される。著者らは、急性虚血性脳卒中患者の治療に使用されるtongxinluoカプセルの潜在的な利益と安全性についてシステマティックレビューを行った。合計232例が参加した2件の関連試験を特定したが、本治療の効果については信頼性のあるエビデンスは得られなかった。脳卒中患者を対象とした、tongxinluoカプセルの効果を明らかにするために質の高い大規模ランダム化比較試験(randomised controlled trials :RCT)の実施が必要である。