Xuesaitong injection as one adjuvant treatment of acute cerebral infarction: a systematic review and meta-analysis

Background: Xuesaitong Injection (XST) is one of the most commonly used medicines for treating acute cerebral infarction (ACI) in China. However, compared to the conventional therapy with western medicines (WM), the effectiveness and safety of XST as an adjuvant treatment for ACI needs to be systematically reviewed. Methods: Randomized controlled trials (RCTs) comparing XST & WM with WM for treating ACI were included. Two reviewers independently extracted data. The Cochrane table of Risk of Bias was used to assess the quality of the included studies, and a meta-analysis was conducted using Review Manager 5.2. Results: 23 RCTs, involving 2196 participants, were included in this study. Methodological quality was not well. The meta-analysis indicated that compared to WM, the combined use of XST and WM was more effective in terms of the total clinical effective rate [RR = 1.21, 95% CI (1.16, 1.25), P < 0.00001], neurological deficit scores [MD = -3.31, 95% CI (-4.10, -2.52), P < 0.00001], and plasma viscosity [MD = -0.13, 95% CI (-0.15, -0.11), P < 0.00001]. The included studies reported 37 adverse events, 17 of which belonged to experimental groups. Conclusion: XST combined with WM appeared to be effective for ACI. However, the evidence of XST for treating ACI should be carefully interpreted due to the small sample size, limited number of trials, and unsatisfactory quality of research.