Background: While mailuoning injection has been regarded as having a potential role in treating patients with ischemic stroke, the reported findings are inconsistent. These discrepancies may be a direct result of variations in the measurement of ischemic stroke or definitions of response to mailuoning injection treatment.
Objectives: To assess the clinical effectiveness of mailuoning injection for patients with ischemic stroke.
Methods: We searched the Cochrane Library, MEDLINE, Embase, CBM, Chinese TCM Database CNKI, VIP and WanFang Database, for randomised controlled trials (RCTs) of mailuoning injection and conventional treatment up to 31 January 2016. Studies in which patients suffered intracerebral haemorrhagic stroke were excluded. Two reviewers identified clinical trials for inclusion, assessed quality, and extracted data independently.
Results: We identified eight relevant RCTs involving a total of 701 participants, who were divided into mailuoning injection groups (368 participants) and conventional treatment groups (333 participants). The results of meta-analysis showed that the mailuoning injection group experienced a significant difference in clinical effects after four weeks compared to the conventional treatment group (odd ratio (OR) 0.25, 95% confidence interval (CI) 0.12 to 0.52), as well as NPNI (number of patients with neurological improvement) after four weeks (OR 0.24, 95% CI 0.12 to 0.45) (Figure1). The effect on the activity of daily living and neurological function deficits scale could not be estimated in this analysis. Applying the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach, the overall quality of evidence in this review was graded as low to moderate (Tables 1 and 2).
Conclusions: Given the moderate quality of the evidence, we tentatively recommend mailuoning injection (if available) as a therapy for ischemic stroke, though more high-quality randomised controlled trials are needed. Moreover, the safety as well as long-term outcomes of mailuoning injection for ischemic stroke should take priority in further trials.