Efficacy and safety of Di-Tan Decoction for treating post-stroke neurological disorders: a systematic review and Meta-analysis of randomized clinical trials.
10.1016/S1875-5364(21)60035-3
- Author:
Hyuk-Ku KWON
1
;
Ting ZHANG
2
;
Xuan Gao WU
2
;
Jing Yi QIU
2
;
Sunmin PARK
3
Author Information
1. Dept. of Environmental Engineering, Hoseo University, Asan, South Korea.
2. Dept. of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, South Korea.
3. Dept. of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, South Korea. Electronic address: smpark@hoseo.edu.
- Publication Type:Review
- Keywords:
Adverse effects;
Di-Tan Decoction;
Post-stroke;
Randomized clinical trials;
Risk of bias
- From:
Chinese Journal of Natural Medicines (English Ed.)
2021;19(5):339-350
- CountryChina
- Language:English
-
Abstract:
The management of post-stroke complications plays an important role in the quality of life. Di-Tan Decoction (DTD; ) is a widely used traditional Chinese medicine. This study incorporated systematic review and meta-analysis to evaluate the efficacy of DTD in post-stroke neurological disorders. Randomized clinical trials (RCTs) were searched from English, Chinese and Korean electronic medical databases, by including the keywords "Di-Tan Tang", "Di-Tan Decoction", "Scour Phlegm Decoction", "stroke", and "RCT. Each RCT included control (placebo, conventional therapy, or Western medicine) and experimental (DTD treatment) groups. For patients inflicted with stroke for 1-6 weeks, the outcomes of post-stroke neurological disorders were measured by scales for post-stroke symptoms and were classified as "completely healed", "markedly effective", "effective" and "ineffective". Totally, 11 RCTs (n = 490 controls and n = 502 DTD subjects) were selected from 210 articles identified in the initial search. A meta-analysis of evaluation criteria in post-stroke symptoms revealed that the overall odds ratio (ORs) for alleviating post-stroke neurological disorders were 0.30-fold lower (95% CI = 0.21-0.43) in the DTD group than the control (Western medicine) group (P < 0.000 01). Moreover, regardless of the type of stroke diagnostic scale applied (including NFA, HDS, and NIHSS), the overall post-stroke symptoms determined were less severe in the DTD group (n = 219) than the control group (n = 217). No adverse effects of DTD were observed in the 11 RCTs reviewed. All 11 studies used an appropriate method for randomization of subjects to evaluate the risk of bias (ROB), and 7 studies included allocation concealment as well as blinding of patients and practitioners. High-risk ROB was included in 6 RCTs. No significant publication bias was derived from the funnel plot. Our results indicate that the administration of DTD alone, and DTD in combination with Western medicine, exert greater efficacy for post-stroke complication therapy, than Western medicine administered alone. More rigorous and regulated studies are required to confirm the therapeutic efficacy of DTD for post-stroke neurological disorders. disorders.
