Panax notoginseng saponins in the treatment of ischemic stroke：Meta-analysis and systematic review

Background Panax notoginseng saponins(PNS)preparation is one of the most commonly used Chinese medicines for treating acute ischemic stroke༈AIS༉in China. However, compared with the traditional routine western medicine༈WM༉treatment, the effectiveness and safety of PNS as an auxiliary treatment need to be systematically reviewed. Methods The deadline for inclusion is before June 30, 2024. Comparing the randomized controlled trials(RCT)of PNS༈Include Xuesaitong and Xueshuantong༉combined with WM and WM alone in the treatment of AIS, the two researchers independently extracted the data, used Cochrane Bias Risk Scale to evaluate the quality of the included studies, and used RevMan5.3 for meta-analysis. Results In this study, 15 RCT involving 1499 participants were included, and the treatment of patients was evaluated by the National Institutes of Health Stroke Scale(NIHSS). Meta-analysis shows that adding PNS as an auxiliary treatment is more effective in clinical total efficiency [ RR  = 1.22, 95%CI ༈1.17–1.29༉, P  < 0.00001] compared with simple WM treatment. The included studies reported 49 cases of adverse reactions༈ADR༉, of which 27 cases occurred in the experimental group. Conclusion PNS combined with WM is effective in treating AIS, which suggests that it may be a safe and effective alternative and can better improve neurological symptoms. However, due to the limitations of low methodological quality and small sample size, it is suggested that more high-quality RCT are still needed to verify the safety of PNS preparation.