From 2007. 1000 years of anecdotes doesn't scientifically prove anything.
http://stroke.ahajournals.org/content/38/6/1734.full.pdf
The lack of effective and widely applicable pharmacological
treatments for ischemic stroke patients may
explain a growing interest in traditional medicines, for
which extensive observational and anecdotal experience has
accumulated over the past thousand years. The World Health
Organization (WHO) defines traditional medicine as “health
practices, approaches, knowledge and beliefs incorporating
plant, animal and mineral based medicines, spiritual therapies,
manual techniques and exercises, applied singularly or
in combination to treat, diagnose and prevent illnesses or
maintain well-being”.1 Unlike Western medicine, which focuses
on disease, traditional medicine takes the approach that
the body provides external clues to an internal imbalance that
can be addressed by interventions such as herbs and acupuncture
(holistic treatment approach).2 According to a 2003
WHO report,1 traditional medicine is very popular in all
developing countries, and its use is rapidly increasing in
industrialized countries. For example, traditional herbal preparations
account for 30% to 50% of the total medicinal
consumption in China. In Europe, North America and other
industrialized regions, over 50% of the population have used
traditional medicine at least once. The global market for
herbal medicines currently stands at over US $60 billion
annually and is growing steadily.1
In recent years, several reviews have been published on the
effect and potential benefits of traditional Eastern medicine in
stroke.3–7 It has been suggested that some herbal medicines,
or their products, may improve microcirculation in the
brain,4,8 protect against ischemic reperfusion injury,8,9 possess
neuroprotective properties3,4 and inhibit apoptosis,10 thus
justifying their use in ischemic stroke patients. However,
unlike industrially manufactured pharmacological drugs used
in Western medicine, the active (potent) components of
herbal medicines often have not been specified and measured
precisely, although there have been recent attempts to regulate
dosages and use of these medicines by some governments.
This inevitably leads to variations between formulations
and batches of the same herbal medicines and, as a
consequence, to difficulties in the evaluation and comparison
of the results of trials testing these medicines. The issue is
further complicated by the fact that most publications on the
efficacy of herbal medicines are published locally in non-
English languages, thus making their retrieval and appraisal
very difficult for specialists outside that region. Therefore,
any efforts to systematically analyze and present the existing
clinical evidence on the efficacy of herbal medicines to
English-speaking audiences should be welcome.
In this issue of Stroke, Wu and colleagues11 present the first
systematic review of the efficacy and safety of 59 Traditional
Chinese Patent Medicine* (TCPM) drugs listed in the Chinese
National Essential Drug list (2004) and commonly used
in China for ischemic stroke patients. The authors tried to
apply Cochrane systematic review methodology to their
review, and chose death/dependency and adverse events at 3
months of follow-up as the primary outcome measures. Six
reviewers independently selected the studies and extracted
the data, which reduced the potential for bias and errors. Their
thorough literature search (1966 –2005) of both published and
unpublished Chinese and non-Chinese language literature
yielded 5 definitely randomized, 115 possibly randomized
and 71 nonrandomized controlled clinical trials (19 338
patients in total) conducted in China to evaluate the efficacy
of 22 TCPM drugs (no eligible trials were identified for the
remaining 37 TCPM drugs). The authors correctly stress the
poor methodological quality of almost all (97%) the clinical
trials selected for the review. The pooled analysis of trials
(randomized and nonrandomized combined) showed a strikingly
large and significant (odds ratio [OR] 3.4, 95% CI 3.1
to 3.6) positive effect of almost all TCPM treatments (21 of
22) analyzed in improving neurological impairment (over
3-fold improvement compared with controls) and an extremely
low (3%) case-fatality in 10 trials that reported death
outcome, again, in favor of the treatment group (OR 0.5, 95%
CI 0.2 to 0.9). However, only 2 trials (both with adequate
concealment of randomization) reported primary outcomes
(death or dependency), and no difference was found in these
trials between treatment and control groups. The extremely
low case-fatality is most likely to be explained by a highly
selected group of patients included in these trials, although
reporting bias (underreporting) cannot be excluded. No statistically
significant difference in adverse events between
treatment and control groups on 14 TCPM analyzed was
found in 38 trials that reported adverse events, although it
remains unclear whether adverse events were registered but
not reported in the remaining 57 trials included in the analysis
of adverse events.
A couple more pages at the link.
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