Wednesday, May 30, 2012

Dan Shen agents after an ischaemic stroke - Chinese TCM

From the University of Maryland School of Medicine.  Nothing here is very scientific, although I did like the snake venom.

The University of Maryland and the Center for Integrative Medicine make no warranties, express or implied, about the value or utility for any purpose of the information and resources contained herein.


Dan Shen agents after an ischaemic stroke - Chinese TCM

Dan Shen agents are well accepted by Chinese doctors and they are one of the most frequently used Chinese herbal medicines in the treatment of acute ischaemic stroke, heart disease and major (systemic) blood flow disorders. In stroke, the intent is to improve the local brain blood circulation and limit the nerve and brain cell damage caused by an acute lack of blood flow.
Dan Shen agents are given as tablets or injections, often mixed with other traditional Chinese herbal medicines (as Compound Dan Shen agents). The main botanical family in Dan Shen (red sage) is Radix Salviae Miltiorrhizae. Compound Dan Shen agents also contain other Chinese herbal medicines such as Ligni dalbergiae odoriferae, Sanqi, and Bingpian to promote the curative effects and decrease the adverse effects of Dan Shen. The Compound Dan Shen dropping pill is one of these.

What the synthesised research says

Compound Dan Shen injection and Compound Dan Shen dropping pill may improve neurological impairment caused by an acute ischaemic stroke. This conclusion is based on the results of three trials that looked for an improvement in neurological deficit at the end of treatment. This is too few trials with too few participants to have a clear measure of any benefit.
The methodological quality of the included trials was not scientifically rigorous enough to know whether Dan Shen agents help people with stroke and there were too few patients to draw reliable conclusions. The most important thing to people after a stroke is their ability to go about activities of daily living rather than their neurological deficits; which was not measured in these trials. The follow up was also short, approximately one month, even though spontaneous recovery does not plateau until some 5 to 6 months.

How it was tested

The researchers made a thorough search of the medical literature and found only three controlled trials with 304 acute ischaemic stroke patients. All the trials were conducted in China. The average age of patients, more men than women, was between 56 and 62 years.
Two trials combined Compound Dan Shen injection with snake venom in the treatment group and only used snake venom in the control group over 28 days of treatment; all patients also received routine treatment. The doses of snake venom and Compound Dan Shen injection were 0.25 to 0.75 U and 20 ml respectively.
Oral Compound Dan Shen dropping pill was used in one study. It was given three times daily for 28 days. There was no evidence of a difference of effect between this form of Dan Shen and injection with snake venom. 
The timing of the start of treatment after stroke onset was not reported. No deaths were reported within the first two weeks of treatment or during the following 21 to 28 days. This suggests the strokes were not severe.

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