Effectiveness and Safety of Blending Traditional Chinese Medicine With Western Medicine for Enhanced Secondary Stroke Prevention: A Meta-analysis of RCTs

Abstract

Introduction

To conduct a comprehensive evaluation of the efficacy and safety of combining traditional Chinese medication (TCM) with Western medication to improve secondary stroke prevention. Through meticulous analysis, we investigate the combined approach's potential to yield superior outcomes compared to stand-alone Western medical treatments.

Methods

We rigorously searched for RCTs on secondary stroke prevention using TCM and Western medicine (WM) from database creation to October 2023. PubMed, EMBASE, Cochrane Library, CNKI, SinoMed, WanFang, and VIP yielded pertinent studies. Stata 16.0 was used for comprehensive meta-analyses with predetermined inclusion and exclusion criteria.

Results

This thorough review comprised 40 randomised controlled trials with 3 478 treatment and 3 396 control participants. Combining TCM and WM significantly enhances secondary stroke prevention rates compared to WM alone (OR = 0.83, 95% CI: 0.55–1.12, P < 0.001). Compared to Western medical treatment for secondary stroke prevention, the integrated strategy significantly lowered the National Institutes of Health Stroke Scale score (OR = -0.62, 95% CI: -0.89, -0.35, P < 0.001). Furthermore, this integrated strategy effectively reduced stroke recurrence rates compared to Western medical therapy alone (OR = -0.94, 95% CI: -1.10, -0.76, P < 0.001). The rate of adverse reactions was not significantly different between Western medical treatment and integrated TCM (OR = 0.01, 95% CI: −0.18, 0.05, P = 0.131).

Conclusions

The evidence shows that combining TCM and Western therapy improves secondary stroke prevention. Besides improving clinical effectiveness, this integrated approach may reduce stroke recurrence. These findings strongly support the widespread use of this integrated approach in clinical practice.