Wen Dan Decoction for hemorrhagic stroke and ischemic stroke

• Wen Dan Decoction (WDD) has been used as an herbal medicine since 625 AD.
• WDD displays therapeutic benefits for ischemic stroke.
• WDD displays therapeutic benefits for hemorrhagic stroke.
• WDD displays therapeutic benefits for mixed hemorrhagic and ischemic stroke.
• WDD displays dual actions on both brain hemorrhage and ischemia.

SummaryObjectiveThe use of traditional Chinese medicine (TCM) in stroke is increasing worldwide. Here we report the existing clinical evidence of the Pinellia Ternata containing formula Wen Dan Decoction (WDD) for the treatment of ischemic stroke and hemorrhagic stroke.MethodsPubMed, CNKI, Wan Fang database, Cochrane Library and online Clinical Trial Registry were searched up to 26 February 2013 for randomized, controlled clinical trials (RCTs) using WDD as intervention versus Western conventional medicine as control to treat stroke. Clinical outcomes were improvement of the Neurological Functional Deficit Scores (NFDS) and overall therapeutic efficacy rates including rate of cure. Meta-regression analysis using Hedges’g was performed for RCTs with significant heterogeneity.ResultsA total of 22 RCTs of ischemic stroke and 4 RCTs of hemorrhagic stroke, involving 2214 patients (1167 used WDD), met our inclusion criteria. Meta-analysis of the 13 RCTs reporting NFDS improvement favored WDD over the control (mean difference = −3.40, 95% confidence intervals [CI] = [−4.64, −2.15]). Rate of overall therapeutic efficacy (odds ratio [OR] = 3.39, 95%CI = [1.81, 6.37]) for hemorrhagic stroke were significantly higher in WDD treated patients than the control subjects. In the 1898 patients with ischemic stroke, WDD medication also achieved higher rates of cure (OR = 2.22, 95%CI = [1.66, 2.97]) and overall therapeutic efficacy (OR = 3.31, 95%CI = [2.54, 4.31]) than the conventional treatment.ConclusionsWDD displays benefits on improvement of neurological function and overall therapeutic efficacy in post-stroke patients. TCM such as WDD may serve as a therapeutic tool of dual actions to explore the common mechanisms underlying cerebral hemorrhage and ischemia.