Inkgo Biloba-like Injection of Traditional Chinese Medicine for Acute Ischemic Stroke Net Meta-Analysis of Validity and Safety

Objective To systematically evaluate the efficacy and safety of Ginkgo biloba-based herbal injections for the treatment of acute ischemic stroke (AIS). Methods SinoMed, VIP, Wan Fang Data, CNKI, Pub Med, EMbase, The Cochrane Library, and Web of Science databases were searched to collect randomized controlled trials (RCTs) with the efficacy and safety of Ginkgo biloba-based herbal injections for the treatment of AIS, and the search timeframe was from the establishment of the database to the end of December 2022. December 2022, the time frame of the search was from the establishment of the database to December. Literature screening, extraction of information, quality and risk of bias evaluation were independently operated by 2 researchers, and after the extracted data were used to create a database using Excel, reticulated Meta-analysis was performed using Stata 16.0 software. Results A total of 148 RCTs were included, and a total of 6 ginkgo biloba herbal injections were included: shuxinin injection combined with conventional western medicine (SXN + CT), ginkgoloderm injection combined with conventional western medicine (GD + CT), ginkgo biloba leaf extract injection combined with conventional western medicine (EGb + CT), ginkgolide injection combined with conventional western medicine (GK + CT), ginkgolides diterpene lactone Glucosamine Injection combined with Western medicine conventional treatment (DGMI + CT), Apricot Ligustrum Sodium Chloride Injection combined with Western medicine conventional treatment (FT + CT) and Western medicine conventional treatment (CT). The results of reticulated Meta-analysis showed that: 1) In terms of enhancing the effective rate, the cumulative probability was ranked as follows: GK + CT (74.7%) > SXN + CT (69.7%) > DGMI + CT (68.8%) > FT + CT (64.1%) > DM + CT (38.5%) > EGb + CT (33.7%) > CT (5%). 2) In terms of NIHSS scores, the cumulative probability ranking was: DGMI + CT (71.9%) > GD + CT (68.9%) > SXN + CT (62.3%) > EGb + CT (57.9%) > FT + CT (44.6%) > GK + CT (43.5%) > CT (1%). (iii) In terms of the Barthel Index, the cumulative probability was ranked as SXN + CT (98.2%) > GD + CT (83.3%) > GK + CT (57.4%) > FT + CT (48.5%) > EGb + CT (35.9%) > DGMI + CT (26.6%) > CT (0%). Conclusion Current evidence suggests that GK + CT is more focused on enhancing clinical effectiveness; DGMI + CT is more focused on reducing NIHSS scores; and SXN + CT is more focused on enhancing BI index. The efficacy of Ginkgo biloba-based herbal injections combined with conventional Western medicine in the treatment of AIS was better than conventional Western medicine in all cases, and the conclusions need to be validated by more high-quality RCTs due to the limitations of the quality and quantity of literature included in the study.