12 kinds of Chinese medicine injections for acute cerebral infarction: protocol for a systematic review and network meta-analysis

Introduction
Chinese medicine injections (CMIs) are widely applied to the treatment of acute cerebral infarction (ACI) in China. However, there are very few head-to-head comparative trials to determine the relative efficacy between different CMIs. It is reported that 20 kinds of CMIs are often used for treating cerebral infarction. Due to the fact that various CMIs are used in clinic, it’s difficult for clinicians to choose the optimal CMIs for patients with ACI. We plan to conduct a network meta-analysis (NMA) to compare the efficacy of 12 kinds of different CMIs, including direct and indirect comparisons between CMIs, aiming to provide the best currently available evidence base to guide the choice about CMIs treatment for patients with ACI.
Methods
A systematic and comprehensive search will be performed from inception to August 2018 in both English and Chinese databases, involving PubMed ,Cochrane Library, Embase, China National Knowledge Infrastructure Database (CNKI), Wanfang Database, Chongqing VIP information (CQVIP), and SinoMed. Randomized controlled trial (RCT) related to CMIs in the treatment of ACI will be included. Quality of included literature will be assessed according to the risk of bias tool of Cochrane Handbook 5.1.0. The GRADE approach will be used to rate the quality of evidence of estimates derived from NMA. Data analysis will be conducted by using STATA 13.1.
Results
This systematic review and NMA is to summarise the direct and indirect evidence for 12 kinds of different CMIs to manage ACI, and to rank these CMIs for CMIs treatment of patients with ACI. The findings of this NMA will be reported according to PRISMA-NMA statement.
Conclusion
This study will offer helpful and informative evaluations of current CMIs for ACI. The results will inform clinicians, provide optimal CMI, establish evidence gaps, and identify promising CMIs for evaluation in future trials.