Herbs have been used in traditional Chinese medicine for centuries, but the effectiveness of many of these treatments remain unknown. Recently, various traditional medicines have been tested in randomized clinical trials with variable results. The Chinese herbal medicine in patients with acute intracerebral haemorrhage (CHAIN) trial was a double-blind, prospective, randomized study conducted at 26 hospitals in China. The CHAIN trial randomized 1,648 adult patients with spontaneous intracerebral hemorrhage (mean age, 67 years; 34% female; 84% bleeding at basal ganglia or thalamus) to receive either FYTF-919 (Zhongfeng Xingnao, a blend of four herbs) or a placebo (soybean peptide with black sugar syrup) orally every eight hours or via a nasogastric tube every six hours for 28 days. No differences were observed between study arms based on the utility weighted modified Rankin Scale at 90 days after randomization, which was 0.44 for both arms (mean difference, 0.01; 95% C.I., -0.02 to 0.04; p=0.63). Furthermore, no differences were found in secondary outcomes, including death, disability, or health-related quality of life. Although FYTF-919 was not effective, no adverse reactions occurred. Further randomized clinical trials are needed to evaluate other traditional Chinese medicines.
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