About this trial
Acute ischemic stroke (AIS) is a severe and life-threatening condition, with 35% of AIS patients experiencing impaired consciousness upon admission within 24 hours of onset. Previous studies indicated that patients with impaired consciousness at the onset of stroke have a higher incidence of stroke-related complications, particularly cerebral edema and pneumonia, as well as higher in-hospital and three-month mortality rates. The etiology of impaired consciousness in AIS is complex: ischemic damage to reticular activating system of the brainstem can directly lead to cell necrosis and result in impaired consciousness. Furthermore, secondary pathological changes following AIS, such as excitatory amino acid toxicity, oxidative stress, free radical production, and cascading inflammatory responses, can indirectly worsen impaired consciousness. Therefore, impaired consciousness at the onset of AIS is the result of cellular damage under multiple pathophysiological mechanisms. Developing neuroprotective drugs with multiple targets is key to effectively improving adverse outcomes related to impaired consciousness in AIS. However, there is currently a lack of treatment specifically aimed at improving impaired consciousness at the onset of AIS.
Cultivated Bovine Bezoar (Bovis Calculus Stativus, BCS) combines the advantages of pharmacological similarity to natural bovine by adding components such as deoxycholic acid, cholic acid, and composite calcium bilirubin to fresh bovine bile. It is rich in various trace elements and amino acids and is a compound medication that can exert neuroprotective effects through multiple pathways and targets. In traditional Chinese medicine, it has long been used to treat various consciousness disorder-related diseases, including stroke. The various components of in vitro cultivated bezoar are also widely used in clinical research for various neurological diseases.The above evidence fully demonstrates that BCS is an optimal treatment for impaired consciousness in stroke.
The goal of this clinical trial is to learn if Bovis Calculus Stativus works to treat acute cerebral ischemic stroke with impaired consciousness. It will also learn about the safety of Bovis Calculus Stativus. The main questions it aims to answer are:
1. Does Bovis Calculus Stativus treat and alleviate consciousness disorders in patients with acute cerebral infarction accompanied by impaired consciousness ? 2. What medical problems do participants have when taking Bovis Calculus Stativus?
Researchers will compare Bovis Calculus Stativus to a placebo (a look-alike substance that contains no drug) to see if Bovis Calculus Stativus works to treat acute cerebral ischemic stroke with impaired consciousness.
Participants will:
1. receive treatment with Bovis Calculus Stativus (or placebo) for 5 days. 2. Take an in-person or telephone follow-up within 90 days after the acute stroke.
Eligibility criteria
Qualifiers
Age ≥ 18 years;
Clinically diagnosed with ischemic cerebral infarction;
GCS score: 3-12;
Time from symptom onset to randomization ≤ 24 hours, including wake-up stroke or stroke without a witness; the time of symptom onset is defined as the "last known well time";
Disqualifiers
Use of in BCS within 24 hours before treatment;
Known pregnancy or breastfeeding, or positive pregnancy test before randomization;
Allergy to BCS;
Impaired consciousness caused by other diseases, such as metabolic disorders (e.g., ketoacidosis), trauma, infectious diseases (e.g., pneumonia), neoplastic diseases (e.g., glioma), or toxic conditions (e.g., organophosphate poisoning);
Trial design
Treatments tested in this trial
- Bovis Calculus Stativus (BCS)
- Placebo
Treatment groups
Locations
Sponsors and collaborators
Xiang Luo
Lead sponsor
Tongji Hospital
Sponsor institution
The Fifth Hospital of Wuhan
Collaborator
Jingzhou Hospital of Traditional Chinese Medicine
Collaborator
Xiangyang Hospital of Traditional Chinese Medicine
Collaborator
Wuhan Hospital of Traditional Chinese Medicine
Collaborator
Hubei Hospital of Traditional Chinese Medicine
Collaborator
Wuhan No.1 Hospital
Collaborator
Wuhan Central Hospital
Collaborator
Xiangyang No.1 People's Hospital
Collaborator
Taihe Hospital affiliated to Hubei University of Medicine
Collaborator
Yichang Hospital of Traditional Chinese Medicine
Collaborator