Efficacy evaluation of Buyang Huanwu Decoction in the treatment of ischemic stroke in the recovery period: A systematic review of randomized controlled trials

Abstract

Background and purpose: Buyang Huanwu decoction (BYHWD) is widely used in the treatment of ischemic stroke in the recovery period, and many clinical trials have been reported, but its clinical efficacy and safety have not been fully evaluated. In this study, we conducted a systematic review and meta-analysis to evaluate the clinical efficacy and safety of BYHWD in the recovery period.Materials and methods: Eight databases, including CNKI, Wanfang Database, VIP Database, China Biomedical Literature Database, PubMed, Cochrane Library, EMBASE, and Web of Science, were searched from the establishment of the database to 13 April 2022. We selected all eligible randomized controlled trials of BYHWD in the treatment of ischemic stroke during the recovery period. Systematic review and meta-analysis were conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The National Institutes of Health Stroke Score (NIHSS) was the primary outcome, and the Chinese Stroke Scale (CSS), activities of daily living (ADL), and adverse drug reaction (ADR) were the secondary outcomes.Results: A total of 39 randomized controlled trials were included, and 3,683 patients in the recovery period of ischemic stroke were recruited. Compared with conventional treatment alone, BYHWD combined with conventional treatment significantly decreased the NIHSS score (MD = -1.44, 95% CI: 1.75, -1.12, p < 0.00001), the CSS score (MD = -1.18, 95% CI: 2.02, -0.34, p = 0.006), improved the ADL (MD = 4.33, 95% CI: 3.06, 5.61, p < 0.00001), and did not increase the adverse reactions of patients (OR = 0.88, 95% CI: 0.48, 1.61, p = 0.67).Conclusion: BYHWD is an effective and safe therapy for the recovery of ischemic stroke. To further determine the efficacy and safety of BYHWD in the treatment of ischemic stroke in the recovery period, more high-quality, multicenter, and prospective RCTs are needed.

Traditional Chinese medicines treat ischemic stroke and their main bioactive constituents and mechanisms

“…Pharmacological studies have shown that the mechanisms of BYHWD in the treatment of IS are mainly related to promoting vascular and neural regeneration, anti‐atherosclerosis, anti‐inflammatory, BBB protection, mitochondrial protection, and anti‐platelet aggregation (Chen et al, 2020; Wang et al, 2021). A meta‐analysis of 39 studies showed that BYHWD combined with conventional treatment for IS is more effective in reducing NIHSS and improving ADLs than conventional treatment (Wang, Ren, et al, 2022).…”

Protective effects of paeoniflorin on cardiovascular diseases: A pharmacological and mechanistic overview

“…Buyang Huanwu (BYHW) decoction containing Chishao is also a traditional Chinese medicine compound preparation. Relevant clinical studies and meta-analysis have proved that its therapeutic effect on stable angina pectoris (SAP)and stroke ( Zhang et al, 1995 ; Gao et al, 2021 ; Wang et al, 2022a ). Recently, Wang et al (2022b) designed a randomized, blinded, parallel controlled, multicenter clinical trial to compare the efficacy and safety of NXT and BYHW in the treatment of SAP.…”

Integrative transcriptomic and network pharmacology analysis reveals the neuroprotective role of BYHWD through enhancing autophagy by inhibiting Ctsb in intracerebral hemorrhage mice

“…Previous systematic reviews and meta-analyses have consistently demonstrated the efficacy and safety of BYHWD for treating ICH. [ 24 , 25 ]. As a neuroprotective agent, BYHWD modulates the non-classical NF-κB pathway, attenuating the inflammatory response following ICH [ 23 ].…”