Effect of Buyang Huanwu decoction for the rehabilitation of ischemic stroke patients: a meta-analysis of randomized controlled trials

Gao, Li; Xiao, Zhuoran; Jia, Chunhua; Wang, Wei

doi:10.1186/s12955-021-01728-6

Cited by 25 publications

(9 citation statements)

References 22 publications

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“…In all, 207 studies were excluded due to the following reasons: samples overlap with other studies (n = 80), no necessary sample data (n = 45), other outcomes (n = 27), other stroke (n = 20), other language (n = 17), no placebo group (n = 11), mild cognitive impairment (n = 7), (Figure 1). Thus, 43 studies were included in the umbrella review: Pan et al, 2020;Pan et al, 2020); Liu et al, 2021); (Liu et al, 2011);Blann et al, 2015); (Blann et al, 2015); Emberson et al, 2014) (Emberson et al, 2014); Peng et al, 2014); (Peng et al, 2014); Zhang et al, 2019); Shang et al, 2019); Puñal-Riobóo et al, 2015;Yuan et al, 2008;(Fu et al, 2013), Fan et al, 2014), Lin et al, 2014; Xu et al, 2015); Cao and Li, (2015); Marmagkiolis et al, 2015); Zheng et al, 2017), Li et al, 2017), Zhang et al, 2017), Chong et al, 2020); (Zhao et al, 2021), Li et al (2020); (Li et al, 2020), Gao et al, 2021); Huang et al, 2020); (Huang and Xiao, 2021), Liu et al, 2022), Feng et al, 2021, Lee et al (2010); Zhou et al, 2022); Hu et al, 2021); Lee, 2015, Liu et al, 2021); (Liu et al, 2021), Xin et al, 2020);…”

Section: Resultsmentioning

confidence: 99%

The Efficacy and Safety of Ischemic Stroke Therapies: An Umbrella Review

Cui

Fan

et al. 2022

Front. Pharmacol.

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Background: Ischemic stroke is a leading cause of morbidity and mortality in neurological diseases. Numerous studies have evaluated the efficacy and safety of ischemic stroke therapies, but clinical data were largely inconsistent. Therefore, it is necessary to summarize and analyze the published clinical research data in the field.Objective: We aimed to perform an umbrella review to evaluate the efficacy and safety of ischemic stroke therapies.Methods: We conducted a search for meta-analyses and systematic reviews on PubMed, the Cochrane Library, and the Web of Science to address this issue. We examined neurological function deficit and cognitive function scores, quality of life, and activities of daily living as efficacy endpoints and the incidence of adverse events as safety profiles.Results: Forty-three eligible studies including 377 studies were included in the umbrella review. The results showed that thrombolytic therapy (tPA; alteplase, tenecteplase, and desmoteplase), mechanical thrombectomy (MTE), edaravone with tPA, stem cell-based therapies, stent retrievers, acupuncture with Western medicines, autologous bone marrow stromal cells, antiplatelet agents (aspirin, clopidogrel, and tirofiban), statins, and Western medicines with blood-activating and stasis-dispelling herbs (NaoShuanTong capsule, Ginkgo biloba, Tongqiao Huoxue Decoction, Xuesaitong injection) can improve the neurological deficits and activities of daily living, and the adverse effects were mild for the treatment of ischemic stroke. Moreover, ligustrazine, safflower yellow, statins, albumin, colchicine, MLC601, salvianolic acids, and DL-3-n-butylphthalide showed serious adverse events, intracranial hemorrhage, or mortality in ischemic stroke patients.Conclusion: Our study demonstrated that tPA, edaravone and tPA, tPA and MTE, acupuncture and Western medicines, and blood-activating and stasis-dispelling herbs with Western medicines are the optimum neurological function and activities of daily living medication for patients with ischemic stroke.Systematic Review Registration: https://inplasy.com/, identifier [INPLASY202250145].

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Section: Resultsmentioning

confidence: 99%

The Efficacy and Safety of Ischemic Stroke Therapies: An Umbrella Review

Cui

Fan

et al. 2022

Front. Pharmacol.

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“…Qi deficiency causes week blood circulation, while yin deficiency causes obscure bloodstream, and either one of the results in unsmooth blood flow, stasis, and blocking the meridians, forming the syndrome of blood stasis due to qi deficiency. e occurrence and development of DN show a dynamic evolution process, and finally, spleen-kidney deficiency is mingled with damp-heat and blood stasis [20][21][22]. erefore, invigorating the spleen and kidney and promoting blood circulation to remove blood stasis are the root for treatment, and Buyang Huanwu decoction, a classic TCM formula for qi invigoration and blood activation, is exactly a perfect choice for symptomatic treatment of syndromes caused by qi deficiency and blood stasis.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Restricting Dietary Protein Intake Combined with Buyang Huanwu Decoction in Treating Diabetic Nephropathy and Its Effect on Patients’ Inflammatory Factor Levels

Chen

Huang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. To study the efficacy of restricting dietary protein intake combined with Buyang Huanwu decoction in treating diabetic nephropathy (DN) and its effect on patients’ inflammatory factor levels. Methods. The medical data of 150 DN patients treated in Wuhan No.1 Hospital (June 2018—May 2021) were retrospectively analyzed. All patients received regular therapy, those who received the intervention of restricting dietary protein intake were included in the control group (n = 75), and on this basis, those treated with Buyang Huanwu decoction were included in the experimental group (n = 75), so as to scientifically evaluate their efficacy and inflammatory factor levels after treatment. Results. The patients’ general information was not statistically different between the two groups ( P > 0.05 ); after treatment, the experimental group gained remarkably higher marked effective rate and total effective rate of treatment than the control group ( P < 0.05 ); the inflammatory factor levels of all patients were obviously better than before ( P < 0.05 ), and the levels of TNF-α, IL-2, IL-8, IL-4, and IL-10 were obviously lower in the experimental group than in the control group ( P < 0.05 ); the levels of fasting blood glucose, 2 h postprandial blood glucose, and glycosylated hemoglobin of all patients were remarkably lower than before ( P < 0.05 ), but with no significant between-group difference ( P > 0.05 ); the renal function indexes of all patients were better than before, and between the two groups, the levels of 24 h microalbuminuria, 24 h urine protein excretion, and serum creatinine were obviously lower and the glomerular filtration rate was significantly higher in the experimental group ( P all <0.05), and the patients’ traditional Chinese medicine (TCM) symptom scores were remarkably lower in the experimental group ( P < 0.05 ). Conclusion. Jointly applying Buyang Huanwu decoction on the basis of restricting dietary protein intake can effectively promote the clinical efficacy of DN, which is conducive to adjusting the inflammatory factor levels, promoting the patients’ renal function, and alleviating the clinical symptoms.

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“…Diels (Danggui) 6 g, Paeonia lactiflora Pall (Chishao) 4.5 g, Ligusticum striatum DC. (Chuanxiong) 3 g, Lumbricus (Dilong) 3 g, Prunus persica (L.) Batsch (Taoren) 3 g, and Carthamus tinctorius L. (Honghua) 3 g, among which RAP is monarch medicine, with a dosage of up to 120 g [30][31][32][33]. In this study, we adopted the same dose of RAP in BHD.…”

Section: Introductionmentioning

confidence: 99%

Roots of Astragalus propinquus Schischkin Regulate Transmembrane Iron Transport and Ferroptosis to Improve Cerebral Ischemia-Reperfusion Injury

Chen

Bao

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Background. The dried roots of the Astragalus propinquus Schischkin (RAP) plant, as a traditional Chinese medicine, has been widely used to treat stroke, cerebral ischemia, qi deficiency, and hypertension. Buyang Huanwu decoction is traditionally used to treat stroke in China for more than 200 years and has a significant effect on cerebral ischemia, and RAP is monarch medicine of Buyang Huanwu decoction. Therefore, this study was designed to observe the regulatory effect of RAP on transmembrane iron transporters and ferroptosis-related factors in cerebral ischemia-reperfusion injury (CIRI) in rats. Methods. Middle cerebral artery occlusion (MCAO) was used to block blood flow in the blood supply area of the middle cerebral artery in seventy male SD rats to induce focal CIRI to establish a rat model of CIRI. RAP was administered to explore the regulatory effect of RAP on iron transmembrane transport under the condition of CIRI. The infarct size was measured using 2,3,5-triphenyl-tetrazolium chloride (TTC) staining, the pathological structure of brain tissue was observed by HE staining, and neuronal injury was evaluated by Nissl staining after treatment. Then, changes in the iron transporters ferritin (Fn), ferritin heavy chain (FHC), ferritin light chain (FLC), transferrin (Tf), transferrin receptor (TfR), divalent metal transporter 1 (DMT1), L-type calcium channel (LTCC), transient receptor potential canonical 6 (TRPC6), and ferroportin 1 (FPN1) were observed by immunohistochemistry staining (IHC) and Western blotting. The expression of key factors of ferroptosis, including the membrane sodium-dependent cystine/glutamate antiporter System Xc− (System Xc−) light chain subunit (XCT) and heavy chain subunit (SLC3A2), glutathione peroxidase 4 (GPX4), nuclear factor erythroid 2-related factor (NRF2), heme oxygenase-1 (HO-1), and iron-responsive element-binding protein 2 (IREB2) in the brain tissues of rats was assessed by Western blotting. RAP decreased the infarct size and neuronal injury after CIRI in rats. Similarly, RAP treatment regulated the expression of iron transporters. As such, RAP was able to reduce the expression of Fn, FHC, FLC, Tf, TfR, DMT1, and TRPC6 and increase the expression of FPN1 through a Tf/TfR-independent pathway after CIRI in rats. Conclusion. RAP stimulation inhibited ferroptosis by regulating the expression of the key ferroptosis factors XCT, SLC3A2, GPX4, NRF2, HO-1, and IREB2. In conclusion, RAP regulates transmembrane iron transport and ferroptosis to improve CIRI.

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Effect of Buyang Huanwu decoction for the rehabilitation of ischemic stroke patients: a meta-analysis of randomized controlled trials

Cited by 25 publications

References 22 publications

The Efficacy and Safety of Ischemic Stroke Therapies: An Umbrella Review

The Efficacy and Safety of Ischemic Stroke Therapies: An Umbrella Review

Efficacy of Restricting Dietary Protein Intake Combined with Buyang Huanwu Decoction in Treating Diabetic Nephropathy and Its Effect on Patients’ Inflammatory Factor Levels

Roots of Astragalus propinquus Schischkin Regulate Transmembrane Iron Transport and Ferroptosis to Improve Cerebral Ischemia-Reperfusion Injury

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