Effects of the traditional Chinese herb Astragalus membranaceus in patients with poststroke fatigue: A double-blind, randomized, controlled preliminary study

Liu, Chung Hsiang; Tsai, Chang Hai; Li, Tsai‐Chung; Yang, Yu Wan; Huang, Wei; Lu, Ming-Kuei; Tseng, Chun Hung; Chen, Kuan Fei; Hsu, Thih Shan; Hsu, Yi Ting; Tsai, Chon Haw; Hsieh, Ching Liang

doi:10.1016/j.jep.2016.10.058

Cited by 45 publications

(33 citation statements)

References 15 publications

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“…Most of the interventional studies have a medium to high risk of bias. Table 2 shows only two studies in white cells (indicating low risk of bias) but both have small sample size consisting of 34 (MIDAS study 63 – 68 ) and 64 randomised patients 61 respectively.…”

Section: Resultsmentioning

confidence: 99%

Post-stroke fatigue: a scoping review

et al. 2020

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Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1st March 2016 and the search date (19th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.

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Section: Resultsmentioning

confidence: 99%

Post-stroke fatigue: a scoping review

et al. 2020

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“…Noticeable, the current study showed that higher intake of avone was associated with a moderately lower risk of developing coronary heart disease [22]. Total avone of Astragalus membranaceus (TFA) is extracted from Astragalus membranaceus, a traditional Chinese medicine that has protective effects on cardiovascular disease [23,24]. Additionally, chronic treatment with certain component of Astragalus avone has shown potential antiatherogenic function.…”

Section: Introductionmentioning

confidence: 66%

Astragalus flavone ameliorates atherosclerosis and hepatic steatosis via improving lipid metabolism and inhibition of inflammation in apoE-/- mice

Zhang

Yang

et al. 2020

Preprint

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Background: Atherosclerosis is a major pathogenic factor in cardiovascular diseases during the aging process. Foam cell formation and endothelial dysfunction play a key role in the initiation and development of atherosclerosis, which are affected by lipid disorder and inflammation. Therefore, the drug for inhibition of endothelial dysfunction and the subsequent foam cell formation is a therapeutic approach for atherosclerosis treatment. Total flavone of Astragalus membranaceus (TFA) is extracted from Astragalus membranaceus that has protective effect on cardiovascular disease. However, the effect of TFA on atherosclerosis and the underlying mechanism remains unknown. Methods: In this study, we determined whether TFA could inhibit atherosclerosis; and uncovered the underlying molecular mechanisms. In vivo, apoE deficient mice were treated with TFA contained in high-fat diet for 16 weeks. After treatment, aorta, macrophage and serum samples were collected to determine atherosclerotic lesions, lipid metabolism, and expression of associated genes. Concurrently, we investigated the effect of TFA on monocyte adhesion, foam cell formation, endothelial activation, and macrophage polarization in vitro and in vivo. Results: TFA reduced atherosclerotic plaque size; and enhanced lesion stability by changing the composition of plaque. Moreover, foam cell formation and its accumulation in arterial wall were attenuated by TFA, which might be attributed to improved lipid disorder, reduced inflammation, and decreased monocyte adhesion to endothelial cells. Mechanistically, TFA reduced the expression of scavenger receptor, such as CD36 and SRA; promoted the expression of ATP-binding cassette transporter A1 and G1 (ABCA1/G1). More importantly, TFA reduced the expression of miR-33, a negative regulator of cholesterol efflux as well as positive mediator on inflammation; and concurrently reduced NFkB activity, by which de-repressed ABCA1/G1 activity and inhibited the inflammation. Conclusions: This study demonstrates that TFA can attenuate atherosclerosis via dual inactivation of miR-33 and NFkB signaling pathway and inhibition of scavenger receptors (CD36 and SRA), which suggests that TFA might be a novel therapeutic approach for inhibition of atherosclerosis.

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“…In general, BYHWT includes seven Chinese herbs, and the effects of its active components have been widely reported as follows. The major herb of BYHWT is Huanqi, which is beneficial for patients with post-stroke fatigue and improves the functional outcomes of hemorrhagic stroke patients 32,33. The major active component of Huanqi is astragaloside IV that has neuroprotective properties stemming from antioxidative, antiapoptotic, and anti-inflammatory actions 34,35.…”

Section: Discussionmentioning

confidence: 99%

The effects of Bu Yang Huan Wu Tang on post-stroke epilepsy: a nationwide matched study

Weng

Chen

Yeh

et al. 2018

CLEP

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ObjectiveTo compare the long-term risk of epilepsy in stroke patients who use Bu Yang Huan Wu Tang (BYHWT) and those who do not.MethodsIn the Taiwanese national insurance claims data, we identified newly diagnosed stroke patients receiving inpatient care in the years 2000–2004. Using propensity score-matched pairs to balance the baseline characteristics, we selected eligible stroke patients who did (n=8,971) and did not (n=8,971) receive BYHWT. These two groups were followed up until the end of 2009 to track the occurrence of epilepsy. We used Cox proportional hazard models to calculate the adjusted HRs and 95% CIs for post-stroke epilepsy during the follow-up period according to BYHWT use.ResultsCompared with the control group, stroke patients with BYHWT had a reduced risk of epilepsy during the 5–9 years of the follow-up period (HR 0.69, 95% CI 0.61–0.77). The association between BYHWT and reduced post-stroke epilepsy was significant in various subgroups of stroke patients. There was a dose-dependent decrease in the frequency of epilepsy with increasing quantities of BYHWT use from 1 package (HR 0.77, 95% CI 0.66–0.90) to ≥6 packages (HR 0.52, 95% CI 0.42–0.65).ConclusionStroke patients who received BYHWT therapy had a reduced long-term risk of epilepsy, and the beneficial effect could be observed in various subgroups. However, future clinical trials will be necessary to corroborate the present findings and identify the biochemical mechanism involved.

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Effects of the traditional Chinese herb Astragalus membranaceus in patients with poststroke fatigue: A double-blind, randomized, controlled preliminary study

Cited by 45 publications

References 15 publications

Post-stroke fatigue: a scoping review

Post-stroke fatigue: a scoping review

Astragalus flavone ameliorates atherosclerosis and hepatic steatosis via improving lipid metabolism and inhibition of inflammation in apoE-/- mice

The effects of Bu Yang Huan Wu Tang on post-stroke epilepsy: a nationwide matched study

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