TITLE:
Efficacy and Safety of Tonifying Qi and Circulating Blood Chinese Herbal Medicines in Post-Stroke Cognitive Impairment: A Systematic Review and Network Meta-Analysis
AUTHORS:
Jixiang Chen, Kun Gao, Na Li, Zaijun Zhang, Mei Jing, Fang Wang, Jin Li
KEYWORDS:
Tonifying Qi and Circulating Blood, Chinese Herbal Medicines, Post-Stroke Cognitive Impairment, Systematic Review, Network Meta-Analysis
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.4,
April
30,
2026
ABSTRACT: Background: Post-stroke cognitive impairment (PSCI) significantly aggravates the burden of stroke. Current conventional Western medical treatments have limited efficacy, tonifying qi and circulating blood Chinese herbal medicine which is based on the theory of traditional Chinese medicine to target the core pathogenesis of PSCI, emerge as potential candidates for PSCI management. Methods: We systematically searched PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang, VIP and China Biology Medicine disc for randomized controlled trials. The primary outcomes included clinical efficacy rate, Mini-Mental State Examination (MMSE) score, Montreal Cognitive Assessment (MoCA) score, National Institutes of Health Stroke Scale (NIHSS) score, and adverse event incidence. Both direct and indirect evidence were integrated through meta-analysis to evaluate the relative efficacy and safety of different tonifying qi and circulating blood Chinese herbal medicine using the Surface Under the Cumulative Ranking Curve. Results: A total of 49 studies involving 4260 participants were included. The systematic review showed that Chinese herbal medicine for tonifying qi and circulating blood with conventional Western medicines increased the clinical efficacy rate more significantly than conventional Western medicine alone (RR: 1.23, 95% CI: 1.19 to 1.27), improved cognitive function by MMSE score (MD: 3.13, 95% CI: 2.54 to 3.73), MoCA score (MD: 2.76, 95% CI: 2.19 to 3.32), and reduced NIHSS score (MD: 2.78, 95% CI: 1.76 to 3.80). Network meta-analysis results showed that Buyang Huanwu decoction and its modified formulations demonstrated particularly prominent efficacy in improving cognitive and neurological functions in PSCI patients. No serious adverse reactions were reported. Conclusion: This study provides preliminary evidence that tonifying qi and circulating blood Chinese herbal medicines are beneficial for PSCI, indicating that Buyang Huanwu decoction and its modified formulations may be potential safe and effective adjunctive therapeutic options for PSCI.