Efficacy of Buyang Huanwu Decoction in treating acute ischemic stroke based on the neurovascular unit

Introduction:
The aim of the study was to investigate the clinical efficacy of Buyang Huanwu Decoction (BHD) in the treatment of patients who had an acute ischemic stroke (AIS).

Material and methods:
A total of 100 patients who had experienced an AIS were selected as participants and were randomly divided into the control group and the observation group. Patients in the control group received comprehensive treatment using Western medicine, while those in the observation group received BHD internally. Both groups received ongoing treatment for 2 weeks. We examined the effects of BHD on traditional Chinese medicine (TCM) syndrome scores and neurological deficits, as well as on the expression of S100 calcium-binding protein b (S100b), neuron-specific enolase (NSE), matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor (VEGF) in brain tissue.

Results:
By monitoring patients’ adverse reactions and laboratory test indicators, it was found that BHD did not significantly increase the safety risk of patients during the treatment process. The TCM evidence score and National Institutes of Health Stroke Scale (NIHSS) score of the observation group were lower compared with the control group after treatment (p < 0.05). The TCM evidence score and NIHSS reduction of the observation group were decreased compared with those before treatment (p < 0.05). The serum S100b protein and NSE levels in the observation group were lower than those in the control group before and after treatment (p < 0.05). The serum MMP-9 level of the observation group was lower compared with the control group, and the serum VEGF level was higher than that of the control group after treatment (p < 0.05). The serum MMP-9 level in the observation group was decreased and the serum VEGF level was increased compared with those before treatment (p < 0.05). The overall response rate of the observation group was higher than that of the control group (p < 0.05). Spearman correlation analysis revealed no correlation between TCM syndrome score and S100 protein, NSE, MMP-9, and VEGF (p > 0.05). Furthermore, the NIHSS score was negatively correlated with MMP-9 (r_s = –0.359, p < 0.05) but not with S100 protein, NSE, and VEGF (p > 0.05).

Conclusions:
BHD boasts various benefits in the treatment of AIS patients with Qi deficiency and blood stasis. The mechanism may be associated with the protection of vascular endothelial cell integrity and the promotion of endothelial cell proliferation.