Journal of Traditional Chinese Medicine ›› 2025, Vol. 45 ›› Issue (2): 458-472.DOI: 10.19852/j.cnki.jtcm.2025.02.017
• Review • Previous Articles
Application of promoting blood circulation and resolving blood stasis in intracerebral hemorrhage: a traditional method gradually being reconsidered
ZHANG Dingshan1, CHEN Li1(
), MARYAM Mazhar1, XUE Jinyi2, LIU Ping1, LIU Mengnan1()
- 1 National Traditional Chinese Medicine Clinical Research Base, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China
2 School of Integrated Traditional Chinese and Western Medicine, Southwest Medical University, Luzhou 646000, China
-
Received:2023-12-19Accepted:2024-05-24Online:2025-04-15Published:2025-03-10 -
Contact:Dr. Liu Mengnan, National Traditional Chinese Medicine Clinical Research Base, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China. liumengnan.swmu.edu.cn; Dr. Chen Li, National Traditional Chinese Medicine Clinical Research Base, the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, Luzhou 646000, China. chenli199108@foxmail.com, Telephone: +86-15386580658 -
Supported by:National Natural Science Foundation of China: Study on the Intervention Mechanism of Zhilong Huoxue Tongyu Capsule in Hypertensive Myocardial Fibrosis by Regulating Transforming Growth Factor-β/Smad3/Erbb4-IR/miR29b Loop(82074378);Science & Technology Department of Sichuan Province: Research on the Optimization of Basic and Clinical Plans for Treating Coronary Heart Disease and Heart Failure based on Xuanfu Theory(2022YFS0618);Luzhou Science and Technology Bureau Project: the Mechanism of Hirudin Inhibiting AngⅡ Induced Myocardial Hypertrophy by Regulating Autophagy and NOD-like Receptor Family Pyrin Domain Containing Protein 3 Inflammasome(2023JYJ029);Southwest Medical University Project: Study on the Mechanism of Zhilong Huoxue Tongyu Capsules in Improving NOD-like Receptor Family Pyrin Domain Containing Protein 3 Inflammasome Mediated Cardiomyocyte Pyroptosis in Heart Failure by Regulating the Hippo-Yes-Associated Protein Pathway(2023ZYYQ04)
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ZHANG Dingshan, CHEN Li, MARYAM Mazhar, XUE Jinyi, LIU Ping, LIU Mengnan. Application of promoting blood circulation and resolving blood stasis in intracerebral hemorrhage: a traditional method gradually being reconsidered[J]. Journal of Traditional Chinese Medicine, 2025, 45(2): 458-472.
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Figure 1 The pathological and physiological bases of ICH ICH: intracerebral hemorrhage.
Figure 1 The pathological and physiological bases of ICH ICH: intracerebral hemorrhage.
Figure 2 The role of cytokines and signaling pathways in brain injury and repair after ICH ICH: intracerebral hemorrhage; TJ protein: tight junction; AQP-4: aquaporin-4; TIMP-1: tissue inhibitors of metalloproteinases-1; Fe2+: ferrous iron; Fe3+: ferric iron; BV: biliverdin; CO: carbon monoxide; Fe: free iron; Ca2+: calcium; MMP-9: matrix metalloproteinase-9; HO: heme oxygenase; RhoA/ROCK: RhoA/Rho-associated kinase; Hb: hemoglobin; RBC: red blood cell; M1: pro-inflammatory microglia; M2: repair microglia; IL: interleukin; TNF-α: tumor necrosis factor-α; ICAM-1: intercellular cell adhesion molecule-1; ROS: reactive oxygen species; SOD: superoxide dismutase; Prx: peroxidase; GSH: glutathione; GSH-Px: glutathione peroxidase; VitE: vitamin E; Lip: lipids; Pr: protein; NA: nucleic acids; MDA: malondialdehyde; 3-NT: 3-nitrotyrosine; 8-OHDG: 8-hydroxy deoxyguanosine; Nrf2: nuclear factor erythroid 2-related factor 2; ARE: antioxidant response elements; CAT: catalyst; RNS: reactive nitrogen species; PLT: platelet; cFN: cell fibronectin; PAR-1: protease-activated receptor-1; PTK: protein tyrosine kinase; JAK-STAT: janus kinase/signal transducer and activator of transcription; APE: apurinic/apyrimidinic endonuclease; ATF: activating transcription factor; GRP: glucose regulatory protein; PERK: protein kinase R-like ER kinase; IRE1: inositol requiring enzyme 1; ERS: endoplasmic reticulum stress; UPR: unfolded protein response; Cytc: cytochrome c; GSK-3β: glycogen synthase kinase-3β; PI3K-Akt: PI3 kinase-Akt; Bcl-2: B-cell lymphoma-2.
Figure 2 The role of cytokines and signaling pathways in brain injury and repair after ICH ICH: intracerebral hemorrhage; TJ protein: tight junction; AQP-4: aquaporin-4; TIMP-1: tissue inhibitors of metalloproteinases-1; Fe2+: ferrous iron; Fe3+: ferric iron; BV: biliverdin; CO: carbon monoxide; Fe: free iron; Ca2+: calcium; MMP-9: matrix metalloproteinase-9; HO: heme oxygenase; RhoA/ROCK: RhoA/Rho-associated kinase; Hb: hemoglobin; RBC: red blood cell; M1: pro-inflammatory microglia; M2: repair microglia; IL: interleukin; TNF-α: tumor necrosis factor-α; ICAM-1: intercellular cell adhesion molecule-1; ROS: reactive oxygen species; SOD: superoxide dismutase; Prx: peroxidase; GSH: glutathione; GSH-Px: glutathione peroxidase; VitE: vitamin E; Lip: lipids; Pr: protein; NA: nucleic acids; MDA: malondialdehyde; 3-NT: 3-nitrotyrosine; 8-OHDG: 8-hydroxy deoxyguanosine; Nrf2: nuclear factor erythroid 2-related factor 2; ARE: antioxidant response elements; CAT: catalyst; RNS: reactive nitrogen species; PLT: platelet; cFN: cell fibronectin; PAR-1: protease-activated receptor-1; PTK: protein tyrosine kinase; JAK-STAT: janus kinase/signal transducer and activator of transcription; APE: apurinic/apyrimidinic endonuclease; ATF: activating transcription factor; GRP: glucose regulatory protein; PERK: protein kinase R-like ER kinase; IRE1: inositol requiring enzyme 1; ERS: endoplasmic reticulum stress; UPR: unfolded protein response; Cytc: cytochrome c; GSK-3β: glycogen synthase kinase-3β; PI3K-Akt: PI3 kinase-Akt; Bcl-2: B-cell lymphoma-2.
Figure 3 The process of thrombosis and the therapeutic effects of PBCRBS ICH: intracerebral hemorrhage; PBCRBS: promoting blood circulation and removing blood stasis therapy.
Figure 3 The process of thrombosis and the therapeutic effects of PBCRBS ICH: intracerebral hemorrhage; PBCRBS: promoting blood circulation and removing blood stasis therapy.
Figure 4 Overview of the critical mechanisms in the treatment of ICH with PBCRB ICH: intracerebral hemorrhage; PBCRBS: promoting blood circulation and removing blood stasis therapy.
Figure 4 Overview of the critical mechanisms in the treatment of ICH with PBCRB ICH: intracerebral hemorrhage; PBCRBS: promoting blood circulation and removing blood stasis therapy.
Table 1 Clinical trial on the treatment of ICH with PBCRBS
| Reference | Number of cases (Tre/Con) | Treatment Interventional herbs | Dose/day | Course of treatment (days) | Clinical outcomes | Total effective rate (%) | ||
|---|---|---|---|---|---|---|---|---|
| Sun 2016 | 57/56 | Sanqi fen (三七粉) | 3 g | 14 | A, D | 83.9 | 80.7 | |
| Sun 2017 | 120/120 | - | 21 | A, D, F | 83.3 | 81.7 | ||
| Zhang 2018 | 49/49 | 5 g | - | A | 77.6 | 49.0 | ||
| Lu et al 2015 | 40/40 | Danhong injection (丹红注射液) | 80 mL | 15 | A, D | 90.0 | 75.0 | |
| Wang 2018 | 5050 | A, D | 90.0 | 74.0 | ||||
| Gao et al 2022 | 120/120 | 20 mL | 14 | A, B, D, F | 92.5 | 83.3 | ||
| Huang 2013 | 54/52 | Safflower injection (红花注射液) | 15 mL | 14 | A, F | 62.7 | 41.3 | |
| Shang 2014 | 39/39 | A, F | - | - | ||||
| Shang 2015 | 21/19 | 25 mL | - | 94.7 | 81.0 | |||
| Qin 2014 | 30/30 | Astragalus injection (黄芪注射液) | 25 mL | 14 | A, D, F | 96.7 | 70.0 | |
| Zhuang et al 2016 | 44/44 | A, D | 95.5 | 81.8 | ||||
| Song et al 2014 | 150/150 | Compound musk injection (复方麝香注射液) | 30 mL | 10-14 | A, D | 71.3 | 45.3 | |
| Wang et al 2015 | 43/43 | 20 mL | 14 | A, D, G | 79.1 | 60.5 | ||
| Ji et al 2019 | 21/21 | 80 mL | - | A, D, F | - | - | ||
| Xie 2016 | 20/20 | Xingnaojing injection (醒脑静注射液) | 20 mL | 14 | A, D | 90.0 | 75.0 | |
| Ma et al 2017 | 54/54 | A, C, D | 96.3 | 85.2 | ||||
| Shi et al 2020 | 42/42 | A, D, F | 90.5 | 71.4 | ||||
| Li et al 2018 | 44/42 | Taohe Chengqi decoction (桃核承气汤) | 1dose | 21 | A, D | - | - | |
| Chen 2020 | 20/20 | D | - | - | ||||
| Dong 2021 | 31/31 | A, D | 96.8 | 71.0 | ||||
| Meng 2014 | 30/30 | Xijiao Dihuang decoction (犀角地黄汤) | 1 dose | - | A | 86.7 | 63.3 | |
| Tang 2016 | 45/45 | A | 86.7 | 66.7 | ||||
| Zhang et al 2016 | 78/79 | Taohe Chengqi and Xijiao Dihuang decoction (桃核承气合犀角地黄汤) | 1 dose | - | C, D | 93.7 | 84.6 | |
| Liu et al 2016 | 30/30 | Naoxin Fumai decoction (脑心复脉汤) | 1 dose | 14 | - | 93.3 | 80.0 | |
| Zeng 2016 | 58/59 | Danshen injection (丹参注射液) | 20 mL | 28 | D | 93.2 | 84.5 | |
| Wang 2016 | 68/68 | 16 mL | 14 | A, D | 86.8 | 72.1 | ||
| Mei 2018 | 37/37 | Compound danshen drop pills (复方丹参滴丸) | 30 pills | 28 | A, B, D | 91.9 | 73.0 | |
| Gao et al 2019 | 40/40 | Xuefu Zhuyu decoction (血府逐瘀汤) | 1 dose | 28 | A, D, F | 95.0 | 77.5 | |
| Hei et al 2021 | 50/50 | 56 | A, D | 96.0 | 82.0 | |||
| Meng et al 2013 | 30/30 | Qingkailing injection (清开灵注射液) | 60 mL | 14 | D, F | 93.3 | 63.3 | |
| Hu 2014 | 25/26 | 20-40 mL | - | - | 96.2 | 76.0 | ||
| Dong 2015 | 45/45 | 50 mL | 20 | D | 97.8 | 55.6 | ||
| Zhang et al 2013 | 34/34 | Buchang Naoxintong capsule (步长脑心通胶囊) | 1.2 g | 42 | A, B | - | - | |
| Guan 2015 | 17/19 | - | 94.7 | 82.4 | ||||
| Zhong 2014 | 20/52 | Tongqiao Huoxue decoction (通窍活血汤) | 1 dose | 14 | - | 86.5 | 80.0 | |
| He 2018 | 43/43 | A, D | 95.4 | 81.4 | ||||
| Jiang 2021 | 30/30 | 28 | A, B | 90.0 | 66.7 | |||
| Wang et al 2019 | 52/52 | Taohong Siwu decoction (桃红四物汤) | 1 dose | 14 | D, F | 92.3 | 75.0 | |
| Li et al 2019 | 45/45 | Erchen and Taohong Siwu decoction (二陈合桃红四物汤） | 1 dose | 28 | C, D, E, F | 88.9 | 68.9 | |
| Zhang 2018 | 24/24 | Taoren Chuanxiong decoction (桃仁川芎汤) | 1 dose | 30 | A, B | 95.8 | 83.3 | |
| Zhao 2020 | 45/45 | 30 | A, B, D | 88.9 | 71.1 | |||
| Zhao 2020 | 60/60 | 90 | A, C | 93.3 | 73.3 | |||
| Liu et al 2014 | 40/40 | Salviae miltiorrhizae and ligustrazine hydrochloride injection (丹参川芎嗪注射液) | 40 mL | 28 | A, D | 87.5 | 72.5 | |
| Ding et al 2017 | 59/59 | 10 mL | 28 | A, D, E | - | - | ||
| Yin et al 2021 | 41/41 | Buyang Huanwu dection (补阳还五汤) | 1 dose | 60 | B, C | 95.1 | 68.3 | |
| Yang et al 2022 | 37/37 | 56 | C, F | 83.8 | 62.1 | |||
| Qu 2022 | 56/56 | 30 | C, D | 96.4 | 83.9 | |||
| Fan et al 2013 | 34/34 | Shuxuening injection (舒血宁注射液) | 20 mL | 7-21 | A, D, G | - | - | |
| Li et al 2015 | 42/42 | 10 mL | 7 | D | 90.5 | 73.8 | ||
| Huang et al 2013 | 52/52 | 15 mL | 21 | A, D | 92.3 | 73.1 | ||
| Wang et al 2015 | 34/34 | Ginkgo biloba extract (银杏叶提取物) | 20 mL | 14 | D | - | - | |
| Ni et al 2018 | 49/49 | A, B, D, F | 93.9 | 75.5 | ||||
| Min et al 2016 | 41/41 | 17.5 mg | 14 | A, D, F | 90.2 | 95.1 | ||
| Tian et al 2018 | 51/51 | Ginkgo Leaf Extract and Dipyridamole Injection (银杏达莫注射液) | 40 mL | 14 | A, D | 88.2 | 70.7 | |
| Geng et al 2019 | 60/78 | A, D, E | - | - | ||||
| Wei et al 2021 | 58/58 | 5 mL | 14 | A, D, F | - | - | ||
| Liu et al 2017 | 42/42 | Mailuoning injection (脉络宁注射液) | 20 mL | 28 | A, D, F | 92.9 | 76.1 | |
| Cheng et al 2018 | 39/39 | 30 | A, D | 94.9 | 64.1 | |||
| Zhou 2019 | 40/40 | 28 | - | 92.5 | 75.0 | |||
| Fan 2016 | 20/20 | Ciwujia injection (刺五加注射液) | 60 mL | 21 | - | 95.0 | 60.0 | |
| Miao et al 2014 | 34/35 | Naoxueshu oral liquid (脑血疏口服液) | 30 mL | 30 | A | 97.1 | 79.4 | |
| Chen et al 2016 | 32/35 | A, B, D, F | 80.0 | 62.5 | ||||
| Wu 2018 | 41/41 | A, D | 97.6 | 80.5 | ||||
| Liang 2013 | 20/20 | Yangxue Qingnao granule (养血清脑颗粒) | 12 g | 21 | A, D, F | 95.0 | 90.0 | |
| Qin et al 2013 | 42/42 | A, F | 76.2 | 46.9 | ||||
| Liang 2017 | 46/46 | - | D, F | 87.0 | 69.6 | |||
| Duo et al 2013 | 60/60 | Zhongfeng Capsules (中风胶囊) | 15 pills | 14 | D | 87.0 | 73.0 | |
| Feng 2013 | 35/35 | Xiaoyukang capsules (消瘀康胶囊) | 12 pills | 14 | A, D, F | 88.5 | 62.8 | |
| Song et al 2017 | 55/55 | A, D, F | 95.6 | 76.4 | ||||
| Xu et al 2022 | 59/59 | 10 | A, B, D, F | 98.3 | 83.1 | |||
| Li 2020 | 81/81 | 9 pills | 14 | A, D | 96.3 | 82.7 | ||
| Gao et al 2013 | 97/103 | Xuesaitong injection (血塞通注射液) | 500 mg | 14 | - | 90.3 | 80.4 | |
| Wang 2017 | 57/57 | 400 mg | 28 | A, D | 93.0 | 79.0 | ||
| Wang 2017 | 38/38 | Xueshuantong injection (血栓通注射液） | 175 mg | 14 | A, D | 92.1 | 73.7 | |
| Chen 2013 | 60/61 | Panax notoginseng saponins injection (三七皂苷注射液) | 350 mg | 14 | D | 90.2 | 76.7 | |
| Liu et al 2016 | 35/35 | - | 94.3 | 77.1 | ||||
| Chen 2015 | 54/54 | Xiangdan injection (香丹注射液) | 10 mL | 21 | D | - | - | |
| Liu 2016 | 40/40 | 20 mL | 15 | D | 95.0 | 75.0 | ||
| Ze 2021 | 1000/1000 | Huoxue Xingnao decoction (活血醒脑汤) | 1 dose | 21 | A, D, F | - | - | |
| Xiao C 2021 | 35/33 | A, D | - | - | ||||
| Wu 2018b | 30/30 | Qigui Huoxue decoction (芪归活血汤) | 1 dose | - | B | 90.0 | 70.0 | |
| Zhao et al 2013 | 60/60 | Huoxue Huayu Fang (活血化瘀方） | 1 dose | 21 | D, F | 85.0 | 63.3 | |
| Gai 2014 | 40/40 | C, F | 95.0 | 77.0 | ||||
Table 1 Clinical trial on the treatment of ICH with PBCRBS
| Reference | Number of cases (Tre/Con) | Treatment Interventional herbs | Dose/day | Course of treatment (days) | Clinical outcomes | Total effective rate (%) | ||
|---|---|---|---|---|---|---|---|---|
| Sun 2016 | 57/56 | Sanqi fen (三七粉) | 3 g | 14 | A, D | 83.9 | 80.7 | |
| Sun 2017 | 120/120 | - | 21 | A, D, F | 83.3 | 81.7 | ||
| Zhang 2018 | 49/49 | 5 g | - | A | 77.6 | 49.0 | ||
| Lu et al 2015 | 40/40 | Danhong injection (丹红注射液) | 80 mL | 15 | A, D | 90.0 | 75.0 | |
| Wang 2018 | 5050 | A, D | 90.0 | 74.0 | ||||
| Gao et al 2022 | 120/120 | 20 mL | 14 | A, B, D, F | 92.5 | 83.3 | ||
| Huang 2013 | 54/52 | Safflower injection (红花注射液) | 15 mL | 14 | A, F | 62.7 | 41.3 | |
| Shang 2014 | 39/39 | A, F | - | - | ||||
| Shang 2015 | 21/19 | 25 mL | - | 94.7 | 81.0 | |||
| Qin 2014 | 30/30 | Astragalus injection (黄芪注射液) | 25 mL | 14 | A, D, F | 96.7 | 70.0 | |
| Zhuang et al 2016 | 44/44 | A, D | 95.5 | 81.8 | ||||
| Song et al 2014 | 150/150 | Compound musk injection (复方麝香注射液) | 30 mL | 10-14 | A, D | 71.3 | 45.3 | |
| Wang et al 2015 | 43/43 | 20 mL | 14 | A, D, G | 79.1 | 60.5 | ||
| Ji et al 2019 | 21/21 | 80 mL | - | A, D, F | - | - | ||
| Xie 2016 | 20/20 | Xingnaojing injection (醒脑静注射液) | 20 mL | 14 | A, D | 90.0 | 75.0 | |
| Ma et al 2017 | 54/54 | A, C, D | 96.3 | 85.2 | ||||
| Shi et al 2020 | 42/42 | A, D, F | 90.5 | 71.4 | ||||
| Li et al 2018 | 44/42 | Taohe Chengqi decoction (桃核承气汤) | 1dose | 21 | A, D | - | - | |
| Chen 2020 | 20/20 | D | - | - | ||||
| Dong 2021 | 31/31 | A, D | 96.8 | 71.0 | ||||
| Meng 2014 | 30/30 | Xijiao Dihuang decoction (犀角地黄汤) | 1 dose | - | A | 86.7 | 63.3 | |
| Tang 2016 | 45/45 | A | 86.7 | 66.7 | ||||
| Zhang et al 2016 | 78/79 | Taohe Chengqi and Xijiao Dihuang decoction (桃核承气合犀角地黄汤) | 1 dose | - | C, D | 93.7 | 84.6 | |
| Liu et al 2016 | 30/30 | Naoxin Fumai decoction (脑心复脉汤) | 1 dose | 14 | - | 93.3 | 80.0 | |
| Zeng 2016 | 58/59 | Danshen injection (丹参注射液) | 20 mL | 28 | D | 93.2 | 84.5 | |
| Wang 2016 | 68/68 | 16 mL | 14 | A, D | 86.8 | 72.1 | ||
| Mei 2018 | 37/37 | Compound danshen drop pills (复方丹参滴丸) | 30 pills | 28 | A, B, D | 91.9 | 73.0 | |
| Gao et al 2019 | 40/40 | Xuefu Zhuyu decoction (血府逐瘀汤) | 1 dose | 28 | A, D, F | 95.0 | 77.5 | |
| Hei et al 2021 | 50/50 | 56 | A, D | 96.0 | 82.0 | |||
| Meng et al 2013 | 30/30 | Qingkailing injection (清开灵注射液) | 60 mL | 14 | D, F | 93.3 | 63.3 | |
| Hu 2014 | 25/26 | 20-40 mL | - | - | 96.2 | 76.0 | ||
| Dong 2015 | 45/45 | 50 mL | 20 | D | 97.8 | 55.6 | ||
| Zhang et al 2013 | 34/34 | Buchang Naoxintong capsule (步长脑心通胶囊) | 1.2 g | 42 | A, B | - | - | |
| Guan 2015 | 17/19 | - | 94.7 | 82.4 | ||||
| Zhong 2014 | 20/52 | Tongqiao Huoxue decoction (通窍活血汤) | 1 dose | 14 | - | 86.5 | 80.0 | |
| He 2018 | 43/43 | A, D | 95.4 | 81.4 | ||||
| Jiang 2021 | 30/30 | 28 | A, B | 90.0 | 66.7 | |||
| Wang et al 2019 | 52/52 | Taohong Siwu decoction (桃红四物汤) | 1 dose | 14 | D, F | 92.3 | 75.0 | |
| Li et al 2019 | 45/45 | Erchen and Taohong Siwu decoction (二陈合桃红四物汤） | 1 dose | 28 | C, D, E, F | 88.9 | 68.9 | |
| Zhang 2018 | 24/24 | Taoren Chuanxiong decoction (桃仁川芎汤) | 1 dose | 30 | A, B | 95.8 | 83.3 | |
| Zhao 2020 | 45/45 | 30 | A, B, D | 88.9 | 71.1 | |||
| Zhao 2020 | 60/60 | 90 | A, C | 93.3 | 73.3 | |||
| Liu et al 2014 | 40/40 | Salviae miltiorrhizae and ligustrazine hydrochloride injection (丹参川芎嗪注射液) | 40 mL | 28 | A, D | 87.5 | 72.5 | |
| Ding et al 2017 | 59/59 | 10 mL | 28 | A, D, E | - | - | ||
| Yin et al 2021 | 41/41 | Buyang Huanwu dection (补阳还五汤) | 1 dose | 60 | B, C | 95.1 | 68.3 | |
| Yang et al 2022 | 37/37 | 56 | C, F | 83.8 | 62.1 | |||
| Qu 2022 | 56/56 | 30 | C, D | 96.4 | 83.9 | |||
| Fan et al 2013 | 34/34 | Shuxuening injection (舒血宁注射液) | 20 mL | 7-21 | A, D, G | - | - | |
| Li et al 2015 | 42/42 | 10 mL | 7 | D | 90.5 | 73.8 | ||
| Huang et al 2013 | 52/52 | 15 mL | 21 | A, D | 92.3 | 73.1 | ||
| Wang et al 2015 | 34/34 | Ginkgo biloba extract (银杏叶提取物) | 20 mL | 14 | D | - | - | |
| Ni et al 2018 | 49/49 | A, B, D, F | 93.9 | 75.5 | ||||
| Min et al 2016 | 41/41 | 17.5 mg | 14 | A, D, F | 90.2 | 95.1 | ||
| Tian et al 2018 | 51/51 | Ginkgo Leaf Extract and Dipyridamole Injection (银杏达莫注射液) | 40 mL | 14 | A, D | 88.2 | 70.7 | |
| Geng et al 2019 | 60/78 | A, D, E | - | - | ||||
| Wei et al 2021 | 58/58 | 5 mL | 14 | A, D, F | - | - | ||
| Liu et al 2017 | 42/42 | Mailuoning injection (脉络宁注射液) | 20 mL | 28 | A, D, F | 92.9 | 76.1 | |
| Cheng et al 2018 | 39/39 | 30 | A, D | 94.9 | 64.1 | |||
| Zhou 2019 | 40/40 | 28 | - | 92.5 | 75.0 | |||
| Fan 2016 | 20/20 | Ciwujia injection (刺五加注射液) | 60 mL | 21 | - | 95.0 | 60.0 | |
| Miao et al 2014 | 34/35 | Naoxueshu oral liquid (脑血疏口服液) | 30 mL | 30 | A | 97.1 | 79.4 | |
| Chen et al 2016 | 32/35 | A, B, D, F | 80.0 | 62.5 | ||||
| Wu 2018 | 41/41 | A, D | 97.6 | 80.5 | ||||
| Liang 2013 | 20/20 | Yangxue Qingnao granule (养血清脑颗粒) | 12 g | 21 | A, D, F | 95.0 | 90.0 | |
| Qin et al 2013 | 42/42 | A, F | 76.2 | 46.9 | ||||
| Liang 2017 | 46/46 | - | D, F | 87.0 | 69.6 | |||
| Duo et al 2013 | 60/60 | Zhongfeng Capsules (中风胶囊) | 15 pills | 14 | D | 87.0 | 73.0 | |
| Feng 2013 | 35/35 | Xiaoyukang capsules (消瘀康胶囊) | 12 pills | 14 | A, D, F | 88.5 | 62.8 | |
| Song et al 2017 | 55/55 | A, D, F | 95.6 | 76.4 | ||||
| Xu et al 2022 | 59/59 | 10 | A, B, D, F | 98.3 | 83.1 | |||
| Li 2020 | 81/81 | 9 pills | 14 | A, D | 96.3 | 82.7 | ||
| Gao et al 2013 | 97/103 | Xuesaitong injection (血塞通注射液) | 500 mg | 14 | - | 90.3 | 80.4 | |
| Wang 2017 | 57/57 | 400 mg | 28 | A, D | 93.0 | 79.0 | ||
| Wang 2017 | 38/38 | Xueshuantong injection (血栓通注射液） | 175 mg | 14 | A, D | 92.1 | 73.7 | |
| Chen 2013 | 60/61 | Panax notoginseng saponins injection (三七皂苷注射液) | 350 mg | 14 | D | 90.2 | 76.7 | |
| Liu et al 2016 | 35/35 | - | 94.3 | 77.1 | ||||
| Chen 2015 | 54/54 | Xiangdan injection (香丹注射液) | 10 mL | 21 | D | - | - | |
| Liu 2016 | 40/40 | 20 mL | 15 | D | 95.0 | 75.0 | ||
| Ze 2021 | 1000/1000 | Huoxue Xingnao decoction (活血醒脑汤) | 1 dose | 21 | A, D, F | - | - | |
| Xiao C 2021 | 35/33 | A, D | - | - | ||||
| Wu 2018b | 30/30 | Qigui Huoxue decoction (芪归活血汤) | 1 dose | - | B | 90.0 | 70.0 | |
| Zhao et al 2013 | 60/60 | Huoxue Huayu Fang (活血化瘀方） | 1 dose | 21 | D, F | 85.0 | 63.3 | |
| Gai 2014 | 40/40 | C, F | 95.0 | 77.0 | ||||
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