Buyang Huanwu Decoction With Wuling Powder for Acute Ischemic Stroke

Liaoning University of Traditional Chinese Medicine102 enrolled

Overview

Acute ischemic stroke is a common cause of disability. Standard Western medical treatment is widely used, but some patients continue to have neurological impairment and difficulty with daily activities after stroke. This study evaluated whether Buyang Huanwu Decoction combined with Wuling Powder, when added to standard Western medical treatment, could help improve recovery in patients with acute ischemic stroke. Eligible patients were randomly assigned to receive either standard Western medical treatment alone or standard Western medical treatment plus Buyang Huanwu Decoction combined with Wuling Powder for 14 days. The study assessed neurological function, activities of daily living, disability outcomes, and short-term safety. Blood samples were also collected to explore changes in serum metabolites and redox-related biomarkers that may be related to treatment response. A non-stroke reference group was included only for serum metabolomic comparison and was not part of the randomized treatment comparison.

This single-center, randomized, assessor-blinded, controlled clinical study was designed to evaluate Buyang Huanwu Decoction combined with Wuling Powder as an adjunct to standard Western medical treatment in patients with acute ischemic stroke. Eligible patients with acute ischemic stroke were randomly assigned to receive standard Western medical treatment alone or standard Western medical treatment plus Buyang Huanwu Decoction combined with Wuling Powder for 14 days. Because the intervention involved an oral herbal decoction, participant blinding was not feasible. Clinical outcome assessors, laboratory technicians, and metabolomics analysts were blinded to group allocation. The clinical part of the study focused on neurological function, activities of daily living, disability outcomes, and short-term safety. These were assessed using the National Institutes of Health Stroke Scale, Barthel Index, modified Rankin Scale, and adverse event monitoring. The exploratory mechanistic part of the study examined serum drug-derived constituents, untargeted serum metabolomic profiles, and redox-related biomarkers. Serum samples were collected from patients with acute ischemic stroke before and after treatment. A non-stroke reference group provided serum samples for metabolomic comparison only and was not included in the randomized treatment comparison.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Interventions

Standard Western Medical TreatmentPROCEDURE

Standard guideline-based medical care for acute ischemic stroke.

Serum Sample Collection for Metabolomics OnlyOTHER

Blood samples collected for metabolomic profiling only.

Buyang Huanwu Decoction Combined With Wuling PowderDRUG

14-day oral decoction, twice daily, composed of Astragali Radix, Angelicae Sinensis Radix, and other herbs as specified.

Standard Western Medical TreatmentPROCEDURE

Guideline-based acute ischemic stroke management.

Eligibility

Sex: ALLMin age: 20 YearsMax age: 75 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: Clinical diagnosis of acute ischemic stroke confirmed by CT or MRI Age 40-75 years (stroke group) Age 20-75 years (non-stroke reference group) Enrollment within 7 days of symptom onset NIHSS score 4-22 mRS score 2-4 First-ever ischemic stroke or prior infarction without baseline disability No intravenous thrombolysis, thrombectomy, or vascular stenting Written informed consent obtained Exclusion Criteria: Transient ischemic attack or hemorrhagic stroke Subarachnoid hemorrhage or vascular malformation Lacunar infarction or large infarction with severe edema Non-atherothrombotic stroke causes (tumor, trauma, metabolic, parasitic, rheumatic heart disease) Severe cardiac, hepatic, renal, hematologic, or endocrine disease Severe psychiatric or cognitive impairment Severe physical disability affecting evaluation Pregnancy or lactation Drug allergy or bleeding tendency Participation in other clinical trials within 4 weeks Progressive stroke Use of organ-damaging drugs within 4 weeks

Outcomes

Primary Outcomes

Change in National Institutes of Health Stroke Scale (NIHSS; 0-42) score from baseline to Day 14

The National Institutes of Health Stroke Scale was used to assess neurological deficit severity in patients with acute ischemic stroke. Scores were assessed before treatment and after 14 days of treatment. A lower score indicates less severe neurological impairment. Scale: 0-42 Higher score = worse neurological deficit Lower score = improvement

Time frame: Baseline and Day 14

Change in Barthel Index (0-100) score from baseline to Day 14

Range: 0-100 Higher score = better activities of daily living The Barthel Index was used to assess activities of daily living in patients with acute ischemic stroke. Scores were assessed before treatment and after 14 days of treatment. A higher score indicates better ability to perform activities of daily living.

Time frame: Baseline and Day 14

Change in modified Rankin Scale (mRS; 0-6) score from baseline to Day 14

Range: 0-6 Higher score = worse disability The modified Rankin Scale was used to assess disability outcome in patients with acute ischemic stroke. Scores were assessed before treatment and after 14 days of treatment. A lower score indicates less disability.

Time frame: Baseline and Day 14

Secondary Outcomes

Modified Rankin Scale Score at 90 Days After Stroke Onset

The modified Rankin Scale was assessed at 90 days after stroke onset to evaluate longer-term functional outcome. A lower score indicates less disability.

Time frame: 90 days after stroke onset

Incidence of Adverse Events During the Treatment Period

Safety was assessed by monitoring adverse events during the treatment period. The incidence, type, severity, duration, management, and outcome of adverse events were recorded.

Time frame: Baseline to Day 14

Change in serum MMP-9 (ng/mL) from baseline to Day 14

Serum MMP-9 levels were measured at baseline and Day 14 using ELISA.

Time frame: Baseline, Day 14

Change in serum superoxide dismutase (SOD; U/mL) from baseline to Day 14

Serum SOD levels were measured at baseline and Day 14 using ELISA.

Time frame: Baseline, Day 14

Change in serum malondialdehyde (MDA; nmol/mL) from baseline to Day 14

Serum MDA levels were measured at baseline and Day 14 using ELISA.

Time frame: Baseline, Day 14

Change in serum malondialdehyde (HO-1 (ng/mL)) from baseline to Day 14

Serum HO-1 levels were measured at baseline and Day 14 using ELISA.

Time frame: Baseline, Day 14

Change in serum malondialdehyde (Keap1 (ng/mL)) from baseline to Day 14

Serum Keap1 levels were measured at baseline and Day 14 using ELISA.

Time frame: Baseline, Day 14

Change in serum superoxide dismutase (NQO1 (ng/mL)) from baseline to Day 14

Serum NQO1 levels were measured at baseline and Day 14 using ELISA.

Time frame: Baseline, Day 14

Change in serum malondialdehyde (Nrf2 (ng/mL)) from baseline to Day 14

Serum Nrf2 levels were measured at baseline and Day 14 using ELISA.

Time frame: Baseline, Day 14

Serum metabolomic profile changes from baseline to Day 14

Serum metabolomic profiles were analyzed using ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry. Untargeted metabolomics was used to evaluate treatment-associated metabolic changes.

Time frame: Baseline, Day 14

Buyang Huanwu Decoction With Wuling Powder for Acute Ischemic Stroke

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes