14B. Buyang Huanwu Decoction for Post-stroke Sequelae (Qi And Blood Stasis): A Systematic Review of Randomized Controlled Trials

Focus Area: Integrative Approaches to Care OBJECTIVE: Currently, Buyang Huanwu Decoction (BHD) used alone or integrated with Western drugs has been widely used as an alternative and effective method for the treatment of stroke of sequelae in China. Many clinical studies reported the effectiveness ranging from case reports and case series to controlled observational studies and randomized clinical trials, but the evidence for its effect is not clear. Our objective was to evaluate the clinical efficacy of Buyang Huanwu decoction (BHD) in treating sequelae of stroke. METHODS: Thirteen databases were searched from their inception through January 2013. Randomized clinical trials (RCTs) were included if BHD was used as the sole treatment or as a part of a combination treatments for post-stroke sequlae. Studies were included if they were placebo-controlled or controlled against a drug therapy or no treatment group. Cochrane criteria were used to assess the risk of bias. RESULTS: Our search strategy generated 105 hits, and 25 RCTs met our inclusion criteria. All the included RCTs were associated with a high risk of bias. The majority of BHD plus conventional treatments with response rate showed favorable effects compared to conventional treatments in individual studies. However, a meta-analysis suggested that BHD did not generate a better effect than conventional treatments (n=1534; RR, 1.19; 95% CI 1.14 to 1.25; P<.00001). The results of this systematic review provide no strong evidence for the effectiveness of BHD in the management for post-stroke sequlae. CONCLUSION: This systematic review showed that decoction in BHD for recuperation is effective and safety for stroke with sequlae. However, the total number of RCTs included in the analysis and their methodological quality were too low to draw firm conclusions. Future rigorous RCTs will be necessary to assess the clinical efficacy of HMs in this area.