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Chinese herbal medicine as an adjunct to conventional therapy reduces carotid plaque area and improves lipid profilesChinese herbal medicine may help reduce carotid artery plaque

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Key Takeaway
Consider Chinese herbal medicine as a potential adjunct to reduce plaque area and improve lipid profiles in carotid atherosclerosis.

This meta-analysis evaluated the efficacy and safety of oral Chinese herbal medicine (CHM) as an adjunctive therapy to conventional treatment for patients with carotid atherosclerosis. The analysis included a total of 3,078 patients to assess impacts on carotid plaque area, intima-media thickness (IMT), and various lipid markers including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C).

Key findings indicate that CHM as an adjunct significantly reduced carotid plaque area (MD = 4.94; 95% CI: 3.13 to 6.76, p < 0.01) and intima-media thickness (MD = 0.12; 95% CI: 0.07 to 0.17, p < 0.05). Additionally, CHM was associated with reductions in TC (MD = 0.32; 95% CI: 0.22 to 0.42, p < 0.01), TG (MD = 0.24; 95% CI: 0.11 to 0.37, p < 0.01), and LDL-C (MD = 0.37; 95% CI: 0.21 to 0.53, p < 0.01), while HDL-C increased (MD = -0.20; 95% CI: -0.29 to -0.10, p < 0.01). Safety data indicated that adverse events were not significantly increased (RR = 0.84, 95% CI: 0.64 to 1.10, p = 0.20) and did not impair liver or kidney function.

The authors note that the overall quality and heterogeneity of the included studies limit the strength of the evidence. While CHM may be a promising adjunctive therapy for reducing plaque burden and improving lipid metabolism, the evidence is currently limited by study quality and heterogeneity.

How this fits prior evidence

This meta-analysis addresses a gap in the management of carotid atherosclerosis by evaluating Chinese herbal medicine as an adjunct to conventional therapy. It extends the evidence regarding lipid-modifying interventions, specifically building upon the finding that Tongxinluo plus statins may improve carotid atherosclerosis markers, though that evidence was of moderate to low certainty. This study provides a broader look at herbal adjuncts for plaque reduction and lipid metabolism in carotid atherosclerosis.

Living with carotid atherosclerosis means dealing with a buildup of plaque in the arteries of the neck. This buildup can restrict blood flow and poses risks to heart and brain health. Researchers looked at how adding oral Chinese herbal medicine to standard treatments affects these conditions.

In a review of data from over 3,000 patients, the results showed that this herbal addition helped reduce the size of carotid plaque and the thickness of the artery walls. It also improved lipid metabolism, which means it helped lower total cholesterol, triglycerides, and bad cholesterol while increasing good cholesterol.

While the results are promising, the evidence is not yet definitive. The study noted that the quality and variety of the original trials were inconsistent. However, the herbal treatment did not appear to cause more side effects than standard care alone and did not harm liver or kidney function. Talk to your doctor to see if this approach fits your specific health needs.

What this means for you:
Adding Chinese herbal medicine to standard care may reduce artery plaque and improve cholesterol levels.

Common questions

Can Chinese herbal medicine help with carotid artery plaque?

Yes, the data suggests that adding oral Chinese herbal medicine to standard treatment can reduce carotid plaque area and intima-media thickness. It also helps improve lipid levels by lowering total cholesterol, triglycerides, and LDL-C, while increasing HDL-C.

Is it safe to take these herbal medicines?

The study found that the herbal medicine did not significantly increase adverse events compared to standard care. It also did not impair liver or kidney function, though the overall quality of the research was varied.

How does this differ from standard treatment?

This approach uses Chinese herbal medicine as an addition to, not a replacement for, conventional therapy. It aims to improve both the physical size of the plaque and the body's cholesterol levels.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
BackgroundAlthough conventional therapies for Carotid atherosclerosis (CAS) remain the standard treatment, their effectiveness is often limited and accompanied by adverse effects. Chinese herbal medicine (CHM) is a promising adjunctive therapy for CAS; however, robust clinical evidence supporting its efficacy and safety remains limited.ObjectiveThis systematic review and meta-analysis evaluates the efficacy and safety of CHM for CAS treatment and characterizes its medication patterns.MethodsFive databases were searched from inception to December 2025. Randomized controlled trials (RCTs) evaluating oral CHM for CAS were included. Study quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Data were extracted and analyzed using RevMan v5.3 and R software. Sources of heterogeneity were investigated through meta-regression and subgroup analyses. Network analysis reveals herbal medication patterns across 21 studies.ResultsTwenty-one RCTs involving 3,078 patients were included. Compared with conventional therapy alone, adjunctive CHM significantly reduced carotid plaque area (MD = 4.94, 95% CI: 3.13 to 6.76, p < 0.01), intima-media thickness (IMT) (MD = 0.12, 95% CI: 0.07 to 0.17, p < 0.05), total cholesterol (TC) (MD = 0.32, 95% CI: 0.22 to 0.42, p < 0.01), triglycerides (TG) (MD = 0.24, 95% CI: 0.11 to 0.37, p < 0.01), and low-density lipoprotein cholesterol (LDL-C) (MD = 0.37, 95% CI: 0.21 to 0.53, p < 0.01), while greatly increasing high-density lipoprotein cholesterol (HDL-C) (MD = −0.20, 95% CI: −0.29 to −0.10, p < 0.01). CHM did not significantly increase the risk of adverse events (RR = 0.84, 95% CI: 0.64 to 1.10, p = 0.20) or impair liver/kidney function. Network analysis identified core actions as clearing phlegm and removing blood stasis, with Danshen (Salvia miltiorrhiza Bge.) and Banxia [Pinellia ternata (Thunb.) Breit.] as pivotal botanical drugs exerting anti-stasis and lipid-regulating effects.ConclusionAs an adjunct to conventional therapy, CHM may further reduce carotid IMT and plaque burden, improve lipid metabolism, and demonstrate a favorable safety profile. However, the overall quality and heterogeneity of the included studies limit the strength of the evidence, highlighting the need for well-designed, high-quality RCTs to confirm these findings.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420261285381, identifier CRD420261285381.
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