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Specific traditional Chinese medicine formulations show varied outcomes in patients with ischemic strokeSpecific Chinese medicine formulas may help some stroke patients

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Key Takeaway
Note that while specific TCM formulations show some benefit, evidence is not sufficient to support TCM as a class.

This meta-analysis evaluated the efficacy of various traditional Chinese medicine (TCM) formulations as adjunctive treatments for adults with imaging-confirmed ischemic stroke. The analysis included 12,348 patients and compared several specific formulations against placebo or standard care. The study reported several positive outcomes for specific products: Tongxinluo showed a favorable functional outcome at 90 days (OR 1.33, 95% CI 1.11 to 1.60). Panax notoginseng saponins were associated with functional independence at 3 months (OR 1.95, 95% CI 1.56 to 2.44). Qizhitongluo showed a mean difference of 1.81 points for lower-limb motor function at 12 weeks (95% CI 0.88 to 2.74). Additionally, Naoxintong and Dengzhan Shengmai were associated with reductions in 2-year recurrence (HR 0.665, 95% CI 0.492 to 0.899) and 1-year stroke incidence (HR 0.70, 95% CI 0.50 to 0.98), respectively.

Several limitations were noted, including incomplete safety reporting, lack of prospective registration, and the fact that findings are not replicated. The GRADE certainty for these findings ranged from moderate to very low. Because the results are highly specific to individual formulations rather than TCM as a general treatment class, the evidence does not support routine clinical use of TCM as a broad category for ischemic stroke management.

Recovering from a stroke is a long journey where every small improvement in movement or independence matters. A review of data from over 12,000 adults with ischemic stroke looked at how specific traditional Chinese medicine (TCM) formulas might help during recovery.

Researchers found that specific formulas showed different benefits. For example, Tongxinluo was linked to better functional outcomes at 90 days, while Panax notoginseng saponins were associated with better independence at three months. Other specific formulas, like Qizhitongluo, showed improvements in lower-limb motor function. Additionally, some formulas like Naoxintong and Dengzhan Shengmai were linked to lower rates of stroke recurrence over one to two years.

It is important to note that these findings are specific to each individual formula, not to traditional Chinese medicine as a whole. Because the evidence is not yet replicated and safety reporting was incomplete, these results do not currently support using these medicines as a standard routine treatment. Talk to your doctor to see if these specific options are right for your recovery plan.

What this means for you:
Specific Chinese medicine formulas may help some stroke patients, but results vary by formula and need more study.

Common questions

Which specific formulas showed the most promise?

Different formulas showed different benefits. Tongxinluo showed improvement in functional outcomes at 90 days. Panax notoginseng saponins were linked to better functional independence at 3 months. Qizhitongluo showed improved lower-limb motor function at 12 weeks. Naoxintong and Dengzhan Shengmai were linked to lower rates of stroke recurrence.

Is this a general treatment for all stroke patients?

No, the findings are specific to each individual formula rather than traditional Chinese medicine as a whole. Because the results are not yet replicated and safety reporting was incomplete, these findings do not support using these medicines as a routine treatment for everyone.

Are these treatments safe to use?

The study did not provide enough information on safety, side effects, or how well these treatments were tolerated by patients. You should always consult with your doctor before starting any new treatment to ensure it is safe for your specific health needs.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedSep 2026
View Original Abstract ↓
Ischemic stroke is a leading cause of death and long-term disability, and traditional Chinese medicine (TCM) is widely used alongside conventional care in East Asia. We reviewed randomized controlled trials (RCTs) of adjunctive TCM in ischemic stroke, analyzing the evidence by clinical phase and by individual formulation rather than as a single treatment class. We searched seven bibliographic databases and one clinical trial registry to 8 April 2026, for trials of adults with imaging-confirmed ischemic stroke given a TCM formulation in addition to standard care, compared with placebo plus standard care or standard care alone. Nine RCTs enrolling 12,348 randomized participants were eligible. They evaluated eight formulations across three clinical phases, with different outcome instruments and follow-up of 14 days to 24 months, so we did not pool them; each trial is reported with its published effect measure and synthesized under Synthesis Without Meta-analysis guidance. In acute treatment, Tongxinluo improved a favorable functional outcome at 90 days (modified Rankin Scale [mRS] 0 to 1: 640/973 vs. 575/973; odds ratio [OR] 1.33, 95% confidence interval [CI] 1.11 to 1.60), and Panax notoginseng saponins improved functional independence at 3 months (mRS 0 to 2: 1,328/1,487 vs. 1,218/1,479; OR 1.95, 95% CI 1.56 to 2.44); these thresholds are related but not interchangeable. Angong Niuhuang Pills and NeuroAiD (MLC601) showed no clear difference, and a small trial of Xueshuan Xinmai tablets reported no between-group estimate. In early recovery, Qizhitongluo improved lower-limb motor function at 12 weeks (mean difference 1.81 points, 95% CI 0.88 to 2.74). In secondary prevention, Naoxintong reduced 2-year recurrence [hazard ratio (HR) 0.665, 95% CI 0.492 to 0.899] and Dengzhan Shengmai reduced 1-year stroke incidence (HR 0.70, 95% CI 0.50 to 0.98). GRADE certainty, rated separately by formulation, clinical phase, and outcome, ranged from moderate to very low. Safety reporting was incomplete, so comparative safety cannot be established. The review was not prospectively registered and no dated protocol preceded screening. The findings are formulation-specific, unreplicated, and do not support routine clinical use or any conclusion about TCM as a treatment class.
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