The Pathological Complexity of Stroke and Rational Treatment Principles of Chinese Herbal Medicine

This paper first analyzes the complexity of pathological processes involved in acute hemorrhagic or ischemic stroke, including primary and secondary brain injury manifestations and mechanisms, potential transformations between hemorrhage and infarction, and the impact of postbrain injury inflammatio...

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Main Authors: Guanyuan Jin, Louis Lei Jin, Belinda Jie He
Format: Article
Language:English
Published: Georg Thieme Verlag KG 2025-03-01
Series:Chinese Medicine and Natural Products
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1807257
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author Guanyuan Jin
Louis Lei Jin
Belinda Jie He
author_facet Guanyuan Jin
Louis Lei Jin
Belinda Jie He
author_sort Guanyuan Jin
collection DOAJ
description This paper first analyzes the complexity of pathological processes involved in acute hemorrhagic or ischemic stroke, including primary and secondary brain injury manifestations and mechanisms, potential transformations between hemorrhage and infarction, and the impact of postbrain injury inflammation on disease progression. Based on decades of extensive clinical and pharmacological research on the usage of Chinese herbal medicine (CHM) monomers or formulas that promote blood circulation and remove blood stasis (such as Angong Niuhuang Wan, Buyang Huanwu Tang, Dahuoluo Wan, and Dushen Tang) for stroke treatment, it proposes that tonifying qi, promoting blood circulation, removing blood stasis, and detoxifying are rational treatment principles of CHM. These principles correspond to the following Western medical implications: tonifying qi corresponds to neuroprotection effects, promoting blood circulation corresponds to anticoagulation and thrombolysis, removing blood stasis addresses hematoma absorption and cerebral edema reduction, and detoxifying corresponds to anti-inflammatory actions. This paper further proposes from a systems medicine perspective that acute stroke is a complex disease requiring individualized CHM treatment with timely modifications rather than a one-size-fits-all approach. CHM monomers or formulas for promoting blood circulation and removing blood stasis, which have various effects such as lowering blood pressure, hemostasis, anticoagulation, antiplatelet, anti-inflammatory, promoting fibrinolysis, and edema reduction, must align with disease progression and be applied within appropriate therapeutic time windows to ensure efficacy and safety. Finally, this paper suggests that a combined use of acupuncture and CHM can potentially synergistically leverage their respective therapeutic strengths. Additionally, acupuncture shows clear benefits in the acute phase of intracerebral hemorrhage (ICH), such as stimulating the vagus nerve to enhance cerebral blood flow, reducing inflammation, as well as triggering hemostatic effects. By applying these rational treatment principles in an integrated approach, better CHM treatment outcomes and higher efficacy of stroke management may be attained.
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spelling doaj-art-bf6e923e666f4d8fb129ae25fbc8dc3a2025-08-20T02:16:29ZengGeorg Thieme Verlag KGChinese Medicine and Natural Products2096-918X2749-568X2025-03-010501e1e2210.1055/s-0045-1807257The Pathological Complexity of Stroke and Rational Treatment Principles of Chinese Herbal MedicineGuanyuan Jin0Louis Lei Jin1Belinda Jie He2International Institute of Systems Medicine, Milwaukee, Wisconsin, United StatesInternational Institute of Systems Medicine, Milwaukee, Wisconsin, United StatesInternational Institute of Systems Medicine, Milwaukee, Wisconsin, United StatesThis paper first analyzes the complexity of pathological processes involved in acute hemorrhagic or ischemic stroke, including primary and secondary brain injury manifestations and mechanisms, potential transformations between hemorrhage and infarction, and the impact of postbrain injury inflammation on disease progression. Based on decades of extensive clinical and pharmacological research on the usage of Chinese herbal medicine (CHM) monomers or formulas that promote blood circulation and remove blood stasis (such as Angong Niuhuang Wan, Buyang Huanwu Tang, Dahuoluo Wan, and Dushen Tang) for stroke treatment, it proposes that tonifying qi, promoting blood circulation, removing blood stasis, and detoxifying are rational treatment principles of CHM. These principles correspond to the following Western medical implications: tonifying qi corresponds to neuroprotection effects, promoting blood circulation corresponds to anticoagulation and thrombolysis, removing blood stasis addresses hematoma absorption and cerebral edema reduction, and detoxifying corresponds to anti-inflammatory actions. This paper further proposes from a systems medicine perspective that acute stroke is a complex disease requiring individualized CHM treatment with timely modifications rather than a one-size-fits-all approach. CHM monomers or formulas for promoting blood circulation and removing blood stasis, which have various effects such as lowering blood pressure, hemostasis, anticoagulation, antiplatelet, anti-inflammatory, promoting fibrinolysis, and edema reduction, must align with disease progression and be applied within appropriate therapeutic time windows to ensure efficacy and safety. Finally, this paper suggests that a combined use of acupuncture and CHM can potentially synergistically leverage their respective therapeutic strengths. Additionally, acupuncture shows clear benefits in the acute phase of intracerebral hemorrhage (ICH), such as stimulating the vagus nerve to enhance cerebral blood flow, reducing inflammation, as well as triggering hemostatic effects. By applying these rational treatment principles in an integrated approach, better CHM treatment outcomes and higher efficacy of stroke management may be attained.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1807257strokechinese herbal medicinetonifying qipromoting blood circulationremoving blood stasisdetoxifyinganti-inflammatorytherapeutic time windowstreatment with timely modification
spellingShingle Guanyuan Jin
Louis Lei Jin
Belinda Jie He
The Pathological Complexity of Stroke and Rational Treatment Principles of Chinese Herbal Medicine
Chinese Medicine and Natural Products
stroke
chinese herbal medicine
tonifying qi
promoting blood circulation
removing blood stasis
detoxifying
anti-inflammatory
therapeutic time windows
treatment with timely modification
title The Pathological Complexity of Stroke and Rational Treatment Principles of Chinese Herbal Medicine
title_full The Pathological Complexity of Stroke and Rational Treatment Principles of Chinese Herbal Medicine
title_fullStr The Pathological Complexity of Stroke and Rational Treatment Principles of Chinese Herbal Medicine
title_full_unstemmed The Pathological Complexity of Stroke and Rational Treatment Principles of Chinese Herbal Medicine
title_short The Pathological Complexity of Stroke and Rational Treatment Principles of Chinese Herbal Medicine
title_sort pathological complexity of stroke and rational treatment principles of chinese herbal medicine
topic stroke
chinese herbal medicine
tonifying qi
promoting blood circulation
removing blood stasis
detoxifying
anti-inflammatory
therapeutic time windows
treatment with timely modification
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0045-1807257
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