Sanhua decoction: Current understanding of a traditional herbal recipe for stroke

Lanlan Zheng; Linglei Meng; Huazheng Liang; Jiandao Yang

doi:10.3389/fnins.2023.1149833

Sanhua decoction: Current understanding of a traditional herbal recipe for stroke

Front Neurosci. 2023 Apr 13:17:1149833. doi: 10.3389/fnins.2023.1149833. eCollection 2023.

Authors

Lanlan Zheng^#¹, Linglei Meng^#¹, Huazheng Liang^{2

3

4

5}, Jiandao Yang¹

Affiliations

¹ Department of Neurology, Shanghai Jiangong Hospital, Shanghai, China.
² Clinical Research Center for Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
³ Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
⁴ Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
⁵ Monash Suzhou Research Institute, Suzhou Industrial Park, Suzhou, Jiangsu, China.

^# Contributed equally.

Abstract

Both thrombolytic and endovascular therapies are optimal treatment options for patients with acute ischemic stroke, but only less than half of these patients can benefit from these treatments. Traditional Chinese medicine has a long history of successfully managing ischemic stroke using both herbal and physical therapeutics. Among herbal recipes, Sanhua decoction (SHD) is one of the classical prescriptions for ischemic stroke. The present review aimed to summarize evidence from both clinical and basic research to demonstrate its efficacy in managing ischemic stroke and the potential mechanisms underlying its therapeutic effects, which will provide evidence on the therapeutic effect of this herbal recipe and guide future studies on this recipe. SHD is composed of four herbs, Rheum palmatum L. [Polygonaceae], Magnolia officinalis Rehder & E.H.Wilson [Magnoliaceae], Citrus × aurantium L. [Rutaceae], Hansenia weberbaueriana (Fedde ex H.Wolff) Pimenov & Kljuykov [Apiaceae]. We found that the majority of clinical studies on SHD are case reports and they showed positive therapeutic effect of SHD on both acute and chronic ischemic stroke. There are over 40 bioactive compounds identified in SHD, but few experimental studies have examined their individual molecular mechanisms. As an extract of SHD, it improves neurological functions through suppressing inflammation, protecting the blood brain barrier from degradation, restoring the number of neural stem cells, inhibiting apoptosis and brain edema, scavenging oxygen free radicals, and regulating the brain-gut axis. These will lay the theoretical foundation for future studies on this prescription and its clinical application. Future research may need to confirm its clinical efficacy in large-scale clinical trials and to disentangle its bioactive compounds and their potential mechanisms.

Keywords: Sanhua decoction; clinical efficacy; composition analysis; ischemic stroke; pharmacological analysis.

Publication types

Review

Grants and funding

This study was supported by a grant from Shanghai Fourth People’s Hospital awarded to HL (2019-001). The funder had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.