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Quantitative analysis of Chinese herbal medicine for post-stroke fatigue: a meta-analysis and medication pattern
Yunlu Liu1, Jiyue Wang1, Xinyuan Wu1
1Sports Medicine Key Laboratory of Sichuan Province, Key Laboratory of Sports Medicine, General Administration of Sport of China, School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China.
Background:
Post-stroke fatigue (PSF) is a common and distressing condition among stroke survivors. Chinese herbal medicine (CHM) is frequently utilized in China to manage PSF. However, robust synthesized evidence supporting its efficacy remains limited. This study integrates meta-analysis with medication pattern analysis to establish a comprehensive evidence base for the rational clinical application of CHM in PSF treatment.
Methods:
Relevant RCTs were retrieved from eight databases-including PubMed, Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure Chinese Biomedical Database (SinoMed), Chinese Scientific Journal Database (VIP), and Wanfang-up to March 2026. Meta-analysis was performed using Review Manager 5.4, while funnel plot and Egger's test were utilized to evaluate potential publication bias. Furthermore, we analyzed medication pattern in terms of usage frequency, properties, flavors, meridian tropism, and hierarchical cluster of Traditional Chinese Medicine actions of Chinese medicinal materials.
Results:
Nineteen trials involving 1,474 patients were included. Meta-analysis indicated that CHM significantly alleviated fatigue severity, as measured by fatigue severity scale. Evidence also suggested that CHM improved quality of life, motor function, and mood disorders. No significant publication bias was detected. Medication pattern analysis of 15 unique CHM formulas identified 52 Chinese medicinal materials, with high-frequency ingredients including Astragali radix, Angelicae sinensis radix, Chuanxiong rhizoma. The medicinal profiles were characterized by warm or slightly warm natures, sweet and pungent flavors, and tropism toward the spleen, liver, and heart meridians, reflecting core efficacies of tonifying deficiency and activating blood to resolve stasis.
Conclusion:
This study provides preliminary evidence for the clinical consideration of CHM in the management of post-stroke fatigue and highlights key Chinese medicinal materials and core TCM therapeutic strategies. However, further large-scale, multicenter randomized controlled trials are warranted to strengthen the evidence base and facilitate the integration of CHM into global clinical practice for post-stroke fatigue.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420261356354.
