Institute of Pharmacology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, 271016, China.
Institute of Pharmacology, Shandong First Medical University & Shandong Academy of Medical Sciences, 619 Chang Cheng Road, Tai'an, Shandong, 271016, People's Republic of China.
Metab Brain Dis. 2020 Jan;35(1):83-93. doi: 10.1007/s11011-019-00483-4. Epub 2019 Aug 22.
Post-stroke fatigue (PSF) is a common symptom after stroke and interferes with the rehabilitation. There are limited pharmacological therapies for managing PSF. Astragalus membranaceus (Huangqi) is a frequently used Chinese herbal medicine (CHM) in the treatment of fatigue in China. The aim of this review was to summarize the efficacy of adjuvant therapy with CHM Huangqi (CHM-HQ) in managing fatigue after stroke. We searched the databases in both English and Chinese for randomized controlled trials (RCTs) on CHM-HQ for PSF till November 2016. The Cochrane risk of bias tool was used to assess the quality of included trials, and the Review Manager 5.3 software was used to conduct the data analysis. Sixteen RCTs with a total of 1222 participants were included. The evidence was poor in quality with unclear or high risks of bias. Compared to routine intervention, treatment with CHM-HQ decreased the fatigue severity based on the assessment of the Fatigue Severity Scale, Fugl-Meyer and Visual Analogue Scale, and improved the quality of life as measured by the Stroke Specific Quality of Life scale, the Barthel index, and the modified Barthel index, while the adverse effects were mild. In conclusions, adjuvant therapy with CHM-HQ may benefit in managing fatigue and quality of life in stroke patients. However, stronger evidence is needed for a promising conclusion and more rigorous designs of RCTs are merited in the future.
中风后疲劳（PSF）是中风后的常见症状，并干扰康复。目前针对 PSF 的药物治疗方法有限。黄芪（Huangqi）是中国治疗疲劳时常用的中草药（CHM）。本综述的目的是总结辅助 CHM 黄芪（CHM-HQ）治疗中风后疲劳的疗效。我们检索了英文和中文数据库中关于 CHM-HQ 治疗 PSF 的随机对照试验（RCT），检索截止日期为 2016 年 11 月。采用 Cochrane 偏倚风险工具评估纳入试验的质量，并使用 Review Manager 5.3 软件进行数据分析。纳入了 16 项 RCT，共 1222 名参与者。证据质量差，偏倚风险不明确或高。与常规干预相比，CHM-HQ 治疗可降低疲劳严重程度（基于疲劳严重程度量表、Fugl-Meyer 和视觉模拟量表的评估），改善生活质量（基于中风专用生活质量量表、巴氏量表和改良巴氏量表的评估），而不良反应轻微。总之，辅助 CHM-HQ 治疗可能有益于管理中风患者的疲劳和生活质量。但是，需要更强的证据才能得出有前途的结论，未来值得进行更严格的 RCT 设计。
