Effects of hyperbaric oxygen combined with Danhong injection on 90-day functional independence and the 1-year recurrence rate in patients with ischemic stroke: A matched cohort study.

BACKGROUND

Both hyperbaric oxygen therapy and Danshen (Salvia miltiorrhiza) injection have shown potential therapeutic effects on ischemic stroke, but the impact of their combination on long-term functional outcomes and recurrence risk has not been systematically evaluated. This study aimed to assess the effects of hyperbaric oxygen combined with Danhong injection on 90-day functional independence and the 1-year recurrence rate in patients with ischaemic stroke.

METHODS

This study employed a retrospective matched cohort design and collected data from patients with ischemic stroke treated at our hospital between January 2018 and December 2022. After 1:1 propensity score matching, 80 patients were included in each group. The intervention group received hyperbaric oxygen therapy (2.0-2.5 ATA, once daily for 10 sessions) combined with Danhong injection (20 ml/day for 14 consecutive days) in addition to standard treatment; the control group received standard treatment only. The primary outcome was 90-day functional independence (mRS ≤2); secondary outcomes included the 1-year stroke recurrence rate, NIHSS score improvement, and others.

RESULTS

The percentage of 90-day functional independence in the intervention group (72.5 %) was significantly greater than that in the control group (53.8 %) (P = 0.014), with a relative risk ratio of 1.35 (95 % CI: 1.06-1.71). Multivariate analysis revealed that combined therapy was independently associated with 90-day functional independence (adjusted OR = 2.28, 95 % CI: 1.19-4.37; P = 0.013). The 1-year stroke recurrence rate in the intervention group (7.6 %) was significantly lower than that in the control group (16.5 %) (P = 0.042), with an adjusted hazard ratio of 0.46 (95 % CI: 0.22-0.94, P = 0.033). Subgroup analysis revealed that patients aged <65 years, those with NIHSS scores ranging from 4-15, those with small-artery occlusion or large-artery atherosclerosis stroke, and those who began treatment within 24 hours benefited more significantly. The combined therapy was well tolerated, with no serious adverse events.

CONCLUSION

Hyperbaric oxygen combined with Danhong injection significantly improved 90-day functional independence and reduced the 1-year recurrence risk in patients with ischaemic stroke, particularly in specific patient subgroups. This combined treatment strategy provides a new therapeutic option for comprehensive stroke management.