Key result
Adding Astragalus-based TCM to Western medicine improves clinical efficacy, 6MWT, and natriuretic peptides in HF.
Why the study?
Heart failure incidence has been rising, and while traditional Chinese medicines containing Astragalus are widely used, definitive research on their efficacy remains lacking.
Does the addition of oral traditional Chinese medicines containing Astragalus to Western medicine improve clinical efficacy and surrogate markers in patients with heart failure?
Meta-Analysis (n=1,584)
Does the addition of oral traditional Chinese medicines containing Astragalus to Western medicine improve clinical efficacy and surrogate markers in patients with heart failure?
Adding Astragalus-containing traditional Chinese medicines to standard Western medicine may improve clinical efficacy and surrogate markers in heart failure, though high-quality randomized controlled trials are needed for validation.
Supports adjunctive Astragalus granule with Western medicine in heart failure; extends RCT evidence via network rankings of formulations.
Background: The incidence of cardiovascular diseases, particularly heart failure, has been rising year by year. Traditional Chinese medicines containing Astragalus have been widely used in clinical research. However, there is no definitive research on the efficacy of proprietary Chinese medicines containing Astragalus. A network meta-analysis was conducted to investigate the efficacy and safety of oral traditional Chinese medicines containing Astragalus for the treatment of heart failure. Methods: This study searched 6 databases for clinical randomized controlled trials involving the use of traditional Chinese herbal medicines containing Astragalus alone or in combination with other drugs, with a search period from the establishment of the databases to May 27, 2025. Using the Cochrane Quality Assessment Manual, we conducted a bias analysis of the included studies, and the extracted data were analyzed using network meta-analysis in Stata 18. Results: A total of 18 studies were included, involving 1584 patients with heart failure, with 16 types of traditional Chinese medicines containing Astragalus. The network meta-analysis via Surface Under the Cumulative Ranking Curve analysis indicated that: Compared to using Western medicine (WM) alone, Astragalus Granule + WM ranked best for improving overall clinical efficacy rate; Qiangxin Capsule + WM was optimal for improving six-minute walk test; Astragalus Granule + WM showed the best efficacy for reducing B-type natriuretic peptide levels; Yanxing Decoction + WM ranked first for lowering N-terminal pro-B-type natriuretic peptide levels; Xinlishen Compound + WM was the optimal combination for improving left ventricular ejection fraction; Qili Qiangxin Capsule + WM performed best for reducing left ventricular end-diastolic diameter; Yangxin Tongmai II Prescription + WM exhibited the highest efficacy for decreasing Minnesota Heart Failure Quality of Life Questionnaire scores. Conclusions: Adding oral traditional Chinese medicine containing Astragalus to WM treatment can further improve the clinical efficacy of heart failure. However, due to the limited number and quality of the included studies in this research, the above conclusions still require further validation through well-designed randomized double-blind controlled trials.
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Rui et al. (2026) conducted a meta-analysis in Heart failure (n=1,584). Oral traditional Chinese medicines containing Astragalus vs. Western medicine alone was evaluated on Overall clinical efficacy rate, six-minute walk test, B-type natriuretic peptide levels, N-terminal pro-B-type natriuretic peptide levels, left ventricular ejection fraction, left ventricular end-diastolic diameter, and Minnesota Heart Failure Quality of Life Questionnaire scores. Adding oral traditional Chinese medicine containing Astragalus to Western medicine improved overall clinical efficacy, 6-minute walk test, and natriuretic peptide levels in heart failure patients.
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