Baoyuan Decoction in the Treatment of Chronic Heart Failure: A Review

Q: What are the key findings of this study?

Baoyuan Decoction combined with conventional Western medicine improved the clinical response rate and LVEF in chronic heart failure.

Q: What is the clinical evidence from this study?

Study design: Review. Population: Chronic heart failure. Intervention: Baoyuan Decoction (alone or combined with conventional Western medicine or other TCM formulas) vs. Conventional Western medicine alone. Primary outcome: Overall clinical response rate (from cited meta-analysis of 12 RCTs, n=976) (RR 1.23, 95% CI 1.16-1.31, p=<0.00001).

Q: What does this research mean for the field?

Baoyuan Decoction combined with conventional Western medicine improves clinical response rates and left ventricular ejection fraction in chronic heart failure. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To systematically review the herbal composition, active chemical constituents, underlying biological mechanisms, and clinical research progress of Baoyuan Decoction in chronic heart failure.

doi:10.23977/medcm.2026.080205

January 1, 2026MEDS Chinese MedicineOpen Access

Baoyuan Decoction in the Treatment of Chronic Heart Failure: A Review

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Key result

Adding Baoyuan Decoction to conventional therapy yields ~23% higher clinical response in chronic heart failure.

RR 1.23
95% CI 1.16-1.31
P<0.00001

Why the study?

A systematic summary of the formula composition, chemical constituents, mechanisms, and clinical research progress of Baoyuan Decoction in chronic heart failure was needed to provide a theoretical basis for its rational clinical application.

Does Baoyuan Decoction combined with conventional Western medicine improve clinical efficacy, cardiac function, exercise tolerance, and quality of life in patients with chronic heart failure?

Key Points

To systematically review the herbal composition, active chemical constituents, underlying biological mechanisms, and clinical research progress of Baoyuan Decoction in chronic heart failure.
Narrative literature review synthesizing historical sources, herbal formulations, phytochemical analyses, preclinical models, and clinical studies of Baoyuan Decoction in cardiovascular disease.
The formula contains Ginseng Radix et Rhizoma, Astragali Radix, Cinnamomi Cortex, and Glycyrrhizae Radix et Rhizoma, rich in active flavonoids (liquiritin, calycosin) and saponins (ginsenosides, astragaloside IV).
Preclinical findings demonstrate that Baoyuan Decoction attenuates inflammation (downregulating TNF-α, TLR4, and NF-κB), improves mitochondrial energy metabolism, and suppresses cardiomyocyte apoptosis by regulating AT1R-CARP, upregulating Bcl-2, and downregulating p53, Bax, and cleaved caspase-3.

Structured PICO

Does Baoyuan Decoction combined with conventional Western medicine improve clinical efficacy, cardiac function, exercise tolerance, and quality of life in patients with chronic heart failure?

P

Population

Patients with chronic heart failure, particularly those presenting with traditional Chinese medicine patterns of Qi deficiency and blood stasis, evaluated across preclinical and clinical studies.

I

Intervention

Baoyuan Decoction (a traditional Chinese medicine formula composed of Ginseng Radix et Rhizoma, Astragali Radix, Cinnamomi Cortex, Glycyrrhizae Radix et Rhizoma, and ginger) and its modifications, typically administered in combination with conventional Western heart failure medications or other TCM formulas.

C

Comparator

Conventional Western medicine heart failure treatment alone

Main Result

Relative Risk: 1.23 (95% CI 1.16–1.31)

p-value: p=<0.00001

Limitations

Methodological quality of existing clinical studies is generally low
Most included RCTs failed to implement blinding or allocation concealment
Lack of large-sample, multi-center, high-quality clinical evidence
The methodological quality of existing clinical studies is generally low
Lack of large-sample, multi-center high-quality evidence

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Implication

This narrative review summarizes preclinical and clinical evidence indicating that Baoyuan Decoction combined with conventional Western therapy improves cardiac function, symptoms, and quality of life in chronic heart failure patients via multi-target cardioprotective mechanisms, though high-quality multicenter trials are still needed.

Abstract

Chronic heart failure (CHF) is the final stage of various cardiovascular diseases and is also one of the most lethal diseases worldwide. As a classical traditional Chinese medicine (TCM) formula for benefiting Qi and warming Yang, Baoyuan Decoction has demonstrated favorable clinical efficacy and safety in the treatment of CHF, particularly in patients with the Qi deficiency and blood stasis pattern. This review systematically summarizes the formula composition, chemical constituents, anti-CHF mechanisms, and clinical research progress of Baoyuan Decoction, aiming to provide a theoretical basis for its rational clinical application and to promote the development of TCM in the prevention and treatment of cardiovascular diseases.

Discussion

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Cite This Study

A 2026 study conducted a review in Chronic heart failure. Baoyuan Decoction (alone or combined with conventional Western medicine or other TCM formulas) vs. Conventional Western medicine alone was evaluated on Overall clinical response rate (from cited meta-analysis of 12 RCTs, n=976) (RR 1.23, 95% CI 1.16-1.31, p=<0.00001). Baoyuan Decoction combined with conventional Western medicine improved the clinical response rate and LVEF in chronic heart failure.

synapsesocial.com/papers/6af88e2c0e4d8f4b089c1ca2 https://doi.org/10.23977/medcm.2026.080205

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Baoyuan Decoction in the Treatment of Chronic Heart Failure: A Review

Key Points

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Baoyuan Decoction in the Treatment of Chronic Heart Failure: A Review

Key Points

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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