Abstract: Ischemic stroke (IS) is a severe cerebrovascular disease characterized by high incidence, disability, and mortality rates. Despite continuous advancements in medical technology, the clinical treatment of IS continues to face significant challenges. The pathological mechanisms of IS are complex and diverse, involving processes such as oxidative stress, neuroinflammation, and apoptosis. Traditional Chinese Medicine (TCM), a longstanding therapeutic system, has demonstrated unique advantages in IS treatment. The classical formula Buyang Huanwu Decoction (BYHWD) has become a commonly used prescription for treating stroke and its sequelae, particularly in East Asia. BYHWD, through its multi-pathway and multi-target mechanisms of action, can significantly enhance treatment efficacy while reducing adverse reactions. Exploring the molecular mechanisms of BYHWD offers the potential for a more comprehensive therapeutic strategy for global patients suffering from IS. This article outlines the key signaling pathways and therapeutic targets involved in the treatment of IS with BYHWD, including the PI3K-Akt pathway, autophagy, Nrf2, VEGF, inflammasome, the Notch pathway, NF-κB, and ferroptosis. Additionally, it summarizes the role of BYHWD in ameliorating neurological deficits through the regulation with synaptic plasticity, as well as the current progress in clinical applications and the development and utilization status of its derived preparations. This review aims to provide a solid theoretical foundation for further in-depth research and development of BYHWD, guiding the development of anti-IS drugs based on the holistic treatment concept of TCM formulas. Keywords: ISCHEMIC stroke, Buyang Huanwu decoction, traditional Chinese medicine, mechanisms, clinical treatment
Kuang et al. (Sun,) studied this question.