Efficacy of Huangqi Guizhi Wuwu Decoction Combined with Conventional Therapy for Cerebral Infarction Recovery: A Systematic Review and Meta-Analysis

Jianguo Lin^1,2Tan Meng³Guanjun Jiang^4*

• ¹Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
• ²The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China
• ³Chongqing University of Chinese Medicine, Chongqing, China
• ⁴Longyou county Hospital of Traditional Chinese Medicine, Longyou, China

Background: Cerebral infarction is a leading cause of disability and mortality worldwide. Huangqi Guizhi Wuwu Decoction (HGWD), a classical Chinese herbal formula, is widely used in post-stroke rehabilitation, but its efficacy and safety have not been systematically evaluated. Objective: To assess the clinical efficacy and safety of HGWD combined with conventional therapy in patients during the recovery phase of cerebral infarction. Methods: A comprehensive search of six English and Chinese databases was conducted for randomized controlled trials (RCTs) from 2015 to 2025. Eligible studies compared HGWD plus conventional treatment versus conventional treatment alone. The primary outcome was the overall clinical efficacy rate; secondary outcomes included the National Institutes of Health Stroke Scale (NIHSS), hemodynamic parameters (Resistance Index [RI], Pulsatility Index [PI], and Mean Flow Velocity [Vm]), and adverse events. Meta-analysis was performed using R software, and study quality was assessed using the Cochrane Risk of Bias 2.0 tool. Results: Twelve RCTs involving 1,093 patients (547 in the HGWD group and 546 in the control group) were included. Compared with conventional therapy alone, HGWD significantly improved neurological function (NIHSS score change: SMD = 1.51, 95% CI: 0.91–2.11; I² = 94.8%, P < 0.0001) and increased the overall clinical efficacy rate (RR = 1.18, 95% CI: 1.12–1.25; I² = 0.0%, P= 0.9030). Cerebral hemodynamics also improved, with reductions in PI (SMD = 1.10, 95% CI: 0.92–1.28; I² = 0.0%), RI (SMD = 0.73, 95% CI: 0.55–0.91; I² = 0.0%), and increased Vm (SMD = 1.10, 95% CI: 0.86–1.35; I² = 50.8%). The incidence of adverse events did not differ significantly between groups (RR = 0.98, 95% CI: 0.54–1.77; I² = 0.0%), and sensitivity analyses confirmed the robustness of these findings. Conclusion: HGWD combined with conventional therapy may be effective in improving neurological recovery and cerebral perfusion in patients during the recovery phase of cerebral infarction. Despite limitations in study quality, these findings provide preliminary evidence supporting its use as a complementary treatment in stroke rehabilitation.