Four Chinese Patent Medicines for Post-Stroke Sequelae
After patients survive cerebrovascular events such as cerebral thrombosis, cerebral infarction, or cerebral hemorrhage, they often develop sequelae such as hemiplegia, aphasia, hemianopia, hemisensory deficits, disturbances of consciousness, and psychiatric disturbances; these are collectively called post-stroke sequelae. The underlying cause is primary disease of local vessels followed by secondary thrombosis, which thickens the vessel wall and narrows or occludes the lumen, reducing or interrupting local cerebral blood flow; ischemia, hypoxia, and necrosis of brain tissue then produce focal neurological deficits.
The key to treating such diseases is to unblock the cerebral vessels, improve cerebral blood supply, and promote recovery of brain function. The earlier treatment begins the better; starting gradually one to two weeks after emergency resuscitation from a stroke gives the best results.
Treatment of post-stroke sequelae should adopt a comprehensive plan in which medication, acupuncture (which is very effective for post-stroke sequelae), and rehabilitation training proceed simultaneously. Grade-A secondary hospitals across China now mostly have rehabilitation departments that can help patients recover from post-stroke sequelae. Their rehabilitation facilities are relatively complete, and professionals guide patients through rehabilitation exercises, so patients who can should begin rehabilitation in a hospital rehabilitation department as early as possible after a stroke.
Those unable to do so may watch rehabilitation videos for post-stroke sequelae on their own and learn the techniques from the videos, but in the early stage it is best to have professionals guide rehabilitation in the hospital. Rehabilitation training videos for post-stroke sequelae can be found on video sites such as Bilibili. Acupuncture must be performed in the acupuncture department by a professional acupuncturist for targeted treatment.
Some patients develop secondary psychiatric disturbances after stroke (depression, anxiety, irritability). If the psychiatric symptoms are severe (such as assaulting others or self-harm), they still need antipsychotic drugs such as carbamazepine, olanzapine, or lithium carbonate prescribed by a psychiatrist, or Chinese patent medicines such as Jieyu Anshen Granule, Mengshi Guntan Wan, or Zhusha Anshen Wan.
This article introduces four commonly used Chinese patent medicines for post-stroke sequelae. Taking these medicines promptly after a stroke can, in some patients, improve post-stroke symptoms and quality of life.
Xiaoshuan Oral Liquid (or Xiaoshuan Capsule)
This product is composed of: Huangqi (Astragalus), Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), Dilong (Pheretima), Chuanxiong (Chuanxiong Rhizoma), Taoren (Persicae Semen), Honghua (Carthami Flos). It supplements qi, activates blood, and unblocks the collaterals. It is indicated for hemiplegia, deviation of the mouth and eye, slurred speech, drooling, flaccid paralysis of the lower limbs, and frequent urination caused by stroke. Dosage and administration follow the package insert. Patients with yin deficiency and yang hyperactivity, or a bleeding tendency, should use it cautiously.
This formula was built by combining and modifying elements of Huangqi Buxue Tang, Taohong Siwu Tang, and Buyang Huanwu Tang; it has some efficacy for post-stroke sequelae, especially ischemic cerebral thrombosis. However, its blood-activating and stasis-resolving action is strong, so the patient's response must be monitored closely during treatment. If the patient shows a bleeding tendency—such as epistaxis, black stools, or purpura—the drug should be stopped and medical care sought.
Xiaoshuan Zaizao Wan
This formula is composed of: Xuejie (Draconis Sanguis), Chishao, Moyao (Myrrha), Danggui, Niuxi (Achyranthis Bidentatae Radix), Danshen (Salviae Miltiorrhizae Radix), Chuanxiong, Guizhi (Cinnamomi Ramulus), Sanqi (Notoginseng), Doukou (Amomi Fructus Rotundus), Yujin (Curcumae Radix), Zhiqiao (Aurantii Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng), Chenxiang (Aquilariae Lignum), Jinqian Baihuashe (Bungarus Parvus), Jiangchan (Bombyx Batryticatus), Baifuzi (Typhonii Rhizoma), Tianma (Gastrodiae Rhizoma), Fangji (Stephaniae Tetrandrae Radix), Mugua (Chaenomelis Fructus), Quanxie (Scorpio), Tiesiweilingxian (Clematidis Radix), Huangqi, Zexie (Alismatis Rhizoma), Fuling (Poria), Duzhong (Eucommiae Cortex), Huaihua (Sophorae Flos), Maidong (Ophiopogonis Radix), Wuweizi (Schisandrae Fructus), Gusubum (Drynariae Rhizoma), Songxiang (Colophonium), Shanzha (Crataegi Fructus), Rougui (Cinnamomi Cortex), Bingpian (Borneolum), Suhexing (Styrax), Anxixiang (Benzoinum), Zhusha (Cinnabaris), and others.
Xiaoshuan Zaizao Wan activates blood and resolves stasis, extinguishes wind and unblocks the collaterals, supplements qi and nourishes blood, and dissolves thrombi. It is indicated for post-stroke sequelae due to qi deficiency and blood stasis with wind-phlegm obstructing the collaterals, presenting with limb paralysis, hemiplegia, deviation of the mouth and eye, speech disturbance, and chest oppression. Dosage and administration follow the package insert. It is available as small water-honey pills and large honey pills; patients may choose the dosage form they prefer.
This formula is relatively complex; most herbs have anticoagulant and thrombolytic effects, and it also contains various symptomatic herbs that have some effect on relieving psychiatric disturbance. But some of the herbs (such as Zhusha and Baifuzi) are quite toxic; overdose or prolonged use easily causes poisoning, so patients must control dosage and course carefully.
Xiaoshuan Tongluo Tablets (or Capsules or Granules)
This formula is composed of: Chuanxiong, Danshen, Huangqi, Zexie, Sanqi, Huaihua, Guizhi, Yujin, Muxiang (Aucklandiae Radix), Bingpian, Shanzha, and others. It activates blood and resolves stasis, warms the vessels and unblocks the collaterals. It is indicated for post-stroke sequelae due to static blood obstructing the collaterals, presenting with dull expression, slurred speech, cold hands and feet, and limb pain, as well as for ischemic stroke and hyperlipidemia presenting with the above symptoms. Dosage and administration follow the package insert. Those with yin deficiency and internal heat should use it cautiously; those with a bleeding tendency should use it cautiously; those with prominent wind-fire or phlegm-heat patterns are contraindicated.
Xiaoshuan Tong Granule
This formula is composed of: Huangqi, Danggui, Dihuang (Rehmanniae Radix), Taoren, Chishao, Chuanxiong, Dilong, Zhishi (Aurantii Fructus Immaturus), Sanqi, Danshen, Gancao (Glycyrrhizae Radix), Honghua, Niuxi, Bingpian, and others. It supplements qi and activates blood, dispels stasis and unblocks the collaterals. It is indicated for post-stroke sequelae due to qi-blood stasis, presenting with hemiplegia, deviation of the mouth and tongue, slurred speech, headache, chest pain, and hypochondriac pain; it also has some preventive effect in patients with impending stroke (mild cerebral thrombosis or forming thrombosis). Dosage and administration follow the package insert.
This formula was also built by modifying Taohong Siwu Tang, Huangqi Danggui Buxue Tang, and Buyang Huanwu Tang, but its anticoagulant and thrombolytic action is stronger than that of Xiaoshuan Oral Liquid, so those with a bleeding tendency should use it cautiously.
Note: stroke (cerebral hemorrhage, cerebral thrombosis) has high mortality and disability rates. Once a stroke occurs, the patient must be taken immediately to a hospital's neurology or neurosurgery department for inpatient treatment; it cannot be managed with oral medication alone. Since ancient times, TCM classics have recorded very high mortality from stroke; the Qing-dynasty physician Xu Lingtai even stated that at that time the mortality of stroke approached 100%. But modern critical-care medicine is advanced and can greatly reduce stroke mortality. This shows that TCM does not excel at rescuing stroke patients, with a lower success rate than modern medicine; patients and families must not delay the best treatment window by blindly believing in TCM.
Post-stroke sequelae are common, and the condition is chronic; long-term hospitalization is unrealistic, and Chinese patent medicines may serve as adjuvant therapy. If the comprehensive treatment plan described at the start of this article is used, rehabilitation results will be better, faster, and less costly overall. The golden window for treating post-stroke sequelae is within six months after the stroke; sequelae lasting beyond six months are difficult to treat and require much more complex medication than these patent medicines, under the guidance of a specialist.
During treatment of post-stroke sequelae, blood pressure must be monitored closely, and hypertensive patients must not stop their antihypertensive drugs. If anticoagulants (such as aspirin or blood-activating, stasis-resolving Chinese patent medicines) are used later, watch closely for bleeding; once a bleeding tendency appears (black stools mean gastric bleeding; epistaxis or subcutaneous purpura also mean bleeding), stop the drug immediately and seek medical care to prevent a second stroke.
Post-stroke sequelae are difficult to treat. If a patient taking Chinese patent medicines on their own shows no improvement after two weeks, they should stop and promptly seek more targeted treatment from a specialist. Treatment should not be delayed; delay lengthens the rehabilitation needed and increases the medical burden. Timely, correct treatment can prevent or reduce most post-stroke sequelae.
In addition, secondary hospitals, fearing that getting patients out of bed too early may cause a second stroke, often adopt relatively conservative plans to avoid medical risk, which raises the likelihood of post-stroke sequelae. Families of reasonable means should, after the acute episode is handled, begin rehabilitation as early as possible in a specialized hospital or the rehabilitation department of a tertiary hospital; this improves the patient's later quality of life.
This article only presents treatment plans for post-stroke sequelae; the medicines mentioned are available at pharmacies or hospitals nationwide. Readers should not contact the author to buy these medicines.