{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T16:02:21Z","timestamp":1776268941991,"version":"3.50.1"},"reference-count":109,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:p>Both thrombolytic and endovascular therapies are optimal treatment options for patients with acute ischemic stroke, but only less than half of these patients can benefit from these treatments. Traditional Chinese medicine has a long history of successfully managing ischemic stroke using both herbal and physical therapeutics. Among herbal recipes, Sanhua decoction (SHD) is one of the classical prescriptions for ischemic stroke. The present review aimed to summarize evidence from both clinical and basic research to demonstrate its efficacy in managing ischemic stroke and the potential mechanisms underlying its therapeutic effects, which will provide evidence on the therapeutic effect of this herbal recipe and guide future studies on this recipe. SHD is composed of four herbs, <jats:italic>Rheum palmatum<\/jats:italic> L. [Polygonaceae], <jats:italic>Magnolia officinalis<\/jats:italic> Rehder &amp;amp; E.H.Wilson [Magnoliaceae], Citrus \u00d7 aurantium L. [Rutaceae], Hansenia weberbaueriana (Fedde ex H.Wolff) Pimenov &amp;amp; Kljuykov [Apiaceae]. We found that the majority of clinical studies on SHD are case reports and they showed positive therapeutic effect of SHD on both acute and chronic ischemic stroke. There are over 40 bioactive compounds identified in SHD, but few experimental studies have examined their individual molecular mechanisms. As an extract of SHD, it improves neurological functions through suppressing inflammation, protecting the blood brain barrier from degradation, restoring the number of neural stem cells, inhibiting apoptosis and brain edema, scavenging oxygen free radicals, and regulating the brain-gut axis. These will lay the theoretical foundation for future studies on this prescription and its clinical application. Future research may need to confirm its clinical efficacy in large-scale clinical trials and to disentangle its bioactive compounds and their potential mechanisms.<\/jats:p>","DOI":"10.3389\/fnins.2023.1149833","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T04:48:52Z","timestamp":1681361332000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Sanhua decoction: Current understanding of a traditional herbal recipe for stroke"],"prefix":"10.3389","volume":"17","author":[{"given":"Lanlan","family":"Zheng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linglei","family":"Meng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huazheng","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiandao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1126\/science.abi6087","article-title":"Signaling inflammation across the gut-brain axis.","volume":"374","author":"Agirman","year":"2021","journal-title":"Science"},{"key":"B2","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/s12975-018-0617-z","article-title":"Release of IL-6 After stroke contributes to impaired cerebral autoregulation and hippocampal neuronal necrosis through NMDA receptor activation and upregulation of ET-1 and JNK.","volume":"10","author":"Armstead","year":"2019","journal-title":"Transl. Stroke. Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1007\/s11064-014-1326-y","article-title":"Protective effect of naringenin in experimental ischemic stroke: Down-regulated NOD2, RIP2, NF-\u03baB, MMP-9 and up-regulated claudin-5 expression.","volume":"39","author":"Bai","year":"2014","journal-title":"Neurochem. Res."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/jpsyneuen.2021.105640","article-title":"The gut microbiota-brain axis, psychobiotics and its influence on brain and behaviour: A systematic review.","volume":"137","author":"Barrio","year":"2022","journal-title":"Psychoneuroendocrinology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15912\/j.cnki.gocm.2022.05","article-title":"Analysis of clinical efficacy of traditional Chinese medicine in treating stroke.","volume":"2022","author":"Bi","year":"2022","journal-title":"Guide China. Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1161\/STROKEAHA.115.012166","article-title":"Inflammatory markers and outcomes after lacunar stroke: Levels of inflammatory markers in treatment of stroke study.","volume":"47","author":"Boehme","year":"2016","journal-title":"Stroke"},{"key":"B7","first-page":"1834","article-title":"Study on the treatment of stroke with Sanhua decoction.","volume":"27","author":"Chen","year":"2021","journal-title":"J. Basic. Chin. Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1485","DOI":"10.7501\/j.issn.0253-2670.2019.06","article-title":"Multifunctional regularity of Rhei Radix et Rhizoma in ancient and modern medicine.","volume":"50","author":"Chen","year":"2019","journal-title":"Chin. Trad. Herb. Drugs"},{"key":"B9","year":"2015","journal-title":"Chinese pharmacopoeia."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1877","DOI":"10.1152\/physrev.00018.2018","article-title":"The microbiota-gut-brain axis.","volume":"99","author":"Cryan","year":"2019","journal-title":"Physiol. Rev."},{"key":"B11","doi-asserted-by":"publisher","first-page":"3191","DOI":"10.1021\/pr801012x","article-title":"Vascular MMP-9\/TIMP-2 and neuronal MMP-10 up-regulation in human brain after stroke: A combined laser microdissection and protein array study.","volume":"8","author":"Cuadrado","year":"2009","journal-title":"J. Proteome. Res."},{"key":"B12","doi-asserted-by":"publisher","first-page":"4079","DOI":"10.3877\/cma.j.issn.1674-0785.2011.14.018","article-title":"Effects of Sanhua decoction on expression of sodium ion channel in cerebral infarct zone in rats.","volume":"5","author":"Dai","year":"2011","journal-title":"Chin. J. Clin."},{"key":"B13","author":"Dong","year":"2005","journal-title":"Qi Xiao Liang Fang."},{"key":"B14","doi-asserted-by":"publisher","first-page":"24","DOI":"10.3969\/j.issn.1674-7860.2018.25.008","article-title":"Pharmacological activity and clinical application of Dahuang.","volume":"10","author":"Du","year":"2018","journal-title":"Clin. J. Chin. Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"558","DOI":"10.13729\/j.issn.1671-7813.2005.06.068","article-title":"Therapeutic effect of guige sanhua decoction on 85 cases of stroke.","volume":"6","author":"Duan","year":"2005","journal-title":"J. Pract. Trad. Chin. Intern. Med."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.7666\/d.D01327537","author":"Duan","year":"2017","journal-title":"Stroke patients with limb dysfunctions during rehabilitation: Studies on their duel rehabilitation models in communities and at homes."},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.7666\/d.D458696","author":"Fan","year":"2010","journal-title":"The research on mechanism of Sanhuatang treating acute storke through regulating qi and recanalizing sweat pore."},{"key":"B18","doi-asserted-by":"publisher","first-page":"871","DOI":"10.16295\/j.cnki.0257-358x.2011.12.031","article-title":"Effect of Sanhua decoction on the expression of IL-1\u03b2 and ICAM-1 in brain tissue of rats with cerebral ischemia-reperfusion.","volume":"30","author":"Fan","year":"2011","journal-title":"Shandong J. Trad. Chin. Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"5","DOI":"10.13457\/j.cnki.jncm.2012.02.054","article-title":"Sanhua decoction recanalize sweat pore to treat acute stroke.","volume":"44","author":"Fan","year":"","journal-title":"New Chin. Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"216","DOI":"10.13422\/j.cnki.syfjx.2012.09.044","article-title":"The effect of Sanhua Tang on expression of ZO-1 in brain tissues of cerebral ischemia-reperfusion rat.","volume":"18","author":"Fan","year":"","journal-title":"Chin. J. Exp. Trad. Med. Form."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.3969\/j.issn.1008-0805.2009.06.034","article-title":"Effects of Sanhua Decoction on Na+-K+-ATPase activity and Ca2+-ATPase activity in gastrointestinal tissue of aged rats with cerebral ischemia-reperfusion.","volume":"20","author":"Fan","year":"2009","journal-title":"Lishizhen Med. Mater. Med. Res."},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-15-343","article-title":"MR CLEAN, a multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands: Study protocol for a randomized controlled trial.","volume":"15","author":"Fransen","year":"2014","journal-title":"Trials"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00057","article-title":"Sanhua decoction, a classic herbal prescription, exerts neuroprotection through regulating phosphorylated tau level and promoting adult endogenous neurogenesis after cerebral ischemia\/reperfusion injury.","volume":"11","author":"Fu","year":"2020","journal-title":"Front. Physiol."},{"key":"B24","author":"Gao","year":"1959","journal-title":"Yi Xue Wen Dui."},{"key":"B25","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1016\/S1474-4422(18)30322-3","article-title":"Global, regional, and national burden of migraine and tension-type headache, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016.","volume":"17","year":"2018","journal-title":"Lancet Neurol."},{"key":"B26","author":"Gong","year":"2007","journal-title":"Gu Jin Yi Jian."},{"key":"B27","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jep.2014.03.002","article-title":"1H NMR-based metabonomic analysis of the effect of optimized rhubarb aglycone on the plasma and urine metabolic fingerprints of focal cerebral ischemia-reperfusion rats.","volume":"154","author":"Guan","year":"2014","journal-title":"J. Ethnopharmacol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"2445","DOI":"10.3969\/j.issn.1001-1528.2019.10.033","article-title":"Research Progress on chemical constituents and pharmacological activities of Notopterygium.","volume":"41","author":"Guo","year":"2019","journal-title":"Chin. Trad. Patent Med."},{"key":"B29","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/S0140-6736(16)30962-X","article-title":"Stroke.","volume":"389","author":"Hankey","year":"2017","journal-title":"Lancet"},{"key":"B30","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.vph.2010.03.002","article-title":"Emodin and rhein inhibit LIGHT-induced monocytes migration by blocking of ROS production.","volume":"53","author":"Heo","year":"2010","journal-title":"Vasc. Pharmacol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"8278","DOI":"10.1007\/s12035-018-0986-z","article-title":"Resveratrol prevents the cellular damages induced by monocrotophos via pi3k signaling pathway in human cord blood mesenchymal stem cells.","volume":"55","author":"Jahan","year":"2018","journal-title":"Mol. Neurobiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"878","DOI":"10.3969\/j","article-title":"Mechanism research of emodin in the treatment of ischemic stroke based on network pharmacology and molecular docking.","volume":"16","author":"Jia","year":"2021","journal-title":"World Chin. Med."},{"key":"B33","doi-asserted-by":"publisher","first-page":"121","DOI":"10.19656\/j.cnki.1002-2406.200027","article-title":"Research progress on chemical constituents and pharmacology of rhubarb.","volume":"37","author":"Jin","year":"2020","journal-title":"Inform. Tradit . Chin. Med."},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines8080284","article-title":"Neuroprotection: Targeting multiple pathways by naturally occurring phytochemicals.","volume":"8","author":"Khan","year":"2020","journal-title":"Biomedicines"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.7666\/d.Y2914841","author":"Li","year":"2015","journal-title":"The effect of Sanhua decoction on neurogenesis after focal cerebral ischemia\/reperfusion injury in rats."},{"key":"B36","first-page":"140","article-title":"Analysis of clinical efficacy of traditional Chinese medical syndrome differentiation in the treatment of stroke.","volume":"24","author":"Li","year":"2018","journal-title":"Psychol. Doc."},{"key":"B37","doi-asserted-by":"publisher","first-page":"668","DOI":"10.3321\/j.issn:1006-2157.2008.10.005","article-title":"Influence of rhubarb aglycone on neurocytes and neurotrophic factors in rats with cerebral ischemia after BMSC transplantation.","volume":"31","author":"Li","year":"2008","journal-title":"J. Beijing Univ. Tradit . Chin. Med."},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004904","article-title":"Bioactive components of Chinese herbal medicine enhance endogenous neurogenesis in animal models of ischemic stroke: A systematic analysis.","volume":"95","author":"Li","year":"2016","journal-title":"Medicine"},{"key":"B39","doi-asserted-by":"publisher","first-page":"769","DOI":"10.3969\/j.issn","article-title":"Effect of rhubarb and its abstract on nitric oxide and tumor necrosis factor of cerebral ischemia rats.","volume":"23","author":"Li","year":"2003","journal-title":"Chin. J. Gerontol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"142","DOI":"10.3321\/j.issn:1673-8225.2005.21.077","article-title":"Effect of different- dose rhubarb aglycone on thrombosis, platelet aggregation and adhesion, and blood coagulation in rats with cerebral ischemia: Comparison with aspirin and Nimodipine.","volume":"9","author":"Li","year":"2005","journal-title":"Chin. J. Clin. Rehabil."},{"key":"B41","author":"Li","year":"2012","journal-title":"The impact of citrus aurantium on gastrointestinal dysfunction in acute stage of cerebral infarction."},{"key":"B42","doi-asserted-by":"publisher","first-page":"1072","DOI":"10.19945\/j.cnki.issn.1006-3250.2022.07.039","article-title":"Protective effect of sanhua decoction on blood-brain barrier in rats with cerebral ischemia reperfusion injury.","volume":"28","author":"Li","year":"2022","journal-title":"J. Basic Chin. Med"},{"key":"B43","article-title":"60 cases of Stroke Treated with modified Sanhua Decoction.","volume":"5","author":"Li","year":"2008","journal-title":"Jilin J. Chin. Med."},{"key":"B44","doi-asserted-by":"publisher","first-page":"145","DOI":"10.13194\/j.issn.1673-842x.2019.11.037","article-title":"New progress in traditional Chinese medicine treatment of ischemic stroke.","volume":"21","author":"Li","year":"2019","journal-title":"J. Liaoning Univ. Tradit . Chin. Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"296","DOI":"10.13286\/j.cnki.chinhosppharmacyj.2015.04.05","article-title":"Protective effect of different extracts from Notopterygium against cerebral ischemia and anoxia in mice.","volume":"35","author":"Li","year":"2015","journal-title":"Chin. J. Hosp. Pharm."},{"key":"B46","author":"Li","year":"1998","journal-title":"Lei Gong Pao Zhi Yao Xing Jie."},{"key":"B47","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.brainres.2003.08.026","article-title":"Honokiol protects rat brain from focal cerebral ischemia-reperfusion injury by inhibiting neutrophil infiltration and reactive oxygen species production.","volume":"992","author":"Liou","year":"2003","journal-title":"Brain Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"61","DOI":"10.3969\/j.issn.1004-6852.2011.07.024","article-title":"Observation on treating acute ischemic stroke for 28 cases with Sanhuatang.","volume":"24","author":"Liu","year":"2011","journal-title":"West. J. Tradit . Chin. Med"},{"key":"B49","doi-asserted-by":"publisher","first-page":"158","DOI":"10.3969\/j.issn.1004-745X.2005.02.034","article-title":"The influence of rhubarb\u2019s glucoside and aglycone on cytokines of rats with cerebral ischemia.","volume":"14","author":"Liu","year":"2005","journal-title":"J. Emerg. Tradit. Chin. Med"},{"key":"B50","first-page":"554","article-title":"Analysis of clinical efficacy of integrated traditional Chinese and western medicine in treating stroke.","volume":"25","author":"Liu","year":"2013","journal-title":"Med. Inform."},{"key":"B51","author":"Liu","year":"2007","journal-title":"Su Wen Bing Ji Qi Yi Bao Ming Ji."},{"key":"B52","first-page":"882","article-title":"Protective effects of orally administered honokiol on cerebral ischemia reperfusion in rats and on stroke in SHRsp.","volume":"25","author":"Liu","year":"2016","journal-title":"J. Chin. Pharm. Sci."},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2020.110433","article-title":"Targeting foam cell formation and macrophage polarization in atherosclerosis: The therapeutic potential of rhubarb.","volume":"129","author":"Liu","year":"2020","journal-title":"Biomed. Pharmacother."},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/584245","article-title":"Neuroprotection of Sanhua decoction against focal cerebral ischemia\/reperfusion injury in rats through a mechanism targeting aquaporin 4.","volume":"2015","author":"Lu","year":"2015","journal-title":"Evid. Based. Complement. Alternat. Med."},{"key":"B55","first-page":"101","article-title":"Antithrombotic effects of nine traditional Chinese medicines.","author":"Lv","year":"1981","journal-title":"Chin. J. Integr. Tradit. West. Med."},{"key":"B56","doi-asserted-by":"publisher","first-page":"85","DOI":"10.3969\/j.issn.1003-8914.2007.01.065","article-title":"Therapeutic effect of Xiongchang Sanhua decoction on acute stroke.","volume":"22","author":"Meng","year":"2007","journal-title":"Guangming Chin. Med."},{"key":"B57","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1159\/000430315","article-title":"Diesel exhaust particles induce impairment of vascular and cardiac homeostasis in mice: Ameliorative effect of emodin.","volume":"36","author":"Nemmar","year":"2015","journal-title":"Cell. Physiol. Biochem."},{"key":"B58","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1016\/S0140-6736(18)31269-8","article-title":"Prevention of stroke: A global perspective.","volume":"392","author":"Pandian","year":"2018","journal-title":"Lancet"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-021-05092-0","article-title":"MR CLEAN-LATE, a multicenter randomized clinical trial of endovascular treatment of acute ischemic stroke in The Netherlands for late arrivals: Study protocol for a randomized controlled trial.","volume":"22","author":"Pirson","year":"2021","journal-title":"Trials"},{"key":"B60","author":"Qiu","year":"2014","journal-title":"Effects of citrus aurantium on the structure and function of Cajal cells in gastrointestinal tract of cerebral infarction rats."},{"key":"B61","doi-asserted-by":"publisher","first-page":"455","DOI":"10.3969\/j.issn.1672-979X.2017.06.020","article-title":"Research progress in Aurantii Fructus Immaturus.","volume":"19","author":"Qu","year":"2017","journal-title":"Food Drug"},{"key":"B62","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1097\/NRL.0000000000000011","article-title":"Perfusion imaging in the 3-hour time window predicts a tPA-associated hemorrhage in acute ischemic stroke.","volume":"19","author":"Rangaraju","year":"2015","journal-title":"Neurologist"},{"key":"B63","doi-asserted-by":"publisher","first-page":"S131","DOI":"10.33549\/physiolres.934345","article-title":"The PI3k\/Akt pathway is associated with angiogenesis, oxidative stress and survival of mesenchymal stem cells in pathophysiologic condition in ischemia.","author":"Samakova","year":"2019","journal-title":"Physiol. Res."},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.3390\/jcm5060056","article-title":"Angiogenesis in ischemic stroke and angiogenic effects of Chinese herbal medicine.","volume":"5","author":"Seto","year":"2016","journal-title":"J. Clin. Med."},{"key":"B65","first-page":"1239","article-title":"Textual research on application of the drug properties of notopterygium root and its effect.","volume":"32","author":"Shi","year":"2017","journal-title":"Acta Chin. Med."},{"key":"B66","first-page":"1828","article-title":"An Junming\u2019s experience in the treatment of aphasia after stroke with acupuncture.","volume":"39","author":"Si","year":"2019","journal-title":"Henan Tradit. Chin. Med."},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1016\/j.phrs.2021.105840","article-title":"The role of microbiota-gut-brain axis in neuropsychiatric and neurological disorders.","volume":"172","author":"Soca\u0142a","year":"2021","journal-title":"Pharmacol. Res."},{"key":"B68","author":"Song","year":"2019","journal-title":"Rhein protects against endothelial function and atherosclerosis by targeting SIRT1 signaling pathway."},{"key":"B69","doi-asserted-by":"publisher","first-page":"51","DOI":"10.3724\/SP.J.1329.2016.06051","article-title":"Discussion on effect of wind on stroke incidence and course of disease from two Sanhua decoction.","volume":"26","author":"Song","year":"2016","journal-title":"Rehabil. Med."},{"key":"B70","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2020.e03259","article-title":"Skull diplo\u00eb is rich in aquaporin-4.","volume":"6","author":"Suzuki","year":"2020","journal-title":"Heliyon"},{"key":"B71","doi-asserted-by":"publisher","first-page":"228","DOI":"10.13422\/j.cnki.syfjx.20201866","article-title":"Research progress in modern pharmacology of Magnolia officinalis.","volume":"26","author":"Tan","year":"2020","journal-title":"Chin. J. Exp. Trad. Med. Form."},{"key":"B72","doi-asserted-by":"publisher","first-page":"767","DOI":"10.3969\/j.issn.1003-5699.2008.10.047","article-title":"Effect of Sanhua decoction on the contents of SOD and MDA in brain tissue of aged rats with cerebral ischemia-reperfusion.","volume":"28","author":"Tang","year":"2008","journal-title":"Jilin J. Chin. Med."},{"key":"B73","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.3969\/j.issn.1001-1978.2020.09.022","article-title":"Inhibition of rhubarb extract on apoptosis in ischemic brain injury rats.","volume":"36","author":"Tang","year":"2020","journal-title":"Chin. Pharmacol. Bull."},{"key":"B74","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3969\/j.issn.1000-3614.2019.02.001","article-title":"The prevention and treatment of stroke still face huge challenges\u2013brief report on stroke prevention and treatment in China, 2018.","volume":"34","author":"Wang","year":"2019","journal-title":"Chin. Circ. J."},{"key":"B75","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1161\/CIRCULATIONAHA.116.025250","article-title":"Prevalence, incidence, and mortality of stroke in china: Results from a nationwide population-based survey of 480,687 adults.","volume":"135","author":"Wang","year":"2017","journal-title":"Circulation"},{"key":"B76","doi-asserted-by":"publisher","first-page":"303","DOI":"10.16448\/j.cjtcm.2017.0099","article-title":"The formation and development of etiology and pathogenesis theory for stroke.","volume":"29","author":"Wang","year":"2017","journal-title":"Clin. J. Tradit. Chin. Med."},{"key":"B77","first-page":"561","article-title":"Effects of dredging Fu organs, dispersing phlegm and activating blood method on antithrombin III, prostacyclin, thromboxane A2 levels in patients with acute cerebral infarction.","volume":"24","author":"Wang","year":"2017","journal-title":"Chin. J. Tradit. Med. Sci. Technol."},{"key":"B78","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1111\/1440-1681.12775","article-title":"Naringenin prevents ischaemic stroke damage via anti-apoptotic and anti-oxidant effects.","volume":"44","author":"Wang","year":"","journal-title":"Clin. Exp. Pharmacol. Physiol."},{"key":"B79","doi-asserted-by":"publisher","first-page":"1582","DOI":"10.3892\/ijmm.2017.3134","article-title":"Naringenin reduces oxidative stress and improves mitochondrial dysfunction via activation of the Nrf2\/ARE signaling pathway in neurons.","volume":"40","author":"Wang","year":"","journal-title":"Int. J. Mol. Med."},{"key":"B80","doi-asserted-by":"publisher","first-page":"1871","DOI":"10.16448\/j.cjtcm.2022.1020","article-title":"Study on the mechanism of Sanhua Decoction in treating ischemic stroke.","volume":"34","author":"Wang","year":"2022","journal-title":"Clin. J. Tradit. Chin. Med"},{"key":"B81","doi-asserted-by":"publisher","first-page":"358","DOI":"10.12083\/SYSJ.2020.04.075","article-title":"Research progress on naringenin\u2019s neuroprotective effect.","volume":"23","author":"Wang","year":"2020","journal-title":"Chin. J. Pract. Nerv. Dis."},{"key":"B82","doi-asserted-by":"publisher","first-page":"333","DOI":"10.3969\/j.issn.1006-1959.2015.31.507","article-title":"Clinical study of the treatment of acute ischemic stroke with Sanhua decoction.","volume":"31","author":"Wang","year":"2015","journal-title":"Med. Inform."},{"key":"B83","doi-asserted-by":"publisher","first-page":"1047","DOI":"10.16295\/j.cnki.0257-358x.2020.10.004","article-title":"Application of relax bowels combined with other methods in treating apoplexy.","volume":"39","author":"Wang","year":"2020","journal-title":"Shandong J. Tradit. Chin. Med."},{"key":"B84","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1672-2205.2013.01.001","article-title":"Origin and development of therapy of resolving phlegm and relaxing bowels for treating syndrome of phlegm heat and bowel excess of stroke (I): History, origin, syndromes, pathogenesis and clinical application.","volume":"20","author":"Wang","year":"2013","journal-title":"Modern Chin. Clin. Med."},{"key":"B85","doi-asserted-by":"publisher","first-page":"140","DOI":"10.6039\/j.issn.1001-0408.2019.01.29","article-title":"Herbal textual research, authenticity identification, chemical constituents, pharmacological effects, clinical application and emerging research of Magnolia officinalis.","volume":"30","author":"Wei","year":"2019","journal-title":"China Pharm."},{"key":"B86","doi-asserted-by":"publisher","first-page":"934","DOI":"10.3969\/j.issn.1004-745X.2009.06.049","article-title":"Effects of emodin on gene expression of NF-KB and ICAM-1 in cerebral tissue of rats with ischemic stroke.","volume":"18","author":"Wu","year":"2009","journal-title":"J. Emerg. Tradit. Chin. Med"},{"key":"B87","doi-asserted-by":"publisher","first-page":"783","DOI":"10.3892\/mmr.2018.9713","article-title":"PI3K\/Akt signaling transduction pathway, erythropoiesis and glycolysis in hypoxia (Review).","volume":"19","author":"Xie","year":"2019","journal-title":"Mol. Med. Rep."},{"key":"B88","doi-asserted-by":"publisher","first-page":"37","DOI":"10.3969\/j.issn.1004-","article-title":"Connotative analysis of the formulation of Sanhua Decoction in the treatment of stroke based on network pharmacology.","volume":"37","author":"Yang","year":"","journal-title":"Northwest. Pharm. J."},{"key":"B89","first-page":"1","article-title":"Research progress on clinical application and pharmacological activity of Notopterygium.","volume":"4","author":"Yang","year":"","journal-title":"J. Pract. Tradit. Chin. Intern. Med."},{"key":"B90","doi-asserted-by":"publisher","first-page":"C135","DOI":"10.1152\/ajpcell.00136.2018","article-title":"Neuroinflammatory mechanisms of blood-brain barrier damage in ischemic stroke.","volume":"316","author":"Yang","year":"2019","journal-title":"Am. J. Physiol. Cell Physiol."},{"key":"B91","doi-asserted-by":"publisher","first-page":"114","DOI":"10.13424\/j.cnki.jsctcm.2017.04.036","article-title":"Neuroprotective mechanism of freeze-dried liposomes for injection with honokiol in the treatment of vascular dementia rats.","volume":"40","author":"Yang","year":"2017","journal-title":"J. Shaanxi Univ. Chin. Med."},{"key":"B92","doi-asserted-by":"publisher","first-page":"33","DOI":"10.3969\/j.issn.1672-397X.2009.07.018","article-title":"Clinical study on 40 cases of acute cerebral infarction treated with integrated traditional Chinese and Western Medicine.","volume":"41","author":"Yang","year":"2009","journal-title":"Jiangsu J. Tradit. Chin. Med."},{"key":"B93","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/7759402","article-title":"Mechanism of sanhua decoction in the treatment of ischemic stroke based on network pharmacology methods and experimental verification.","volume":"2022","author":"YingHuang, Gao","year":"2022","journal-title":"Biomed. Res. Int."},{"key":"B94","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.13935\/j.cnki.sjzx.160815","article-title":"Effect of Honokiol on TXB2, 6-Keto-PGF-(1\u03b1), ET, NO after global cerebral ischemia-reperfusion injury in dog.","volume":"11","author":"Yu","year":"","journal-title":"World J. Integr. Tradit. West. Med."},{"key":"B95","doi-asserted-by":"publisher","first-page":"26","DOI":"10.13412\/j.cnki.zyyl.2016","article-title":"Effects of honokiol on cerebral blood flow in dogs with global cerebral ischemia-reperfusion.","volume":"32","author":"Yu","year":"","journal-title":"Pharmacol. Clin. Chin. Mater. Med."},{"key":"B96","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.3969\/j.issn.1001-1528.2019.05.040","article-title":"Effects of rhubarb anthraquinone glycosides on cerebral ischemia-reperfusion injury and intestinal microflora in rats.","volume":"41","author":"Yu","year":"2019","journal-title":"Chin. Tradit. Pat. Med."},{"key":"B97","author":"Zhang","year":"2017","journal-title":"TCM internal medicine."},{"key":"B98","doi-asserted-by":"publisher","first-page":"28","DOI":"10.3969\/j.issn.1672-5433.2008.05.011","article-title":"Pharmacological research of Rhizomza seu Radix Notopterygii.","volume":"5","author":"Zhang","year":"2008","journal-title":"China Licensed Pharm."},{"key":"B99","first-page":"51","article-title":"Study on analgesic, anti-inflammatory and antithrombotic effects of Notopterygium.","volume":"6","author":"Zhang","year":"1996","journal-title":"Res. Tradit. Chin. Med."},{"key":"B100","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1038\/aps.2017.149","article-title":"Diterpene ginkgolides protect against cerebral ischemia\/reperfusion damage in rats by activating Nrf2 and CREB through PI3K\/Akt signaling.","volume":"39","author":"Zhang","year":"2018","journal-title":"Acta Pharmacol. Sin."},{"key":"B101","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1080\/13880209.2021.2019281","article-title":"Network pharmacology and in vitro experimental verification to explore the mechanism of Sanhua decoction in the treatment of ischaemic stroke.","volume":"60","author":"Zhang","year":"2022","journal-title":"Pharm. Biol."},{"key":"B102","doi-asserted-by":"publisher","first-page":"227","DOI":"10.19613\/j.cnki.1671-3141.2019.94.147","article-title":"Clinical efficacy analysis of internal medicine of traditional Chinese medicine in the treatment of acute stroke.","volume":"19","author":"Zhang","year":"2019","journal-title":"World Latest. Med. Inform."},{"key":"B103","doi-asserted-by":"publisher","first-page":"185","DOI":"10.4268\/cjcmm20150205","article-title":"Progress in research of traditional Chinese medicine Citrus aurantium.","volume":"40","author":"Zhang","year":"2015","journal-title":"China J. Chin. Mater. Med."},{"key":"B104","first-page":"1","article-title":"Research progress of Sanhua Decoction.","volume":"6","author":"Zhang","year":"2022","journal-title":"J. Liaoning Univ. Trad. Chin. Med."},{"key":"B105","doi-asserted-by":"publisher","first-page":"9","DOI":"10.3969\/j.issn.1007-4813.2002.04.009","article-title":"A case of intractable hiccup after stroke.","volume":"18","author":"Zhang","year":"2002","journal-title":"J. Changchun Univ. Tradit. Chin. Med."},{"key":"B106","doi-asserted-by":"publisher","first-page":"4548","DOI":"10.3969\/j.issn.1006-2084.2021.22.032","article-title":"Research progress of traditional Chinese medicine in treatment of ischemic stroke.","volume":"27","author":"Zhao","year":"2021","journal-title":"Med. Recapit."},{"key":"B107","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.jphs.2018.08.002","article-title":"Chrysophanol attenuates nitrosative\/oxidative stress injury in a mouse model of focal cerebral ischemia\/reperfusion.","volume":"138","author":"Zhao","year":"2018","journal-title":"J. Pharmacol. Sci."},{"key":"B108","doi-asserted-by":"publisher","first-page":"254","DOI":"10.3969\/j.issn.1671-3141.2016.69.191","article-title":"Three decoction and Peach Pit Gas Bearing soup treatment, 68 cases of cerebral hemorrhage postoperative complications.","volume":"16","author":"Zhao","year":"2016","journal-title":"World Latest. Med. Inform."},{"key":"B109","doi-asserted-by":"publisher","first-page":"51","DOI":"10.13457\/j.cnki.jncm.2000.03.036","article-title":"Cases of treating stroke with Sanhua decoction.","volume":"3","author":"Zhu","year":"2000","journal-title":"N. Chin. Med."}],"container-title":["Frontiers in Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2023.1149833\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T04:49:52Z","timestamp":1681361392000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2023.1149833\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,13]]},"references-count":109,"alternative-id":["10.3389\/fnins.2023.1149833"],"URL":"https:\/\/doi.org\/10.3389\/fnins.2023.1149833","relation":{},"ISSN":["1662-453X"],"issn-type":[{"value":"1662-453X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,13]]},"article-number":"1149833"}}