{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:55:32Z","timestamp":1790920532951,"version":"4.1.0"},"reference-count":71,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"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. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although conventional therapies for Carotid atherosclerosis (CAS) remain the standard treatment, their effectiveness is often limited and accompanied by adverse effects. Chinese herbal medicine (CHM) is a promising adjunctive therapy for CAS; however, robust clinical evidence supporting its efficacy and safety remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This systematic review and meta-analysis evaluates the efficacy and safety of CHM for CAS treatment and characterizes its medication patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five databases were searched from inception to December 2025. Randomized controlled trials (RCTs) evaluating oral CHM for CAS were included. Study quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Data were extracted and analyzed using RevMan v5.3 and R software. Sources of heterogeneity were investigated through meta-regression and subgroup analyses. Network analysis reveals herbal medication patterns across 21 studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-one RCTs involving 3,078 patients were included. Compared with conventional therapy alone, adjunctive CHM significantly reduced carotid plaque area (MD = 4.94, 95% CI: 3.13 to 6.76,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01), intima-media thickness (IMT) (MD = 0.12, 95% CI: 0.07 to 0.17,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05), total cholesterol (TC) (MD = 0.32, 95% CI: 0.22 to 0.42,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01), triglycerides (TG) (MD = 0.24, 95% CI: 0.11 to 0.37, p &amp;lt; 0.01), and low-density lipoprotein cholesterol (LDL-C) (MD = 0.37, 95% CI: 0.21 to 0.53,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01), while greatly increasing high-density lipoprotein cholesterol (HDL-C) (MD = \u22120.20, 95% CI: \u22120.29 to \u22120.10,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.01). CHM did not significantly increase the risk of adverse events (RR = 0.84, 95% CI: 0.64 to 1.10,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.20) or impair liver\/kidney function. Network analysis identified core actions as clearing phlegm and removing blood stasis, with Danshen (Salvia miltiorrhiza Bge.) and Banxia [Pinellia ternata (Thunb.) Breit.] as pivotal botanical drugs exerting anti-stasis and lipid-regulating effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As an adjunct to conventional therapy, CHM may further reduce carotid IMT and plaque burden, improve lipid metabolism, and demonstrate a favorable safety profile. However, the overall quality and heterogeneity of the included studies limit the strength of the evidence, highlighting the need for well-designed, high-quality RCTs to confirm these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261285381<\/jats:ext-link>\n                      , identifier CRD420261285381.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1903096","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T05:35:32Z","timestamp":1790919332000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of selected Chinese herbal medicine preparations in treating carotid atherosclerosis: a systematic review and meta-analyses"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuemeng","family":"Sun","sequence":"first","affiliation":[{"name":"College of Traditional Chinese Medicine, Inner Mongolia Medical University","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menghan","family":"Feng","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Inner Mongolia Medical University","place":["Hohhot, China"]},{"name":"School of Medicine, Hetao College","place":["Bayannur, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoran","family":"Zhang","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Inner Mongolia Medical University","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Liu","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Inner Mongolia Medical University","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Li","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Inner Mongolia Medical University","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shujing","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Traditional Chinese Medicine, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunjie","family":"Ma","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Inner Mongolia Medical University","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Wu","sequence":"additional","affiliation":[{"name":"College of Traditional Chinese Medicine, Inner Mongolia Medical University","place":["Hohhot, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1038\/s41569-018-0098-5","article-title":"Safety and efficacy of statin therapy","volume":"15","author":"Adhyaru","year":"2018","journal-title":"Nat. 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