Buyang Huanwu Decoction for Healthcare: Evidence-Based Theoretical Interpretations of Treating Different Diseases with the Same Method and Target of Vascularity

Table 1

Study characteristics of included systematic reviews.

Reference	Disorders	Number of randomized controlled trials	Quality assessment	Quality of randomized controlled trials	Intervention(s)	Comparison	Meta-analysis	Author’s self-conclusion	Overview Quality Assessment Questionnaire OQAQ	Result	Safety
Li, 2006 [6]	Acute ischemic stroke	6	Jadad scale	Variable	BHD	Placebo or blank control	Compared total effective rate between BHD group and control group: RR 1.23, 99% CI (1.12, 1.34), 𝑃=0.50.; The comparison of hematocrit in BHD group and blank control group: WMD 0.40, 99% CI (−1.87, 1.07), 𝑃=0.48.; The comparison of whole blood viscosity in BHD group and blank control group: WMD −0.20, 99% CI (−0.76, 1.07), 𝑃=0.70.; The comparison of tumor necrosis factors in BHD group and blank control group: WMD −0.45, 99% CI (−0.81, −0.09), 𝑃=0.001.; The comparison of circulating endothelial cells in BHD group and blank control group: WMD −0.42, 99% CI (−0.78, −0.06), 𝑃=0.003.; The comparison of mortality rate in BHD group and blank control group: RR 0.33, 99% CI (0.01, 21.25), 𝑃=0.50.	The currently available studies demonstrated that BHD is effective in patients with acute ischemic stroke but cannot lower the mortality rate.	4	+	No sufficient evidence
Li, 2006 [7]	Acute ischemic stroke	22	Jadad scale	Poor	BHD	Aspirin, placebo, or blank control	The comparison of total effective rate in BHD group and control group: RR 1.19, 99% CI (1.10, 1.30), 𝑃<0.00001.; The comparison of the score of neurological deficit in BHD group and blank control group: WMD −2.20, 99% CI (−3.48, −0.91), 𝑃<0.0001.	BHD is effective and safe in patients with acute ischemic stroke.	3	+	Safe
Huang, 2009 [8]	Cerebral infarction	9	Jadad scale	Poor	BHD or modified BHD	Other effective therapies	The comparison of improvement of neurological deficit in experimental group and control group: OR 2.80, 95% CI (1.91, 4.09), 𝑃<0.01.	BHD can improve the status of neurological deficit.	2	+	No sufficient evidence
Hao et al., 2012 [9]	Acute ischemic stroke	19	Jadad scale	Poor	BHD plus CWM or modified BHD plus CWM	CWM	Comparison of the score of neurological deficit between experimental group and control group: MD −4.65, 95% CI (−6.57, −2.27), 𝑃<0.001.; The comparison of effective rate of neurological deficit improvement in experimental group and control group: RR 1.18, 95% CI (1.12, 1.24), 𝑃<0.001.	BHD therapy appears to be able to improve neurological deficit in patients with acute ischemic stroke and seems to be generally safe.	5	+	Safe
Liu et al., 2012 [10]	Acute ischemic stroke	10	Cochrane Reviewer’s Handbook	Poor	BHD plus other effective therapies or modified BHD plus other effective therapies	Other effective therapies	The comparison of total effective rate in experimental group and control group: RR 1.23, 95% CI (1.16, 1.31), 𝑃<0.0001.; The comparison of fibrinogen in experimental group control group: SMD 1.98, 95% CI (0.66, 3.31), 𝑃=0.003.; Comparison of the score of neurological deficit between two groups: MD 5.69, 95% CI (1.59, 9.69), 𝑃=0.005.	BHD is effective in patients with acute ischemic stroke. The safety of BHD is inconclusive.	4	+	No sufficient evidence
Li, 2006 [11]	Acute hemorrhagic stroke	2	Jadad scale	Poor	BHD plus CWM	CWM	The comparison of total effective rate in experimental group and control group: RR 1.35, 99% CI (1.03, 1.76), 𝑃=0.005.; The comparison of the score of neurological deficit in BHD groups and control groups: WMD −6.73, 99% CI (−13.71, 0.25), 𝑃=0.01.	BHD is effective and safe in patients with acute hemorrhagic stroke.	3	+	Safe
Li, 2007 [12]	Chronic cor pulmonale at acute onset period	3	Jadad scale	Poor	Modified BHD	Blank control	The comparison of clinical efficacy in experimental group and control group: RR 1.18, 99% CI (1.03, 1.36), 𝑃=0.002.	BHD appears to be effective and safe in patients with chronic cor pulmonale at acute onset period.	3	+	Safe
Li, 2006 [13]	Primary nephrotic syndrome	4	Jadad scale	Poor	BHD plus CWM or modified BHD plus CWM	CWM	The comparison of total effective rate in experimental group and control group: RR 1.14, 99% CI (1.01, 1.28), 𝑃=0.004.; The comparison of relapse rate in experimental group and control group: RR 0.62, 99% CI (0.21, 1.93), 𝑃=0.27.; Comparison of the incidence of adverse reaction of Cortancyl between two groups: RR 0.45, 99% CI (0.17, 1.17), 𝑃=0.27.	BHD is effective and safe in patients with primary nephrotic syndrome.	3	+	Safe
Li, 2007 [14]	Posterior circulation ischemia vertigo	3	Jadad scale	Poor	BHD	Blank control	The comparison of total effective rate in experimental group and control group: RR 1.27, 99% CI (1.04, 1.54), 𝑃=0.002.; Comparison of the vertebral artery blood flow velocity between two groups: RR 4.50, 99% CI (2.71, 6.29), 𝑃<0.00001.	BHD can promote the vertebral artery blood flow velocity and be effective and safe in patients with posterior circulation ischemia vertigo.	3	+	Safe
Shu, 2010 [15]	Vascular dementia	9	Cochrane Reviewer’s Handbook	Variable	Modified BHD	CWM	The comparison of total effective rate in experimental group and control group: OR 1.17, 99% CI (1.15, 2.53), and 𝑃=0.007.; The comparison of improving score of MMSE of experimental group and control group: WMD 1.60, 99% CI (0.16, 3.03), 𝑃=0.03.; The comparison of the score of HDS of BHD in experimental group and control group: WMD 2.98, 99% CI (2.34, 3.62), 𝑃<0.00001.	The statistical consequence of total effectiveness of BHD was considered meaningless due to heterogeneity of the meta-analysis. In improving score of MMSE and HDS, BHD seems more effective than western conventional medicine.	5	−	Safe
Li, 2011 [16]	Diabetic nephropathy	17	Jadad scale	Poor	BHD plus CWM	CWM	The comparison of total effective rate in experimental group and control group: OR 3.84, 95% CI (2.73, 5.42), 𝑃<0.00001.; Comparison of urinary albumin-excretion rate between two groups: WMD −61.76, 95% CI (−92.35, −31.16), 𝑃<0.0001.; Comparison of blood urea nitrogen between two groups: WMD −1.36, 95% CI (−1.70, −1.02), 𝑃<0.00001.; Comparison of 24-hour urine protein between two groups: SMD −0.92, 95% CI (−1.44, −0.40), 𝑃=0.0005.; The comparison of serum creatinine in experimental group and control group: WMD −12.82, 95% CI (−26.67, −1.02), 𝑃=0.07.; The comparison of blood glucose in experimental group and control group: WMD −0.33, 95% CI (−0.72, −0.06), 𝑃=0.10.	The effectiveness is obviously much better in experimental group.	4	+	No sufficient evidence
Liao, 2012 [17]	Diabetic peripheral neuropathy	8	Jadad scale	Poor	CWM plus modified BHD	CWM	The comparison of total effective rate in experimental group and control group: RR 1.42, 95% CI (1.28, 1.58), 𝑃<0.00001.; Comparison of symptom score between two groups: WMD 1.07, 95% CI (0.81, 1.33), 𝑃<0.00001.; Comparison of the left sural movement nerve conduction velocity between two groups: WMD 3.79, 95% CI (2.62, 4.95), and 𝑃<0.00001.; Comparison of sensory nerve conduction velocity between two groups: WMD 3.97, 95% CI (2.93, 5.01), and 𝑃<0.00001.; The comparison of improving ankle-reflex in experimental group and control group: RR 1.30, 95% CI (0.96, 1.75), 𝑃=0.09.; Comparison of plasma viscosity between two groups: WMD −0.14, 95% CI (−0.23, −0.05), 𝑃=0.002.	BHD is mainly effective in improving clinical symptoms and nerve conduction velocity and reducing plasma viscosity.	4	+	Safe
Li et al., 2012 [18]	Angina pectoris of coronary heart disease with Qi deficiency and blood stasis pattern	14	Jadad scale	Poor	BHD plus CWM	CWM	Comparison of clinical efficacy of improving the symptom of angina pectoris between two groups: OR 3.39, 95% CI (2.43, 4.72), 𝑃<0.00001.; Comparison of clinical efficacy of improving the change of electrocardiogram of angina pectoris between two groups: OR 3.27, 95% CI (1.91, 5.60), and 𝑃<0.00001.	BHD can improve the symptom of angina pectoris and the change of electrocardiogram of angina pectoris but needs further study.	5	+	No sufficient evidence

Note: BHD: Buyang Huanwu Decoction; CWM: conventional western medicine; MMSE: minimum mental state examination; HDS: Hasegawa’s Dementia Scale.