Application of promoting blood circulation and resolving blood stasis in intracerebral hemorrhage: a traditional method gradually being reconsidered.

Abstract

Intracerebral hemorrhage (ICH) is a significant and growing threat to human health, with increasing incidence. Promoting blood circulation and removing blood stasis therapy (PBCRBS), a Traditional Chinese Medicine therapy, can be an adjuvant therapy to benefit patients with ICH by improving clinical efficacy. However, in theory, using PBCRBS to treat ICH carries the risk of hematoma enlargement and rebleeding, which has led to controversy over its application in ICH treatment. To demonstrate the effectiveness and safety of PBCRBS in treating ICH, this review first analyzes the pathological and physiological basis of ICH and secondly, the cascade of response after ICH and the involvement of cytokines and signaling pathways in this process. Finally, experimental and clinical studies on the treatment of ICH with PBCRBS over the past decade were retrieved from the PubMed and China National Knowledge Infrastructure databases, and the content of these studies was used to summarize commonly used herbs with PBCRBS effects and their mechanisms of action. Through analysis, hypertension has been identified as the most common cause of ICH. Heme, interleukin, reactive oxygen species, coagulation promoting particles and other induced mass effects, inflammation, oxidative stress, and coagulation cascade reactions lead to brain damage following ICH. This review includes 56 experimental studies and 83 clinical studies summarizing 28 commonly used herbs, demonstrating the positive impact of PBCRBS as an adjuvant therapy for ICH. In summary, PBCRBS appears effective and safe for treating ICH.