Int J Med Sci 2020; 17(12):1854-1863. doi:10.7150/ijms.46581 This issue

Research Paper

Anti-inflammatory effects of powdered product of Bu Yang Huan Wu decoction: Possible role in protecting against Transient Focal Cerebral Ischemia

Kuan-Yu Chen1,2, Kuo-Chen Wu3, Dueng-Yuan Hueng4, Kuo-Feng Huang5,6✉*, Cheng-Yoong Pang2,7✉*

1. Department of Surgery, New Taipei City Hospital, New Taipei city, Taiwan.
2. Institute of Medical Sciences, Tzu Chi University, Hualien city, Taiwan.
3. School of Pharmacy, National Taiwan University, Taipei, Taiwan.
4. Department of Neurosurgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
5. School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan.
6. Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Medical Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
7. Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien city, Taiwan.
*These authors equally contributed to this study as co-corresponding authors.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Chen KY, Wu KC, Hueng DY, Huang KF, Pang CY. Anti-inflammatory effects of powdered product of Bu Yang Huan Wu decoction: Possible role in protecting against Transient Focal Cerebral Ischemia. Int J Med Sci 2020; 17(12):1854-1863. doi:10.7150/ijms.46581. Available from

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Bu Yang Huan Wu decoction (BYHW) is a traditional Chinese medicine (TCM) that consists of several herbs and has been used in patients with ischemic stroke for centuries. Although powdered formula of BYHW has widely been prescribed in clinic nowadays, evidence-based effectiveness and mechanism of action of BYHW powdered product in stroke remain to be characterized. Adult male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 90 min followed by reperfusion for 24 h (ischemia/reperfusion; I/R) or sham surgery. After I/R, the rats were then given low dose (0.5 g/kg) and high dose (2.5 g/kg) of BYHW or vehicle by oral gavage twice a day for seven consecutive days. The results showed that I/R induced obvious cerebral infarction and neurobehavioral defects, in parallel with histological aberrations and extensive signaling of proinflammatory cytokines, including tumor necrosis factor (TNF-α) and interleukin-6 (IL-6), in the stroke model. Post-I/R treatment with BYHW powdered product significantly reduced the infarct area and ameliorated neurofunctional defects in a dose-dependent manner. The dose dependence was associated with TNF-α downregulation and interleukin-10 (IL-10) induction. In summary, the present findings demonstrated that BYHW powdered product exhibited therapeutic efficacy for experimental stroke and a higher dose treatment may strengthen the effectiveness via inflammatory modulation.

Keywords: Stroke, Ischemic/reperfusion, inflammation, Bu Yang Huan Wu decoction