Research progress on the mechanism of Buyang Huanwu decoction in treating ischemic cardio-cerebrovascular diseases

Buyang Huanwu Decoction (BYHWD), a classic TCM formula for Qi deficiency and blood stasis, improves the clinical prognosis of ischemic cardio-cerebrovascular diseases. This review synthesizes evidence on its pharmacological mechanisms, aiming to elucidate the scientific basis of "treating different diseases with the same method" and support its precision application. A systematic literature search was conducted using PubMed, ScienceDirect, China National Knowledge Infrastructure (CNKI), Springer Link, Wan-fang database, and Chinese Biomedicine Database (CBM). The search was conducted to collect relevant journals and contents from inception to December 2025 using following terms: "Buyang Huanwu Decoction", "ischemic heart disease", "ischemic stroke". Language of publications was unlimited. After excluding 404 meta-analyses and 117 systematic reviews, a total of 83 research articles were included. Bioactive compounds in BYHWD (e.g., astragaloside, paeoniflorin, amygdalin) demonstrate multi-target efficacy against ischemic cardio-cerebrovascular diseases. The therapeutic effects are mediated through coordinated modulation of common pathways, including promoting angiogenesis, exerting anti-inflammatory and antioxidant effects, inhibiting platelet aggregation, and regulating gut microbiota. Targeting common pathological links of ischemic cardio-cerebrovascular diseases is the key for BYHWD to achieve "treating different diseases with the same method." Despite extensive research advances, high-quality clinical studies are still needed to advance BYHWD’s precision research. The Pathological Basis of "Treating Different Diseases with the Same Method" Revealed by the Mechanistic Research on Buyang Huanwu Decoction in Regulating Ischemic Cardio-cerebrovascular Diseases