# Efficacy of Huoxue Tongqiao Decoction combined with aniracetam in treating post-stroke cognitive impairment in elderly patients with ischemic stroke and its effects on serum levels of superoxide dismutase, glutathione peroxidase and nitric oxide

**Authors:** Jinjin Xu, Xue Bai, Hui Wang, Jiangzhe Li, Pan Cai

PMC · DOI: 10.12669/pjms.42.1.12740 · Pakistan Journal of Medical Sciences · 2026-01-01

## TL;DR

This study shows that combining a traditional Chinese medicine decoction with aniracetam improves cognitive function and blood flow in elderly stroke patients.

## Contribution

The study introduces a novel combination therapy using HXTQD and aniracetam for post-stroke cognitive impairment.

## Key findings

- The observation group showed greater improvements in cognitive scores and cerebral perfusion than the control group.
- Serum levels of SOD, GSH-Px, and NO increased significantly in the observation group.
- No adverse reactions were reported in either group.

## Abstract

To evaluate the clinical efficacy of Huoxue Tongqiao (blood-invigorating and orifice-unblocking) Decoction (HXTQD) combined with aniracetam in the treatment of post-ischemic stroke cognitive impairment (PISCI) in elderly patients and its effects on related serum biochemical markers.

This was a retrospective study. A total of 80 elderly patients with PSCI admitted to Baoding No.1 Central Hospital between January 2022 to December 2024 were enrolled and randomly assigned to either the control group or the observation group using a random number table. All patients received standard internal medicine management. The control group was treated with aniracetam, while the observation group was orally administered HXTQD in combination with aniracetam. TCM syndrome, MoCA, MMSE, ADL scores, cerebral hemodynamic parameters and serum biochemical markers were assessed before and after treatment. The overall response rate was compared between the two groups.

After treatment, both groups showed significant improvements in MoCA, MMSE and ADL scores, Vm and serum levels of SOD, GSH-Px and NO(all P< 0.05), with the observation group demonstrating significantly greater improvements than the control group (P< 0.05). TCM syndrome scores, RI and PI decreased in both groups, with more pronounced reductions noted in the observation group (P< 0.05, respectively). The ORR in the observation group was significantly higher than in the control group (P< 0.05). No adverse reactions were reported in either group.

The combination of HXTQD and aniracetam can significantly improve cognitive function and cerebral perfusion in elderly patients with post-ischemic stroke cognitive impairment, potentially by regulating serum SOD, GSH-Px and NO levels.

## Linked entities

- **Chemicals:** aniracetam (PubChem CID 2196), nitric oxide (PubChem CID 145068)
- **Diseases:** ischemic stroke (MONDO:1060198)

## Full-text entities

- **Genes:** SOD1 (superoxide dismutase 1) [NCBI Gene 6647] {aka ALS, ALS1, HEL-S-44, IPOA, SOD, STAHP}
- **Diseases:** PISCI (MESH:D003072), blood stasis syndrome (MESH:D054070), brain tumors (MESH:D001932), memory impairment (MESH:D008569), deficits (MESH:D009461), TCM Syndrome (MESH:C562377), beta-amyloid (MESH:C000718787), dementia (MESH:D003704), diarrhea (MESH:D003967), drooling (MESH:D012798), post-stroke (MESH:D020521), allergy (MESH:D004342), dysfunction (MESH:D006331), appetite loss (MESH:D001068), blood stasis (MESH:D014647), rash (MESH:D005076), nausea (MESH:D009325), obesity (MESH:D009765), visual or hearing impairments (MESH:D006311), cerebrovascular diseases (MESH:D002561), head heaviness (MESH:D006258), ADRs (MESH:D064420), ischemic necrosis (MESH:D005271), meningitis (MESH:D008580), aphasia (MESH:D001037), insufficiency of liver and kidney (MESH:D051437), Alzheimer's disease (MESH:D000544), Psychiatric disorders (MESH:D001523), insomnia (MESH:D007319), Coagulation disorders (MESH:D001778), gastrointestinal discomfort (MESH:D005767), cerebral ischemia (MESH:D002545), Ischemic stroke (MESH:D002544), mental dullness (MESH:D008607), arterial stenosis or occlusion (MESH:D001157), hypertension (MESH:D006973), pain (MESH:D010146), mitochondrial dysfunction (MESH:D028361), TCM syndrome (MESH:D013577), headache (MESH:D006261), inflammation (MESH:D007249), platelet aggregation (MESH:D001791), hyperglycemia (MESH:D006943), reperfusion injury (MESH:D015427)
- **Chemicals:** NO (MESH:D009569), Reactive oxygen species (MESH:D017382), alcohol (MESH:D000438), aniracetam (MESH:C036466), lipid (MESH:D008055), reduced glutathione (MESH:D005978), oxidized glutathione (MESH:D019803), peroxides (MESH:D010545), Tetramethylpyrazine (MESH:C017953), Atorvastatin calcium (MESH:D000069059), HXTQD (-), Clopidogrel bisulfate (MESH:D000077144), NO (MESH:D009614)
- **Species:** Acorus tatarinowii (species) [taxon 123564], Scolopendra (genus) [taxon 41364], Scorpio (genus) [taxon 53955], Alpinia oxyphylla (sharp-leaf galangal, species) [taxon 125261], Pseudostellaria heterophylla (hai er shen, species) [taxon 418402], Glycyrrhiza (licorice, genus) [taxon 46347], Astragalus membranaceus (species) [taxon 649199], Homo sapiens (human, species) [taxon 9606], Polygala tenuifolia (species) [taxon 355332], Ligusticum chuanxiong [taxon 49555], Mus musculus (house mouse, species) [taxon 10090], Wolfiporia cocos (species) [taxon 81056], Citrus reticulata (mandarin orange, species) [taxon 85571], Atractylodes macrocephala (species) [taxon 265785]

## Full text

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## References

19 references — full list in the complete paper: https://tomesphere.com/paper/PMC12927166/full.md

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Source: https://tomesphere.com/paper/PMC12927166