Small vessel disease is a particular type of vascular disease that affects the brain. Recent research suggests as much as one-third of the risk for developing Alzheimer's disease is attributable to small vessel disease. Patients with the condition also appear to have an increased risk of stroke.

According to a study published in Neurology Research, herbal therapy can significantly reduce the risk of stroke recurrence in patients with small vessel disease. KiHo Cho and colleagues, from the Department of Cardiovascular and Neurologic Diseases at the Kyung-Hee University College of Oriental Medicine in Seoul, tested the herbal formula chung hyul dan (otherwise known as qing xie dan) to determine if it could reduce the recurrence of small vessel disease stroke. Chung hyul dan is composed of huan qin (Scutellariae radix), huang lian (Coptidis rhizome), huang bai (Phellodendri cortex), zhi zi (Gardeniae fructus) and da huang (Rhei rhizome).

Previous research showed that chung hyul dan has anti-apoptotic (cell death), antioxidative, anti-inflammatory and antihypertensive properties. The researchers speculated these effects might be helpful for reducing the risk of microangiopathy, which is believed to play a major role in the progression of small vessel disease.

One hundred forty-eight subjects with small vessel disease and a history of stroke were treated with 600 mg of chung hyul dan for two years and monitored for stroke recurrence. This group was compared to 208 other control patients who did not receive the herb. Patients in both groups underwent MRI at the beginning of the study and then again two years later in order to determine if there were any new brain lesions that might indicate another stroke had occurred.

Only three patients suffered another stroke (a recurrence rate of 2 percent) after two years. By comparison, among the control subjects treated with medication alone for two years, 17 had a stroke recurrence (a recurrence rate of 8.2 percent). Furthermore, the risk of stroke recurrence among patients taking the herbal formula was lower even after just one year.

The researchers noted, "Previous works reported that the inhibitory rate of aspirin on stroke recurrence was 15-20%, dipyridamole [Persantine] 15-40% and ticlopidine [Ticlid] 20-25%. We calculated the inhibitory rate of chung hyul dan on stroke recurrence using multiple logistic regressions. One year of chung hyul dan medication reduced the OR [odds ratio] of stroke recurrence by 77% compared to the control. The inhibitory rate increased to 79%, when adjusted for other relevant risk factors for stroke occurrence. These reductions were much higher than that of aspirin and other kinds of conventional anti-platelets."

They concluded, "Considering that the inhibitory rate of chung hyul dan on stroke recurrence was much higher than that of the conventional agents, we suggest that chung hyul dan may be useful for inhibition of stroke recurrence."

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