Chinese med 'can make life-or-death difference'

Angong Niuhuang Wan, a traditional Chinese medicinal formula, can buy 30 minutes more for ischemic stroke patients to extend their golden time window for treatment to five hours, researchers at the University of Hong Kong have found.

The Department of Health says stroke was the fourth most common cause of death in Hong Kong, with 3,126 registered deaths in 2021 and a crude death rate of 42.1 people per 100,000 population.

The number of people diagnosed with stroke increased by 52 percent from 37,800 in 2009/10 to 57,500 in 2018/19.

A research team led by Shen Jiangang, a professor at HKU's School of Chinese Medicine, found that Angong Niuhuang Wan can extend the therapeutic window for ischemic stroke patients by 30 minutes from 4 hours to five hours.

The study results have been published in the scientific journal Chinese Medicine.

The research team has now collaborated with Queen Mary Hospital for clinical trials. The 4-hour therapeutic window to ischemic stroke patients is crucial, said Shen in an interview with The Standard. Beyond that time, the chance of having intracerebral hemorrhage will be significantly increased, and the mortality rate can grow nearly 10 times.

Shen described the results as encouraging and they can increase the possibility of saving stroke patients' lives.

"Even though the treatment time is only extended for half an hour, it is significant for patients," he said. "It matters whether the patient will be paralyzed or not, die or alive."

In the study, researchers simulated the delayed treatment in rats for five hours after the stroke onset. After the rats were given Angong Niuhuang Wan during the second hour of cerebral ischemia, the researchers assessed the extent of damage in their brains and cultured their brain cells in vitro.

The results showed the six active compounds in this Chinese medicine could remove key molecules that cause inflammation and damage.

Angong Niuhuang Wan is one of the three famous traditional Chinese medicine elixirs that promote blood circulation, and is mainly used to treat fevers and stroke comas.

Due to heavy-metal elements such as arsenic and mercury in this medicine, countries such as the United States and Japan have banned its import and sale. But the HKU team found no heavy-metal residues in the experiment and no liver or kidney damage from taking it. They also said that earlier studies have proved that it is safe to take the correct dose - one capsule per day for a week.

However, Shen reminded patients to take this medicine under doctors' guidance, especially for patients with low blood pressure, cold sweats and rapid heartbeat.

"Many people may have this medicine in their homes, so further clinical trial studies may lead to a new therapeutic strategy to rescue ischemic stroke patients if the clinical trial succeeds," Shen said.

In the early days of Covid-19 in 2020, the Chinese National Health Commission listed Angong Niuhuang Wan on the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia, leading to a rush for the drug.

Subsequently, an official statement was issued emphasizing that Angong Niuhuang Wan is for patients in the severe stage, not a preventive drug, so people should not take it casually.