Abstract

Post-stroke fatigue is one of the concomitant symptoms of stroke. Despite the existence of various non-pharmacological interventions, there are no specific medications for patients with post-stroke fatigue because of its unclear mechanisms. This systematic review and meta-analysis aimed to summarize the role of Chinese medicine decoctions in managing post-stroke fatigue based on randomized controlled trials. This study used the Cochrane risk of bias tool to assess randomized controlled trials quality. The meta-analysis was conducted using RevMan 5.3. Eighteen randomized controlled trials met the study criteria, including 1478 patients with stroke. The control and experimental groups comprised 747 and 731 cases, respectively. The meta-analysis demonstrated that the Chinese medicine group experienced a greater level of fatigue relief compared to the control group, with improved fatigue severity scale scores (mean difference=-6.40; 95 % confidence interval=-8.12-4.68; p<0.00001) and fatigue impact scale scores (mean difference=-19.64; 95 % confidence interval=-25-14.29; p<0.00001). The quality of life and energy improvement in the Chinese medicine group were higher than those in the non-Chinese-medicine group, with improved stroke-specific quality of life scale scores (mean difference=19.80; 95 % confidence interval=12.59-27.01; p<0.00001) and stroke-specific quality of life scale-energy scores (mean difference=2.32; 95 % confidence interval=1.32-3.32; p<0.0001). The daily living activities of the Chinese medicine group were higher than those of the non-Chinese-medicine group, with improved modified Barthel index scores (mean difference=6.34; 95 % confidence interval=3.19-9.49; p<0.0001). The overall quality of evidence evaluated by the Cochrane system was not high. Three studies reported no adverse reactions in the patients. The effectiveness and safety of utilizing Chinese medicine decoctions in treating post-stroke fatigue were demonstrated. However, more rigorous studies with superior quality and expansive data are needed to further validate these findings.