Baoyuan Decoction in the Treatment of Chronic Heart Failure: Formula Composition, Chemical Constituents, Anti-CHF Mechanisms, and Clinical Research Progress
Keywords:
Chronic Heart Failure, Baoyuan Decoction, Traditional Chinese Medicine, Qi Deficiency And Blood Stasis Pattern, Chemical Constituents, Anti-CHF Mechanisms, Clinical Research, Systematic ReviewAbstract
Chronic heart failure (CHF) represents the terminal stage of various cardiovascular diseases and remains one of the most lethal diseases worldwide. As a classical traditional Chinese medicine (TCM) formula for benefiting Qi and warming Yang, Baoyuan Decoction has demonstrated favorable clinical efficacy and safety in the treatment of CHF, particularly in patients presenting with the Qi deficiency and blood stasis pattern. The present review systematically consolidates the formula composition, chemical constituents, anti-CHF mechanisms, and clinical research progress of Baoyuan Decoction, with the aim of providing a theoretical basis for its rational clinical application and promoting the development of TCM in the prevention and treatment of cardiovascular diseases.
References
Zou CH, Zhang J. Latest epidemiology of heart failure. Chinese Journal of Heart Failure and Cardiomyopathy. 2024;8(4):263-285.
Chinese Society of Cardiology, Chinese Medical Association; Chinese College of Cardiovascular Physicians, Chinese Medical Doctor Association; Heart Failure Committee of Chinese Medical Doctor Association; et al. Chinese guidelines for the diagnosis and treatment of heart failure 2024. Chinese Journal of Cardiology. 2024;52(3):235-275.
Chen KJ, Wu ZG, Zhu MJ, et al. Expert consensus on integrated traditional Chinese and Western medicine diagnosis and treatment of chronic heart failure. Prevention and Treatment of Cardio-Cerebral-Vascular Disease. 2016;16(5):340-347.
Cheng HB, Hu H, Li QA, et al. Ancient literature analysis and modern research overview of Baoyuan Decoction. Modern Chinese Medicine. 2021; 23(10): 1842-1850.
Gao J, Lyu SW. Research progress on chemical constituents and pharmacological effects of Ginseng. Guiding Journal of Traditional Chinese Medicine and Pharmacy. 2021;27(1):127-130, 137.
Nie J, Xie LH, Ma GY, et al. Research progress on chemical constituents and pharmacological effects of Astragalus membranaceus. Hunan Journal of Traditional Chinese Medicine. 2018;34(7):228-231.
Xiao X, Li CY, Liu XL, et al. Research progress on main chemical constituents and pharmacological effects of Glycyrrhiza. Journal of Xinxiang Medical University. 2023;40(3):280-285.
Wu XF. Research progress on main chemical constituents and pharmacological activities of cinnamon extract. China Pharmacy. 2015;26(24):3454-3456.
Yu G, Liang HH, Wen W, et al. Research progress of Baoyuan Decoction and predictive analysis of its quality markers. Chinese Traditional and Herbal Drugs. 2021;52(2):567-577.
Yuan XY, He TZ, Sui DJ. Research progress of Baoyuan Decoction and its active components in treating chronic heart failure. Jilin Journal of Traditional Chinese Medicine. 2021;41(4):556-560.
Yuan G, Han A, Wu J, Lu Y, Zhang D, Sun Y, Zhang J, Zhao M, Zhang B, Cui X. Bao Yuan decoction and Tao Hong Si Wu decoction improve lung structural remodeling in a rat model of myocardial infarction: Possible involvement of suppression of inflammation and fibrosis and regulation of the TGF-β1/Smad3 and NF-κB pathways. Biosci Trends. 2018;12(5):491-501.
Zhou AM, Yang DQ, Zhao FL. Effects of Baoyuan Decoction combined with Xuefu Zhuyu Decoction on cardiac function and inflammatory factors in patients with chronic heart failure. China Medical Herald. 2019;16(10):128-131.
Dhalla NS, Elimban V, Bartekova M, Adameova A. Involvement of oxidative stress in the development of subcellular defects and heart disease. Biomedicines. 2022;10(2):393.
Sun L, Lin BX, Fang XJ, et al. Effects of Modified Baoyuan Decoction on SOD and GSH-Px activities in hippocampus of chronic stress rats. Journal of Dalian University. 2017;38(3):51-53.
Wang X, Meng H, Wang Q, Shao M, Lu W, Chen X, Jiang Y, Li C, Wang Y, Tu P. Baoyuan decoction ameliorates apoptosis via AT1-CARP signaling pathway in H9C2 cells and heart failure post-acute myocardial infarction rats. J Ethnopharmacol. 2020;252:112536.
Wan YJ, Liao LX, Liu YQ, et al. Identification and functional analysis of target group of myocardial protective effect of Baoyuan Decoction. China Journal of Chinese Materia Medica. 2017;42(19):3650-3655.
Zhong L, Chiusa M, Cadar AG, Lin A, Samaras S, Davidson JM, Lim CC. Targeted inhibition of ANKRD1 disrupts sarcomeric ERK-GATA4 signal transduction and abrogates phenylephrine-induced cardiomyocyte hypertrophy. Cardiovasc Res. 2015;106(2):261-271.
Meng H, Du Z, Lu W, Wang Q, Sun X, Jiang Y, Wang Y, Li C, Tu P. Baoyuan decoction (BYD) attenuates cardiac hypertrophy through ANKRD1-ERK/GATA4 pathway in heart failure after acute myocardial infarction. Phytomedicine. 2021;89:153617.
Jian ZG. Effect of Baoyuan Decoction on cardiac function in elderly patients with coronary heart disease and chronic heart failure of heart qi deficiency type. Guangming Journal of Chinese Medicine. 2020; 35(16): 2447-2448, 2509.
Wang LJ, Guo H, Cai HR, et al. Clinical efficacy of Baoyuan Decoction combined with Xuefu Zhuyu Decoction in treating elderly patients with chronic heart failure. Shenzhen Journal of Integrated Traditional Chinese and Western Medicine. 2024;34(15):31-34.
Huo L, Sun YL, Wang XL, et al. Meta-analysis of clinical efficacy of Baoyuan Decoction in treating chronic heart failure. Journal of Emergency in Traditional Chinese Medicine. 2021;30(2):207-212.
Ma XZ, Wang MR, Li QY. Clinical observation of Baoyuan Decoction in treating chronic heart failure of qi deficiency and blood stasis type. Guangming Journal of Chinese Medicine. 2022;37(16):2868-2874.
Li WW, Wang DD, Yu ZQ, et al. Clinical Efficacy of Baoyuan Decoction Combined with Bufei Decoction in the Treatment of Chronic Heart Failure (Cardiac and Pulmonary Qi Deficiency Syndrome) and Its Influence on Serum sSema4D Level. Journal of Medical Research. 2026;55(3):128-134.
Duan LX. Clinical observation of Baoyuan Decoction in treating elderly patients with coronary heart disease and chronic heart failure. Chinese Medicine Modern Distance Education of China. 2021;19(16):84-86.
Zhang RJ, Cao PH, Lu X. Clinical efficacy observation on Baoyuan Decoction combined with Taohong Siwu Decoction in the treatment of heart failure with qi deficiency and blood stasis syndrome. Hubei Journal of Traditional Chinese Medicine. 2026;48(4):11-15.
Chen ZY. Effect of Baoyuan Decoction combined with Tingli Dazao Xiefei Decoction in treating patients with heart failure with reduced ejection fraction. Chinese and Foreign Medical Research. 2024;22(29):25-28.
Meng FB, Zhang Y. Application effect of recombinant human brain natriuretic peptide combined with Baoyuan Decoction in patients with refractory heart failure. China Modern Medicine. 2025;32(34):45-48.
Wang DD, Li WW. Clinical efficacy of Baoyuan Decoction combined with Bufei Decoction as an adjunct to sacubitril/valsartan in treating HFmrEF. Journal of Xinjiang Medical University. 2025;48(3):362-367.
Lin R, Li X. Clinical study on Qili Qiangxin Capsule combined with Baoyuan Decoction in treating chronic heart failure. Guangming Journal of Chinese Medicine. 2021;36(23):3926-3929.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Minglang Cao, Yan Zhao, Peng Yang
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
