Medicinal Plant Research 2025, Vol.15, No.4, 188-196 http://hortherbpublisher.com/index.php/mpr 190 remodeling" with Boolean operators in comprehensive retrieval. Manual searches of reference lists were also performed. Inclusion criteria were determined in line with the PICOS structure: (1) English or Chinese peer-reviewed RCTs; (2) ≥18-year-old heart failure patients (LVEF ≤40%); (3) oral or intravenous Astragalus membranaceus as monotherapy or used in addition to conventional treatment; (4) placebos or conventional treatment as controls; (5) left ventricular remodeling and clinical efficacy as main outcomes (Zheng et al., 2020; Wang et al., 2023; Liu et al., 2024). Figure 1 The docking model of isorhamnetin, quercetin, calycosin, formononetin, and kaempferol with ESR1. (A) The network diagram of 10 hub genes and 5 HQ active ingredients was constructed. (B) Molecular docking map of 5 HQ active ingredients and ESR1 (Adopted from Chen et al., 2024) 3.2 Data extraction and quality assessment of studies Extraction of data was done by a minimum of two reviewers in duplicate on study design, participant information, interventions, comparators, outcomes, and adverse events. Assessment of the quality of included studies was done with the Cochrane Risk of Bias tool for RCTs and the SYRCLE tool for animal studies. In case of disagreement, a third reviewer or consensus resolved it. The quality of the evidence was graded, and the high-bias risk studies were included in the analysis (Han et al., 2024; Liu et al., 2024). 3.3 Statistical methods and heterogeneity analysis Statistical analysis was performed with Review Manager (RevMan) and Stata software. In case of continuous outcome measures, mean difference (MD) or standardised mean difference (SMD) with 95% confidence intervals (CIs) were employed, and in the case of dichotomous outcome measures, risk ratios (RRs) or odds ratios (ORs) were employed. I²statistic and Chi-square test were employed in order to check heterogeneity. For substantial heterogeneity (I²> 50%), a random-effects model was employed, and a fixed-effect model otherwise. Subgroup and sensitivity analysis was carried out to explore possible explanations for heterogeneity, such as intervention type, dose, or study quality (Zheng et al., 2020; Wang et al., 2023). 3.4 Publication bias and sensitivity analysis Publication bias was estimated through funnel plots and statistical tests such as Egger's or Begg's test. Sensitivity analysis was done by sequentially removing the studies to confirm the reliability of the pooled effect, ensuring the stability of the result within the meta-analysis (Zheng et al., 2020; Liu et al., 2024). 4 Clinical Efficacy of Astragalus in Cardiovascular Diseases 4.1 Chronic heart failure Astragalus membranaceus and AS-IV have also exhibited excellent potential in chronic heart failure (CHF). AS-IV improves myocardial contractility, inhibits myocardial hypertrophy and fibrosis, enhances energy
RkJQdWJsaXNoZXIy MjQ4ODYzNA==