OBJECTIVE: To evaluate the effectiveness of Chaimu Xingnao decoction combined with western medicine in the treatment of brain tissue injury and cognitive disorders after stroke by Meta-analysis. METHODS: The Cochrane Library、PubMed、Embase、CNKI、CBM、Wanfang Data and VIP were electronically retrieved to collect the relevant randomized controlled trials（RCT）. The retrieval time was from the establishment of the database to Feb. 2021. After literature screening and data extraction

Meta-analysis was performed by RevMan 5.4 software and trial sequential analysis（TSA） was performed by TSA v0.9 software. RESULTS: A total of 9 RCT were extracted

including 777 patients. Compared with conventional western medicine treatment

Chaimu Xingnao decoction combined with western medicine could improve the total effective rate（RR=1.25

95%CI=1.17-1.34

P<0.000 01）

neurobehavioral cognitive status examination score（RR=6.36

95%CI=5.08-7.63

P<0.000 01）

decreased the level of hemorheology indicators（whole blood high shear viscosity: RR=-0.53

95%CI=-0.58--0.49

P<0.000 01; whole blood low shear viscosity: RR=-2.03

95%CI=-2.56--1.50

P<0.000 01; plasma viscosity: RR=-0.21

95%CI=-0.24--0.18

P<0.000 01）

and increased the levels of vascular proliferation related indicators（vascular endothelial growth factor: RR=57.50

95%CI=51.33-63.66

P<0.000 01; angiopoietin-1: RR=6.58

95%CI=6.00-7.16

P<0.000 01）

the differences were statistically significant. TSA results showed that Chaimu Xingnao decoction combined with western medicine can improve the total effective rate of treatment. CONCLUSIONS: Results of the available studies suggest that the clinical efficacy of Chaimu Xingnao decoction in the treatment of brain tissue injury and cognitive disorders after stroke is significant

yet more high-quality RCT are needed to validate the conclusions.