Abstract
Stroke poses a severe threat to human health, with limited therapeutic options currently available. Astragaloside IV (AS-IV), a primary bioactive metabolite derived from Astragalus membranaceus, exhibits multifaceted pharmacological effects, including anti-inflammatory, anti-fibrotic, and antioxidative properties. This review systematically examines recent advances in AS-IV research for stroke treatment, detailing its sources, physicochemical characteristics, mechanisms of action, and therapeutic efficacy in both in vitro and in vivo models. We critically analyze the potential of AS-IV as an adjunctive therapy for stroke, addressing current research hotspots, challenges, and emerging strategies. Notably, AS-IV synergistically enhances neuroprotection when combined with other plant-derived metabolites. This work provides a theoretical foundation for further development of AS-IV in stroke management. In summary, AS-IV demonstrates significant promise as a natural neuroprotective agent worthy of continued exploration for adjuvant stroke therapy.