Cerebral ischemia is a cerebrovascular disease characterized by the sudden interruption of cerebral blood flow，leading to neuronal death and impaired neurological function，posing a severe threat to patients' health and safety.Research has shown that vascular homeostasis plays a crucial role in the prevention and treatment of cerebral ischemic injury.By regulating the dynamic balance between vascular endothelial cells and smooth muscle cells，extracellular matrix components and neurons，as well as glial cells，vascular homeostasis helps restore the function of ischemic brain tissue and mitigate the extent of cerebral ischemic injury.Therefore，maintaining vascular homeostasis is fundamental to life activities and is key to preventing and treating cerebral ischemia.Qi-tonifying and blood-activating herbal formulas exert protective effects against cerebral ischemic injury by regulating vascular homeostasis through multiple pathways，including protecting vascular endothelium，inhibiting smooth muscle cell proliferation，exerting anti-inflammatory and antioxidant effects，promoting angiogenesis，and improving lipid metabolism.Moreover，Chinese medicine and its compound formulations，with their multi-pathway，multi-component，and multi-target advantages，have demonstrated significant efficacy in regulating vascular homeostasis after cerebral ischemia.