Bioactive components and molecular mechanisms of Salvia miltiorrhiza Bunge in promoting blood circulation to remove blood stasis.

ETHNOPHARMACOLOGICAL RELEVANCE: Salvia miltiorrhiza Bunge (SM) is an outstanding herbal medicine with various traditional effects, especially promoting blood circulation to remove blood stasis. It has been widely used for centuries to treat blood stasis syndrome (BSS)-related diseases. BSS is one of the basic pathological syndromes of diseases such as cardiovascular and cerebrovascular diseases in traditional East Asian medicine, which is characterized by disturbance of blood circulation. However, the bioactive components and mechanisms of SM in the treatment of BSS have not been systematically reviewed. Therefore, this article outlines the anti-BSS effects of bioactive components of SM, concentrating on the molecular mechanisms. AIM OF THE REVIEW: To summarize the bioactive components of SM against BSS and highlight its potential targets and signaling pathways, hoping to provide a modern biomedical perspective to understand the efficacy of SM on enhancing blood circulation to remove blood stasis. MATERIALS AND METHODS: A comprehensive literature search was performed to retrieve articles published in the last two decades on bioactive components of SM used for BSS treatment from the online electronic medical literature database (PubMed). RESULTS: Phenolic acids and tanshinones in SM are the main bioactive components in the treatment of BSS, including but not limited to salvianolic acid B, tanshinone IIA, salvianolic acid A, cryptotanshinone, Danshensu, dihydrotanshinone, rosmarinic acid, protocatechuic aldehyde, and caffeic acid. They protect vascular endothelial cells by alleviating oxidative stress and inflammatory damage and regulating of NO/ET-1 levels. They also enhance anticoagulant and fibrinolytic capacity, inhibit platelet activation and aggregation, and dilate blood vessels. Moreover, lowering blood lipids and improving blood rheological properties may be the underlying mechanisms of their anti-BSS. More notably, these compounds play an anti-BSS role by mediating multiple signaling pathways such as Nrf2/HO-1, TLR4/MyD88/NF-κB, PI3K/Akt/eNOS, MAPKs (p38, ERK, and JNK), and Ca2+/K+ channels. CONCLUSIONS: Both phenolic acids and tanshinones in SM may act synergistically to target different signaling pathways to achieve the effect of promoting blood circulation.

Exploration in the mechanism of rhubarb for the treatment of hyperviscosity syndrome based on network pharmacology.

ETHNOPHARMACOLOGICAL RELEVANCE: Hyperviscosity syndrome (HVS) is a major risk factor for thrombotic diseases. Rhubarb, well-known as a traditional Chinese medicine, exhibits multiple pharmacological activities, especially for promoting blood circulation to remove blood stasis (PBRB), which has been become a functional health food for decreasing the risk of cardiovascular diseases. However, due to the complexity of rhubarb components, it is still difficult to clarify the specific targets of effective substances in PBRB, and the pharmacodynamic mechanism needs to be further probed. MATERIALS AND METHODS: The "compound-target-cell-disease" network analysis was initially used to predict potential targets and bioactive compounds. The effect of rhubarb for the treatment of HVS was examined by histopathology and biochemical assays based on the HVS rat model. RESULTS: Through the "compound-target-cell-disease" network analysis, eight potential therapeutic targets were eventually screened out, and platelets were predicted as the main effector cells of rhubarb in PBRB. Among targets coagulation factor II (prothrombin, F2) and fibrinogen gamma chain (FGG) were closely related to platelets, and five compounds associated with F2 and FGG were predicted including emodin-8-O-beta-D-glucopyranoside (Emo), physcion-8-O-beta-D-glucopyranoside (Phy), procyanidin B-5,3'-O-gallate, torachrysone-8-O-beta-D-(6'-oxayl)-glucoside and epicatechin. Furthermore, thoracic aorta histopathology and biochemical examinations showed middle dose of rhubarb (0.42 g/kg/day) significantly ameliorated pathological changes, hemorheology parameters, as well as levels of representative biomarkers such as plasma P-selectin (P-sel) and thromboxane (TXB2) in platelet activation compared to HVS rat model, whose effects were comparable to the positive drug aspirin or even better. Finally, it was further validated F2 and FGG as the major effective targets of rhubarb as well as its two active ingredients Emo and Phy in PBRB. CONCLUSIONS: This study may provide an innovative way and scientific information to further understand the main effective components of rhubarb and its mechanisms about targets of F2 and FGG in PBRB, especially the new therapeutic target FGG, which also provide a basis for establishing a quality control for rhubarb by bioassays that could correlate the clinical efficacy and its mechanism.

Coronary Heart Disease Phlegm-blood Stasis-stagnation-deficiency Innovation Theory and Clinical Application Based on Complex System / 中国实验方剂学杂志

There exits a trend of treatment for coronary heart disease(CHD) in terms of Chinese medicine(CM) in history,from warming Yang and dispelling cold,moving Qi and dissolving phlegm to invigorating blood and dissolving stasis,whose time-space development accords to the theory of complex system.Targeting the contemporary population of CHD,phlegm-blood stasis-stagnation-deficiency theory is proposed to direct clinical application to further improve effectiveness.From the perspective of theory,blood stasis-stagnation is the basic pathogenesis of CHD that runs through the whole period in the advance of CHD,while phlegm has been changing the feature of CM Zheng of CHD population with the development of the society,and nourishing the body according to the type of deficiency might delay the process of growing older,postpone the occur of disease and hinder the advance of disease,which genuinely differs from modern medicine to render the superiority of CM to work out the challenges of CHD.As for the clinical application,the treatment options could consider invigorating blood,dissolving stasis and removing stagnation as the basic method,such as CHD formula 2,Xuefu Zhuyutang,Zhizi Chitang and Danggui Niantongtang could be used in varied period of CHD.Moreover,boosting the body by herbal medicine could regulate the routine of body,then to prevent CHD and fear down the advance of CHD,for instance,Codonopsis Radix,Astragali Radix,Liuwei Dihuang pills,Zuoguiyin and Youguiyin.Furthermore,balmiest herbs could not only dissolve phlegm,unblock the meridian and relieve pain,but also calm the mind and eliminate the anxiety.For example,Aquilariae Lignum Resinatum,Santali Albi Lignum and Moschus could be used handily in the treatment of CHD.

Intervention effect of total flavonoids of ilex pubesceus on tolerant rat models under cerebral anoxia.

Objective: To observe the intervention effect of total flavonoid of ilex pubesceus on animal models of cerebral ischemic tolerance. Methods: A rat model of global-focal cerebral ischemic tolerance was established by blocking bilateral common carotid artery blood flow and occluding left middle cerebral artery using thread-occlusion method. After the first operation, the Ginaton group and large-dosage, medium-dosage and small-dosage groups of total flavonoid of ilex pubesceus were given intragastric administration of corresponding drugs. The sham-operated group, pretreatment model group and ischemia-reperfusion group were given intragastric administration of the same volume of normal saline, 1 time a day, and administrated for 4d. At 24 h after the second operation, the neurological deficit was assessed, the whole blood viscosity, plasma viscosity, iNOS activity as well as NO level, IL-1ß content and TNF-α content in the brain tissue of the rats were determined, and the morphological changes of brain tissue of the rats were observed by HE staining. Results: All the rat models of cerebral ischemic tolerance were established successfully. The total flavonoid of ilex pubesceus can obviously or significantly reduce the neurological deficit score, whole blood viscosity and plasma viscosity, obviously or significantly increase the NO level in the brain tissue of the rats, and significantly reduce the pathological damage of brain tissue of the rats. But compared with the ischemia-reperfusion group, the total flavonoid of ilex pubesceus can significantly or obviously increase the iNOS activity, IL-1ß content and TNF-α content in the brain tissue of the rats.

Treating Chronic Atrophic Gastritis from Blood Stasis / 浙江中医药大学学报

[Objective] To explore the clinical experience of Professor ZHOU Xiaohong in treating chronic atrophic gastritis(CAG) from blood stasis.[Methods]Through the analysis of literature,tracing the source of the disease,following the teacher clinic and collecting relevant medical records,Professor ZHOU Xiaohong's clinical experience in treating CAG from blood stasis is summarized from the aspects of etiology,pathogenesis,treatment and so on.At the same time,the characteristics of the prescription of herbal are summarized,and exemplify that.[Result]Professor ZHOU Xiaohong thinks that blood stasis is the basic pathological factor of CAG.It plays an important role in the occurrence and development of this disease,and blood circulation and blood stasis should be carried through the whole process of clinical syndrome differentiation and treatment.ZHOU attachs importance to the application of drugs for promoting blood circulation to remove blood stasis,such as syndrome differentiation,disease differentiation,experience.In addition,another key view is the selection of drugs that can activate blood circulation to remove blood stasis,combining with modern research.The uhimatc result is to promote rcstoration of the gastric mucosa and absorption of local inflammation,enhance and improve the function of gastric mucosal barrier,reduce the degree of glandular atrophy,prevent cancer,and,thus significantly improve clinical efficacy.[Conclusion] Professor ZHOU Xiaohong has rich clinical experience and unique opinion in treatment of CAG.The clinical curative effect of CAG from the treatment of blood stasis is significant,which is worth learning and popularizing.

Clinical observation on treatment of coronary heart disease by promoting blood circulation and removing stasis / 中国生化药物杂志

ObjectiveAnalyze the mechanism of traditional Chinese medicine Salvia miltiorrhiza in treating coronary heart disease (CHD).MethodsThe animal experiment using actual research, namely the selection of rat isolated heart perfusion model, rat model of myocardial ischemia and ventricular tachycardia in rabbits model, then the effects of different animal groups in hemodynamics, coronary flow, serum superoxide dismutase (SOD) content, malondialdehyde (MDA) the results of the content.ResultsAfter treatment, the content of SOD was significantly increased and the content of MDA was significantly decreased in the treatment group, and the difference between the two groups was statistically significant (P<0.05).ConclusionTraditional chinese medicine Salvia miltiorrhiza has significant effect on the treatment of coronary heart disease, which is beneficial to the recovery of patients' condition, and is worthy of clinical application.

Clinical study on the method of reinforcing qi nourishing yin and promoting blood circulation to remove blood stasis in the treatment of restenosis after percutaneous coronary intervention / 国际中医中药杂志

Objective To observe the clinical effects of the method of reinforcing qi,nourish ing yin and promoting blood circulation to remove blood stasis in the treatment of restenosis after percutaneous coronary intervention.Methods 60 coronary heart disease patients who had accepted PCI treatment and occurred restenosis were randomly recruited into a control group and a treatment group,30 eases in each group.The control group received conventional therapy.The treatment group was treated with conventional therapy combined with TCM of reinforcing qi,nourishing yin and promoting blood circulation to remove blood stasis.Both groups were treated for 6 months.The clinical symptoms,coronary angiography or coronary artery CTA,blood lipids were observed.Results The total effective rate was 93.33％ and 66.67％ in the treatment group and the control group respectively,showing statistical difference (x2=8.787,P＜0.05).The patients' clinical symptoms in the treatment group were improved,such as chest pain,chest tightness,shortness of breath,fatigue,dry mouth [The scores were respectively(1.07± 1.01)、(1.33±1.21)、(1.47±1.17)、(1.53±1.14)、(1.53± 1.01),(P＜0.05) ].The treatment group demonstrated a significantly better therapeutic results than the control group [Thescoreswererespectively(2.07±1.53)、(2.27±1.46)、(3.73±1.46)、(3.73±1.87)、(3.13±1.63),(P＜0.05) ].The results of coronary angiography or coronary artery CTA showed that the narrow degree in the treatment group was no more aggravating and it had no new restenosis.After the treatment,the level of CHOL、TG、HDL-C、LDL-C in the treatment group was improved [They were respectively (4.55±0.44)mmol/L、(1.81±0.56)mmol/L、(1.26±0.38)mmol/L、(2.25±0.49)mmol/L,(P＜0.05) ].The improvement in CHOL、TG、LDL-C of the treatment group was better than that of the control group [They were respectively (4.86±0.63)mmol/L、(2.29±1.06)mmol/L,(2.60±0.73)mmol/L,(P＜0.05)].Conclusion The method of reinforcing qi,nourishing yin and promoting blood circulation to remove blood stasis could improve the patients clinical symptoms and blood lipids,and therefore spreventing restenosis.

Fuzzy Grouping Analysis on Herbs for Promoting Blood Circulation to Remove Blood Stasis / 中国药房

OBJECTIVE:To classify the herbs for promoting blood circulation to remove blood stasis.METHODS:Database of 33 commonly used herbs for promoting blood circulation to remove blood stasis was established by means of SPSS10.0 software package;and the nature,tastes,meridian attributions and actions of the herbs were collected as variables showing the characteristics of classification,and the names of the herbs served as variables for measurement to proceed Q Cluster in Hierarchical Cluster.RESULTS:When the herbs were classified into 4 groups,the first group included the herbs for promoting blood circulation to restore menstrual flow,the second the herbs for promoting blood circulation to arrest pain and dissipate tumor,the third the herbs of herbs for activating blood circulation to dissipate blood stasis and kill pain,the fourth the herbs for severely activating blood circulation to dissipate blood stasis.When the herbs were classified into 5 groups,the fifth group included herbs for activating blood circulation to cure wound.When the herbs were classified into 6 groups,the third one included the herbs for activating blood circulation to exclude wind and the sixth the herbs for activating blood circulation to stanch blood.CONCLUSION:Fuzzy grouping analysis can be applied to classify herbs of different kinds yet with the same efficacy and to classify the same group of herbs according to their drug actions.