Panax notoginseng

BACKGROUND/OBJECTIVES: Whether saponins aid in whey protein supplementation remains unclear. We aimed to investigate the effects of Astragalus and Panax saponins (APS) on whey protein absorption, intestinal permeability, and muscle function in healthy adults across different age groups. METHODS: A randomized, double-blind, placebo-controlled crossover trial was conducted with 30 healthy participants equally stratified into three age groups (18-25, 26-59, and 60-80 years), over two phases: a single-dose trial to measure immediate amino acid absorption from whey protein and a 4-week phase combining daily supplementation with resistance training to assess long-term effects on amino acid absorption kinetics, muscle function, and gut health. RESULTS: Immediate APS supplementation resulted in a 6.67% higher area under the curve for valine, 3.62% for leucine, and 0.15% for isoleucine, compared with the placebo. After 4 weeks, APS supplementation significantly increased the absorption of valine (14.07%) and leucine (8.34%) and improved the absorption of isoleucine (6.33%). The effects were most pronounced in older adults (60-80 years), who showed a 12.74% increase in total essential amino acid absorption. APS also caused a substantially greater increase (APS: +5.20% vs. placebo: +2.44%) in grip strength, an increase (APS: +0.85% vs. placebo: +0.68%) in muscle mass, and a reduction in blood zonulin levels (APS: -13.01% vs. placebo: -0.9%), indicating improved muscle function and intestinal barrier integrity, without adverse effects on liver or kidney function. CONCLUSIONS: APS supplementation enhances amino acid absorption from whey proteins, muscle function and gut barrier integrity, especially in older adults. These findings highlight its synergistic role in improving protein supplementation efficacy for those with age-related muscle loss.

OBJECTIVE: To evaluate the clinical efficacy and safety of Xueshuantong Injection (Lyophilized) (XST) in reducing residual inflammatory risk (RIR) in patients with unstable angina (UA). METHODS: This was a randomized, double-blind, parallel-controlled multicenter trial. Patients with UA were recruited from Xiyuan Hospital and Guang'anmen Hospital of the China Academy of Chinese Medical Sciences between January 2024 and March 2025. Eligible participants were randomly assigned to the treatment group (XST 500 mg, 30 cases) or the control group (XST 25 mg, 30 cases) in a 1:1 ratio. Both groups received intravenous XST for 10 consecutive days along with standard medical therapy. The primary outcome was change in C-reactive protein (CRP) level from baseline to post-treatment. Secondary outcomes included changes in interleukin-6 (IL-6), matrix metalloproteinase-9 (MMP-9), high-mobility group box 1 (HMGB1), vascular endothelial growth factor (VEGF), and von Willebrand factor (vWF), as well as the Canadian Cardiovascular Society (CCS) classification, and Chinese Medicine (CM) syndrome scores. Safety was evaluated by monitoring adverse event (AE) and performing laboratory tests of liver and kidney function before and after treatment. RESULTS: A total of 59 patients completed the trial (30 in the treatment group and 29 in the control group). After treatment, the treatment group showed significantly greater reductions in CRP levels compared to the control group (P<0.01). In addition, the treatment group exhibited significantly improved IL-6, MMP-9, and HMGB1 levels, as well as CM symptom scores and CCS classification compared to the control group (all P<0.05). No serious adverse events were reported. Compared with the control group, the treatment group receiving XST showed greater improvements in RIR and clinical symptoms in UA patients with good safety and tolerability. CONCLUSION: XST shows potential to reduce RIR in patients with UA and may inform anti-inflammatory management. (Registration No. ITMCTR2025000552). © 2025. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.

OBJECTIVE: To investigate the effects of the combined Yiqi Huoxue Jiedu formula (YHJF) on intestinal microbiota in elderly patients with pulmonary-derived sepsis and identify potential microbial targets. METHODS: A prospective randomized double-blind controlled trial was conducted. Elderly patients with pulmonary infection-induced sepsis admitted to the emergency department of Guangdong Provincial Hospital of Traditional Chinese Medicine (TCM), intensive care unit (ICU) of Fangcun Hospital, and ICU of Daxuecheng Hospital, from November 2020 to October 2021 were enrolled and randomized into two groups. Both groups received conventional Western medicine treatment. The observation group additionally received YHJF (composed of 15 g of Panax ginseng, 9 g of Panax notoginseng, and 3 g of Rheum palmatum, dissolved in 50 mL warm water) orally or via nasogastric tube twice daily for 7 days; while the control group received a placebo. Clinical data and fresh fecal samples were collected before treatment and on days 5-7 of treatment. Intestinal microbiota diversity and structure were analyzed via 16S rDNA sequencing and bioinformatics [α diversity, β diversity, and linear discriminant analysis effect size (LEfSe)]. RESULTS: Fifty-five patients were included (29 in the control group, 26 in the observation group). There were no significantly differences in gender, age, comorbidities, and baseline sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation II (APACHE II), acute gastrointestinal injury (AGI) classification score, and gastrointestinal failure (GIF) score between the two groups. Compared to the control group, the observation group showed significantly lower serum procalcitonin, APACHE II score, and greater reduction in GIF score by day 7. Thirty fecal samples were collected pre-treatment (baseline group), 29 post-treatment from the control group, and 26 from the observation group. Gut microbiota α diversity analysis revealed that Simpson index in the observation group and control group were significantly decreased compared to the baseline group [0.75 (0.53, 0.91), 0.81 (0.32, 0.91) vs. 0.88 (0.87, 0.89), both P < 0.05], but there w

IMPORTANCE: Preclinical and clinical studies have suggested the neuroprotective effect of Panax notoginseng saponins (Xuesaitong soft capsules). However, robust evidence in patients with ischemic stroke is lacking. OBJECTIVE: To assess the efficacy and safety of Xuesaitong soft capsules in patients with ischemic stroke. DESIGN, SETTING, AND PARTICIPANTS: This multicenter, double-blind, placebo-controlled randomized clinical trial was conducted at 67 tertiary health centers in China from July 1, 2018, to June 30, 2020. Included patients were aged 18 to 75 years with a diagnosis of ischemic stroke and a National Institutes of Health Stroke Scale score between 4 and 15. INTERVENTIONS: Eligible patients were randomly assigned within 14 days after symptom onset to receive either treatment with Xuesaitong soft capsules (120 mg orally twice daily) or placebo (120 mg orally twice daily) for 3 months. MAIN OUTCOMES AND MEASURES: The primary outcome was functional independence at 3 months, defined as a modified Rankin Scale score of 0 to 2. RESULTS: Among 3072 eligible patients with ischemic stroke who were randomized, 2966 (96.5%) were included in the modified intention-to-treat cohort (median [IQR] age, 62 [55-68] years; 1982 male [66.8%]). The number of patients who achieved functional independence at 3 months was 1328 (89.3%) in the Xuesaitong group and 1218 (82.4%) in the control group (odds ratio, 1.95; 95% CI, 1.56-2.44; P < .001). In the safety cohort, serious adverse events occurred in 15 of 1488 patients (1.0%) in the Xuesaitong group and 16 of 1482 (1.1%) in the control group (P = .85). CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, Xuesaitong soft capsules significantly increased the likelihood of functional independence at 3 months in patients with ischemic stroke, indicating that this may be a safe and effective alternative therapy to improve prognosis in this population. TRIAL REGISTRATION: Chinese Clinical Trial Registry Identifier: ChiCTR1800016363.

BACKGROUND: Heart failure (HF), manifested as a severe or end stage of various cardiac diseases, is characterized by increased incidence, mortality, re-hospitalization, and economic burden. Myocardial infarction (MI) is one of the most common and important causes of HF. Since 2005, acute MI (AMI)-associated mortality in China has been on the rise, and MI accounts for 23.1% of the causes of HF. Traditional Chinese medicine (TCM) has the unique advantages of controlling angina pectoris and HF symptoms, and improving patients' quality of life. Compound Xueshuantong Capsule (CXSTC), also named as Fufang Xueshuantong Capsule, has the effect of increasing cardiac output and protecting myocardial function. In this trial, we aim to investigate the efficacy and safety of CXSTC in the prophylactic treatment of post-infarction HF and attempt to provide a clinical evidence-based basis for the prophylactic treatment of HF after AMI using TCM. METHODS: This will be a multi-center, randomized, double-blind, placebo-parallel controlled trial. A total of 300 patients diagnosed with AMI and undergoing percutaneous coronary intervention within 12 hours of diagnosis will be randomized 1:1 into 2 groups: the control group that will be administered conventional Western medicine plus placebo and the trial group that will be administered XST along with the conventional Western medicine. The duration of treatment will be 3 months and the follow-up will be up to 6 months for both groups. The main efficacy indicator is the incidence of HF. The secondary efficacy indicators are cardiac function classification, 6-minute walk test score, TCM syndrome score, survival quality score, brain natriuretic peptide level, ultrasensitive C-reactive protein level, and cardiac ultrasound result. Data will be collected to analyze the underlying mechanisms by using IBM SPSS 23.0 software. DISCUSSION: By investigating the efficacy and safety of CXSTC, this study will provide a clinical evidence base for the use of TCM in the prophylactic treatment of post-infarction HF.

OBJECTIVE: To investigate the efficacy of the Panax notoginseng Ejiao suppository in patients with ulcerative proctitis and its effect on inflammatory response and immune function. METHODS: This study recruited 100 patients with ulcerative proctitis who were hospitalized to our hospital's anorectal outpatient department between May 2015 and October 2020. They were randomly separated into either a control or a study group, with 50 cases in each. The control group received the mesalazine suppository, whereas the study group received the Panax notoginseng Ejiao suppository. Outcome measures included clinical effectiveness, inflammatory response, and immunological state of patients. RESULTS: The total efficiency in the study group was significantly higher than that in the control group (P = 0.019). The Mayo score and Baron endoscopic score between the two groups were significantly decreased after treatment, with lower results in the study group (P < 0.05). The inflammatory variables were dramatically reduced following therapy, with the study group doing worse. Following treatment, the number of Th 17 cells declined dramatically in both groups, while the proportion of Treg cells increased significantly, with greater alterations of Th17 cells and Treg cells observed in the study group than those in the control group (P < 0.05). The Panax notoginseng Ejiao suppository resulted in significantly shorter time lapses before symptom alleviation and a lower incidence of recurrence at 6 months after treatment versus mesalazine suppository (P < 0.05). CONCLUSION: In patients with ulcerative proctitis, the Panax notoginseng Ejiao suppository significantly improves clinical efficacy, reduces the incidence of recurrence, mitigates inflammatory response, and improves immune function.

OBJECTIVE: The aim of this study is to investigate the effect of Tianjiang Xueshuantong Wan pills on reperfusion injury after venous thrombolysis in acute cerebral infarction. METHODS: The strategy used in this study is a randomised controlled clinical trial. In total, 72 cases were included, with 36 in the trial group and 36 in the control group, with a 1:1 ratio. Both groups were given standardised treatment for acute cerebral infarction. Based on the rt-PA intravenous thrombolysis, the test group took Tianjiang Xueshuantong Wan pills orally, whereas the control group solely utilised rt-PA for intravenous thrombolysis and did not take the test medicine orally. The patients' intracranial hemorrhage was clarified by head CT scan, and the occurrence of reperfusion injury was recorded during the entire trial. RESULTS: There were no significant differences in serum IL-6, MDA, SOD and TNF concentrations and NIHSS scores between the two groups before therapy (P > 0.05). After treatment, the serum concentrations of IL-6, MDA and TNF in the experimental group were significantly decreased compared with the control group, while the serum concentrations of SOD were significantly increased compared with the control group, with statistical significance (P > 0.05). After seven days of treatment, the total effective rate in the experimental group was 88.89%, while the data in the control group was 75%. There was a statistically significant difference between the experimental and control groups. CONCLUSION: Tianjiang Xueshuantong Wan pills can effectively prevent reperfusion injury following intravenous thrombolysis in individuals with cerebral infarction while improving patients' neurological deficits.

Panax notoginseng root rot is caused by a variety of pathogens. However, the fungicides registered for the prevention and control of P. notoginseng diseases cannot meet the demand. Thus, it is particularly important to screen out a broad-spectrum combined fungicide with a synergistic effect. This study selected thiram(Baofusi), pyraclostrobin(BASF), and difenoconazole(Shili) with good inhibitory effects on Fusarium oxysporum, F. solani, and A. alternata from commonly used fungicides in the market. When the ratio of pyraclostrobin to difenoconazole and thiram to difenoconazole was 1∶2.5 and 1∶5, respectively, the highest synergistic coefficients were observed for F. oxysporum with values of 2.32 and 2.11, respectively. When the ratio of pyraclostrobin to thiram, pyraclostrobin to difenoconazole, and thiram to difenoconazole was 1∶5, 1∶2.5, and 1∶1, respectively, the highest synergistic coefficients against F. solani were obtained with values of 1.9, 2.55, and 2.04, respectively. When the ratio of pyraclostrobin to thiram, pyraclostrobin to difenoconazole, and thiram to difenoconazole was 1∶5, 1∶2.5, and 5∶1, the highest synergistic coefficients against A. alternata were shown with values of 1.63, 1.71, and 2.04, respectively. The spore yield and germination rate of F. oxysporum and F. solani were significantly reduced when pyraclostrobin and difenoconazole in combination with a synergistic effect on the three pathogens was used at a ratio of 1∶2.5. These results lay the foundation for broad-spectrum combined fungicides with a synergistic effect for the prevention and control of P. notoginseng root rot.

ETHNOPHARMACOLOGICAL RELEVANCE: Panax notoginseng (Burkill) F.H. Chen, documented in the Compendium of Materia Medica, promotes blood circulation and removes stasis. Despite extensive research, the above-ground parts (stems and leaves) remain underutilized. The synergistic mechanism of the effects of hawthorn (Crataegus pinnatifida) juice (SZ) on Panax notoginseng stem-leaf extract (SQ) to regulate sugar and lipid metabolism has not been reported. AIM OF THE STUDY: To elucidate SZ's effects on SQ saponins and their synergistic mechanisms in glucose/lipid metabolism. MATERIALS AND METHODS: The optimum technological parameters of SSZ were determined using single-factor and orthogonal tests, and the effectiveness of SSZ in regulating glucose and lipid metabolism was investigated using a high-fat and high-sugar model. The main saponins were characterized using LC-MS/MS, the synergistic mechanism of rare saponins was analyzed using network pharmacology and molecular docking, and the Rb3 transformation pathway was analyzed using transformation kinetics. RESULTS: The results showed that SSZ could enhance the synergistic effect, alleviate liver injury, significantly improve the metabolic parameters of glucose and lipids, and adjust blood viscosity. Mechanistically, maslinic acid in SZ hydrolyzed protopanaxadiol saponins into active rare ginsenosides (S/R-Rg3, Rg5, and Rk1) through selective glycoside cleavage. CONCLUSION: This study solved the problems of the limited curative effect of monotherapy and difficulty in obtaining rare saponins with high activity, provided innovative strategies for functional food development, promoted the efficient utilization of aboveground resources of Panax notoginseng, and was very important for solving the global disorder of glucose and lipid metabolism and promoting the application of natural products.

ETHNOPHARMACOLOGICAL RELEVANCE: In China, the integration of Chinese traditional medicine with Western medicine for the treatment of multifactorial diseases provides notable therapeutic benefits. Given this integration involving co-administration of herbal medicines and synthetic drugs, it is critical to evaluate the potential for associated drug interactions. AIM OF THE STUDY: This investigation aimed to evaluate an oral extract of Panax notoginseng roots (Sanqi) for its potential to induce CYP3A activity, which may contribute to herb-drug interactions. METHODS: Human microbiota-associated (HMA) rats were used to determine whether repeated oral administration of Sanqi extract induces CYP3A activity. Cryopreserved primary rat and human hepatocytes were used to evaluate the ability of ginsenoside metabolites and their combinations to induce rat Cyp3a and human CYP3A. Fecal samples from HMA rats repeatedly treated with oral Sanqi extract were analyzed for microbial deglycosylation activity on ppt-type ginsenosides. Quantitative real-time polymerase chain reaction was used to measure mRNA levels of rat Cyp3a1 and Cyp3a2, and human CYP3A4 and CYP3A5. Liquid chromatography/mass spectrometry was used to quantify ginsenosides and their metabolites in rat samples and in vitro study samples. 16S rRNA gene sequencing was used to analyze intestinal microbiota composition. RESULTS: Repeated oral administration of Sanqi extract did not induce hepatic Cyp3a expression in rats. Neither ginsenoside metabolites nor their combinations induced rat Cyp3a or human CYP3A in vitro. Systemic exposure to oxidized metabolites of 20(S)-protopanaxtriol showed significant accumulation in HMA rats following repeated administration of Sanqi extract. This accumulation pattern mirrored previous findings in humans. The increased systemic exposure to the oxidized metabolites was likely due to enhanced microbial deglycosylation activity resulting from repeated oral administration of the extract. CONCLUSIONS: Oral Sanqi extract exhibits a low propensity to induce CYP3A. This limited potential for drug interactions supports its safe use in cardiovascular therapies, particularly in polypharmacy setti

In this study, we investigated the synergistic effect of co-administration of osimertinib and HAD-B1 using gefitinib-resistant non-small cell lung cancer cells, HCC827-GR. HAD-B1 is composed of 4 natural drugs, Panax Notoginseng Radix, Panax ginseng C. A. Meyer, Cordyceps militaris, and Boswellia carterii Birdwood, and has been reported to have therapeutic effects on patients with advanced non-small cell lung cancer in several studies. Resistance to gefitinib in HCC827 cells was acquired through MET activity. Co-treatment with osimertinib and HAD-B1 reduced the cell viability of HCC827-GR cells. In addition, phosphorylation of MET and ERK were effectively suppressed for HCC827-GR cells. And, compared to when osimertinib and HAD-B1 were administered alone, cell proliferation was significantly inhibited and apoptosis was effectively induced when osimertinib and HAD-B1 were co-administered to HCC827-GR cells. We found that the synergistic effect of osimertinib and HAD-B1 combination therapy resulted in cancer cell death and cell cycle arrest by targeting the ERK and mTOR signaling pathways. In conclusion, this study confirmed that the combination of osimertinib, a third-generation anticancer drug, and HAD-B1, a natural anticancer drug, had a potentially synergistic effect on non-small cell lung cancer resistant to EGFR-targeted anticancer drugs.

Compound Danshen dripping pills (CDDP), a well-known traditional Chinese medicine, is widely used to prevent and treat cardiovascular diseases. CDDP is usually prescribed in combination with clopidogrel (CLP), but the herb-drug interactions are rarely reported. This study evaluated the effects of CDDP on the pharmacokinetics and pharmacodynamics of coadministered CLP, and ensured the safety and efficacy of their usage. The trial design included a single-dose administration and multidose test for 7 consecutive days. Wistar rats received CLP alone or CLP combined with CDDP. After the final dose, plasma samples were collected at various time points, and the active metabolite H4 of CLP was analyzed by ultrafast liquid chromatography coupled with triple quadrupole tandem mass spectrometry. The main pharmacokinetic parameters of Cmax (maximum [or peak] serum concentration), Tmax (peak plasma time), t1/2 (half-time), AUC0-∞ (area under the concentration-time curve from dosing (time 0) to infinite time), and AUC0-t (area under the concentration-time curve from dosing [time 0] to time t) were calculated using the non-compartment model. In addition, prothrombin time, activated partial thromboplastin time, bleeding time, and adenosine diphosphate-induced platelet aggregation were evaluated for anticoagulation and antiplatelet aggregation activity. In this study, we found that CDDP had no significant effect on the metabolism of CLP in rats. In pharmacodynamic studies, the combination group showed significant synergistic antiplatelet activity compared with the CLP or CDDP groups alone. Based on pharmacokinetic and pharmacodynamic results, CDDP and CLP have synergistic effects on antiplatelet aggregation and anticoagulation. © 2023 John Wiley & Sons Ltd.

ETHNOPHARMACOLOGICAL RELEVANCE: Herbs, along with the use of herb-drug interactions (HDIs) to combat diseases, are increasing in popularity worldwide. HDIs have two effects: favorable interactions that tend to improve therapeutic outcomes and/or minimize the toxic effects of drugs, and unfavorable interactions aggravating the condition of patients. Panax notoginseng (Burk.) F.H. Chen is a medicinal plant that has long been commonly used in traditional Chinese medicine to reduce swelling, relieve pain, clear blood stasis, and stop bleeding. Numerous studies have demonstrated the existence of intricate pharmacodynamic (PD) and pharmacokinetic (PK) interactions between P. notoginseng and conventional drugs. However, these HDIs have not been systematically summarized. AIM OF THE REVIEW: To collect the available literature on the combined applications of P. notoginseng and drugs published from 2005 to 2022 and summarize the molecular mechanisms of interactions to circumvent the potential risks of combination therapy. MATERIALS AND METHODS: This work was conducted by searching PubMed, Scopus, Web of Science, and CNKI databases. The search terms included "notoginseng", "Sanqi", "drug interaction," "synergy/synergistic", "combination/combine", "enzyme", "CYP", and "transporter". RESULTS: P. notoginseng and its bioactive ingredients interact synergistically with numerous drugs, including anticancer, antiplatelet, and antimicrobial agents, to surmount drug resistance and side effects. This review elaborates on the molecular mechanisms of the PD processed involved. P. notoginseng shapes the PK processes of the absorption, distribution, metabolism, and excretion of other drugs by regulating metabolic enzymes and transporters, mainly cytochrome P450 enzymes and P-glycoprotein. This effect is a red flag for drugs with a narrow therapeutic window. Notably, amphipathic saponins in P. notoginseng act as auxiliary materials in drug delivery systems to enhance drug solubility and absorption and represent a new entry point for studying interactions. CONCLUSION: This article provides a comprehensive overview of HDIs by analyzing the results of the in vivo and in vitro studies on P.

Notoginseng total saponins (NS), safflower total flavonoids (SF), and the combination of NS and SF, namely CNS, are used for the treatment of cardiovascular diseases in clinic. This study developed a cocktail assay involving seven cytochrome P450 (CYP) enzymes to elucidate the effect of NS, SF, and CNS on CYP enzymes and to explore the synergistic effect of CNS in terms of CYP enzymes. Ultra-performance liquid chromatography-MS and reverse-transcription polymerase chain reaction were applied to detect the activities and mRNA expression levels of CYP enzymes. SF exhibited inhibitory effects on CYP1A2, 2B1, 2E1, and 2C11 and induction effects on CYP2C19 and 2D4. NS exhibited induction effects on CYP1A2, 2B1, 2E1, 2C11, 2C19, and 2D4. CNS exhibited induction effects on CYP1A2, 2B1, 2E1, 2C19, and 2D4 and inhibitory effects on CYP3A1 in vivo. Moreover, mRNA expression results were consistent with pharmacokinetic results. Potential herb-drug interactions should be studied closely when SF, NS, or CNS with clinical drugs are metabolized by CYP1A2, 2B1, 2E1, 2C11, 2C19, 2D4, and 3A1. CNS could change the inhibition or induction effects of CYP compared to the NS group, which might be one of the causes for the synergistic effects of the combination of NS and SF. © 2021 John Wiley & Sons, Ltd.

BACKGROUND: Our previous studies demonstrated that the administration of crude Polysaccharide from Panax notoginseng (CPPN) can effectively prolong the lifespan of tumor-bearing mice via boosting the host immune system as well as weak cytotoxicity against hepatocellular carcinoma (HCC). In the present study, Neutral Polysaccharide (NPPN) were further purified from crude polysaccharide isolated from panax notoginseng. The effects of NPPN on the immune function and hematopoietic function of mice with low immunity and myelosuppression induced by cyclophosphamide (CTX) were investigated. The effect of NPPN combined with CTX on the tumor inhibition rate of the H22 tumor-bearing mice and the impact of NPPN on the proliferation of H22 liver cancer cells in vitro were investigated. METHODS: CPPN was obtained by water extraction and alcohol precipitation method, and further purified by DEAE Sepharose Fast Flow ion exchange resin column. NPPN was added to the immunosuppressed with myelosuppression mice induced by CTX. Thymus index, spleen index, lymphocyte proliferation stimulation index by adding of concanavalin A, determination of serum hemolysin, NK cell activity assay, mice carbon clearance experiment, blood count tests were detected. The tumor inhibition rate of the H22 tumor-bearing mice treated with NPPN combined with CTX was recorded. RESULTS: NPPN and 4 kinds of acid polysaccharide from Panax notoginseng (APPN) were successfully isolated from the CPPN by DEAE Sepharose Fast Flow ion exchange resin column. NPPN inhibited the growth of H22 cells and significantly increase the tumor inhibition rate of the H22 tumor-bearing mice combined with CTX. The elevation of the cellular and humoral immunity levels as well as a variety of blood count tests indicators of immunosuppressive with myelosuppression mice may contribute to the antitumor activity of NPPN. CONCLUSION: NPPN has a potential antitumor activity for the treatment of liver cancer combined with cyclophosphamide.

High platelet reactivity and gastric mucosal injury after aspirin (ASA) treatment are associated with poor compliance and an increased risk of cardiovascular events. Panax notoginseng saponins (PNS) have been widely used for the treatment of coronary heart disease (CHD) in addition to antiplatelet drugs in China; however, the joint effect and possible mechanism of PNS in addition to ASA on platelet activation and gastric injury remain unclear. This study was designed to investigate the combinational effects of PNS with ASA, and to explore the underlying mechanism via arachidonic acid (AA) metabolism pathway using lipidomic analysis. In a randomized, assessor-blinded trial, 42 patients with stable coronary heart disease (SCHD) and chronic gastritis were randomly assigned to receive ASA (n = 21) or PNS + ASA (n = 21) for 2 months. Compared with ASA alone, PNS + ASA further inhibited CD62p expression, GPIIb-IIIa activation and platelet aggregation and led to increased platelet inhibition rate. PNS + ASA suppressed the activity of platelet cyclooxygenase (COX)-1, and decreased the production of TXB2, PGD2, PGE2, 11-HETE, the downstream oxylipids of AA/COX-1 pathway in platelets, compared with ASA alone. The severity of dyspepsia assessment (SODA) results showed that patients in PNS + ASA group exhibited relieved dyspeptic symptoms as compared with those in ASA group, which might be associated with enhanced secretion of gastrin and motilin. In vivo study of myocardial infarction rats demonstrated that PNS attenuated ASA-induced gastric mucosal injury, which was related to markedly boosted gastric level of 6,15-diketo-13,14-dihydro-prostaglandin (PG)F1α, 13,14-dihydro-15-keto-PGE2 and PGE2 from AA/PG pathway in response to PNS + ASA compared with ASA alone. In summary, our study demonstrated that the combination of PNS and ASA potentiated the antiplatelet effect of ASA via AA/COX-1/TXB2 pathway in platelets, and mitigated ASA-related gastric injury via AA/PG pathway in gastric mucosa.

The Notoginseng-Safflower pair composed of Panax notoginseng (Burk.) F. H. Chen and Carthamus tinctorius L. has remarkable clinical efficacy for preventing and treating cardiovascular diseases in China. Notoginseng total saponins (NS) and Safflower total flavonoids (SF) are the major effective ingredients in Notoginseng and Safflower, respectively. Though our previous study showed that the combination of NS and SF (NS-SF) exhibits significant cardioprotective effects for myocardial ischemia (MI), there might be difference in their action mechanisms. However, the anti-MI characteristics of individual NS and SF remains unclear. Herein, an integrated metabolomics strategy coupled with multiple biological methods were employed to investigate the cardioprotective effects of NS and SF alone or in combination against isoproterenol (ISO)-induced MI and to further explore the synergistic relationship between NS and SF. Our results demonstrated that pretreatments with NS, SF, and NS-SF all showed cardioprotective effects against MI injury and NS-SF exhibited to be the best. Interestingly, the results demonstrated that NS and SF exhibited differentiated metabolic targets and mediators in the glycerophospholipid metabolism. Furthermore, administration of NS alone exhibited greater effects on reversing the elevated the proinflammatory metabolites and mediators in MI rats compared to SF alone. However, individual SF showed greater amelioration of MI-disturbed antioxidant and prooxidative metabolites and better inhibition of the oxidative stress than NS alone. Collectively, our study demonstrated that the capability of NS-SF to regulate both metabolic targets of NS and SF might be the basis of NS-SF to produce a cooperative effect greater than their individual effects that enhance the anti-MI efficacy and provided valuable information for the clinical application of Notoginseng-Safflower pair. A phase I dose-escalation study to evaluate tolerability in a Western population to T89, a modern cardiovascular herbal medicine. Ling S(1), Luo RZ, Nheu L, Guo ZX, Sun H, Komesaroff PA. Author information: (1)Department of Medicine, Monash University Central Clinical School, Alfred C

11. J Cardiovasc Pharmacol. 2012 Dec;60(6):513-9. doi: 10.1097/FJC.0b013e31826f6179. A phase I dose-escalation study to evaluate tolerability in a Western population to T89, a modern cardiovascular herbal medicine. Ling S(1), Luo RZ, Nheu L, Guo ZX, Sun H, Komesaroff PA. Author information: (1)D

Anti-inflammatory factor (AIF) is a water soluble extract of three herbs, Panax notoginseng (Burk.) F. H. Chen, Rehmannia glutinosa Libosch and Eleutherococcus senticosus. The present study aimed to investigate the safety and efficacy of herb extracts, AIF, on Korean knee osteoarthritis patients for six weeks. Fifty seven patients with knee osteoarthritis, ranging from 43 to 73 years of age, who fulfilled the "American College of Rheumatology" (ACR) classification of idiopathic osteoarthritis of knee and radiographic criteria were randomly selected and enrolled for the study. After initial screening and resting period, two capsules each of AIF (Each capsule contains; 400 mg) and similar identical placebo were administered twice a day to both groups. Pain intensity at second, fourth, and sixth weeks of study as well as one week after discontinuation of drugs was assessed by using 100 mm visual analogue scale (VAS). Changes in the Korean version of the Western Ontario and McMaster Universities (K-WOMAC) index score were compared at the initiation and completion of the study. VAS assessed by patients were significantly reduced (at visit 2; 54.64+/-14.72, at visit 4, 37.32+/-16.58, p< 0.001) after AIF administration. Results showed an improvement in the physical function of K-WOMAC scale which was significantly higher (p=0.013) in AIF than placebo group, and decreases of total K-WOMAC score were also significantly higher (p=0.030) in AIF groups than placebo group. No serious adverse effect was observed, and there was no difference in incidence of adverse effect between AIF and placebo groups. In this population of Korean patients with knee osteoarthritis, AIF was found to be safe, tolerable and effective for symptomatic improvement of pain and physical function.

Traditional Chinese Medicine (TCM) has a longstanding history in the treatment of fatigue-related conditions, and is increasingly recognized as a foundation for novel therapeutic approaches. The Panax genus, extensively utilized in the fundamental TCM principles to enhance vitality, modulate immune function, and stimulate Yang energy, is a key resource in managing both physiological and pathological fatigue. This study provides a comprehensive synthesis of recent advancements in plant-derived metabolites from various Panax species with an emphasis on their structural diversity and structure-activity relationships. Notably, this represents the first systematic exploration of Panax metabolites with potential antifatigue effects. A systematic literature review was conducted using major scientific databases such as PubMed, Google Scholar, and ScienceDirect. The search query "(scientific name of herbal medicine in the Panax genus) AND ("antifatigue")" was employed. Additionally, classical herbals, botanical literature, and pharmacopoeias were reviewed to contextualize the findings. Comprehensive analysis of 105 studies elucidated 16 predominant metabolites exhibiting antifatigue activity. These metabolites primarily originated from Panax ginseng, Panax quinquefolium, and Panax notoginseng. Ginsenosides Rb1 and Rg1 demonstrated the most substantial pharmacological efficacy in experimental models, in particular by ameliorating metabolic perturbations and mitigating oxidative stress in vivo. Clinical trials predominantly relied on subjective patient-reported measures, such as the Multidimensional Fatigue Inventory (MFI) and Visual Analogue Scale (VAS), and yielded largely positive outcomes. These findings substantiate fundamental TCM principles and reinforce the therapeutic potential of Panax species in fatigue management. The integration of traditional knowledge with contemporary biomedical research enhances the understanding and clinical applicability of Panax species in addressing fatigue-related disorders.

ETHNOPHARMACOLOGICAL RELEVANCE: Ischemic stroke is a global public health problem with limited effective therapeutic options. Panax notoginseng saponins (PNS), the active extract derived from the well-known medicinal material called San-Qi in Chinese, has been widely used in the intervention of ischemic stroke. AIM: This systematic literature review aims to integrate the evidence for PNS against ischemic stroke and proposes future research directions. METHODS: With "Panax notoginseng saponins" and "ischemic stroke" as keywords, we conducted systemic literature search across eight databases update to May 2025, including Scopus, PubMed, Embase, Web of Science, the Chinese National Knowledge Infrastructure, the Chinese Biomedical Database, the WanFang Database, and the Chinese Science and Technology Journals Database. Eligible studies focused on the phytochemical profiles, pharmacokinetic characteristics, pharmacological mechanisms, and clinical applications were integrated in this review. RESULTS: More than 200 saponins have been identified from PNS, with ginsenoside Rg1, Rb1, Rd, Re and notoginsenoside R1 accounts for 90 % of the saponins content. Extensive degradation in digestive tract and poor intestinal absorption are the primary reasons for low bioavailability of PNS. Pharmacological evidences suggest that PNS can regulate the oxidative stress, inflammatory responses, apoptosis, ferroptosis, pyroptosis, angiogenesis, and neurogenesis in ischemic stroke. It can support the treatment of ischemic stroke by lowering the neurological deficit score, inhibiting the inflammatory level, improving cerebral hemorheology, and promoting neurological function recovery. However, there are still some flaws in the research and application of PNS, including incomprehensive quality control, low bioavailability and the lack of high-quality clinical evidence (e.g. relatively small sample size and non-standardized drug combination). CONCLUSION: Existing experimental studies and clinical applications have indicated the therapeutic potential of PNS against ischemic stroke, but high-quality clinical trails are required for validation. Future studies should focus on the overall quali

ETHNOPHARMACOLOGICAL RELEVANCE: Panax species (Panax ginseng, Panax quinquefolius L., and Panax notoginseng) are globally recognized as valuable medicinal and dietary resources with a long history of use in traditional medicine. Ginsenosides are their primary active constituents, among which rare ginsenosides, particularly Rk1 and Rg5, exhibit superior physiological activities-including antitumour, anti-inflammatory, and immunomodulatory effects-compared to common ginsenosides. However, their industrial application is hindered by low natural abundance, structural complexity, and challenges in sustainable production. AIM OF THE REVIEW: This review systematically summarizes recent advances in rare ginsenosides Rk1 and Rg5, covering their natural sources, extraction and processing techniques, structural characteristics, pharmacological mechanisms, and potential applications in functional foods and nutraceuticals. By consolidating existing evidence, this work aims to bridge the gap between preclinical research and clinical translation, facilitating their broader utilization in healthcare and nutrition. METHODS: A comprehensive literature search was conducted using PubMed, Web of Science, and other databases for English publications from March 2005 to March 2025. Keywords included "rare ginsenosides," "Rk1," "Rg5," "pharmacological effects," and "biosynthesis." Additionally, network pharmacology and molecular docking techniques were employed to predict the potential anticancer and reproductive protective effects of Rk1 and Rg5. RESULTS: As representative rare ginsenosides, Rk1 and Rg5 exhibit significantly superior biological activities compared to common saponin components such as Rb1 and Rg1. This advantage primarily stems from their unique structural characteristics: a reduction in the number of glycosyl groups and decreased polarity during thermal processing, which markedly enhance cell membrane permeability and oral bioavailability, thereby improving in vivo absorption and tissue distribution. In various pharmacological models, Rk1 and Rg5 demonstrate stronger anti-tumor, antibacterial, anti-inflammatory, and neuroprotective effects. Currently, the production of

ETHNOPHARMACOLOGICAL RELEVANCE: Panax notoginseng saponins (PNS), the primary bioactive constituents of the traditional medicinal herb P. notoginseng (Sanqi), have demonstrated antiplatelet properties and the enhancement of functional recovery in patients with ischemic stroke (IS). The potential of PNS as a therapeutic agent for IS has garnered considerable interest in recent years. AIM OF THE STUDY: This study conducted a network meta-analysis (NMA) to provide evidence to indicate the efficacy and safety of PNS and other antiplatelet agents in patients with IS, aiming to determine whether PNS alone or in combination with antiplatelet therapy is more effective than conventional antiplatelet treatments in reducing disability rates. MATERIALS AND METHODS: We systematically searched the PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang Data, and SinoMed databases to identify eligible RCTs published from inception until 1 December 2023. The primary outcome was the proportion of patients with favorable functional outcome, defined as a modified Rankin scale (mRS) score ≤2 at 90 days. Secondary outcomes included changes in the NIHSS score, changes in the Barthel index (BI), and the occurrence of adverse effects. RESULTS: Fifty eligible studies involving 18,424 patients were included in this NMA. These therapies were included in the studies involving PNS and seven antiplatelet agents. PNS plus aspirin was associated with a higher improvement in mRS compared with clopidogrel plus aspirin (RR: 1.08, 95 % CI: 1.04 to1.12), indobufen (RR: 1.09, 95 % CI: 1.05 to 1.13) and aspirin (RR: 1.08, 95 % CI: 1.05 to 1.12). The surface under the cumulative ranking curve (SUCRA) probability of PNS plus aspirin ranked fourth (57.2 %) in terms of mRS. PNS plus aspirin leads to more decreases in post-treatment NIHSS score change than clopidogrel (mean difference [MD]: -3.31, 95 % CI: -6.51 to -0.11) and aspirin (MD: -3.17, 95 % CI: -5.08 to -1.27). However, PNS plus aspirin was associated with a lower increase in post-treatment BI score than tirofiban plus aspirin plus clopidogrel (MD: -21.47,

In recent years, numerous researchers have focused on plant extracts derived from traditional medicines to treat stroke, as these extracts may improve patients' cognitive function and quality of life. This study aims to evaluate the effects of nine distinct plant extracts ( Ginkgo biloba extract, Ginsenosides, Berberine, St. John's Wort extract, Resveratrol, Gastrodin, Crocus sativus L., Moringa oleifera Seed extract, and Panax Notoginseng Saponins) on cognitive function and quality of life in stroke patients. This study seeks to conduct a network meta-analysis to assess the impact of these plant extracts on cognitive function and quality of life in stroke patients. Researchers systematically searched the Embase, PubMed, Cochrane Library, and Web of Science databases from database inception through October 2024 searched for randomized controlled trials (RCTs) exclusively(no language restrictions). The selected studies were evaluated for methodological quality via the Cochrane bias risk assessment tool, and data analysis software was used to analyze the data accordingly. The primary outcome measures included the following assessment scales: National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), Activities of Daily Living Scale (ADLs), Barthel Index (BI), Montreal Cognitive Assessment (MOCA), and Mini-Mental State Examination (MMSE). Treatment effects were ranked based on probability values derived from the surface under the cumulative ranking curve (SUCRA). Moreover, cluster analysis was applied to evaluate the effects of plant extracts on six scales that reflect cognitive function and quality of life in patients. After screening, 48 eligible randomized controlled trials were included, covering 6599 stroke patients and evaluating nine different plant extract treatments. Specifically, results from 33 trials were included in the NIHSS score, 10 in the mRS score, 11 in the ADL score, 11 in the BI score, nine in the MMSE score, and eight in the MOCA score. Findings indicate that St. John's Wort extract (SUCRA 71.2%) was the most effective in reducing NIHSS scores, Berberine (SUCRA 84.1%) was most effective in reducing mRS scores, and St. John

Panax notoginseng (PN) root is a renowned nutritional supplement, health food additive, and traditional medicine that maintains homeostasis within the human microcirculatory system. Notoginsenoside R1 (NG-R1), an active compound derived from PN root, has been reported to possess various pharmacological activities, including anti-inflammatory, antioxidant, anticancer, antimicrobial, and angiogenic effects. However, NG-R1's pharmacokinetic properties and pharmacological activities have not been systematically elucidated. In this paper, the pharmacokinetic properties of NG-R1, its pharmacological effects, mechanisms of actions, and structure-activity relationship have been reviewed. Notably, NG-R1 inhibits tumor necrosis factor α (TNF-α) expression, enhances the expression of nuclear factor erythroid 2-related factor 2 (NRF2), and enhances the expression of vascular endothelial growth factor receptor (VEGFR). The pharmacological effects of NG-R1 are associated with the modulation of several signaling pathways, such as mitogen-activated protein kinase (MAPK)/nuclear factor κ-B (NF-κB), NRF2/antioxidant response element (ARE), Wnt/β-catenin, and phosphoinositide-3 kinase (PI3K)/protein kinase B (AKT). NG-R1 offers potentially protective effects against numerous diseases, including cardiovascular, neurological, renal, pulmonary, bone, and diabetes-related conditions. Although the pharmacological activities and diverse effects of NG-R1 have been demonstrated in various diseases, its clinical applications are limited by poor bioavailability. Several strategies have been explored to improve the pharmacokinetic profile of NG-R1, making it a promising candidate for drug development.

BACKGROUND: Panax notoginseng saponins (PNS) are the primary active components of an ancient Chinese herb Panax notoginseng. Hypercoagulable state of blood (HCS) is an independent risk factor and a cause of death in chronic obstructive pulmonary disease (COPD). Several vivo studies have demonstrated the use of PNS preparations for treating COPD with HCS. PURPOSE: This study aimed to systematically evaluate the clinical efficacy and safety of PNS preparations in treating COPD with HCS. STUDY DESIGN: Meta-analysis of the randomized controlled trials (RCTs) was conducted to review data. METHODS: RCTs on the treatment of COPD with HCS and PNS preparations were searched from PubMed, Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure, Vip Information Database, Wanfang data, and Chinese Biomedical Literature Database. Relevant data were extracted from the included studies and methodological quality evaluation was performed. R language (version 4.2.3) was applied for the meta-analysis. RESULTS: Twenty RCTs involving 1831 patients were analyzed. The results revealed that PNS preparations considerably increased the total clinical efficiency, improved forced expiratory volume in one second percent of predicted, and forced expiratory volume/forced vital capacity ratio. Further, PNS preparations improved fibrinogen, plasma d-dimer, whole blood viscosity at high cut, whole blood viscosity at low cut, and plasma viscosity levels. The results obtained for activated partial thromboplastin and prothrombin times were not statistically significant. Finally, PNS preparations increased partial pressure of oxygen and decreased carbon dioxide pressure. CONCLUSION: This is the first relatively comprehensive systematic review of the clinical efficacy and safety of PNS preparations for treating COPD with HCS. The study revealed that PNS preparations considerably improve lung function, hypoxia, and blood hypercoagulability in patients with COPD and HCS without increasing the risk of hemorrhage and has a good safety profile; therefore, it can be used as a new modulating agent and anticoagulant.

BACKGROUND: Microbiomes and their host plants are closely linked with each other; for example, the microbiome affects plant growth, fitness, nutrient uptake, stress tolerance and pathogen resistance, whereas the host plant supports the photosynthetically carbon-rich nutrition of the microbiome. The importance of the microbiome in plant‒soil ecosystems is unquestioned and has expanded to influence the medicinal application of some herbal plants via the gut microbiota. PURPOSE: Herbal plant-microbiome interactions may provide novel knowledge to enhance the robustness of herbal plant crop performance and medicinal applications, which requires a systematic review and preceding discussion. STUDY DESIGN AND METHODS: The interactions between Panax notoginseng and microorganisms (from soil to host) were reviewed from the literature. The terms "Panax notoginseng" and "microbiota" were used in combination with the keywords "microbiota/microbes", "bacteria/bacterium" or "fungi/fungus" or "endophyte", as well as our targeted bioactive phytochemicals, including saponins and ginsenosides. RESULT: Our study focuses on the famous medicinal herb Panax notoginseng F. H. Chen and proposes that the microbiota is a crucial participant not only in the cultivation of this herbal plant but also in its medicinal application. We also summarize and discuss how these plant‒microbe co-associations shape the assembly of plant-related microbiomes and produce bioactive phytochemicals, as well as influence beneficial herbal traits, such as herbal plant health and pharmacology. In addition, we also highlight future directions. CONCLUSION: The rhizosphere and endophytic microbiome of Panax notoginseng are indirectly or directly involved in plant health, biomass production, and the synthesis/biotransformation of plant secondary metabolites. Harnessing the microbiome to improve the quality of traditional Chinese medicine and improve the value of medicinal plants for human health is highly promising.

ETHNOPHARMACOLOGICAL RELEVANCE: In traditional Chinese medicine, Shen Nong, BenCao Jing, and Compendium of Materia Medica (Bencao Gangmu), Panax ginseng, and its prescriptions have been used for the treatment of dementia, depression, weight loss, Xiaoke disease (similar to diabetes), and vertigo. All these diseases are associated with the drug-controllable risk factors for Alzheimer's disease (AD), including depression, obesity, diabetes, and hypertension. Ginsenoside Rg1, one of the main active ingredients of P. ginseng and its congener Panax notoginseng, possesses therapeutic potentials against AD and associated diseases. This suggests that ginsenoside Rg1 might have the potential for AD prevention and treatment. Although the anti-AD effects of ginsenoside Rg1 have received more attention, a systematic review of its effects on depression, obesity, diabetes, and hypertension is not available. AIM OF THE REVIEW: This systematic literature review comprehensively summarized existing literature on the therapeutic potentials of ginsenoside Rg1 in AD prevention for the propose of providing a foundation of future research aimed at enabling the use of such drugs in clinical practice. METHODS: Information on ginsenoside Rg1 was collected from relevant published articles identified through a literature search in electronic scientific databases (PubMed, Science Direct, and Google Scholar). The keywords used were "Ginsenoside Rg1," "Panax ginseng," "Source," "Alzheimer's disease," "Brain disorders," "Depression," "Obesity," "Diabetes," and "Hypertension." RESULTS: The monomer ginsenoside Rg1 can be relatively easily obtained and has therapeutic potentials against AD. In vitro and in vivo experiments have demonstrated the therapeutic potentials of ginsenoside Rg1 against the drug-controllable risk factors of AD including depression, obesity, diabetes, and hypertension. Thus, ginsenoside Rg1 alleviates diseases resulting from AD risk factors by regulating multiple targets and pathways. CONCLUSIONS: Ginsenoside Rg1 has the potentials to prevent AD by alleviating depression, obesity, diabetes, and hypertension.

Among 17 Panax species identified across the world, Panax ginseng (Korean ginseng), Panax quinquefolius (American ginseng), and Panax notoginseng (Chinese ginseng) are highly recognized for the presence of bioactive compound, ginsenosides and their pharmacological effects. P. ginseng is widely used for synthesis of different types of nanoparticles compared to P. quinquefolius and P. notoginseng. The use of nano-ginseng could increase the oral bioavailability, membrane permeability, and thus provide effective delivery of ginsenosides to the target sites through transport system. In this review, we explore the synthesis of ginseng nanoparticles using plant extracts from various organs, microbes, and polymers, as well as their biomedical applications. Furthermore, we highlight transporters involved in transport of ginsenoside nanoparticles to the target sites. Size, zeta potential, temperature, and pH are also discussed as the critical parameters affecting the quality of ginseng nanoparticles synthesis. © 2023 The Authors. Medicinal Research Reviews published by Wiley Periodicals LLC.