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This study aims to compare the efficacy and safety of different traditional Chinese medicine injections(TCMIs) combined with conventional western medicine in the treatment of chronic obstructive pulmonary disease(COPD) with respiratory failure(RF) using a network Meta-analysis approach. A comprehensive literature search was conducted in CNKI, VIP, Wanfang, SinoMed, Web of Science, PubMed, Cochrane Library, and EMbase databases from inception to June 29, 2025. Randomized controlled trials(RCTs) were performed by employing the literature on the treatment of COPD with RF by TCMIs, and data were analyzed by Stata 17. A total of 110 RCTs involving 9 218 participants and 11 different TCMIs were included. The ranking of efficacy in the surface under the cumulative ranking curve(SUCRA) from network Meta-analysis was as follows:(1) for improving clinical total response rate, Chuanxiongqin Injection + conventional western medicine, Shankezhi Injection + conventional western medicine, and Danhong Injection + conventional western medicine ranked top three;(2) for reducing mortality, Chuanxiongqin Injection + conventional western medicine, Danshen Chuanxiongqin Injection + conventional western medicine, and Shenfu Injection + conventional western medicine ranked top three;(3) for shortening length of hospital stay, Danshen Chuanxiongqin Injection + conventional western medicine, Shenfu Injection + conventional western medicine, and Shenmai Injection + conventional western medicine ranked top three;(4) for reducing duration of mechanical ventilation, Shenqi Fuzheng Injection + conventional western medicine, Shenmai Injection + conventional western medicine, and Tanreqing Injection + conventional western medicine ranked top three;(5) for improving arterial partial pressure of oxygen(PaO_2), Chuanxiongqin Injection + conventional western medicine, Danshen Injection + conventional western medicine, and Danhong Injection + conventional western medicine ranked top three;(6) for reducing arterial partial pressure of carbon dioxide(PaCO_2), Shenfu Injection + conventional western medicine, Tanreqing Injection + conventional western medicine, and Danshen Chuanxiongqin Injection + con

BACKGROUND: Fufang Danshen Tablet (FDT) is a traditional Chinese medicine (TCM) formula with remarkable efficacy in invigorating blood and eliminating blood stasis, thus commonly used in treating ischemic stroke. However, no systemic summary has been conducted to evaluate its efficacy yet. This study aims to determine the efficacy of FDT therapy for promoting the rehabilitation of ischemic stroke and to explore the potential pharmacological mechanism through an in silico approach. METHODS: Eligible clinical trials involving FDT therapy for ischemic stroke were searched across nine online databases. Meta-analysis was conducted with RevMan and Stata software. Evaluation of the quality of evidence was performed on the GRADE system. Moreover, GEO datasets, network pharmacology, and molecular docking were employed to explore the potential pharmacological mechanism. RESULTS: 29 clinical trials concerning 1,634 participants were incorporated into the present meta-analysis. Compared with usual care alone, FDT combined with usual care exerted better efficacy in individuals with ischemic stroke, as evidenced by an elevated overall response rate and decreased National Institute of Health Stroke Scale (NIHSS), as well as the improvement of hemorheology, inflammation, and lipid metabolism. Moreover, meta-analysis of FDT individual intervention trials also showed significant therapeutic effects. Further network pharmacology and molecular docking analysis emphasized the potentially important role of the AKT/GSK3β/Cyclin D1 pathway for FDT to regulate oligodendrocyte precursor cells (OPCs) in treating ischemic stroke. CONCLUSION: FDT appears to significantly enhance neurological recovery, promote blood circulation, inhibit the inflammatory cascade, and lower blood lipid levels in patients with ischemic stroke. The AKT/GSK3β/Cyclin D1 pathway was predicted to be a potential mechanism of FDT in intervening ischemic stroke. In the future, more long-term follow-up RCTs with high quality are urgently needed, as well as experimental validations for the pharmacological mechanism. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251015475, CRD420251015475.

ETHNOPHARMACOLOGICAL RELEVANCE: Patients with coronary heart disease (CHD) remain at high risk of major adverse cardiovascular events (MACEs) after percutaneous coronary intervention (PCI). Chinese Patent Medicines (CPMs) have demonstrated therapeutic potential as adjunctive therapies, however, direct comparative evidence regarding their effectiveness is lacking. AIM OF THE STUDY: This network meta-analysis (NMA) aims to systematically evaluate and compare the clinical efficacy and safety of CPMs combined with conventional therapy (CT) in post-PCI management. MATERIALS AND METHODS: A systematic literature search was performed in PubMed, Web of Science, Embase, Cochrane Library, CNKI, CBM, VIP, and Wanfang databases up to December 24, 2024. Randomized controlled trials investigating CPMs in CHD patients following PCI were included. Methodological quality was assessed using the Cochrane Risk of Bias tool. Outcome measures included major adverse cardiovascular events (MACEs), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and nitric oxide (NO) levels. NMA was implemented using STATA 16.0 and R 4.1.2. Odds ratios and standardized mean differences with 95% confidence intervals were calculated for dichotomous and continuous outcomes, respectively. Model selection was guided by heterogeneity assessed using the I2 statistic. Intervention rankings were estimated using the surface under the cumulative ranking curve (SUCRA), with robustness and publication bias evaluated through sensitivity analyses and funnel plots. RESULTS: A total of 84 RCTs involving 10,524 patients and eight CPMs were included. For the primary outcome (MACEs), the SUCRA ranking indicated that Tongxinluo capsules combined with conventional therapy (TXLJN + CT) was the most effective intervention, followed by Shensong Yangxin capsules plus CT (SSYXJN + CT), Shexiang Baoxin pills plus CT (SXBXW + CT), Qili Qiangxin capsules plus CT (QLQXJN + CT), Qishen Yiqi dripping pills plus CT (QSYQDW + CT), Xinyu capsules plus CT (XYJN + CT), Fufang Danshen Dripping Pills p

ETHNOPHARMACOLOGICAL RELEVANCE: Atherosclerosis (AS) severely threatens global health, while current therapies exhibit limitations. Recognized as a 'superior-grade' herb in the Shennong Ben Cao Jing, Salvia miltiorrhiza Bunge (Danshen) has been shown in modern studies to protect against cardiovascular diseases. AIM OF THE STUDY: The aim of this study was to investigate the therapeutic potential and protective mechanism of pharmacological components of Salvia miltiorrhiza against AS. MATERIALS AND METHODS: Relevant animal studies were collected from 8 databases, namely, PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang Data, VIP, and SinoMed. Risk of bias of the included studies was evaluated using the SYRCLE's tool. Statistical analysis was performed using R 4.2.0 and Python 3.14.2 software. Machine learning model was trained to predict optimal intervention parameters and was subsequently validated. RESULTS: A total of 64 studies were included. The pharmacological components of Salvia miltiorrhiza ameliorated atherosclerotic plaque formation and stability, and modulated various biomarkers, including lipid profiles, inflammatory cytokines, oxidative stress indicators, endothelial function markers, as well as matrix metalloproteinases. Machine learning identified an optimal Tanshinone IIA regimen against AS, which was defined as a single dose of 33.18 mg/kg dose over 84 days and demonstrated predictive robustness in validation. CONCLUSIONS: The pharmacological components of Salvia miltiorrhiza attenuate AS by regulating lipid metabolism, anti-inflammatory and antioxidant actions, improving endothelial function, modulating of vascular smooth muscle cells, remodeling extracellular matrix, and regulating programmed cell death. These findings provide translational insights that pave the way for subsequent preclinical and early-clinical studies, pending systematic validation through more rigorous research.

Type 2 diabetes mellitus (T2DM), a globally prevalent chronic metabolic disorder, imposes a significant worldwide public health burden. As a vital "microbial organ" within the human body, the balance of the gut microbiota (GM) structure and function is crucial for maintaining host metabolic health. Short-chain fatty acids (SCFAs), the metabolic products of GM, serve as key signaling molecules that play central roles in maintaining intestinal homeostasis, regulating systemic energy metabolism, and improving insulin sensitivity. Dysregulation of the "GM-SCFA axis" has emerged as a core pathological mechanism in the onset and progression of T2DM. Traditional Chinese Medicine (TCM) possesses unique advantages in T2DM treatment through its "holistic regulation and multi-targeted intervention," which enables precise modulation of the GM-SCFA axis. This paper provides a systematic review of the pathological mechanisms by which dysregulation of the GM-SCFA axis induces T2DM, and specifically covers energy metabolism disorders, insulin resistance, intestinal barrier impairment, chronic low-grade inflammatory activation, abnormal bile acid metabolism regulation, and disrupted gut-pancreatic axis and gut-brain axis signaling. Using keywords such as TCM, GM, SCFAs, and T2DM, we conducted an extensive literature search across databases including PubMed, Google Scholar, and Web of Science for publications from the past decade. This systematic review examines the application of TCM in regulating the "GM-SCFA axis" from multiple perspectives: Chinese herbal compounds (e.g., Zuogui Jiangtang Qinggan Formula, Gegen Qinlian Decoction), Chinese patent medicines (e.g., Shouhui Tongbian Capsules, Compound Danshen Dripping Pills), single-herb Chinese medicines (e.g., Edgeworthia gardneri, Alpinia oxyphylla), single-component compounds from TCM (e.g., Cyclocarya paliurus polysaccharide, Achyranthes bidentata polysaccharide water-soluble 1), and other TCM therapies (e.g., tuina, acupuncture). This study aims to systematically explore the mechanisms by which dysregulation of the "GM-SCFA axis" induces T2DM while providing novel therapeutic strategies for T2DM prevention and treatment usi

OBJECTIVE: As the use of Traditional Chinese Medicine injections (TCMIs) for sepsis-induced myocardial dysfunction (SIMD) becomes increasingly diverse, this study aims to evaluate their efficacy, optimal combinations, and safety. METHODS: A comprehensive computerized search was conducted across multiple databases, including PubMed, Web of Science, the Cochrane Library, China National Knowledge Infrastructure, VIP Database, Wanfang Database, and SinoMed, for randomized controlled trials (RCTs) on TCMIs for treating SIMD, covering the period from the inception of these databases to 25 June 2025. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool (ROB 2.0). A network meta-analysis was performed using Stata 18.0 software. The study protocol has been registered with PROSPERO. RESULTS: A total of 31 randomized controlled trials (RCTs) were included, comprising 2,166 participants (intervention group: n = 1,099; control group: n = 1,067). Nine TCMIs were investigated: Shenmai injection (SM), Danshen Chuanxiongqin injection (DSCXQ), Xuebijing injection (XBJ), Shenfu injection (SF), Shuxuening injection (SXN), Xinmailong injection (XML), Huangqi injection (HQ), Danhong injection (DH), and Shenqi fuzheng injection (SQFZ). Based on the surface under the cumulative ranking curve values, (1) In reducing 28-day mortality, Shuxuening Injection combined with conventional therapy ranked first based on the Surface Under the Cumulative Ranking Curve (SUCRA) (relative risk [RR], 3.67; 95% confidence interval [CI], 1.09-12.32). (2) For the improvement of cardiac troponin I (cTnI) levels, Danshen Chuanxiongqin Injection combined with conventional therapy ranked first based on SUCRA (mean difference [MD], 0.87; 95% CI, 0.22-1.52). (3) In terms of left ventricular ejection fraction (LVEF) improvement, Shenqi Fuzheng injection combined with conventional therapy ranked first based on SUCRA (MD, -8.79; 95% CI, -15.99 to -1.59). (4) For the reduction of B-type natriuretic peptide (BNP), Xinmailong injection combined with conventional therapy ranked first based on SUCRA (MD, 353.37; 95% CI, 188.55-518.19). (5) Regarding the improvement of N-t

Viral myocarditis (VMC) is the predominant type of myocarditis and currently lacks specific therapies. Salvia miltiorrhiza (Danshen) injection has demonstrated beneficial effects as a supplementary VMC treatment, yet its pharmacological mechanisms are ambiguous, and its efficacy lacks robust evidence. This study aims to preliminarily address these issues through computational approaches and meta-analysis. Using network pharmacology, we identified 257 therapeutic targets, 106 hub genes, and 4 key S. miltiorrhiza ingredients implicated in VMC treatment. Integrating transcriptome data with LASSO and SVM machine learning algorithm yielded six core therapeutic targets from the hub genes-TNF, JUN, PECAM1, KDR, TIMP1, and EPAS1-which are primarily associated with anti-inflammatory activity, vascular remodeling, and fibrosis suppression. GO analysis identified the "inflammatory response" as the most prominent biological process. Concurrently, the PI3K-Akt, TNF, and HIF-1 signaling pathways-each closely associated with inflammation-appeared among the top 20 KEGG pathways. Overall, these results indicate that suppressing excessive inflammation is likely the primary pharmacological mechanism. In molecular docking, four key ingredients-dan-shexinkum D, danshenol A, cryptotanshinone, and methylrosmarinate-exhibited strong binding to the core therapeutic targets, with dan-shexinkum D showing the lowest total binding energy and stable binding confirmed by molecular dynamics simulations. The meta-analysis indicates that S. miltiorrhiza injection improves clinical outcomes and significantly reduces TNF-α, hs-CRP, CK-MB, cTnT, and H-FABP levels. This study used multiple computational approaches to explore the pharmacological mechanisms and identify key active components of S. miltiorrhiza in treating VMC, thereby establishing an evidence-based foundation and providing preliminary groundwork for subsequent clinical application and translational research.

BACKGROUND: Doxorubicin (DOX) is an effective first-line chemotherapeutic agent used to treat various kinds of cancers. The most serious side effect of DOX is its irreversible cardiotoxicity. Salviae Miltiorrhizae Radix et Rhizoma, which is the dry root of the natural plant Salvia miltiorrhiza and is named "Danshen" in Chinese, is a widely used Chinese Materia Medica for the treatment of cardiovascular and cerebrovascular disorders in traditional Chinese medicine. OBJECTIVE: This study aims to review the potential protective effect of Danshen against DOX-induced cardiotoxicity (DIC). METHODS: A comprehensive systematic search was performed in various electronic databases, including Web of Science, PubMed and Scopus up to July 2025 according to the PRISMA guideline. Two hundred and sixty studies were screened in accordance with a predefined set of inclusion and exclusion criteria. Thirty-five eligible articles were finally included in the current systematic review. All the characteristics and underlying mechanisms of Danshen protecting against DIC were summarized. Additionally, all the Danshen-related clinical trials evaluating their treatment effects for cardiovascular and cerebrovascular diseases were extracted and summarized from the registration databases of clinical trials. RESULTS: Danshen ameliorated DOX-caused pathological alterations of cardiac cells/tissue, decrease of surviving cardiomyocytes, body weight, heart weight and the ratio of heart to body weight, and increase of mortality. Eleven active ingredients and derivatives of Danshen including tanshinone IIA, sodium tanshinone IIA sulfonate, tanshinone I, salvianolic acid A, salvianolic acid B, salvianolic acid C, cryptotanshinone, ferulic acid, danshensu, dihydrotanshinone I and diethyl blechnic, were identified with potential protective effects against DIC in vitro and in vivo as well as the eight extracts and formulas of S. miltiorrhiza including salvianolic acids, S. miltiorrhiza aqueous extract, Compound DanShen Dripping Pill, Danhong injection, Qiliqiangxin, herbal formula B307, Qishen granule and Ershen Zhenwu Decoction. The underlying mechanisms were associated with the Danshen's multiple pha

OBJECTIVE: Hypertension remained an important public health problem with high morbidity and mortality and was emerging as a risk factor for future heart failure. The transition from hypertension to hypertensive heart disease (HHD) and heart failure grew progressively with time. Traditional Chinese medicine (TCM) has a history of several thousand years, where selected TCM for replenishing qi and activating blood circulation provides an alternative treatment for HHD. METHODS: An extensive literature search was conducted across eight electronic databases from their inception until 8 September 2023, to evaluate the potential preventive effects of selected TCM as an adjuvant therapy on the progression of HHD. The outcome measures included blood pressure and indicators of cardiac structure and function under cardiac ultrasound. The mean difference (MD) and 95% confidence interval (CI) were used to determine continuous outcomes. Risk ratio (RR) with 95% confidence interval (CI) was used to determine dichotomous outcomes. The information about the overall certainty of the evidence from studies was presented according to specific outcomes using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Guideline Development Tool (GDT) online software. RESULTS: Twenty-one randomized controlled trials (RCTs) involving 2, 055 participants were included. Meta-analyses favored integrated Chinese botanical drugs and Western medicine on blood pressure, New York Heart Association classification, left ventricular ejection fraction, transmitral peak early diastolic velocity/peak late diastolic velocity ratio, left ventricular internal diameters, left ventricular mass index, interventricular septum thickness in diastole, and B-type natriuretic peptide compared with Western medicine alone. Results on cardiac output should be interpreted with caution due to sample size limitations. No severe adverse events were identified. Most of the Chinese botanical drugs originated from classical TCM formulas. The dosage form of Chinese botanical drugs was oral. Salvia miltiorrhiza Bunge (Danshen), Oreocome striata (DC.) Pimenov & Kljuykov (Chuanxiong), Pueraria montana var. lo

BACKGROUND: This study aimed to systematically evaluate the efficacy and safety of various Chinese herbal medicines combined with immunomodulators (IMM) in the treatment of erosive oral lichen planus (EOLP) through a network meta-analysis. METHODS: A total of 21 randomized controlled trials involving 1762 patients were included. Relevant randomized controlled trials were retrieved from 9 major electronic databases. All data were analyzed using a random-effects model. The surface under the cumulative ranking curve (SUCRA) was employed to rank the treatment regimens based on efficacy and clinical significance. To validate the robustness of the results, publication bias was assessed using funnel plots, and inconsistency tests were performed to compare direct and indirect effects. League tables were used to visualize comparative effects between treatments. Contribution plots were generated to evaluate the influence of individual treatments on the overall network effects. Statistical analyses were conducted using STATA 16.0 (StataCorp LLC, College Station), and study quality was assessed with Review Manager 5.4 (The Cochrane Collaboration, London, UK). RESULTS: The combination of Kouyanqing granules and IMM (KYQ+IMM) demonstrated the highest efficacy in terms of response rate (SUCRA 82.7%) and pain relief (SUCRA 90.8%). Compound Danshen preparation combined with IMM (CDF+IMM) and Jiedu Yukou decoction combined with IMM (JDYK+IMM) ranked second and third, respectively. Total glucosides of peony showed the lowest recurrence risk (SUCRA 94.3%), while Kangfuxin solution combined with IMM (KFX+IMM) exhibited the most significant improvement in erosion area (SUCRA 86.4%). All treatment regimens were well-tolerated, with a low incidence of adverse events. CONCLUSION: This study demonstrates that integrated traditional Chinese and Western medicine regimens exhibit superior efficacy in improving response rates, pain relief, recurrence rates, and erosion healing in EOLP, with favorable safety profiles. Notably, KYQ+IMM, CDF+IMM, and KFX+IMM stand out as optimal therapeutic strategies, providing robust evidence for optimizing EOLP treatment.

INTRODUCTION: AR36 is a pharmaceutical-grade plant extract used to support cardiovascular health in traditional Chinese medicine. Studies suggest that AR36 may prevent acute mountain sickness (AMS) during gradual ascent to high altitude. This randomized, placebo-controlled Phase 2 trial aimed to evaluate dosing regimens and assess efficacy and safety of AR36 for AMS prevention during rapid ascent. METHODS: Participants received placebo, low-dose AR36 (225 mg twice daily for 14 d prior and 5 d at altitude), or high-dose AR36 (12 d placebo, 300 mg twice daily for 2 d prior and 5 d at altitude). The primary efficacy outcome was 1993 Lake Louise Scoring System (LLSS) score on the morning after ascent. Safety was assessed through the proportion of treatment-emergent adverse events (TEAEs). RESULTS: One hundred thirty-two participants were randomized. Mean±SD age was 31.4±8.6 (range, 19-54) y. Baseline characteristics did not differ across groups. Lake Louise Scoring System scores on Day 16 in the placebo, low-dose, and high-dose groups were 4.03 (2.88), 4.42 (3.17), and 3.5 (2.31), respectively (placebo versus low-dose, P=0.462; placebo versus high-dose, P=0.574; n=110). The incidence of AMS on Day 16 was 66.7% in the placebo, 61.1% in the low-dose, and 55.3% in the high-dose group (P=0.66). The proportion of TEAEs in the placebo, low-dose, and high-dose groups was 38.4% (81), 28.4% (60), and 33.2% (70), respectively (P=0.205; n=127). There was no statistical difference between groups in LLSS, incidence of AMS, or TEAEs. CONCLUSIONS: AR36 did not improve LLSS or AMS incidence using the current regimens. AR36 was well tolerated.

OBJECTIVE: To assess the efficacy and safety of Guanxin Danshen Dripping Pills (GXDS) in the treatment of depression or anxiety in patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). METHODS: From September 2017 to June 2019, 200 CHD patients after PCI with depression and anxiety were included and randomly divided into GXDS (100 cases) and placebo control groups (100 cases) by block randomization and a random number table. Patients in the GXDS and control groups were given GXDS and placebo, respectively, 0.4 g each time, 3 times daily for 12 weeks. The primary outcomes were scores of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Scale (GAD-7) and the Seattle Angina Pectoris Scale (SAQ). The secondary outcomes included 12 Health Survey Summary Form (SF-12) scores and the first onset time and incidence of major adverse cardiovascular events (MACEs). Other indices including blood pressure, blood lipids, microcirculation and inflammatory-related indices, etc. were monitored at baseline, week 4, and week 12. RESULTS: In the full analysis set (200 cases), after treatment, the PHQ-9 and GAD-7 scores in the GXDS group were considerably lower than those in the control group (P<0.05). Compared with the baseline, the total PHQ-9 scores of the experimental and control groups decreased by 3.97 and 1.18, respectively. The corrected mean difference between the two groups was -2.78 (95% CI: -3.47, -2.10; P<0.001). The total GAD-7 score in the GXDS group decreased by 3.48% compared with the baseline level, while that of the placebo group decreased by 1.13%. The corrected mean difference between the two groups was -2.35 (95% CI: -2.95, -1.76; P<0.001). The degree of improvement in SAQ score, SF-12 score, endothelin and high-sensitive C-reactive protein levels in the GXDS group were substantially superior than those in the placebo group, and the differences between the two groups were statistically significant (P<0.05). Similar results were obtained in the per protocol population analysis of 177 patients. Three cases of MACES were reported in this study (1 in the GXDS group and 2 in the placebo group), and no serious adverse eve

AIMS: To investigate the effect of injectable salvia polyphenolic acid on the improvement of limb movement and cognitive dysfunction in acute stroke patients. MATERIALS AND METHODS: The clinical data of 90 acute stroke patients were collected for retrospective study and divided into 45 cases each in the comparison group and the observation group according to the different treatment methods; using basic treatment + salvianolic acid, the comparison group implemented conventional alteplase and butalbital treatment, and the observation group used injectable salvianolic acid treatment, to observe and compare the clinical efficacy, changes in neurological deficits, cognitive function, and motor function scores before and after treatment in the two groups. RESULTS: The NIHSS (National Institute of Health stroke scale) score, cerebral infarct volume, NSE (neuron-specific enolase), and S100β (A neurotrophic factor) levels were reduced after treatment compared with those before treatment in this group, and the NIHSS score, cerebral infarct volume, NSE, and S100β levels in the observation group were lower than those in the comparison group after treatment, and the difference was statistically significant (P < 0.05). Compared with the clinical efficacy of the comparison group and the observation group, the treatment effect of the observation group was better than that of the comparison group, and the difference was statistically significant (P < 0.05). After treatment, the cognitive function and motor function scores of both groups were significantly improved compared with those before treatment, and the degree of improvement of each score in the observation group was significantly better than that in the comparison group (P < 0.05). During the trial, two patients in the comparison group developed a generalized rash and withdrew from the experiment, and the rash subsided after anti-allergic treatment, and no significant adverse events were observed in the remaining participants. There was no statistically significant difference in liver and kidney function and cardiac enzyme test indexes between the two groups of patients at 14 days of treatment (P > 0.05). CONCLUSION: Dans

AIMS: This study is designed to explore the effect of compound Danshen injection combined with magnesium sulfate on TNF-α, NO, oxidative stress, and therapeutic efficacy in severe preeclampsia (S-PE). METHODS: Sixty S-PE patients were placed into the control group and the therapy group, randomly. The control group was under the treatment of magnesium sulfate, and the therapy group was under the treatment of compound Danshen injection with magnesium sulfate. After treatment, the therapeutic efficacy of the two groups was comparatively analyzed. RESULTS: 7 days after treatment, DBP, SBP, and 24 h urinary protein were sharply lower than those before treatment. The 24 h urinary protein was notably lower in the therapy group. After treatment, the expression level of TNF-α in both groups was notably higher than before treatment, while NO level was higher than that before treatment. Furthermore, D-D level in two groups was dramatically decreased compared to that before treatment. Moreover, Fib, PT, and APTT in two groups showed statistically significant differences after 7 days. The contents of ALT, AST, BUN, and Scr in therapy group were notably lower than those in control group. CONCLUSION: Our results indicated that compound Danshen injection could improve renal function, blood hypercoagulability, and oxidative stress level and had a better therapeutic effect on S-PE.

OBJECTIVE: To investigate the combined anti-inflammatory effect of activating blood circulation and detoxifying Chinese medicines in unstable angina (UA) patients. METHODS: This study was an open-labeled, randomized controlled trial conducted in 5 centers in Beijing. A total of 154 patients were randomized into two groups at a 1:1 ratio by random numbers. Based on the conventional treatment, patients in the activating blood circulation (ABC) group were treated with Guanxin Danshen Droping Pill (, 0.4 g, thrice daily), and patients in the activating blood circulation and detoxifying (ABCD) group were treated with Guanxin Danshen Droping Pill (0.4 g, thrice daily) and Andrographis tablet (0.2 g, thrice daily) for 4 weeks. The primary outcome was the serum level of high sensitive C reaction protein (hs-CRP), and the secondary outcome index included the serum levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), soluble CD40 ligand (sCD40L), thrombomodulin (TM), the score of angina pectoris, the score of blood stasis syndrome, and the score of Chinese medicine symptoms, observed at week 0 and week 4. RESULTS: A total of 144 patients completed the trial (ABC group, n=70; ABCD group, n=74). There were no significant differences in the clinical baseline characteristics between the two groups. When compared with the ABC group, ABCD group showed better performance in reducing the level of inflammatory factors, especially hs-CRP (P<0.05), IL-6 (P<0.01) and TNF-α (P<0.01). In term of clinical symptoms, ABCD group played a better role in improving the scores of angina pectoris and blood stasis syndrome than ABC group (all P<0.05). CONCLUSIONS: The combination of Guanxin Danshen Dropping Pill and Andrographis tablet exert significant anti-inflammatory effect on UA patients, which is superior to single Guanxin Danshen Dropping Pill. (Registration No. ChiCTR-TRC-13004072). © 2021. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.

OBJECTIVES: This study aims to compare the clinical efficacy of an integrated approach to prevent and treat the recurrence of moderate-to-severe intrauterine adhesions (IUA) after hysteroscopic transcervical resection of adhesion (TCRA). METHODS: The study included a total of 70 patients with moderate-to-severe IUAs who underwent TCRA. Patients were randomly divided into two groups: treatment group (n=35) and control group n=35). In the treatment group, patients underwent balloon uterine stent placement and artificial cycle as well as received intrauterine perfusion of Danshen injection and oral Chinese medicine. In the control group, patients underwent balloon uterine stent placement and artificial cycle as well as received hyaluronic acid sodium and intrauterine device (IUD). Follow-up was performed after treatment of uterine cavity, menstruation and pregnancy. RESULTS: After 3 months of treatment, we observed a significantly lower rate of intrauterine re-adhesion (45.71% versus 77.14%, p=0.044) and significantly higher clinical efficiency (82.86% versus 77.14%, p=0.025) in the treatment group than those in the control group. After 6 months of treatment, we observed a significantly higher clinical efficiency in the treatment group than that in the control group (88.57% versus 68.57%, p=0.039). During the follow-up period, the pregnancy rate was 45.71% and 37.14% in the treatment group and control group, respectively, although the difference was not statistically significant (p=0.628). CONCLUSIONS: After surgical management of IUA, the integrated treatment combining a uterus stent placement and artificial cycle with Danshen injection and oral Chinese medicine can improve the condition of menstruation, and prevent and treat recurrence of IUA.

BACKGROUND: Mastitis is a common disease occurs in breast-feeding mothers, but published data are poor. This study aimed to study the effects of Tanshinones on treating mastitis. METHODS: Clinical trials performed in 58 breast-feeding mothers were carried out. B-ultrasound and blood test were used to measure the size of breast mass and the change of blood cell counts. BALB/c mice were injected with LPS and then treated by Tanshinone I or Tanshinone IIA/B. Myeloperoxidase (MPO) activity and the release of inflammatory cytokines were tested by MPO kit, RT-qPCR and ELISA. Mouse mammary epithelial cells (mMECs) were isolated and the effects of Tanshinones were measured by conducting CCK-8 assay, flow cytometry, RT-qPCR and ELISA. RESULTS: Patients treated by Cefprozil combined with Tanshinone got better outcomes than patients treated by Cefprozil alone. In animal trials, Tanshinone I and Tanshinone IIA/B significantly reduced MPO activity, and the levels of TNF-α, IL-1β and IL-6 in serum and mammary gland tissues. In mMECs, Tanshinone I and Tanshinone IIA/B attenuated LPS-induced viability loss and apoptosis. And they effectively inhibited the release of TNF-α, IL-1β and IL-6. Also, Tanshinone I and Tanshinone IIA/B significantly attenuated LPS-evoked NF-κB activation. CONCLUSION: Tanshinone I and Tanshinone IIA/B have potentials in treating mastitis. The beneficial effects might be through regulating NF-κB activation.

OBJECTIVES: At the present study, we aimed at evaluating the effect of Salvia officinalis (S. officinalis) extract on "anthropometric indices" and "insulin resistance markers" in Polycystic Ovary Syndrome (PCOS) patients. DESIGN AND SETTING: This was a randomized, triple-blinded, controlled trial performed in gynecology hospitals affiliated to Iran University of Medical Sciences. PARTICIPANTS: Sixty PCOS patients diagnosed according to Rotterdam criteria. INTERVENTIONS: Consumption of the 330 mg oral S. officinalis extract or placebo capsules daily for eight weeks. MAIN OUTCOME MEASURES: Body mass index (BMI), waist to hip ratio (WHR), blood pressure, homoeostatic model assessment-insulin resistance (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI). RESULTS: Results showed a statistically significant decrease in the BMI (P = 0.001) in S. officinalis group, but, there were no significant differences between the two groups for WHR (P = 0.164). Although we failed to find a significant effect of S. officinalis extract on systolic blood pressure (P = 0.283) but using a multivariate model showed a significant difference between two groups regarding diastolic blood pressure (P = 0.025). Also, the consumption of S. officinalis extract, compared to the placebo, resulted in a significant decrease in Insulin levels (P < 0.001), and HOMA-IR (P < 0.001). As well as, S. officinalis extract supplementation resulted in a greater increase in QUICKI (P < 0.001) compared with placebo groups. CONCLUSION: S. officinalis extract at a dose of 330 mg/day could decrease BMI and systolic blood pressure, and it could enhance insulin resistance markers in euglycemic PCOS patients. TRIAL REGISTRATION: Iranian Registry of Clinical Trials (IRCT201504146917N2, 2015-10-03).

ETHNOPHARMACOLOGICAL RELEVANCE: Clopidogrel is the recommended treatment by current clinical practice guidelines to prevent adverse cardiovascular events in patients with coronary heart disease (CHD), but this treatment regimen still fails and 5-40% patients display inadequate antiplatelet responses. Fufang Danshen Dripping Pill (FDDP), a Chinese patient drug, was used as the combination with clopidogrel to improve the therapeutic effect. However, the mechanism of the interaction between clopidogrel and FDDP has not been elucidated. MATERIALS AND METHODS: We have used non-targeted metabolism method based on GC-MS and LC-MS for the investigation of drug interactions between clopidogrel and FDDP. 63 patients were divided into four groups with different dosage regimen and the serum samples were collected for the analysis. RESULTS: We have found 5 and 55 differential metabolites between health volunteer group and CHD patients group, respectively. The contents of these differential metabolites had diverse changes in clopidogrel group, FDDP group, and drug combination group, indicating that the clopidogrel and FDDP combination can adjust the glycometabolism, lipid metabolism, and phospholipid metabolism, sequentially made the content of downstream related metabolites towards to the health volunteer group. CONCLUSION: This work has explained the mechanism of the interaction between clopidogrel and FDDP from the point of view of metabolic product change, and revealed the potential metabolic pathways it affects, which provided the new ideas for clinical medication.

The vascular endothelium is a favorite early target of cardiovascular risk factors, including cigarette smoking. Here, we investigated the synergistic effects of Sanghuang⁻Danshen (SD) bioactives on vascular stiffness in a controlled clinical trial of healthy chronic smokers (n = 72). Relative to placebo, 4-week SD consumption at 900 mg/day improves pulse wave velocity (p = 0.0497), reduces systolic blood pressure (peripheral, p = 0.0008; brachial, p = 0.0046; and ankle, p = 0.0066), and increases endothelial nitric oxide synthase activation (p < 0.0001). We then mapped all differential markers obtained from the clinical data, Affymetrix microarray, and ¹H NMR metabolomics, together with 12 SD bioactives, onto the network platform termed the context-oriented directed associations. The resulting vascular subnetwork demonstrates that ellagic acid, caffeic acid, protocatechuic acid, cryptotanshinone, tanshinone I, and tanshinone IIA are linked to NOS3, ARG2, and EDN1 for vascular dilation, implicated with arginine/proline metabolism. They are also linked to SUCLG1, CYP1A1, and succinate related to the mitochondrial metabolism and detoxification, implicated with various metabolic pathways. These results could explain the synergistic action mechanisms of SD bioactives in the regulation of vascular endothelial dilation and metabolism, confirming the potential of SD in improving vascular stiffness and blood pressure in healthy smokers.

Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, creating interest in adjunctive strategies that complement standard care. Salvia miltiorrhiza (Danshen), a traditional Chinese medicinal herb rich in tanshinones and salvianolic acids, has been investigated for multi-target cardiovascular effects. This narrative review summarizes key phytochemical classes, preclinical mechanisms, human clinical findings, and formulation approaches aimed at improving bioavailability. Preclinical studies consistently report antioxidative, anti-inflammatory, vasodilatory, antithrombotic, and anti-fibrotic activities, involving pathways such as endothelial nitric oxide signaling and modulation of NF-κB/MAPK-related inflammation. Clinical studies have reported potential benefits in conditions such as coronary artery disease and myocardial ischemia; however, the overall evidence is limited by heterogeneity in preparations and dosing, variable product composition, small sample sizes, and a shortage of rigorously designed trials. Practical translation is further constrained by poor solubility and rapid metabolism of key constituents, though delivery platforms (e.g., liposomes, nanoparticles, and self-microemulsifying systems) may enhance exposure in experimental settings. Overall, Danshen remains a plausible adjunct candidate, but standardization and high-quality randomized clinical trials are needed to establish efficacy, safety, and interaction risk with conventional cardiovascular therapies. © 2026 The Author(s). Food Science & Nutrition published by Wiley Periodicals LLC.

INTRODUCTION: Danshen injection, derived from the traditional Chinese medicine Salvia miltiorrhiza Bunge, has been clinically validated for its safety and efficacy in treating various gynecological diseases, including endometrial fibrosis caused by Intrauterine Adhesion (IUA). However, its molecular mechanism in regulating the Laminin Subunit Gamma 2 (LAMC2)-CD44-TGF-β1-SMAD2/3 signaling pathway remains unclear. METHODS: An IUA rat model was established and treated with low-, medium-, or high-dose Danshen injection via tail vein injection. Endometrial injury and fibrosis were assessed by H&E and Masson's staining, and epithelial/mesenchymal markers were evaluated by immunohistochemistry and Western blot. Single-cell RNA sequencing (scRNA-seq) was performed to characterize cellular composition, pathway enrichment, and predicted intercellular communication. In vitro, Lipopolysaccharide (LPS)-stimulated uterine fibroblasts were used to examine LAMC2 expression, Epithelial-Mesenchymal Transition (EMT)-related marker changes, and TGF-β1/Smad signaling, with pathway interrogation using a CD44 blocker. Simultaneously, corresponding verification was conducted in vivo. RESULTS: Danshen injection improved uterine histopathology, increased endometrial gland number, and reduced collagen deposition in IUA rats. CK-19 and Vimentin showed changes consistent with epithelial-mesenchymal marker alterations, which were partially reversed after Danshen treatment. scRNA-seq revealed an increased fibroblast proportion in the Model group that decreased after Danshen intervention, with differentially expressed genes enriched in fibrosis-related pathways. Cell-cell communication analysis suggested reduced repair-associated signaling and increased LAMC2-associated interactions in the Model group. In vitro, LPS induced LAMC2 upregulation and activation of TGF-β1/SMAD2/3 signaling, which was attenuated by CD44 blockade; similarly, Danshen injection and CD44 inhibition reduced LAMC2 and TGF-β1/SMAD2/3 activation in vivo. CONCLUSION: Danshen injection may mitigate endometrial fibrosis in IUA, potentially by modulating fibroblast abundance, reducing EMT-related changes, and dampening LAMC2-CD

Doxorubicin (DOX)-induced cardiotoxicity significantly impairs patients' quality of life and long-term prognosis, and can lead to irreversible cardiac dysfunction and heart failure years or even decades after chemotherapy has ceased. Natural medicinal products represent a promising strategy for preventing or treating this cardiotoxicity, with Salvia miltiorrhiza (Danshen) demonstrating therapeutic properties in this context. Considerable attention has been focused on Tanshinone IIA, the principal lipophilic diterpenoid quinone compound found in Danshen, for its potential efficacy against doxorubicin-induced cardiac injury. Its therapeutic mechanisms include alleviating oxidative stress, inhibiting cardiomyocyte apoptosis, exerting anti-inflammatory effects in the myocardium, attenuating cardiac fibrosis, and modulating cardiomyocyte autophagy. This article provides an in-depth elaboration of the mechanisms and targets through which Tan IIA counteracts doxorubicin-induced cardiotoxicity. Furthermore, we explored Tan IIA drug delivery systems (DDS) and device-assisted delivery platforms, thus offering novel insights for future research and clinical translation of Tan IIA, as well as presenting new strategies for addressing doxorubicin-induced cardiac injury.

Danshen-Honghua Herb Pair (DHHP) is a classic combination for treating cardiovascular diseases with significant clinical efficacy. However, it exhibits low oral bioavailability, suggesting gut microbiota metabolism may enhance its biological activity. This study investigated the pharmacological basis and mechanism of DHHP against myocardial ischemia through gut microbiota metabolites. We adopted an integrated strategy combining network pharmacology, molecular docking, and animal experiments. 15 metabolite-derived components and 85 potential antimyocardial ischemia targets were identified. GO and KEGG enrichment analyses revealed that these targets were mainly involved in apoptosis-related biological processes and multiple cardiovascular signaling pathways. Molecular docking indicated that Salvianolic acid B and its methylated derivative, Lithospermic acid and its methylated and decarboxylated derivatives, as well as Hydroxysafflor Yellow A and its dehydration product exhibited lower binding energies with key targets including AKT, GSK-3β, Bcl-2, Bax, and Caspase 3. These components showed potential anti-apoptotic activity accordingly. Animal experiments confirmed DHHP metabolites significantly upregulated p-AKT, p-GSK-3β, and Bcl-2 expression in myocardial tissue (p <0.01) while downregulating Bax and Cleaved-Caspase 3 (p <0.01). These results demonstrate that DHHP, via gut microbiota metabolism, exerts antimyocardial ischemia effects through the p-AKT-mediated Bcl-2/Bax/Caspase 3 pathway. © 2026 Wiley‐VHCA AG.

INTRODUCTION: Myocardial ischemia-reperfusion injury (MIRI) significantly impairs the prognosis of cardiac surgery. Baihe Dihuang-Danshen Decoction (BDDSD), a Chinese herbal formula, has shown efficacy against MIRI. This study combined network pharmacology and experimental validation to identify the core compounds and mechanisms of BDDSD. METHODS: The compounds of BDDSD were identified through the TCMSP and BATMAN databases. Potential targets were determined by intersecting MIRI-related differential genes with BDDSD compound targets. A protein-protein interaction (PPI) network was constructed using the STING platform. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed using the Metascape database. A TF-gene network and a gene-miRNA network were generated using the NetworkAnalyst platform. Immune infiltration analysis was conducted using CIBERSORT. In vivo verification was then performed, followed by molecular docking analysis. RESULTS: The analysis revealed that BDDSD's cardioprotective effects against MIRI are mediated by six core compounds (e.g., Tanshinone IIA, Cryptotanshinone), which synergistically modulate key targets (e.g., IL6, HMOX1). In rats, BDDSD treatment reduced myocardial structural damage. Notably, MIRI-induced upregulation of mRNA expression of all six core targets was significantly suppressed by BDDSD. Molecular docking confirmed strong compound-target binding, further validating BDDSD's efficacy in MIRI. DISCUSSION: Our study elucidated the mechanisms underlying BDDSD's action in MIRI treatment. However, given that BDDSD operates through multiple components and targets, the complex interactions between these compounds require further investigation. Additionally, comprehensive toxicity assessments in preclinical models are needed to establish its safety profile. CONCLUSION: This study provides a comprehensive overview of the core compounds, potential targets, and mechanisms of BDDSD in MIRI treatment, offering a foundation for further research into the pathological mechanisms of MIRI and the therapeutic potential of traditional Chinese herbal decoctions.

Salvia miltiorrhiza Bunge, known as danshen in China, is a key medicinal herb in traditional Chinese medicine that has long been used for the treatment of cardiovascular and cerebrovascular disorders. Its principal bioactive constituents fall into two broad categories: water-soluble phenolic acids (primarily including danshensu, salvianic acid A, salvianolic acid B, and rosmarinic acid) and lipid-soluble diterpenoids (primarily including tanshinone I, tanshinone IIA, cryptotanshinone, and dihydrotanshinone). Accumulating evidence shows that these active components exert diverse pharmacological effects, including anti-tumor, anti-inflammatory, antioxidant, and anti-neurodegenerative activities, via modulating the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. Consistently, these components hold promising therapeutic potential against various diseases, including cancer, atherosclerosis, Alzheimer's disease, and diabetic nephropathy. Nevertheless, there is still a lack of a comprehensive and systematic summary of the precise mechanisms by which the active ingredients of danshen exert their therapeutic actions against the aforementioned diseases via the PI3K/Akt signaling pathway. To address this gap, this review systematically summarizes the regulatory effects of danshen's active components on the PI3K/Akt signaling pathway, aiming to clarify their therapeutic potential in various pathological conditions and thereby provide novel insights for the basic research and clinical application of danshen. © 2026 Wiley‐VHCA AG.

Rhabdomyosarcoma (RMS) is an aggressive pediatric soft tissue sarcoma with limited treatment options and poor prognosis. Dihydrotanshinone I (DT), a bioactive compound from Danshen, exhibits anti-inflammatory and antitumor properties, but its effects on RMS remain unclear. To investigate the mode of cell death induced by DT, various inhibitors were employed. RNA sequencing and co-immunoprecipitation assays were utilized to explore the mechanism of DT-induced ferroptosis in RMS. Furthermore, the anti-RMS efficacy of DT was evaluated through in vitro experimental models and nude mouse xenograft models. We found that DT induces the ubiquitination and degradation of HSP90AA1, thereby inhibiting the HSP90AA1/RACK1/AKT signaling axis and subsequently triggering ferroptosis in RMS. This process significantly suppresses the proliferation of RMS. These findings highlight the potential of DT as a therapeutic candidate for RMS and propose a ferroptosis-targeting strategy that may improve treatment outcomes. © 2026 John Wiley & Sons, Ltd.

157. Artif Organs. 2026 Mar;50(3):483. doi: 10.1111/aor.70109. Epub 2026 Mar 18. Correction to "Danshen-Enhanced Cardioprotective Effect of Cardioplegia on Ischemia Reperfusion Injury in a Human-Induced Pluripotent Stem Cell-Derived Cardiomyocytes Model". [No authors listed] Erratum for Artif Organs. 2017 May;41(5):452-460. doi: 10.1111/aor.12801.

This study investigates the mechanisms and target sites of Renshen(Ginseng Radix et Rhizoma)-Danshen(Salviae Miltiorrhizae Radix et Rhizoma)(RSDS) in regulating myocardial ischemia-reperfusion injury(MIRI) via the silent information regulator 3(SIRT3)/peroxisome proliferator-activated receptor gamma coactivator-1 alpha(PGC-1α)/voltage-dependent anion-selective channel 1(VDAC1) signaling pathway. A rat MIRI model was established and randomly divided into control, model, fosinopril, and low-, medium-, and high-dose RSDS groups. Cardiac function, cell apoptosis, and myocardial fibrosis were assessed using cardiac ultrasound, TUNEL staining, hematoxylin-eosin(HE) staining, and Masson staining. Serum factors and the expression of key proteins and genes, such as SIRT3, PGC-1α, and VDAC1 in myocardial tissue, were analyzed using ELISA, Western blot, and RT-qPCR to investigate the underlying mechanisms through the SIRT3/PGC-1α/VDAC1 signaling pathway. The experimental results showed that, compared with the model group, RSDS significantly improved cardiac function, with the high-dose group exhibiting the most pronounced cardioprotective effect, including increased left ventricular ejection fraction(LVEF), decreased left ventricular end-systolic diameter(LVESD), and increased left ventricular fractional shortening(LVFS). TUNEL staining demonstrated that RSDS reduced myocardial cell apoptosis, and Masson staining indicated that RSDS significantly alleviated myocardial fibrosis. Serum levels of interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), C-reactive protein(CRP), and creatine kinase-MB(CK-MB) were significantly decreased, while superoxide dismutase(SOD) levels were significantly increased, suggesting strong anti-inflammatory and antioxidant effects. Western blot and RT-qPCR analyses demonstrated that RSDS improved mitochondrial function, inhibited oxidative stress, and protected myocardial cells by regulating the SIRT3/PGC-1α/VDAC1 signaling pathway. In conclusion, RSDS significantly ameliorates cardiac dysfunction induced by MIRI through regulation of the SIRT3/PGC-1α/VDAC1 signaling pathway, reducing myocardial apoptosis, fibrosis, and inflammation.

Alzheimer's disease (AD), a form of neurodegenerative disorder characterized by the accumulation of amyloid-β (Aβ), hyperphosphorylated Tau, and neuroinflammation. The increasing population affected by AD urges for the development of effective treatments. The correlation between AD and gut microbiome remains underexplored, potentially providing a better understanding of the disease. Salvianolic acid A (Sal A) and salvianolic acid B (Sal B) are the active components extracted from Salvia miltiorrhiza (Danshen), and their antioxidant, anti-inflammation and Aβ inhibition activities were shown previously. In this study, these compounds were used to investigate their effects on Aβ toxicity, using Drosophila melanogaster expressing human Aβ42 as the model organism, by examining their lifespan and changes in gut bacterial communities. The study used two batches of flies, reared on food with or without methylparaben (MP) supplementation to evaluate the influence of MP on this animal model during pharmacological studies. MP is a common antimicrobial agent used in flies' food. The treatment of Sal A prolonged the lifespan of Aβ-expressing flies reared on MP-supplemented food significantly (P < 0.001), but not those without MP. The lifespan of Sal B-treated flies did not show a significant difference compared to untreated flies for both groups reared on food with and without MP. Sal A-treated flies in the presence of MP exhibited a lower abundance of Corynebacterium and Enterococcus than the untreated flies, while Lactiplantibacillus was the most dominant taxa. Urea cycle was predicted to be predominant in this group compared to the untreated group. The control group, Aβ-expressing flies treated with Sal A and Sal B on MP-supplemented food had improved lifespan compared to their respective groups reared on food without MP, while untreated Aβ-expressing flies was the exception. The gut microbiota composition of flies reared on MP-supplemented food was also significantly different from those without MP (P < 0.001). © 2024. The Author(s), under exclusive licence to Springer Nature B.V.