Zhejiang Key TCM Laboratory for Chinese Resource Innovation and Transformation, School of Pharmaceutical Sciences, School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 311402, PR China.
Huzhou Central Hospital, Huzhou, Zhejiang, 31300, PR China.
J Ethnopharmacol. 2023 Dec 5;317:116697. doi: 10.1016/j.jep.2023.116697. Epub 2023 Jun 8.
Salvia miltiorrhiza Bunge (SM) is an outstanding herbal medicine with various traditional effects, especially promoting blood circulation to remove blood stasis. It has been widely used for centuries to treat blood stasis syndrome (BSS)-related diseases. BSS is one of the basic pathological syndromes of diseases such as cardiovascular and cerebrovascular diseases in traditional East Asian medicine, which is characterized by disturbance of blood circulation. However, the bioactive components and mechanisms of SM in the treatment of BSS have not been systematically reviewed. Therefore, this article outlines the anti-BSS effects of bioactive components of SM, concentrating on the molecular mechanisms.
To summarize the bioactive components of SM against BSS and highlight its potential targets and signaling pathways, hoping to provide a modern biomedical perspective to understand the efficacy of SM on enhancing blood circulation to remove blood stasis.
A comprehensive literature search was performed to retrieve articles published in the last two decades on bioactive components of SM used for BSS treatment from the online electronic medical literature database (PubMed).
Phenolic acids and tanshinones in SM are the main bioactive components in the treatment of BSS, including but not limited to salvianolic acid B, tanshinone IIA, salvianolic acid A, cryptotanshinone, Danshensu, dihydrotanshinone, rosmarinic acid, protocatechuic aldehyde, and caffeic acid. They protect vascular endothelial cells by alleviating oxidative stress and inflammatory damage and regulating of NO/ET-1 levels. They also enhance anticoagulant and fibrinolytic capacity, inhibit platelet activation and aggregation, and dilate blood vessels. Moreover, lowering blood lipids and improving blood rheological properties may be the underlying mechanisms of their anti-BSS. More notably, these compounds play an anti-BSS role by mediating multiple signaling pathways such as Nrf2/HO-1, TLR4/MyD88/NF-κB, PI3K/Akt/eNOS, MAPKs (p38, ERK, and JNK), and Ca/K channels.
Both phenolic acids and tanshinones in SM may act synergistically to target different signaling pathways to achieve the effect of promoting blood circulation.
草药丹参（SM）是一种具有多种传统功效的杰出草药，尤其擅长活血化瘀。几个世纪以来，它一直被广泛用于治疗血瘀证（BSS）相关疾病。BSS 是传统东亚医学中心血管和脑血管等疾病的基本病理综合征之一，其特征是血液循环紊乱。然而，SM 治疗 BSS 的生物活性成分及其机制尚未得到系统综述。因此，本文概述了 SM 生物活性成分的抗 BSS 作用，重点介绍了其分子机制。
总结 SM 抗 BSS 的生物活性成分，并强调其潜在靶点和信号通路，希望为理解 SM 增强活血化瘀功效提供现代生物医学视角。
从在线电子医学文献数据库（PubMed）中检索了过去二十年中关于 SM 生物活性成分治疗 BSS 的文献，进行了全面的文献检索。
SM 中的酚酸和丹参酮是治疗 BSS 的主要生物活性成分，包括但不限于丹参酸 B、丹参酮 IIA、丹参酸 A、隐丹参酮、丹参素、二氢丹参酮、迷迭香酸、原儿茶醛和咖啡酸。它们通过减轻氧化应激和炎症损伤以及调节 NO/ET-1 水平来保护血管内皮细胞。它们还增强抗凝和纤维蛋白溶解能力，抑制血小板活化和聚集，扩张血管。此外，降低血脂和改善血液流变学特性可能是其抗 BSS 的潜在机制。值得注意的是，这些化合物通过介导 Nrf2/HO-1、TLR4/MyD88/NF-κB、PI3K/Akt/eNOS、MAPKs（p38、ERK 和 JNK）和 Ca/K 通道等多种信号通路发挥抗 BSS 作用。
SM 中的酚酸和丹参酮可能协同作用，针对不同的信号通路，达到活血化瘀的效果。
