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Chinese Salvia Extract

Also known as: Salvia miltiorrhiza Bunge, Chinese Salvia, Danshen, Red Sage, Salvia miltiorrhiza

Overview

Salvia miltiorrhiza, commonly known as Danshen or Chinese Salvia, is a plant native to China and Japan, widely used in traditional Chinese medicine. The roots of this plant are rich in bioactive compounds, including salvianolic acids and tanshinones, which contribute to its therapeutic effects. Primarily, Salvia miltiorrhiza is employed to manage cardiovascular conditions such as angina pectoris and coronary heart disease, as well as chronic kidney disease. The extract exhibits antioxidant, anti-inflammatory, and vasodilatory properties, making it a versatile herbal remedy. Research on Salvia miltiorrhiza is extensive, with numerous randomized controlled trials and meta-analyses supporting its efficacy and safety. The available evidence is generally considered high quality, providing robust data on its clinical applications. It is available in various forms, including oral capsules, injections, and infusions, each offering different levels of bioavailability and suitability for specific conditions.

Benefits

Salvia miltiorrhiza offers several evidence-based benefits, particularly for cardiovascular and renal health. In patients with chronic kidney disease (CKD), it significantly reduces serum creatinine and blood urea nitrogen levels while increasing creatinine clearance and glomerular filtration rate, as demonstrated in a meta-analysis of 32 studies. For individuals with angina pectoris, Salvia miltiorrhiza depside salts for infusion, when combined with conventional treatment, improve angina symptoms. Additionally, in patients with coronary heart disease (CHD) comorbid with heart failure, it leads to significant improvements in left ventricular ejection fraction (LVEF) and exercise capacity, along with reductions in left ventricular end-diastolic diameter (LVEDD) and Brain natriuretic peptide (BNP) levels. These effects are supported by multiple meta-analyses and randomized controlled trials, indicating substantial clinical benefits.

How it works

Salvia miltiorrhiza exerts its therapeutic effects through multiple biological pathways. It acts as an antioxidant, reducing oxidative stress, and as an anti-inflammatory agent, mitigating inflammation. Its vasodilatory properties improve blood flow, particularly in the cardiovascular and renal systems. The bioactive compounds, such as salvianolic acids and tanshinones, target molecular pathways involved in inflammation, oxidative stress, and vascular function. By improving vascular function and kidney perfusion, Salvia miltiorrhiza supports overall cardiovascular and renal health. The bioavailability of its extracts can vary depending on the formulation, with injections and infusions generally offering higher bioavailability compared to oral forms.

Side effects

Salvia miltiorrhiza is generally considered safe when used as directed, with the incidence of adverse effects being similar to that of control groups in most studies. There are no commonly reported side effects at a frequency greater than 5% in the reviewed studies. Potential interactions with anticoagulants and antiplatelet agents exist due to its antiplatelet effects, although this is not well-documented in human studies. Caution is advised in patients with bleeding disorders or those taking anticoagulant medications. Pregnant or breastfeeding women should use it under medical supervision due to limited data on its safety in these populations. While rare side effects are not documented in the reviewed literature, it is essential to monitor for any adverse reactions and discontinue use if they occur.

Dosage

The minimum effective dose of Salvia miltiorrhiza varies by formulation and condition. For chronic kidney disease (CKD), doses ranging from 400 mg to 1.2 g per day have shown significant improvements in kidney function. Optimal dosages typically fall within the range of 400 mg to 2 g per day, depending on the specific preparation and condition being treated. There is no established maximum safe dose, but doses above 2 g per day are not commonly studied. Consistent dosing as part of a treatment regimen is recommended. Injections and infusions may be more effective for acute conditions, while oral forms may be suitable for chronic conditions. No specific cofactors are required for its efficacy.

FAQs

Is Salvia miltiorrhiza safe?

Salvia miltiorrhiza is generally safe, but caution is advised for individuals with bleeding disorders or those taking anticoagulant medications due to its antiplatelet effects.

How should I take Salvia miltiorrhiza?

Consistent dosing as part of a treatment regimen is recommended. The specific form (e.g., oral, injection) and dosage should be determined based on the condition being treated.

What results can I expect from taking Salvia miltiorrhiza?

Improvements in cardiovascular and renal function can be expected, depending on the condition being treated. It is often used as a complementary therapy alongside conventional medical treatments.

Can Salvia miltiorrhiza replace my current medications?

No, Salvia miltiorrhiza is not a replacement for conventional medical treatment but rather a complementary therapy. Consult with your healthcare provider before making any changes to your treatment plan.

Research Sources

  • https://onlinelibrary.wiley.com/doi/10.1155/2022/2117433 – This systematic review and meta-analysis of 32 studies (2264 participants) found that Salvia miltiorrhiza significantly improved kidney function parameters in patients with chronic kidney disease, including reductions in serum creatinine and blood urea nitrogen. The study assessed the risk of bias and used the GRADE framework to determine the quality of evidence, concluding that the evidence was of high quality.
  • https://www.sciencedirect.com/science/article/pii/S0944711317300028 – This systematic review and meta-analysis of 56 RCTs (5503 patients) showed that Salvia miltiorrhiza depside salts for infusion, when combined with conventional treatment, improved angina symptoms, ECG improvements, and reduced nitroglycerin use in patients with angina pectoris. The trials had an unclear risk of bias due to poor reported methodology, but the overall quality was assessed as moderate to high using the Cochrane risk-of-bias tool and CONSORT for TCM.
  • https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.972738/full – This systematic review and meta-analysis of 19 studies demonstrated that Salvia miltiorrhiza Bunge extract significantly improved left ventricular ejection fraction (LVEF) and 6-minute walking test (6MWT), and reduced left ventricular end-diastolic diameter (LVEDD) and Brain natriuretic peptide (BNP) levels in patients with coronary heart disease comorbid with heart failure. The study evaluated heterogeneity and publication bias, and the evidence was considered high-quality using Review Manager 5.4.1 and STATA SE 15.1.
  • https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4865309 – This source appears to be a working paper or preprint, and without further context, it's difficult to provide a specific summary. Generally, such papers present preliminary research findings or theoretical analyses that have not yet undergone peer review. The abstract should be consulted for specific details.
  • https://pubmed.ncbi.nlm.nih.gov/16369479/ – This study investigates the effects of Salvia miltiorrhiza on myocardial protection during ischemia and reperfusion. The research suggests that Salvia miltiorrhiza may have protective effects on the heart muscle by reducing oxidative stress and inflammation during periods of reduced blood flow followed by restoration of blood flow.

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