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San Qi

Also known as: San Qi, Tian Qi, Notoginseng, Panax notoginseng

Overview

San Qi, derived from the root of Panax notoginseng, is a prominent herb in Traditional Chinese Medicine (TCM) renowned for its multifaceted therapeutic properties. It is primarily utilized for its beneficial effects on blood circulation, hemostasis (stopping bleeding), and inflammation. Historically, San Qi has been applied in various health conditions, including cardiovascular disorders, kidney protection, and as an anti-inflammatory agent. Its pharmacological actions are attributed to a rich profile of active constituents, notably saponins (notoginsenosides), flavonoids such as quercetin, and phytosterols like beta-sitosterol. Modern research, including randomized controlled trials and meta-analyses, increasingly supports its traditional uses, although more extensive, high-quality clinical trials are needed to fully elucidate its efficacy and mechanisms across all purported applications. San Qi is commonly available as dried root, granules, or oral liquids.

Benefits

San Qi offers several evidence-based benefits, primarily in renal protection, anti-inflammatory effects, and cardiovascular health. For renal protection, San Qi-containing formulas have demonstrated efficacy in reducing proteinuria and improving serum albumin levels in models of membranous nephropathy and ischemia/reperfusion injury. This protective effect is likely mediated through its anti-inflammatory and anti-apoptotic mechanisms, as supported by a moderate-quality RCT. Its anti-inflammatory and immunomodulatory properties are significant; network pharmacology and molecular docking studies suggest that compounds like quercetin, oleic acid, and beta-sitosterol modulate key signaling pathways such as PI3K-Akt, which are crucial in inflammatory processes and conditions like endometriosis. In cardiovascular health, meta-analyses indicate that San Qi injections can achieve a clinical efficacy rate of approximately 75% in certain conditions, offering a favorable cost-effectiveness profile compared to alternative treatments. Additionally, San Qi exhibits antioxidant effects and potential in vitro anti-tumor activity, though these benefits require further clinical validation.

How it works

San Qi exerts its therapeutic effects through a complex interplay of its bioactive compounds with multiple molecular targets. Its primary mechanism involves modulating key signaling pathways such as NF-κB, Nrf2/HO-1, and ERK/mTOR. These pathways are central to regulating inflammation, oxidative stress, apoptosis (programmed cell death), and autophagy. Specifically, flavonoids like quercetin are implicated in modulating the PI3K-Akt pathway, influencing cell proliferation and immune responses. The saponins, particularly notoginsenosides, are crucial for San Qi's vascular protective and hemostatic properties. By interacting with these pathways, San Qi helps to reduce inflammation, protect against oxidative damage, and support cellular health. The absorption and bioavailability of San Qi's active components are influenced by its preparation form, with oral liquids and granules being common, and pharmacokinetics can be affected by co-administered herbs.

Side effects

San Qi is generally considered safe when used within traditional dosage ranges. Adverse effects are rare and typically mild, with occasional reports of gastrointestinal discomfort. Clinical trials have shown good tolerability in studied populations, and no significant drug interactions or contraindications have been robustly documented. However, due to its known effects on blood circulation and hemostasis, caution is advised when San Qi is used concurrently with anticoagulant medications, as there is a theoretical risk of increased bleeding. While clinical evidence for such interactions is limited, it is prudent for individuals on blood thinners to consult a healthcare professional before using San Qi. Overall, its safety profile is favorable, but long-term safety data, especially at higher doses or in specific populations, remains an area for further research.

Dosage

The optimal dosage of San Qi varies depending on the specific formulation, the condition being treated, and individual factors. Clinical studies have utilized diverse preparations and dosages. For instance, in nephropathy patients, Sanqi Qushi Granule combined with conventional therapy has shown efficacy, but exact dosing protocols differ across studies. Traditionally, the recommended daily dosage of dried San Qi root equivalent ranges from 3 to 10 grams. It is important to note that the timing of administration and the form of preparation (e.g., granule, oral liquid, injection) can significantly influence its bioavailability and clinical outcomes. Due to the variability in formulations and the need for further standardization, it is advisable to follow the specific instructions on product labels or consult with a qualified healthcare practitioner for personalized dosing recommendations. Upper limits and safety thresholds are not definitively established in modern clinical guidelines, but traditional use suggests a good safety margin within the typical dosage range.

FAQs

Is San Qi safe for long-term use?

Current evidence supports the safety of San Qi for short to medium-term use. However, comprehensive data on its long-term safety, especially beyond several months, is limited and requires further research.

Can San Qi be used alone or only in combination?

While San Qi can be used alone, most clinical evidence, particularly in conditions like nephropathy, supports its efficacy when used as part of multi-herb formulas or in combination with conventional medical therapies.

How soon do benefits appear?

Clinical improvements in conditions such as renal function or cardiovascular parameters have been observed within weeks to a few months in various clinical trials, depending on the condition and individual response.

Research Sources

https://pmc.ncbi.nlm.nih.gov/articles/PMC10134584/ – This RCT investigated Sanqi Qushi Granule combined with conventional therapy for membranous nephropathy, showing improved remission rates and renal function. The study linked mechanisms to NF-κB and Nrf2/HO-1 pathways, suggesting San Qi's anti-inflammatory and anti-apoptotic effects.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9478308/ – This computational study used network pharmacology and molecular docking to identify key active compounds in San Qi, such as quercetin, and their potential targets. It suggested modulation of pathways like PI3K-Akt relevant to inflammatory conditions like endometriosis, providing mechanistic insights.
https://atm.amegroups.org/article/view/77988/html – This meta-analysis evaluated the efficacy and cost-effectiveness of Sanqi injections in cardiovascular treatment. It concluded that Sanqi injections showed a clinical efficacy rate of approximately 75% with favorable cost-effectiveness, although heterogeneity among included studies was noted.