Tienchi Notoginseng
Also known as: Tienchi Notoginseng, Notoginseng, Sanqi, Tienchi ginseng, Panax notoginseng
Overview
Panax notoginseng, also known as Tienchi Notoginseng, is a perennial herb native to China and a staple in Traditional Chinese Medicine (TCM). It is primarily recognized for its cardiovascular and cerebrovascular benefits, with its main bioactive compounds being Panax notoginseng saponins (PNS). This herbal supplement is widely used, particularly in the treatment of acute ischemic stroke (AIS) to improve neurological function and aid post-stroke recovery. Beyond stroke, it exhibits anti-inflammatory and hemostatic properties. Research on Panax notoginseng, especially concerning stroke treatment, is extensive, featuring numerous randomized controlled trials (RCTs) and meta-analyses, indicating a moderate to high level of research maturity. While evidence quality varies, large-scale meta-analyses support its efficacy, despite some limitations in trial design and heterogeneity.
Benefits
Panax notoginseng offers significant benefits, particularly for individuals recovering from acute ischemic stroke (AIS). It has been shown to significantly improve neurological deficits in AIS patients, with standardized mean differences (SMD) ranging from -0.7 to -1.1, indicating moderate to large effects on neurological status. Furthermore, it enhances activities of daily living (ADL) post-stroke, with improvements of approximately 10 points on ADL scales. The herb also increases total clinical efficacy rates, suggesting better overall clinical outcomes compared to control treatments. Secondary benefits include a reduction in disability and improved quality of life measures post-stroke, along with potential platelet modulation and anti-inflammatory effects that contribute to vascular protection. Elderly stroke patients particularly benefit from improved neurological recovery and daily functioning. The observed effect sizes are statistically significant (p < 0.00001) with robust confidence intervals across multiple studies. Benefits are typically observed in the short to medium term, within 14 days to several weeks post-stroke.
How it works
Panax notoginseng saponins (PNS) exert their therapeutic effects by modulating multiple biological pathways. They possess anti-inflammatory, antioxidative, and anti-apoptotic properties, which are crucial in mitigating damage following ischemic events. A key mechanism involves improving microcirculation and reducing platelet aggregation, vital processes in the management of ischemic stroke. PNS interact with specific molecular targets, including pathways involved in platelet activation and various neuroprotective signaling cascades, thereby safeguarding brain tissue. While oral formulations are available, bioavailability is often enhanced through intravenous injections in clinical settings, allowing for more direct and potent action within the body's systems.
Side effects
Panax notoginseng is generally well-tolerated, with a lower incidence of adverse reactions compared to control treatments. The most commonly reported side effects are mild gastrointestinal discomfort and skin rash, occurring in less than 5% of users. Rare allergic reactions have been documented, thus caution is advised for individuals with a history of allergies or chronic gastric diseases. Importantly, current literature does not clearly establish significant drug interactions or contraindications. Meta-analytic data further supports its safety profile, indicating no increase in all-cause mortality or serious adverse events. While generally safe, individuals should consult a healthcare professional, especially if they have pre-existing conditions or are taking other medications, to ensure safe usage.
Dosage
In most clinical trials, Panax notoginseng saponins injections (PNSI) were administered intravenously shortly after stroke onset, typically within 14 days. The exact dosing varies depending on the specific formulation and the study protocol, but standardized extracts with quantified saponin content are preferred to ensure consistent therapeutic effects. Oral dosing regimens are less standardized and require further research to establish optimal dosages for various conditions. A critical factor for efficacy is the timing of administration; early intervention post-ischemic event has been shown to yield superior outcomes. Patients should always adhere to dosages recommended by a healthcare professional, especially given the critical nature of conditions like acute ischemic stroke.
FAQs
Is Tienchi Notoginseng safe?
Yes, it is generally considered safe, with clinical trials reporting only mild and infrequent side effects such as gastrointestinal discomfort or rash. Serious adverse events are rare.
When should it be taken?
For acute ischemic stroke, early administration, ideally within 14 days of onset, is associated with the best outcomes in neurological recovery and daily functioning.
How soon can benefits be seen?
Improvements in neurological function and activities of daily living are typically observed within weeks of starting treatment, particularly in the short to medium term.
Is it effective alone or combined?
Both monotherapy and combination with conventional Western medicine show benefits. Combination therapy often yields superior outcomes for acute ischemic stroke patients.
Research Sources
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1376025/full – This systematic review and meta-analysis by Li et al. (2024) investigated the effects of Panax notoginseng saponins injection (PNSI) in acute ischemic stroke (AIS) patients post-thrombolysis. It found that PNSI improved neurological deficits and reduced disability without increasing mortality or adverse events, though it noted some heterogeneity and limited long-term data.
- https://onlinelibrary.wiley.com/doi/10.1155/2023/4312489 – Guan et al. (2023) conducted a systematic review and meta-analysis of 206 RCTs involving 21,759 elderly stroke patients. The study concluded that Panax notoginseng saponins significantly improved neurological status, activities of daily living (ADL), and overall clinical efficacy with a low risk of bias, despite some heterogeneity among studies predominantly involving Chinese populations.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8289597/ – Zhang et al. (2021) performed a systematic review and meta-analysis of 43 RCTs on AIS patients. Their findings indicated that Panax notoginseng saponins reduced adverse reactions, improved platelet parameters, and enhanced independent functional outcomes, though they noted limitations such as poor randomization and blinding in some included trials.
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1280559/full – This meta-analysis by Wu et al. (2023) focused on Xuesaitong (a PNS formulation) in 3,158 participants with AIS, administered up to 14 days post-onset. It reported improved modified Rankin Scale (mRS) scores, increased functional independence, and better ADL and neurological impairment outcomes, though the evidence for some outcomes was considered low quality due to a small number of long-term studies.
- https://pubmed.ncbi.nlm.nih.gov/37908976/ – This PubMed entry likely refers to the same Wu et al. (2023) meta-analysis on Xuesaitong, highlighting its benefits in improving mRS scores, functional independence, ADL, and neurological impairment in AIS patients within 14 days post-onset, despite some limitations in evidence quality for certain outcomes.
- https://onlinelibrary.wiley.com/doi/10.1155/2021/4694076 – This Wiley Online Library article likely corresponds to the Zhang et al. (2021) systematic review and meta-analysis, which found that Panax notoginseng saponins reduced adverse reactions, improved platelet parameters, and enhanced independent functional outcomes in AIS patients, while acknowledging issues with randomization and blinding in some trials.
