Salvia miltiorrhiza Injection on Pulmonary Heart Disease: A Systematic Review and Meta-Analysis

Abstract

Cor pulmonale (pulmonary heart disease) is a chronic progressive complicated disease for which treatment needs to be sustained all the time, creating a great financial burden on individuals and society. In order to improve the life quality of cor pulmonale patients and decrease the dosage and quantity of the routine treatment, in China, TCM is often administered to patients with cor pulmonale. The results of many clinical trials have indicated that Salvia miltiorrhiza and complex Salvia miltiorrhiza injection may be an alternative medicine for cor pulmonale. With the purpose to prove whether Salvia miltiorrhiza and complex Salvia miltiorrhiza benefit the cor pulmonale patients, respectively, we carried out a systematic review to evaluate the efficacy and safety of Salvia miltiorrhiza and complex Salvia miltiorrhiza injection in cor pulmonale patients. Overall, 2,715 patients were identified from 35 randomized controlled trials. The meta-analysis used I(2) test for heterogeneity and chose random or fixed model according to heterogeneity of included studies. Clinical outcomes were evaluated by total effectiveness rate, partial pressure of oxygen ( PaO 2) and carbon dioxide ( PaCO 2), hemorheology, mPAP and adverse effects. Compared with routine medicine treatment alone, routine medicine treatment plus Salvia miltiorrhiza or complex Salvia miltiorrhiza injection showed better outcomes: A significantly higher clinical effectiveness rate ratio (p < 0.001), increase in PaO 2 (p < 0.001) and decrease in PaCO 2 (p < 0.001), improvement in hemorheology (p < 0.001), and alleviation in mPAP (p < 0.05). There is no obvious adverse effect reported. In summary, there are some evidences suggesting that Salvia miltiorrhiza or complex Salvia miltiorrhiza injection are active in cor pulmonale, however, the results were limited by the methodological flaws of the included studies. Long-term and high quality clinical trials are needed to provide more conclusive evidence for the future use of Salvia miltiorrhiza injection.

Pulmonary hypertension: Molecular aspects of current therapeutic intervention and future direction

“…Furthermore, PPARγ agonists have found to reduce the production of ET‐1, which is the key signaling mechanism to induce PH. Pioglitazone can majorly reduce proliferation of PVSMC, PVR, and apoptosis in the experimental model of PH (Idris‐Khodja et al, ; Liu, Tian, et al, ; Sharma & Khanna, ). Recently, it has been demonstrated PPARγ agonist Rosiglitazone ameliorates endothelin‐1‐induced vasoconstriction of pulmonary arteries in the rat model (Liu, Tian, Huang, & Wang, ).…”

“…Herbal constituents of some phytomedicine are capable of improving the PH by modifying various participated signaling cascades. Resveratrol (Csiszar et al, ), Panax ginseng (Araliaceae) (Jiang et al, ), Genistein (Loganville) (Homma et al, ), Salvia Miltiorrhiza (Lamiaceae) (Liu, Huang et al, ), and Chinese herb Naofeikang (Han et al, ) have reported significant improvement in eNOS expression and simultaneous increase production of NO that can majorly knock down the endothelial dysfunction and associated PH (Table ). Indeed, Genistein can also decrease mean arterial pressure of pulmonary vessel and collagen deposition which is the major sign of PH (Homma et al, ).…”

Ginkgo leaf extract and dipyridamole injection for chronic cor pulmonale: a PRISMA-compliant meta-analysis of randomized controlled trials

“…Chronic cor pulmonale (CCP), a common type of heart disease, has become a rising major public problem that threatens people's health and quality of life around the world [1]. Although the term "cor pulmonale" is popular in the medical literature, there is presently no consensual definition [1][2][3]. World Health Organization (WHO) defined CCP as "hypertrophy of the right ventricle resulting from diseases affecting the function and/or structure of the lungs, and may further leading to heart failure" [4].…”

“…is the main clinical therapy for CCP [1]. However, it is universally acknowledged that long-time use of western medicine sometimes may cause drug resistance and toxic side effects, and therefore its clinical efficacy is still unsatisfactory [1,2]. Many researchers in China and some other Asian countries indicated that the combination of Chinese and Western medicine for CCP might be the potential trend of clinical treatment development in future [7][8][9][10][11][12].…”

Multiple on‐line HPLC coupled with biochemical detection methods to evaluate bioactive compounds in Danshen injection

“…Danshen injection, a Chinese traditional preparation from raw materials (roots and rhizoma of Salvia miltiorrhiza , Danshen), is widely used to treat hepatitis, menstrual disorders, menostasis and blood circulation diseases (Liu et al, ; Zhang et al, ; Cho et al, ; Shen, Yang, Sun, & Zheng, ; Wang, Zhao, Li, Gu, & Gou, ). In recent years, the water‐soluble components of Danshen have attracted increasing attention because of their effectiveness in improving the renal function of rats with adenine‐induced renal failure, and as antioxidants for their potential in removal of free radicals (Li et al, ; Guan et al, ).…”