Preclinical and clinical examinations of Salvia miltiorrhiza and its tanshinones in ischemic conditions

James David Adams¹  , Rubin Wang²  , Jun Yang³  and Eric Jungchi Lien^{2  1}Department of Molecular Pharmacology and Toxicology, School of Pharmacy, University of Southern California,1985 Zonal Avenue, Los Angeles, CA 90089-9121, USA²Department of Pharmaceutical Sciences, School of Pharmacy, University of Southern California, 1985 Zonal Avenue, Los Angeles, CA 90089-9121, USA³Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Southern California, Los Angeles, CA 90089-9151, USA

Abstract

Salvia miltiorrhiza (Labiatae, Laminaceae), danshen, is an annual sage mainly found in China and neighboring countries. The crude drug (dried root) and its preparations are currently used in China to treat patients suffering from heart attack, angina pectoris, stroke and some other conditions. The use of S. miltiorrhiza has been increasing in the management of stroke. Pharmacological examinations showed that the plant and its active ingredients, tanshinones and salvianolic acids, have anticoagulant, vasodilatory, increased blood flow, anti-inflammatory, free radical scavenging, mitochondrial protective and other activities. This review discusses the pharmacology, medicinal chemistry and clinical studies published, especially in China, for danshen and tanshinone preparations. Clinical examinations are evaluated in terms of S. miltiorrhiza preparation, dose, double blinding, control, clinical assessments of outcomes and other parameters. Meta-analyses of S. miltiorrhiza are also discussed.

Conclusion

S. miltiorrhiza is a very useful herb in the treatment of cardiovascular disorders. It has been extensively studied in clinical trials in China. Most of the clinical trials have some limitations. However, taken as a whole, the clinical trials present compelling evidence of the efficacy of S. miltiorrhiza in stroke, heart attack and other conditions. Further research is needed to understand all actions of S. miltiorrhiza, and all active compounds found in the plant, in treating cardiovascular diseases. Research is also needed to help us understand the pharmacological effects of other herbs added to S. miltiorrhiza.

The electronic version of this article is the complete one and can be found online at: http://www.cmjournal.org/content/1/1/3