Activating Blood Circulation Research Articles

THMP from non-European countries – View of industry

The European Directive 2004/24/EC has introduced a simplified registration procedure for traditional herbal medicinal products which plays an important role in harmonizing the current legislation framework for all herbal medicinal products in the European Union. Although substantial achievements have been made under this directive, only a limited number of herbal medicinal products from non-European traditions commonly used in Europe have been registered. Identification of the obstacles, and determination of appropriate means to overcome the major challenges in the registration of non-European traditional herbal medicinal products (THMP) are important for the EU herbal medicinal product market. Traditional Chinese Medicine (TCM) is one of the major non-European THMP in the European market. Key for acceptance of TCM is the ability to provide scientific evidence combined with a quality control system based on the bioactive ingredients. Modern scientific technology tools are now available to accomplish standardization of TCM products in order to achieve a high level of efficacy and safety, enhancing the introduction into the international markets. Despite the complexity of ingredients and the aspect of synergistic bioactivities in TCM, so far the analysis for quality control was mainly limited to major components for each herb without evidence for a direct relationship with the bioactive components. In a Systems Biology approach, the multi-dimensional chemical and pharmacological approach enables linking of the complex metabolic profile of herbs with biological effects and is, therefore, a key for quality control of TCM material medica, while providing simultaneous scientific evidence for the underlying efficacy and worldwide acceptance of TCM products. The root extract of Dioscorea nipponica is a well-known component in Traditional Chinese Medicine formula's. The bioactivity of this extract has been described in Chinese medicine as: (1) activating blood circulation to dissipate blood stasis (2) promoting qi circulation to relieve pain and muscle tension due to stress (3) relieving internal resistance of stagnant blood. In order to translate the explanatory system-level functionalities in Chinese medicine into a Western biochemical, functional and clinical understanding, an extensive series of pharmacological experiments was used to obtain insights in various effects of prevention and treatment in the cardiovascular domain. Moreover, the active component profile consisting of saponins was studied and found to be of a system synergetic nature. Integrating this information with the outcome of clinical trials in which over 16.000 patients were involved together with results from over 100 million people treated, yielded a systems pharmacological view on the working mechanism and insights in the effectiveness and safety profile of this product produced and controlled under GALP and GMP. This product was the first tHMP herbal medicine product registered in the EU that was produced in China. It underpins a new view on evaluation of herbal medicine products in general and creates an important systems pharmacology concept applicable in a wider sense.

Simultaneous Detection of Flavonoids, Phenolic Acids and Alkaloids in Abri Herba and Abri Mollis Herba using Liquid Chromatography Tandem Mass Spectrometry.

Abri Herba has remarkable properties, such as cleanup heat detoxification, dampness and activating blood circulation to dissipate blood stasis; as a result, it has been applied to treat acute or chronic hepatitis and mastitis. Abri mollis Herba is often used as Abri Herba. Hierarchical cluster analysis (HCA) was applied to compare the similarities and differences of the chemical compositions in the two types of medicinal materials. To establish a high-performance liquid chromatography and tandem mass spectrometry (HPLC-MS/MS) method for the simultaneous analysis of 15 flavonoids, two phenolic acids and three alkaloids in Abri Herba and Abri mollis Herba. The chromatographic separation was performed on a C18 column with a mobile phase of methanol (A), acetonitrile (B) and 0.5‰ acetic acid in water (C) using gradient elution. The detection of the target compounds was performed in multiple-reaction monitoring (MRM) mode using a hybrid quadrupole linear ion trap mass spectrometer equipped with positive/negative ion-switching electrospray ionisation (ESI) source. The developed method is reliable, sensitive and specific. In addition, the method has been successfully applied to differentiate 15 batches of Abri Herba and 27 batches of Abri mollis Herba stems. Furthermore, a comparison of the contents among stems, roots and leaves from the same strain in seven batches of Abri mollis Herba and four batches of Abri Herba has also been performed. HPLC-MS/MS method is sensitive and selective and can be suitable for the reliable quality control of Abri mollis Herba and Abri Herba.

The difference between blood-associated and water-associated herbs of Danggui-Shaoyao San in theory of TCM, based on serum pharmacochemistry.

Danggui-Shaoyao San (DSS) is a famous Chinese formula for activating blood circulation and promoting urination. This study was to investigate the difference of material basis between a blood-associated herbs group and a water-associated herbs group. According to the theory of traditional Chinese medicine, the formula can be divided into a blood-associated herbs group (Angelica sinensis, Paeonia lactiflora and Ligusticum chuanxiong) and a water-associated herbs group (Atractylodes macrocephala, Alisma orientale and Poria cocos). The HPLC fingerprint of the formula was established for quality control. Serum samples from rats, orally administrated DSS, and the decomposed recipes of DSS, were analyzed by HPLC-DAD and the transitional blood components of DSS were identified. Twenty-one common peaks were identified in the fingerprint of DSS. Contents of paeoniflorin, albiflorin, ferulic acid and alisol B 23-acetate in co-decoction were significantly higher than those in individual decoction. Eleven peaks belonged to the blood-associated herbs group (four metabolites and seven prototype components; paeoniflorin and ferulic acid appeared in prototype components), whereas six peaks belonged to the water-associated herbs group (three metabolites and three prototype components). It was concluded that the serum pharmacochemistry is a meaningful approach for clarifying the difference between blood-associated and water-associated herbs in chemical composition.

Traditional Chinese medicine for activating blood circulation and detoxifying in unstable angina pectoris: A systematic review and meta-analysis

ObjectiveThe purpose of this review was to evaluate the effectiveness of traditional Chinese medicine for activating blood circulation and detoxifying (ABCD) in patients with unstable angina pectoris. MethodsWe performed an electronic literature search of six medical databases for relevant articles published up to December 2014. Randomized controlled trials that compared ABCD Chinese medicine (alone or alongside conventional drugs) with conventional drugs or other Chinese medicines alone were included. A meta-analysis was performed for the following outcome measures: reduction of angina symptoms, electrocardiogram improvement, blood lipid levels, inflammatory factor levels, and plasma fibrinogen levels. ResultsIn total, 11 moderate- to low-quality studies involving 686 patients were included. The evidence indicated that ABCD Chinese medicine exhibited superior effectiveness in relieving angina symptoms compared with conventional drugs [relative risk, 1.23; 95% confidence interval, 1.05–1.44]; however, electrocardiogram improvement was not very significant (relative risk, 1.21; 95% confidence interval, 0.91–1.62). Moreover, ABCD Chinese medicine exhibited superior anti-inflammatory, anticoagulant, and lipid-lowering effects compared with other medicines. ConclusionsWithin the methodological limitations of the included studies, our results suggest that ABCD Chinese medicine is beneficial for the treatment of unstable angina pectoris.

Comparative metabolomics analysis on invigorating blood circulation for herb pair Gui-Hong by ultra-high-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry and pattern recognition approach

The compatibility of Angelicae Sinensis Radix (Danggui, DG) and Flos Carthami (Honghua, HH), a famous herb pair Gui-Hong (GH), can produce synergistic and promoting blood effects. Although some physiological and pathological function parameters of the acute blood stasis have been investigated, little information about the changes of small metabolites in biofluids has been reported. In present study, global metabolic profiling with ultra-high-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UHPLC-QTOF/MS) combined with pattern recognition method was performed to discover the underlying blood-activating regulation mechanisms of DG, HH and GH on the acute blood stasis rats induced by subcutaneous injection of adrenaline hydrochloride and ice water bath. The total 14 metabolites (10 in urine and 4 in plasma), up regulated or down regulated (P<0.05 or 0.01), were identified and contributed to the acute blood stasis progress. These promising identified biomarkers underpin the metabolic pathway including phenylalanine metabolism, sphingolipid metabolism, arachidonic acid metabolism and arginine and proline metabolism are disturbed in the acute blood stasis rats, which identified by using pathway analysis with MetPA. The altered metabolites and hemorheological indexes could be regulated closer to normal level after DG, HH and GH intervention. In term of activate blood circulation function, GH was the most effective as shown by the relative distance in PLS-DA score plots and relative intensity of metabolomics trategy, reflecting the synergic action between Danggui and Honghua. The results demonstrated that biofluids metabolomics was a powerful tool in clinical diagnosis and treatment of syndrome of blood stasis for providing information on changes in metabolites pathways.

Xueshuan Xinmaining Tablet Treats Blood Stasis through Regulating the Expression of F13a1, Car1, and Tbxa2r.

Xueshuan Xinmaining Tablet (XXT), the Chinese formula, has long been administered in clinical practice for the treatment of cerebral thrombosis and coronary heart disease. In this study, we aimed to study the effect and the molecular mechanism of activating blood circulation and removing blood stasis. Rat models of cold coagulation blood stasis were induced with ice-water bath and epinephrine to assess the amelioration of blood stasis by XXT. Microarray technique was used to identify gene expression from the model and XXT-treated rats. In addition, Quantitative Real-Time PCR (qPCR) was performed to verify the microarray results. The results showed that XXT had a good therapeutic effect on blood stasis by reducing the whole blood viscosity (WBV), plasma viscosity (PV), increasing PT, APTT and TT, and by inhibiting platelet aggregation. Genes were differentially expressed in rats among the model group and the XXT-pretreated groups. XXT ameliorated blood stasis by regulating the expressions of F13a1, Car1, and Tbxa2r.

GW25-e1611 The Effects of Activating Blood Circulation and to Remove Stasis on Platelet Activity after Percutaneous Coronary Intervention

GW25-e1611 The Effects of Activating Blood Circulation and to Remove Stasis on Platelet Activity after Percutaneous Coronary Intervention

Oldenlandia corymbosa L. : A Phytopharmacological review

Oldenlandia corymbosa (L.) (Rubiaceae) is a weedy annual herb, found throughout India. It is commonly known as Parppatakapullu in traditional medicine of Kerala. The plant is known to clear heat and toxins, activate blood circulation, promote diuresis and relieve stranguria. It is also active against appendicitis, hepatitis, pneumonia, cholecystesis, urinary infection, cellulites and snake bite. Chinese folk medicine describes the plant to treat skin sores, ulcers, sore throat, bronchitis, gynecologic infections and pelvic inflammatory diseases. The plant contains flavonols, phenolic acids, anthocyanidins, irridoids and alkaloids. A scrutiny of literature revealed some notable pharmacological activities of the plant such as hepatoprotective, cytotoxic anti-oxidant, oxytocic and anti malerial activity. The present review is an attempt to highlight the various ethnobotanical and traditional uses as well as phytochemical and pharmacological reports on Oldenlandia corymbosa.

Cardiovascular Pharmacological Effects of Traditional Chinese Medicine Ginkgo: Mechanisms and Prospects

Ginkgo is one of the traditional Chinese medicine (TCM) herbs for activating blood circulation and ginkgo preparation is one of the most successful cases of botanical drugs developed by modern science and technology. Ginkgo biloba extract, which mainly contains ginkgo flavonis and ginkgolides, is popular in the research field, has a wide range of cardiovascular pharmacological effects for prevention and treatment of a variety of cardiovascular diseases. In this paper, we review the main active ingredients, the cardiovascular pharmacological effects and their mechanisms of ginkgo preparations.

Analysis on prescription rules of treating senile dementia based on traditional Chinese medicine inheritance auxiliary systems

This is designed to analyze and summarize medication rules for treating senile dementia with Chinese medicine in CNKI according to the traditional Chinese medicine (TCM) inheritance auxiliary system. Collect documents in CNKI that account treating senile dementia with Chinese formula; filter and establish a formula database, and then to search for medication rules on the TCM inheritance auxiliary system. It is filtered that 104 formulas are used for treating senile dementia screening treat senile dementia, involving 147 kinds of Chinese medicine. Tonic medicine are most frequently used, followed by the medicine of activating blood circulation and resuscitating; medicine pair most used is Ligusticum chuanxiong Hort-Acorus tatarinowii, accounting for 27.9% of all formula. And then 8 core pairs and 4 new formulas are evolved. Analysis on formulas for treating senile dementia filtered form CNKI by TCM inheritance auxiliary system shows prescription is mainly tonifying, activating blood circulation and resuscitating, that reveals prescription rules, to provide a reference for clinical treatment.

Protective effects of traditional Chinese medicine formula NaoShuanTong capsule on haemorheology and cerebral energy metabolism disorders in rats with blood stasis

NaoShuanTong capsule (NSTC), an oral traditional Chinese medicine formula, is composed of Pollen Typhae, Radix Paeoniae Rubra, Rhizoma Gastrodiae, Radix Rhapontici and Radix Curcumae. It has been widely used to treat ischemic stroke in clinic for many years in China. In addition to neuronal apoptosis, haemorheology and cerebral energy metabolism disorders also play an important role in the pathogenesis and development of ischemic stroke. The present study was designed to evaluate the in vivo protective effects of NSTC on haemorheology and cerebral energy metabolism disorders in rats with blood stasis. Sixty specific pathogen-free sprague-dawley rats, male only, were randomly divided into six groups (control group, model group, aspirin (100 mg/kg/d) group, NSTC low-dose (400 mg/kg/d) group, NSTC intermediate-dose (800 mg/kg/d) group, NSTC high-dose (1600 mg/kg/d) group) with 10 animals in each. The rats except those in the control group were placed in ice-cold water (0–4 °C) for 5 min during the time interval (4 h) of two adrenaline hydrochloride injections (0.8 mg/kg) to induce blood stasis. After treatment, whole blood viscosity at three shear rates, plasma viscosity and erythrocyte sedimentation rate significantly decreased in NSTC intermediate- and high-dose groups; erythrocyte aggregation index and red corpuscle electrophoresis index significantly decreased in all the three dose NSTC groups. Moreover, treatment with high-dose NSTC could significantly improve Na+–K+ adenosine triphosphatase (ATPase) and Ca2+ ATPase activity, as well as lower lactic acid level in brain tissues. These results demonstrated the protective effects of NSTC on haemorheology and cerebral energy metabolism disorders, which may provide scientific information for the further understanding of mechanism(s) of NSTC as a clinical treatment for ischemic stroke. Furthermore, the protective effects of activating blood circulation as observed in this study might create valuable insight for the utilisation of NSTC to be a feasible alternative therapeutic agent for patients with blood stasis.

The use of Chinese medicinal herbs and formulas that activate blood circulation and antiplatelet therapies

The development of oral antiplatelet drugs represents a milestone in the treatment of atherothrombotic cardiovascular diseases. However, the efficacy and safety of prolonged treatment with double or triple anti-platelet drugs, has garnered particular attention in clinical practice. The development of novel classes of antiplatelet agents, with improved efficacy and fewer adverse effects, for the prevention of cardiovascular disease is therefore intensely researched worldwide. Chinese herbs and formulas that activate blood circulation also possess antiplatelet and antiatherosclerotic activities. These Chinese medicinal herbs and formulas have therefore drawn attention among scientists, because they may be more effective and safer compared with currently used therapies. However, the mechanistic basis for this antiplatelet activity remains unclear. This article will review progress made in uncovering the mechanism underlying the antiplatelet activity of Chinese herbs and formulas that activate blood circulation.

Clinical efficacy observation on therepy ovulation failure infertility caursed by PCOS with reinforcing kidney, activating blood circulation and ovarian stimulation compound recipe

Clinical efficacy observation on therepy ovulation failure infertility caursed by PCOS with reinforcing kidney, activating blood circulation and ovarian stimulation compound recipe

Yiqihuoxuejiedu formula inhibits vascular remodeling by reducing proliferation and secretion of adventitial fibroblast after balloon injury.

Vascular remodeling occurs in atherosclerosis, hypertension, and restenosis after percutaneous coronary intervention. Adventitial remodeling may be a potential therapeutic target. Yiqihuoxuejiedu formula uses therapeutic principles from Chinese medicine to supplement Qi, activate blood circulation, and resolve toxin and it has been shown to inhibit vascular stenosis. To investigate effects and mechanisms of the formula on inhibiting vascular remodeling, especially adventitial remodeling, rats with a balloon injury to their common carotid artery were used and were treated for 7 or 28 days after injury. The adventitial area and α-SMA expression increased at 7 days after injury, which indicated activation and proliferation of adventitial fibroblasts. Yiqihuoxuejiedu formula reduced the adventitial areas at 7 days, attenuated the neointima and vessel wall area, stenosis percent, and α-SMA expression in the neointima, and reduced collagen content and type I/III collagen ratio in the adventitia at 28 days. Yiqihuoxuejiedu formula had more positive effects than Captopril in reducing intimal proliferation and diminishing stenosis, although Captopril lowered neointimal α-SMA expression and reduced the collagen content at 28 days. Yiqihuoxuejiedu formula has inhibitory effects on positive and negative remodeling by reducing adventitial and neointimal proliferation, reducing content, and elevating adventitial compliance.

Buyang huanwu decoction for healthcare: evidence-based theoretical interpretations of treating different diseases with the same method and target of vascularity.

Buyang Huanwu Decoction (BHD) is a famous herbal prescription that has been used to treat stroke for centuries. Recent studies reported that the use of BHD had been extended to treat various kinds of disorders according to the TCM syndrome theory of Treating Different Diseases with the Same Method (TDDSM). Here, an overview of systematic reviews (SRs) of BHD for healthcare was conducted to interpret the TCM theory of TDDSM and its target of vascularity in an evidence-based manner. Literature searches were carried out in 5 databases to search SRs of BHD for any indication up to August 2013. Thirteen eligible SRs were identified which reported a wide range of vascular conditions. Based on the Overview Quality Assessment Questionnaire scores, the quality of included SRs was varied, with an average score of 4 points. We found that there is premature evidence for the use of BHD for healthcare, whereas BHD was well tolerable in all patients. BHD can be used to treat many disorders with the same therapeutic principle of invigorating Qi to activate blood circulation, which is essentially a manifestation of the TDDSM and is likely to account for targeting the specific pathogenesis of vascular diseases.

The efficacy of Jing Wan Hong ointment for nerve injury diabetic foot ulcer and its mechanisms.

Jing Wan Hong ointment contains 30 kinds of Chinese herbs, with functions of activating blood circulation to disperse blood stasis, clearing heat, eliminating dampness, and reducing swelling by detoxification. Therefore, Jing Wan Hong ointment may facilitate the healing of ulcers. The aim of this study was to evaluate the efficacy and mechanisms of Jing Wan Hong ointment for healing diabetic foot ulceration in Wistar rats induced by streptozotocin and sciatic nerve damage. The results showed that Jing Wan Hong ointment had a marked effect on foot ulcers in diabetic rats induced by initial nerve injury. These effects were manifested by reducing the foot ulcer size and Wagner grade after seven days of treatment. The diabetic rats with foot ulcers were almost healed after 21 days of treatment. Moreover, the mechanisms of this effect seem to be dependent on increased expression of PDGF mRNA, but there was no influence on the expression of TGF-β, VEGF, and FLT-1 mRNA.

Evaluate activating blood circulation and dissipating blood stasis effect mechanism of Foshousan on acute blood stasis rats on basis of metabolomic approach

Ice water bath and subcutaneous injection of adrenaline were used to establish the acute blood stasis model of rats. Ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS) was used to study the urine metabolic changes of acute blood stasis rats. Potential biomarkers were selected by variable importance projection, and identified on basis of MS information and databases. The metabolic pathways were predicted via MetPA database. To study the effect of Foshousan on endogenous metabolites of acute blood stasis model rats, find potential biomarkers, and explore the effect mechanism of Foshousan on activating blood circulation and dissipating blood stasis. Eleven potential biomarkers were identified with multivariate statistical analysis of urine metabolite profiles, and which also were used to explain the phenylalanine metabolism, tryptophan metabolism and sphingolipid metabolism. Those disturbed metabolic pathways in acute blood stasis rats could be regulated closely to normal state after Foshousan administration. Metabolomics has a bright prospect in the efficacy evaluation and effect mechanism elucidation of the traditional Chinese medicines.

Pharmacovigilance of parenterally administered salvianolate based on analysis of spontaneous reporting system data

Spontaneous reporting system (SRS) is currently a basic method to monitor and find adverse drug reactions (ADR) signals used worldwide. This method can promptly and effectively discover ADR signals and is of great significance to effectively prevent and avoid ADRs. Parenterally administered salvianolate has the functions of activating blood circulation and removing stasis. It is mainly used in the treatment of stable angina pectoris. As the drug is widely used clinically and ADRs are increasingly reported promptly, ADR information in the national ADR monitoring center's SRS database has also increased. How to quickly and effectively identify suspicious ADRs is a major concern. This study uses BCPNN and PRR to detect early warning signals. S739 ADR case reports were identified. There were 106 types, 1 310 events, and 24 serious ADR cases ( 3.25% of 739 case reports) There wre no deaths. The ten most frequent ADRs were: rash, dizziness, itch, headache, chills and breath, nausea, palpitation, anaphylactic reaction and hot. The drugs early warning signs were dizziness, headache, nausea, itchiness and rash estimated using PRR. Early warning signs based on BCPNN were dizziness and headache. The ADRs of dizziness and headache are early warning signals associated with the nervous system.

GW24-e0016 effects of supplements Qi and activating blood circulation herbs on lung protection in acute lung injury ventilation patients

ObjectivesTo study the effects of supplementing Qi and activating blood circulation herbs on lung protection in acute lung injury (ALI) ventilation patients.Methods82 cases of ALI patients were enrolled and randomly...

GW24-e0018 The effects of supplements Qi and activating blood circulation herbs on lung protection in acute lung injury ventilation patients

ObjectivesTo study the effects of supplementing Qi and activating blood circulation herbs on lung protection in acute lung injury (ALI) ventilation patients.Methods82 cases of ALI patients were enrolled and randomly...