Danshen (Salvia Miltiorrhiza) : Scientific and Traditional Uses

by MedlinePlus

Danshen ( Salvia miltiorrhiza ) is widely used in traditional Chinese medicine (TCM), often in combination with other herbs. Remedies containing danshen are used traditionally to treat a diversity of ailments, particularly cardiac (heart) and vascular (blood vessel) disorders such as atherosclerosis ("hardening" of the arteries with cholesterol plaques) or blood clotting abnormalities.

The ability of danshen to "thin" the blood and reduce blood clotting is well documented, although the herb's purported ability to "invigorate" the blood or improve circulation has not been demonstrated in high-quality human trials. Constituents of the danshen root, particularly protocatechualdehyde and 3,4-dihydroxyphenyl-lactic acid, are believed to be responsible for its vascular effects. Because danshen can inhibit platelet aggregation and has been reported to potentiate (increase) the blood-thinning effects of warfarin, it should be avoided in patients with bleeding disorders, prior to some surgical procedures, or when taking anticoagulant (blood-thinning) drugs, herbs, or supplements.

In the mid-1980s, scientific interest was raised in danshen's possible cardiovascular benefits, particularly in patients with ischemic stroke or coronary artery disease/angina. More recent studies have focused on possible roles in liver disease (hepatitis and cirrhosis), and as an antioxidant. However, the available research in these areas largely consists of animal studies and small human trials of poor methodological quality. Therefore, firm evidence-based conclusions are not possible at this time about the effects of danshen for any medical condition.

Synonyms

Ch'ih Shen (scarlet sage), Dan-Shen, Dan Shen, danshen root, Huang Ken, Hung Ken (red roots), Pin-Ma Ts'ao (horse-racing grass), Radix salvia miltiorrhiza , red-rooted sage, red sage root, red saye root, Salvia bowelyana, Salvia miltiozzhiza bunze, Salviae miltiorrhizae , Salvia przewalskii, Salvia przewalskii mandarinorum, Salvia yunnanensis, salvia root, Sh'ih Shen, Shu-Wei Ts'ao (rat-tail grass), Tan Seng, Tan-Shen, Tzu Tan-Ken (roots of purple sage).

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence

Asthmatic bronchitis

A small amount of research in humans suggests that danshen may improve breathing and lessen cough and wheeze in patients with chronic asthmatic bronchitis. Better studies are needed that compare danshen with more proven treatments for this condition before a clear conclusion can be drawn.

Burn healing

Although animal studies suggest that danshen may speed healing of burns and wounds, there are no reliable studies in humans evaluating this claim.

Cardiovascular disease / angina

A small number of poor quality studies in animals and humans report that danshen may provide benefits for treating disorders of the heart and blood vessels, including heart attacks, cardiac chest pain (angina), or myocarditis. Traditionally, danshen is most frequently used for these problems in combination with other herbs. Because most studies have been small and brief with flaws in their designs, and the results of different trials have disagreed with each other, it is not clear whether there is any benefit from danshen for these conditions. No specific dose or standardized preparation is widely accepted for these disorders. Danshen may have effects on blood clotting, and therefore may be unsafe when combined with other drugs used in patients with cardiovascular disease. Patients should check with a physician and pharmacist before combining danshen with prescription drugs.

Glaucoma

Danshen has been proposed as a possible glaucoma therapy, but further studies are needed in humans before a clear conclusion can be drawn. Danshen should not be used in place of more proven therapies, and patients with glaucoma should be evaluated by a qualified eye care specialist.

Increased rate of peritoneal dialysis

One study suggests that danshen may speed peritoneal dialysis and ultrafiltration rates when added to dialysate solution. Although this evidence is promising, it is not known whether danshen is safe for this use.

Liver disease (cirrhosis / chronic hepatitis B, fibrosis)

Some studies suggest that danshen may provide benefits for treating liver diseases such as cirrhosis, fibrosis, chronic hepatitis B. Traditionally, danshen is most frequently used for these problems in combination with other herbs. Although early research in humans suggests a possible reduction in liver fibrosis in people with cirrhosis, and some improvements in liver function in chronic hepatitis, these studies have been small with flaws in their designs. Therefore, it is unclear whether there are any clinically significant effects of danshen in patients with liver disease.

Ischemic stroke

Due to poor quality of evidence, unclear safety, and the existence of more proven treatments for ischemic stroke, this use of danshen cannot be recommended.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acne, anoxic brain injury, anti-inflammatory, antioxidant, antiphospholipid syndrome, anti-thrombosis, antitumor, antiviral, anxiety, bleomycin induced lung fibrosis, blood clotting disorders, bruising, cancer, chemotherapy drug resistance, circulation, clogged arteries, diabetes, diabetic foot, diabetic nerve pain, ectopic pregnancy, eczema, external humeral epicondylitis, gastric ulcers, gentamicin toxicity, hearing loss, heart palpitations, high blood pressure, high cholesterol, HIV, hypercoagulability, immunomodulatory effects, intrauterine growth retardation, kidney disease or failure, left ventricular hypertrophy, leukemia, liver cancer, lung fibrosis, menstrual problems, mycardial reperfusion injury, organ preservation, pre-eclampsia, pregnancy-induced hypertension (high blood pressure), psoriasis, pulmonary hypertension, radiation-induced lung damage, restlessness, sleep difficulties, stimulation of GABA (gamma-aminobutyric acid) release, stomach ulcers, wound healing.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Standardization:

There is no widely accepted standardization or well-studied dosing of danshen, and many different doses are used traditionally. Danshen is frequently used in combination with other herbs.

Adults (18 years and older):

By mouth: Oral dosing has not been studied in well-conducted trials in humans, and therefore no specific dose can be recommended.

By injection: In research from the 1970s, an 8 milliliter injection of danshen (16 grams of the herb) was given intravenously (diluted in 500 milliliters of a 10% glucose solution) for up to four weeks for ischemic stroke. Safety and effectiveness have not been established for this route of administration and it cannot not recommended at his time.

Children (younger than 18 years):

There is not enough scientific evidence to recommend the safe use of danshen in children, and it should be avoided due to potentially serious side effects.

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