HUMAN STUDIES ON LIGUSTICUM HERBS

VI. HUMAN STUDIES ON LIGUSTICUM HERBS

A. Cerebrovascular and Coagulation Effects In Chinese studies, injections of ligusticum, ligustrazine, ligustylid, and ferulic

acid were reported to have better effects on ischemic strokes than standard drugs such as papaverine, dextran, and aspirin-persantin (46). Injections of ligusticum extract, containing ligustrazine, ligustylid, and ferulic acid, were reported to improve brain microvascular circulation in patients with transient ischemic attacks, through inhibition of thrombus formation and platelet aggregation (47). In this study, 158 with transient ischemic attack were ran- domly divided into a ligusticum group(111 cases) and an aspirin group(47 cases). The total effective rate in the ligusticum groupwas 89.2% as compared to 61.7% in the aspirin group (47). Ligusticum was reported to increase cerebral blood flow, accelerate the velocity of blood flow, dilate spastic ar- teries, and decrease peripheral arterial resistance. The same group, in another double-blind trial, administered L. chuanxiong to one group(134 cases) and low-molecular-weight dextran to another group(86 cases) of 220 patients with acute cerebral infarction, to evaluate the herb’s effects on neurological function and living capability (48). The total therapeutic efficacy rate in the chuanxiong groupand in the dextran 40 groupwas reported to be 86.6% and 62.8%, respectively. It was concluded that the effect of chuanxiong in the

Ligusticum chuanxiong Hort. 255

treatment of acute cerebral infarction was significantly superior to that of low-molecular-weight dextran.

B. Anticoagulation Effects Platelet aggregation plays a pathophysiological role in a variety of thrombo-

embolic disorders, including myocardial infraction, atherosclerosis, and cerebrovascular diseases. Tetramethylpyrazine displayed a dose-dependent inhibition of human platelet aggregation and ATP-release reaction induced by various agonists. It was also demonstrated to have inhibitory action against monophosphate formation by collagen as well as an inhibitory effect on intracellular free calcium rise (49). The same groupdemonstrated that tetramethylpyrazine could significantly increase the production of nitrate and cyclic GMP in human platelet. The compound elicited a dose-dependent stimulation of endothelial type constitutive nitric oxide synthase in platelets (50). The investigators concluded that tetramethylpyrazine can provide effective prophylactic or therapeutic treatment for thromboembolic disor- ders. In patients with acute cerebral infarction, the levels of beta-thrombo- globulin, platelet factor 4, and thromboxane B2 in plasma were significantly decreased in those treated with ligusticum extract, suggesting that the ligusticum treatment can effectively inhibit the platelet activation in vivo and correct the thromboxane A2–prostaglandin F2 imbalance in these patients (51).

VII. TOXICITY Ligusticum is prescribed in traditional Chinese decoctions at dosages up to 9 g

administered over several days. Overdose symptoms may include vomiting and dizziness (44).

VIII. CONCLUSION Chuanxiong is a herb that has traditionally been used to promote blood

circulation and treat arthralgias and menstrual disorders. Preliminary animal studies, from mainland China, indicate that administration of the crude extract may improve muscle function, reduce cerebral ischemia, and amelio- rate acute nephrotoxicity induced by cyclosporine A. Tetramethylpyrazine, ferulic acid, and butylidenephthalide, pure compounds present in ligusticum, have been variously reported to display cardiovascular, antianginal, anti- platelet, anti-inflammatory, and tocolytic properties. Some human studies, again from mainland China, indicate that the herb may be beneficial in

256 Lim and Yong

ischemic strokes and as anticoagulation agents. These studies, although largely uncontrolled and which have not been validated outside China, nonetheless suggest that bioactive compounds may be present in ligusticum that will reward scientific scrutiny.

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Salvia miltiorrhiza

Jin Liu University of California

Davis, U.S.A. Choon Nam Ong

National University of Singapore Singapore, Republic of Singapore

I. INTRODUCTION Salvia miltiorrhiza Bunge (SM) is a perennial herbal plant that usually grows

on sunny slopes, by riversides, and on canal banks or edges of forests. It is normally 30–100 cm tall, villous, with purple flowers on the terminal or auxiliary spike (Fig. 1a). The root of SM is forked, brick-red, slender, wrinkled, with a solid and almost brittle texture (Fig. 1b). It is about 10–20 cm long and 0.3–1 cm in diameter. The part of SM used for medication is its dried root, which has a bitter and astringent taste (1).

SM, referred to as Dan Shen in traditional Chinese medicine, as an ingredient of certain medical prescriptions, has been widely used in China for the treatment of various kinds of diseases for centuries. It has been docu- mented that the crude aqueous extract of SM has multiple pharmacological actions, for instance, promoting microcirculation, antiplatelet aggregation, and thrombosis formation, and sedative, tranquilizing, anticarbuncular, and analgesic actions (2). The decoction and injection made from SM exhibit some therapeutic effects on cardiac and cerebral ischemia as well as on liver

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F IGURE 1 (a) Plant of Salvia miltiorrhiza. (b) Dried root, used for medication.

diseases, including chronic hepatitis and liver fibrosis. SM has also been used for other disorders, such as irregular menstruation, dysmenorrhea, amenor- rhea, neurasthenia, irratability, and insomnia (2).