Clinical efficacy and safety of Panax notoginseng saponins in treating chronic obstructive pulmonary disease with blood hypercoagulability: A meta-analysis of randomized controlled trials

Ruiling Zhou; Jie Zhang; Wen Zhang; Xinyu Zhang; Haiyan Zhang; Xia Shi; Bing Wang; Qiong Zhang; He Zhang

doi:10.1016/j.phymed.2023.155244

Clinical efficacy and safety of Panax notoginseng saponins in treating chronic obstructive pulmonary disease with blood hypercoagulability: A meta-analysis of randomized controlled trials

Phytomedicine. 2024 Mar:125:155244. doi: 10.1016/j.phymed.2023.155244. Epub 2023 Dec 2.

Authors

Ruiling Zhou¹, Jie Zhang², Wen Zhang², Xinyu Zhang¹, Haiyan Zhang³, Xia Shi³, Bing Wang², Qiong Zhang⁴, He Zhang⁵

Affiliations

¹ Beijing University of Chinese medicine, Beijing 100029, China; Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.
² Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China.
³ Beijing University of Chinese medicine, Beijing 100029, China.
⁴ Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China. Electronic address: zhangq810@263.net.
⁵ Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China. Electronic address: zhhe1112@163.com.

PMID: 38216446
DOI: 10.1016/j.phymed.2023.155244

Abstract

Background: Panax notoginseng saponins (PNS) are the primary active components of an ancient Chinese herb Panax notoginseng. Hypercoagulable state of blood (HCS) is an independent risk factor and a cause of death in chronic obstructive pulmonary disease (COPD). Several vivo studies have demonstrated the use of PNS preparations for treating COPD with HCS.

Purpose: This study aimed to systematically evaluate the clinical efficacy and safety of PNS preparations in treating COPD with HCS.

Study design: Meta-analysis of the randomized controlled trials (RCTs) was conducted to review data.

Methods: RCTs on the treatment of COPD with HCS and PNS preparations were searched from PubMed, Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure, Vip Information Database, Wanfang data, and Chinese Biomedical Literature Database. Relevant data were extracted from the included studies and methodological quality evaluation was performed. R language (version 4.2.3) was applied for the meta-analysis.

Results: Twenty RCTs involving 1831 patients were analyzed. The results revealed that PNS preparations considerably increased the total clinical efficiency, improved forced expiratory volume in one second percent of predicted, and forced expiratory volume/forced vital capacity ratio. Further, PNS preparations improved fibrinogen, plasma d-dimer, whole blood viscosity at high cut, whole blood viscosity at low cut, and plasma viscosity levels. The results obtained for activated partial thromboplastin and prothrombin times were not statistically significant. Finally, PNS preparations increased partial pressure of oxygen and decreased carbon dioxide pressure.

Conclusion: This is the first relatively comprehensive systematic review of the clinical efficacy and safety of PNS preparations for treating COPD with HCS. The study revealed that PNS preparations considerably improve lung function, hypoxia, and blood hypercoagulability in patients with COPD and HCS without increasing the risk of hemorrhage and has a good safety profile; therefore, it can be used as a new modulating agent and anticoagulant.

Keywords: Chronic obstructive pulmonary disease; Hypercoagulable state of blood; Meta-analysis; Panax notoginseng saponins.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Humans
Panax notoginseng* / chemistry
Pulmonary Disease, Chronic Obstructive* / drug therapy
Randomized Controlled Trials as Topic
Saponins* / adverse effects
Saponins* / therapeutic use
Thrombophilia* / drug therapy
Treatment Outcome

Substances

Saponins