TABLE 1.
Research on anti-platelet drugs combined with BAC botanical drugs.
| BAC Botanical drugs/scientific name | Chemical composition and dosage of formulas | Main research/model | Mechanism/platelet targets | Efficacy | Safety data/side effect | Anti-platelet drugs | References |
|---|---|---|---|---|---|---|---|
| Danshen/Salvia miltiorrhiza Bunge [Lamiaceae; Salviae miltiorrhizae radix et rhizoma] | Salvianolatic acid B (Sal-B), 200 mg/day | Clinical trial: 63 patients with ACS | Phosphodiesterase (PDE) and antagonizing P2Y12 receptor↓; platelet activation↓ | PAC-1 positive: T vs. C (47.0 ± 10.0% vs. 52.1 ± 6.2%, p < 0.05); CD62P expression: T vs. C (39.5 ± 8.3% vs. 45.0 ± 6.7%, p < 0.01) | — | Aspirin and clopidogrel, loading dose:300 mg; maintenance dose:100 mg/d and 75 mg/d | Liu et al. (2014) |
| Panax notoginseng saponins/[Araliaceae; Notoginseng Radix] | Panax notoginseng saponins, 60 mg/d | Clinical trial: 42 patients with stable CHD complicated with chronic gastritis | The activity of platelet COX-1↓; the production of TXB2, PGD2, PGE2, 11-HETE↓; the downstream oxylipids of AA/COX-1 pathway↓ | — | Secretion of gastrin and motilin↑, relieved dyspeptic symptoms | Aspirin, loading dose:300 mg; maintenance dose:100 mg/d | Wang et al. (2021) |
| Sanqi/Panax notoginseng saponins [Araliaceae; Notoginseng Radix] | Panax notoginseng saponins, 118.8 mg/kg/d | MI rats | The level 6,15-diketo-13,14-dihydro-prostaglandin (PG)F1α, 13,14-dihydro-15-keto-PGE2 and PGE2↓ | — | Aspirin -related gastric injury was mitigated | Aspirin, loading dose: 31.25 mg/kg/d; maintenance dose: 31.25 mg/kg/d | Wang et al. (2021) |
| Ligustrazine injection/Ligusticum chuanxiong Hort. [Umbelliferae; Chuanxiong Rhizoma] | Chuanxiongzine, 26.16 mg/kg/d | Rabbit thrombus | AA, ADP, PAF-induced platelet aggregation rate↓ | PAR: T vs. C (14.6 ± 2.6% vs. 35.7 ± 2.9%, p < 0.01); PAIR: T vs. C (65.5 ± 6.2% vs. 15.4 ± 6.8%, p < 0.05) | — | Aspirin and clopidogrel, 5.13 mg/kg/d amd 3.85 mg/kg/d | He et al. (2017) |
| Leech (Whitmania pigra Whitman) [Hirudinidae; Hirudo] | Leech (Whitmania pigra Whitman) powder, 3 g/d | Clinical trial: 42 patients with acute cerebral infarction | vWF↓; GMP-140↓; endothelial injury↓; platelet activation↓ | vWF: T vs. C (150.67 ± 13.00 vs. 191.23 ± 15.67, p < 0.01); GMP-140: T vs. C (14.90 ± 3.01 vs. 15.03 ± 2.98, p < 0.01) | — | Aspirin, 75 mg/d | Wu et al. (2007) |
| Ginkgo biloba leaf extract [Ginkgoaceae; Ginkgo biloba L.] | Ginkgolide B, 0.6 mg/ml | HUVECs were incubated with ginkgolide B and aspirin | TNFα-induced expression of VCAM-1, VE-cadherin, and Cx43↓; platelet and monocyte adhesion↓ | — | — | Aspirin, 1 mM | Zhang et al. (2018b) |
| Xuefu zhuyu pill/- | Peach kernel water extract, safflor yellow pigment, tangerine peel, and saikosaponin, 18 g/d | Clinical trial: 57 patients with atherosclerosis | vWF↓; GMP-140↓; ɑ-GMP-140↓ | ɑ-GMP-140: T vs. C (601 ± 106 vs. 644 ± 87, p < 0.01) | — | Aspirin, 40 mg/d | Li et al. (1998) |
| Taohongsiwu Decoction/- | BAC botanical drugs extracts with water, TSD alcohol extract, 750 ml L−1 90% ethanol, 2 g/ml/d | Clinical trial: 88 patients with stable CHD who underwent PCI | TXB2↓; TX B2/6-Keto-PGF1ɑ↑; vWF↓; GMP-140↓ | TXB2/6-Keto-PGF1ɑ: T vs. C (0.55 ± 0.16 vs. 0.53 ± 0.15, p < 0.05); GMP-140: T vs. C (16.14 ± 3.03 vs. 16.51 ± 3.45, p < 0.01) | — | Aspirin, 10 ml/kg/d | Han et al. (2010) |
| Danhong injection/Salvia miltiorrhiza Bunge [Lamiaceae; Salviae miltiorrhizae radix et rhizoma] and Safflower [Asteraceae; Carthami Flos] | Tanshinone, phenolic acid, safflor yellow pigment, and flavone, 40 ml/d | Clinical trial: 100 patients with ACS | Platelet activation (CD62p, GPⅡb/Ⅲa, FIB-C) and inflammatory response (hs-CRP)↓ | CD62p: T vs. C (6.3 ± 1.6 vs. 8.6 ± 1.8, p < 0.01); GPⅡb/Ⅲa: T vs. C (15.6 ± 6.5 vs. 28.5 ± 7.3, p < 0.01); FIB-C: T vs. C (3.2 ± 1.4 vs. 4.3 ± 1.5, p < 0.01); hs-CRP: T vs. C (13.8 ± 8.4 vs. 18.4 ± 8.2, p < 0.01) | — | Aspirin and clopidogrel, loading dose:300 mg; maintenance dose:100 mg/d and 75 mg/d | Chen et al. (2009) |
| Sulfotanshinone sodium injection/- | Sulfotanshinone sodium, 60 mg/d | Clinical trial:100 patients with UAP | FIB and fibrin DD↓ | — | — | Aspirin, loading dose:300 mg; maintenance dose:100 mg/d | Yan et al. (2009) |
| Compound Danshen Dropping Pills/Salvia miltiorrhiza Bunge [Lamiaceae; Salviae miltiorrhizae radix et rhizoma] | Water-soluble Danshen, 324 mg/kg−1/d−1 | Arteriovenous bypass model in rats | PT↑; APTT↑; TT↑; FIB↓ | APTT: T vs. C (43.85 ± 11.81 vs. 33.77 ± 1.40, p < 0.05); PT: T vs. C (18.35 ± 0.35 vs. 17.63 ± 0.70, p < 0.05); TT: T vs. C (41.13 ± 10.97 vs. 39.2 ± 6.65, p < 0.05); hs-CRP: T vs. C (2.11 ± 1.05 vs. 2.75 ± 0.46, p < 0.05) | — | Clopidogrel, 30 mg/kg | Ma et al. (2014) |
| Shexiang Baoxin pills/- | BAC botanical drugs extracts with water, 90% ethanol, and ethyl acetate, 100 mg−1/d−1 | Clinical trial:131 patients with ACS combined with clopidogrel resistance | Platelet aggregation rate↓; serum level of MMP-2↓ | — | — | Clopidogrel, 75 mg/d | Zhang et al. (2016) |
| Bunchang Naoxintong capsule/- | BAC botanical drugs extracts with water, 90% ethanol, and ethyl acetate, loading dose:3.2 g; maintenance dose:1.6 g−1/d−1 | Clinical trial: 90 patients with CYP2C19*2 polymorphism | percent inhibitions of maximum platelet aggregation and late platelet aggregation↓ | Maximal aggregation with 5 μmol/L ADP: T vs. C (27.66 ± 8.62 vs. 37.45 ± 10.27, p < 0.05); Late aggregation with 5 μmol/L ADP: T vs. C (18.12 ± 9.75 vs. 27.87 ± 9.50, p < 0.05) | MACEs (Sudden cardiac arrest and Readmission due to ACS): T vs. C (31.11% vs. 13.33% ± 6.65, p = 0.043, OR = 0.341, 95% CI: 0.117–0.990) | Aspirin and clopidogrel, loading dose:300 mg; maintenance dose:100 mg/d and 75 mg/d | Chen et al. (2014) |
| Tongxinluo capsules/- | BAC botanical drugs (Salvia miltiorrhiza Bunge [Lamiaceae; Salviae miltiorrhizae radix et rhizoma], Leech (Whitmania pigra Whitman) [Hirudinidae; Hirudo], Rosewood Heart Wood [Thymelaeaceae; Aquilariae Lignum Resinatum] extracts with water, 90% ethanol, 2.6 g/d | Clinical trial:136 patients with ACS after PCI | PRU and hsCRP levels↓ | The prevalence of HPR: T vs. C (15.8% vs. 24.8%, p = 0.013) | The composite prevalence of ischemic events did not differ significantly (χ2 = 1.587, p = 0.208) | Aspirin and clopidogrel, loading dose:300 mg | Zhang et al. (2018a) |
| Xuesaitong capsule/- | Panax notoginseng saponins/[Araliaceae; Notoginseng Radix], 240 mg/d | Clinical trial:120 patients with hyperviscosity syndrome | TXB2↓; TXB2/6-Keto-PGF1ɑ↑; ET↓; CD62P AND CD41↓ | TXB2: T vs. C (64.92 ± 20.51 vs. 66.98 ± 23.85, p < 0.05); TXB2/6-Keto-PGF1ɑ: T vs. C (153.19 ± 52.05 vs. 147.57 ± 39.66, p < 0.05); ET: T vs. C (71.36 ± 17.47 vs. 78.82 ± 30.62, p < 0.05); CD62P: T vs. C (11.22 ± 7.24 vs. 15.99 ± 9.95, p < 0.05); CD41: T vs. C (40.61 ± 16.01 vs. 48.91 ± 22.14, p < 0.05) | T: none; C: gastrointestinal reactions (2 cases); rashes (3 cases) | Aspirin,50 mg/d | Wang et al. (2004) |
| Xiongshao capsule/- | Paeonia lactiflora Pall. [Ranunculaceae; Paeoniae Radix Rubra] and Ligusticum chuanxiong Hort. [Umbelliferae; Chuanxiong Rhizoma], 390 mg/kg−1/d−1 | Rat model of AMI | gelsolin expression↓; the level of plasma F-actin and MFI of platelet calcium ion↓ | — | — | Aspirin, 40 mg/kg/day | Liu et al. (2013b) |
HUVECs, human umbilical vein endothelial cells; UAP, unstable angina pectoris; CHD, coronary heart disease; ACS, acute coronary syndrome; PCI, percutaneous coronary intervention; MI, acute myocardial infarction; AMI, acute myocardial infarction; TX, thromboxane; COX, cyclooxygenase; ADP, adenosine diphosphate; PAF, platelet activating factor; PAR, platelet aggregation rate; PAIR, platelet aggregation inhibition rate; vWF, von Willebrand Factor; GMP, platelet membrane protein; AA, arachidonic acid; VCAM-1, vascular cell adhesion molecule-1;FIB-C, fibrinogen C; hs-CRP, high-sensitivity C-reactive protein; PT, prothrombin time; APTT, activated partial thromboplastin time; TT, concentration and thrombin time; ET, endothelin; PRUs, P2Y12 reaction units; HPR, high platelet reactivity; MFI, mean fluorescence intensity; MACEs, major adverse cardiovascular events; OR, odds ratio; T, treatment group (BAC, botanical drugs combined anti-platelet drugs); C, contrl group (anti-platelet drugs).