Overview of Chinese Medicine: Dan Shen, also known as Chi Shen (Red Sage), Zi Dan Shen (Purple Sage), Hong Gen (Red Root), Huo Xue Gen (Blood Activating Root), Hong Dan Shen (Red Dan Shen), Xue Shen Gen (Blood Sage Root), Duo Duo Hua Gen (Flower Root), Hong Dan Shen (Red Dan Shen), Ni Dan Shen (False Dan Shen), Ben Ma Cao (Galloping Horse Grass), Xie Chan Cao (Xie Chan Grass), Zhu Ma (Chasing Horse), Shao Jiu Hu Gen (Burning Wine Pot Root), Ye Su Zi Gen (Wild Perilla Root), Zi Hua Ni Dan Shen (Purple Flower False Dan Shen), Feng Tang Guo (Honey Jar), Mi Guo Tou (Honey Head), Kao Shan Hong (Mountain Red), Da Hong Pao (Big Red Cannon), and Shan Shen (Mountain Ginseng), is the root of the herbaceous plant Salvia miltiorrhiza. It is bitter and slightly cold, and it enters the Heart, Pericardium, and Liver meridians.
1. Activating Blood and Removing Stasis: Used for conditions such as dysmenorrhea, amenorrhea, and postpartum abdominal pain due to blood stasis, as in Dan Shen San (Dan Shen Powder); also used for masses and limb pain caused by blood stasis, as in Dan Shen Yin (Dan Shen Decoction) from Yi Zong Jin Jian.
2. Cooling Blood and Reducing Abscesses: Used for painful sores and hot bi syndrome, as in Xiao Ru Tang (Breast Abscess Decoction) and Tong Mai Tang (Open Vessel Decoction).
3. Nourishing Blood and Calming the Spirit: Used for irritability and insomnia, as in Qing Ying Tang (Clear Nutrients Decoction) and Tian Wang Bu Xin Dan (Heavenly Emperor’s Heart-Supplementing Pill).
Drug Form: The root is short and thick, sometimes with remnants of the stem base. It has several roots, cylindrical and slightly curved, with some branching and fine root hairs, measuring 10-20 cm in length and 0.3-1 cm in diameter. The surface is reddish-brown or dark reddish-brown, rough, and has longitudinal wrinkles. The outer skin of older roots is loose and often appears scaly. The texture is hard and brittle, with a loose fracture surface that may have cracks or be slightly smooth and dense. The skin is reddish-brown, while the wood part is gray-yellow or purple-brown, with yellow-white vascular bundles arranged radially. The aroma is mild, and the taste is slightly bitter and astringent. Cultivated specimens are sturdier, measuring 0.5-1.5 cm in diameter, with a reddish-brown surface and longitudinal wrinkles, and the outer skin is tightly adhered and not easily peeled off. The texture is solid, and the fracture surface is relatively flat and slightly horn-like.
Pharmacological Identification: This herb activates blood and removes stasis, regulating menstruation, opening vessels, and relieving pain. It is said that “one dose of Dan Shen San has the same effect as Si Wu Tang” (Four Substance Decoction).
Clinical Applications: 1. Dan Shen Yin: (30g Dan Shen, 5g Sandalwood, 5g Amomum) activates blood and removes stasis, regulates qi, and relieves pain for blood stasis and qi stagnation, as well as heart and stomach pain; 2. Compound Dan Shen Tablets: Used for chest tightness and angina pectoris.
Applications and Combinations: 1. Used for women’s menstrual irregularities, dysmenorrhea, amenorrhea, and postpartum stasis abdominal pain. This herb’s function of activating blood and removing stasis is essential for regulating women’s menstruation. Fu Ren Ming Li Lun states, “one dose of Dan Shen San has the same effect as Si Wu Tang.” It can be taken alone as a powder, mixed with wine; it is often combined with Dang Gui (Angelica Sinensis), Chuan Xiong (Ligusticum chuanxiong), and Yi Mu Cao (Leonurus japonicus) to enhance efficacy. In modern clinical practice, it is often used as the main herb for treating ectopic pregnancy: if there is massive bleeding in the abdominal cavity during the acute phase, it is combined with Chi Shao (Red Peony) and Tao Ren (Peach Kernel); if in the chronic phase with blood clots, it is combined with San Leng (Sparganium) and E Zhu (Curcuma zedoaria). 2. Used for chest and abdominal pain due to blood stasis and masses, as well as rheumatic pain. This herb is a key medicine for activating blood and removing stasis, widely used for various blood stasis conditions. It treats chest pain and abdominal pain, often combined with Sandalwood and Amomum, as in Dan Shen Yin from Yi Xue Jin Zhen. In clinical practice for coronary heart disease and angina pectoris, it is often combined with Xiang Fu (Cyperus rotundus), Chuan Xiong, and Hong Hua (Carthamus tinctorius), or used alone as in Dan Shen Shu Guan Pian (Dan Shen Heart-Soothing Tablets). For treating masses, it is often combined with San Leng and E Zhu to remove stasis and dissolve masses. For rheumatic pain, it is combined with Fang Feng (Saposhnikovia divaricata) and Qin Jiao (Gentiana macrophylla) to dispel wind and dampness. 3. Used for sores and abscesses. This herb is cold and can activate blood, clearing heat and removing stasis to reduce abscesses. It is often combined with Yin Hua (Lonicera japonica) and Lian Qiao (Forsythia suspensa) to clear heat and detoxify. 4. Used for heat diseases with irritability and confusion, as well as miscellaneous diseases with palpitations and insomnia. This herb can cool blood and calm the spirit, treating heat pathogens entering the heart and nutrients, combined with Sheng Di (Rehmannia glutinosa), Huang Lian (Coptis chinensis), and Zhu Ye (Bamboo Leaf); for miscellaneous diseases with blood not nourishing the heart and excessive heart fire causing palpitations and insomnia, it is combined with Sheng Di, Suan Zao Ren (Sour Jujube Seed), and Bo Zi Ren (Platycladus orientalis). In modern clinical practice, this herb is also used to treat ischemic stroke, atherosclerosis, viral myocarditis, chronic hepatitis, cirrhosis, and to prevent and treat bronchial asthma and chronic pulmonary heart disease, all showing certain efficacy.
Pharmacological Effects: 1. Effects on the cardiovascular and cerebrovascular systems: (1) Effects on the heart: Dan Shen injection can slow the heart rate of isolated guinea pig and rabbit hearts, initially inhibiting heart contractility, then gradually strengthening it. It can also slow the heart rate of anesthetized dogs. (2) Effects on blood vessels and blood pressure: Dan Shen decoction, Dan Shen injection, and white flower Dan Shen injection show varying degrees of hypotensive effects when injected into anesthetized dogs or rabbits. (3) Effects on coronary flow: In anesthetized dogs or cats, intravenous infusion of Dan Shen injection (3-4g/kg) significantly increases coronary flow and decreases coronary resistance, although myocardial oxygen consumption increases. (4) Effects on myocardial ischemia and myocardial infarction: Dan Shen decoction, compound Dan Shen (Dan Shen, Xiang Fu) injection, and Dan Shen compound can improve or counteract ECG abnormalities caused by acute myocardial ischemia induced by posterior pituitary extract in rabbits or rats. (5) Effects on cerebral circulation and cerebral ischemia: Observations in animal models show that Dan Shen can increase blood flow velocity and improve flow patterns in the microcirculation of the rabbit’s soft meninges, with red blood cells showing varying degrees of disaggregation. Dan Shen has a significant protective effect on ischemic brain tissue, reducing changes in the ultrastructure of ischemic brain tissue and mitochondria. The water-soluble component of Dan Shen, Mi Da Xiang Suan, has a mild anti-thrombotic effect. (6) Effects on myocardial and brain tissue energy metabolism: Bioluminescence measurements show that Dan Shen injection (225-450mg per mouse) can significantly increase ATP content in the heart and brain, benefiting energy metabolism and oxygen effects. (7) Inhibition of Na+, K+-ATPase in the heart and brain: Dan Shen ketone II A sodium sulfonate can reversibly inhibit Na+, K+-ATPase in rat heart and brain microsomes in vitro, with a concentration-dependent effect, and a stronger inhibitory effect on heart microsomal Na+, K+-ATPase. Lowering Na+ or ATP concentration enhances or weakens its inhibitory effect. (8) Effects on microcirculation: In rabbits with peripheral microcirculation disorders caused by high molecular dextran, intravenous injection of Dan Shen injection (3g/kg) can significantly increase blood flow velocity in the conjunctival microcirculation, increase the number of open capillary networks, and improve blood flow patterns in animals over 600A, with red blood cells showing varying degrees of disaggregation. 2. Effects on blood lipids and atherosclerosis: Dan Shen decoction administered by gavage can lower triglycerides in the blood and liver of atherosclerotic rabbits. Dan Shen and white flower Dan Shen can inhibit the formation of large branch atherosclerotic plaques in experimental coronary arteries in rabbits. 3. Effects on the blood system: (1) Anticoagulant and fibrinolytic effects: Animal experiments show that Dan Shen has anticoagulant functions in both the intrinsic and extrinsic coagulation systems, prolonging recalcification time (RT), prothrombin time (PT), and activated partial thromboplastin time (APTT), and promoting fibrin degradation. (2) Inhibition of platelet aggregation and anti-thrombus formation: Dan Shen injection can inhibit ADP-induced platelet aggregation in rabbits, reduce platelet adhesion, and inhibit thrombus formation and coagulation function in vitro. (3) Effects on red blood cell membranes. (4) Effects on the adhesion characteristics of red blood cells and endothelial cells. 4. Effects on hypoxia tolerance. 5. Effects on immune function: 100% Dan Shen decoction (0.5ml/mouse) administered by gavage for 7 days can significantly enhance the phagocytic percentage and index of mouse macrophages, indicating an enhancement of macrophage phagocytic function. The hemolytic plaque assay shows a significant increase in the number of antibodies generated in the spleen (PFC) per 106 spleen cells. 6. Anti-inflammatory and anti-allergic effects. 7. Effects on the liver: Additionally, it can increase liver glycogen, reduce liver fat content, and promote RNA and DNA synthesis, indicating that Dan Shen oral liquid has beneficial effects on liver cell metabolism and promotes the regeneration of damaged liver cells. 8. Anti-gastric ulcer effects. 9. Effects on bile secretion. 10. Effects on tumors: 100% Dan Shen decoction administered by gavage can prolong the survival time of mice with Ehrlich ascites carcinoma. The agar plate method confirms that Dan Shen has anti-tumor effects on mice with Ehrlich ascites carcinoma. Furthermore, Dan Shen can inhibit the activity of cyclic adenosine monophosphate phosphodiesterase (PDE) in vitro, especially sensitive in the brain and lungs, suggesting that the inhibitory effect in the cerebral cortex may be achieved by inhibiting PDE activity and increasing cAMP levels.
Chemical Composition: Contains various Dan Shen ketones, Dan Shen acid, Dan Shen phenol, sage phenol, and vitamins A and E.
Dosage and Administration: 5-15g, decocted in water, or made into pills or powders.
Precautions for Use: Not to be used by women with excessive menstruation or without blood stasis; use with caution in pregnant women; contraindicated with Li Lu (Veratrum).
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