When it comes to “shen” (参), people instinctively think of supplements, such as Ren Shen (Ginseng), Dang Shen (Codonopsis), Xi Yang Shen (American Ginseng), and Tai Zi Shen (Pseudostellaria). These herbs are known for their ability to tonify Qi, especially Ren Shen, which is renowned for its ability to replenish Yuan Qi (元气). The single herb Ren Shen decoction can turn the tide in critical situations, playing a role akin to resurrection. However, there are many types of TCM herbs classified as “shen”. In addition to those that tonify, there are also bitter and cold herbs like Ku Shen (Sophora), Xuan Shen (Scrophularia), and Quan Shen (Corydalis), as well as today’s protagonist, Dan Shen (Salvia miltiorrhiza), which is bitter and slightly cold. It enters the Heart and Liver meridians, promoting blood circulation, dispelling stasis, alleviating pain, cooling the blood, resolving abscesses, and calming the mind. It is not merely a simple tonic.
Promoting Blood Circulation and Regulating Menstruation—A Good Medicine for Gynecology
“A single herb Dan Shen decoction has effects similar to Si Wu Tang (四物汤),” which can easily lead us to understand that Dan Shen is a “blood-nourishing” tonic. This is inaccurate. Si Wu Tang, as a fundamental formula in gynecology, is a general remedy for regulating menstruation and serves as the basis for all blood-nourishing formulas. It has the ability to nourish blood and yin while also promoting blood circulation. Looking at Dan Shen, it is red in color and specifically enters the blood aspect. Zhang Bingcheng in “Ben Cao Bian Du” states: “Dan Shen, with effects similar to Si Wu, can dispel stasis and generate new blood, effectively treating wind and dispersing masses, with a neutral nature that promotes blood circulation… specifically entering the Ying aspect. Although Dan Shen has ‘shen’ in its name, its blood-nourishing power is insufficient, while its blood-promoting power is abundant, making it an essential herb for regulating the blood aspect.” Thus, it is evident that Dan Shen itself does not possess blood-nourishing power; rather, it promotes blood circulation and regulates menstruation, eliminating internal blood stasis to achieve smooth flow of Qi and blood, embodying the principle of “using circulation to nourish.”
Highlight One
Dan Shen is effective in promoting blood circulation and dispelling stasis, capable of breaking up old blood and generating new blood without harming the righteous Qi. It can stop excessive menstrual bleeding and regulate menstrual flow, making it a good medicine for gynecology. Its slightly cold nature is particularly suitable for symptoms of dysmenorrhea, heavy menstrual flow, and early menstruation due to blood heat and stasis. A simple preparation of Dan Shen powder mixed with yellow wine can be used for these mild conditions.
Highlight Two
Cooling the blood and resolving abscesses, many young women experience menstrual issues, such as abdominal pain before menstruation, accompanied by dark red acne on the face, which is caused by internal blood stasis. Dan Shen can alleviate dysmenorrhea while also significantly improving the appearance of dark red acne.
Highlight Three
Dan Shen undergoes processing in traditional Chinese medicine to alter its properties for patients with cold-congealed blood stasis. Dan Shen is cold in nature, but after being processed with wine, it can transform from cold to warm, enhancing its ability to promote blood circulation and dispel stasis. It can also be combined with warming herbs to mitigate its cold nature.
Dispelling Stasis and Alleviating Pain—A Protective Herb for Cardiovascular Health
Dan Shen is effective in promoting blood circulation, dispelling stasis, and can be used for various blood stasis conditions, most commonly in cardiovascular applications, earning it the title of “cleaner of blood vessels.” The “Shen Nong Ben Cao Jing” states: “Dan Shen is indicated for evil Qi in the heart and abdomen, with gurgling sounds in the intestines like flowing water, cold and heat accumulation, breaking masses and removing stagnation,” which includes Dan Shen’s treatment of symptoms related to Qi stagnation and blood stasis in the chest. The well-known Dan Shen drink, recorded in “Yi Zong Jin Jian,” uses Dan Shen to promote blood circulation, dispel stasis, and alleviate pain, combined with Tan Xiang (Sandalwood) to regulate Qi and disperse masses, and Sha Ren (Amomum) to warm the middle and promote Qi flow, used for chest pain due to blood stasis.
Modern Research
Dan Shen, being red and entering the blood, belongs to the Heart meridian and promotes blood circulation, enhancing the heart’s blood supply capacity. Dan Shen contains various chemical components, one class being lipophilic diterpenes such as Danshenone B, Dihydrodanshenone I, and Isodanshenone, while another class consists of water-soluble components primarily made up of phenolic acids, such as Danshensu and Danshenol. These components can inhibit platelet aggregation, improve myocardial remodeling, and provide cardiovascular protective effects against myocardial ischemia, atherosclerosis, and arrhythmias, which is why Dan Shen is gaining recognition in the cardiovascular field.
Dan Shen Tea Formulations
Dan Shen combined with Huang Qi (Astragalus): Tonifies Qi and promotes blood circulation, used for Qi deficiency with blood stasis and chest pain.
Dan Shen combined with San Qi (Notoginseng): Promotes blood circulation and stops bleeding, used for blood stasis with a risk of bleeding.
Dan Shen combined with Hong Hua (Safflower): Strongly promotes blood circulation, used for solid blood stasis and severe chest pain.
Friendly Reminder: Those with spleen and stomach deficiency and cold should consume in moderation; pregnant women should use with caution.
Common Dan Shen Preparations
Fang Fang Dan Shen Di Wan (复方丹参滴丸) and Fang Fang Dan Shen Pian (复方丹参片) are composed of Dan Shen, San Qi, and Bing Pian (Menthol). They are commonly used to treat coronary heart disease, with effects of dilating coronary arteries, increasing coronary blood flow, improving microcirculation, and protecting against myocardial ischemia.
Differences
Fang Fang Dan Shen Pian is a tablet made from powdered medicine, which can only be taken orally, whether in plain or sugar-coated form, with a disintegration time of over 30 minutes, leading to a slow onset of action, thus it cannot be used for acute attacks of angina pectoris, but only as a routine medication for coronary heart disease.
Fang Fang Dan Shen Di Wan is a drop pill made from extracts of Dan Shen and San Qi combined with Bing Pian, which can be absorbed quickly when dissolved under the tongue, making it suitable for acute attacks of angina pectoris.
Medication Reminder: 1. Both Fang Fang Dan Shen Pian and Fang Fang Dan Shen Di Wan contain Bing Pian, which can cause gastrointestinal irritation; taking them after meals can alleviate this. 2. Due to their strong ability to promote blood circulation and dispel stasis, they are not suitable for pregnant women, those with a tendency to bleed, or those already taking anticoagulant medications.
Calming the Mind and Aiding Sleep—A Good Helper for Rest
Dan Shen has a dual effect on calming the mind. Firstly, its slightly cold nature clears heat and cools the blood, which can be used for mental unrest caused by febrile diseases. “Ri Hua Zi Ben Cao” states that Dan Shen can “nourish the spirit and calm the mind, treating blood evil causing heart vexation.” Secondly, Dan Shen can be used for palpitations and insomnia due to insufficient blood nourishing the heart. “Dian Nan Ben Cao” mentions that Dan Shen “calms the mind and aids sleep, primarily for forgetfulness, anxiety, and insomnia.” While Tian Wang Bu Xin Dan nourishes yin and blood, clears the heart, and calms the mind, Dan Shen serves to nourish blood, calm the mind, alleviate vexation, and aid sleep.
It is important to note that although Dan Shen is not a tonic herb, it belongs to the category of “various shen” in the eighteen antagonistic herbs, along with Li Lu (Veratrum) and its preparations, which are incompatible. Dan Shen can inhibit platelet and coagulation functions, activate the plasminogen-plasmin system, and promote the dissolution of fibrinogen. Therefore, Dan Shen injection should not be used with vitamin K or thrombin and other hemostatic drugs, as it will reduce their efficacy. Conversely, when used with anticoagulants like aspirin or warfarin, it can enhance thrombolytic effects, leading to bleeding; dosage adjustments are necessary when used together.
In conclusion, while Dan Shen is beneficial, rational use of medication is key.
Text by:Clinical Pharmacy Research Department
Edited by:Chen XiangMin
Editor: Wei Yanle
Reviewed by: Cui Shenxun
Publicity Department of Juxian Traditional Chinese Medicine Hospital
