Salvia Miltiorrhiza (Dan Shen)

Salvia RootSalvia Miltiorrhiza is a traditional Chinese herb that is commonly used by TCM practitioners. To this date, this herb has more than 2000-year history of mature application. And it is also one of important commodities in the international medicine market. In China it is better known as Dan Shen, which was initially documented and classified as top grade herbs in Shen Nong Ben Cao Jing (Divine Farmer’s Materia Medica), one of the classics and oldest works on Chinese Herbalism. As a matter of fact, there are tons of herbs that are named after “Shen” in Chinese. But it is so wrong to think that they are the same thing and it is dangerous to abuse them for the sake of treatment or simply supplementing. For example, Dan Shen (Salvia), Ren Shen (Ginseng), and Dang Shen (Codonopsis) are so different if viewed from the perspectives of ingredients, pharmacology, and efficacy.

What is salvia miltiorrhiza?

This herb has a few different common names, among which the most common ones are Chinese sage, Radix Salviae miltiorrhiza, red sage, danshen, and Tan Shen. Medicinally it mainly means the dried root and rhizome of Salvia miltiorrhiza Bunge, in the family Labiatae. But some other congeneric plants in different regions are also used for medicine, including Salvia bowleyana Dunn, Salvia przewalskii Maxim., Salvia przewalskii Maxim. var. mandarinorum(Diels)Stib., Salvia yunnanensis C. H. Wright, Salvia kiaometiensis Levl., f. pubescens Stib., Salvia miltiorrhiza Bunge var. alba C. Y. Wu et H. W. Li, mss., Salvia digitaloides Diels, S. trijuga Diels, and S. plectranthoides Girff. It is reported that there are more than 100 medicines based on salvia. Given the fact that the wild resources of wild salvia is dwindling, it fails to meet the clinical needs. Thankfully, so far the cultivation technology has developed rapidly and cultivated salvia miltiorrhiza becomes a good alternative source. However, conventional wisdom tends to believe that wild ones are better than cultivated ones on quality. The medicinal root is usually dug in spring and autumn. Next remove the dirt and then dry them in the sun.

Salvia miltiorrhiza Bunge is a perennial herb, 30 to 100cm high. The whole plant is covered with dense yellowish pubescence and glandular hairs. Roots are long, thin, cylindrical, and covered with earthy red skin. Stems have four prisms and branch on upper part. Leaves are opposite and with odd pinnate. Small leaves are from ovate to broadly ovate and both surfaces are covered densely with white pubescence. It blooms in summer. The inflorescence is terminal and axillary verticillaster, with 3 to 10 flower each round and an alienated raceme arranged by many rounds of flowers. Nutlets are oblong, dark brown or black when ripe, and wrapped in persistent calyx.

Main chemical constituents are fat-soluble and water-soluble ingredients. Fat-soluble ingredients include tanshinone Ⅰ, tanshinone Ⅱ A, tanshinone Ⅱ B, tanshinone Ⅲ, cryptotanshinone, hydroxytanshinone ⅡA, methyl tanshinonate, przewaquinone A, Prze-watanshinquinone B, Miltirone, tanshinol I, tanshinol Ⅱ, Salviol, Tanshialdehyde, and more. Water-soluble ingredients include tanshinol, sal-vianic acid A, B, C, protocatechuic acid, protocatechualdehyde, and so on.

Salvia Miltiorrhiza benefits

Thanks to its possible health benefits, now Salvia Miltiorrhiza has an even expanded medicinal uses, including fat loss, bodybuilding, acne, anxiety, ischemic diseases like acute ischaemic stroke, high blood pressure (hypertension), cancer, cholesterol, depression, diabetes, glaucoma, sleeping problem, fertility, arrhythmia, atrial fibrillation, fibroids, and so on. And it can be consumed also in forms like decoction, extract, capsule, essential oil, tincture, tea, and compound.

Modern pharmacological actions

1. It expands coronary artery, increases coronary blood flow, improves myocardial ischemia, promotes the recovery from myocardial ischemia or injury, and reduces myocardial infarct;
2. It improves hypoxia and protects hypoxic cardiomyocyte;
3. It improves microcirculation and promotes blood flow;
4. It dilates blood vessels and lowers blood pressure;
5. It improves blood rheology, reduces blood viscosity, inhibits platelet and coagulation function, activates the fibrinolysis, and resists the thrombosis;
6. It protects the red cell membrane, regulated blood lipids, and inhibits the formation of atherosclerotic plaque;
7. It protects the liver cell from damage and promotes the regeneration of liver cell, and resists the liver fibrosis;
8. It promotes the healing of broken bones and the skin incision;
9. It protects the gastric mucosa and fights against the ulcer;
10. It calms and eases the pain of the central nervous;
11. It improves renal function and protects the ischemic renal injury;
12. It fights inflammation and allergies;
13. It inhibits, at different levels, staphylococcus aureus, a variety of bacillus, some dermatophytes, leptospirosis, and so on.

Popular salvia miltiorrhiza related Chinese herbal formulas

Traditional Chinese Medicine (TCM) believes that salvia miltiorrhiza root is bitter and slightly cold in properties. It covers two meridians, including heart and liver. Its basic functions are to remove blood stasis to ease pain, promote blood circulation to stimulate the menstrual flow, clear away the heart-fire to relieve restlessness. Main medicinal uses and indications are irregular menstruation, amenorrhea, dysmenorrhea, abdominal mass, stabbing pain in chest and abdomen, pyretic arthralgia pain, sore and ulcer, vexation, insomnia, hepatosplenomegaly, and angina. Recommended dosage is from 9 to 15 grams.

Dan Shen San

This version comes from Fu Ren Da Quan Liang Fang (Great Complete Collection of Fine Formulas for Women). It blends the salvia miltiorrhiza powder with wine to treat irregular menstruation, amenorrhea, dysmenorrhea, and postpartum abdominal pain due to stasis.

Ning Kun Zhi Bao Dan

Ning Kun Zhi Bao Dan comes from Wei Sheng Hong Bao (A Great Precious Sanitation). This prescription is mainly used for irregular menstruation, infertility, morbid leucorrhea, profuse uterine bleeding, consumption, and various diseases before and after the delivery. Other major herbs include Chuan Xiong (Szechuan Lovage Root), Dong Quai (Dang Gui), Yi Mu Cao (Chinese Motherwort), and so on.

Dan Shen Yin

This formula is from Yi Xue Jin Zhen (Medicine Acupuncture Needle). This herb combines Sha Ren (Cardamon) and Tan Xiang (Sandalwood) to treat chest stuffiness and pains and gastralgia due to stasis in blood vessel.

Huo Luo Xiao Ling Dan

Huo Luo Xiao Ling Dan is from Yi Xue Zhong Zhong Can Xi Lu (Records of Heart-Felt Experiences in Medicine with Reference to the West). This prescription is exclusively designed for injuries and bruises from falls, fractures, contusions and strains. Other key herald ingredients are Dang Gui, Ru Xiang (Frankincense), Mo Yao (Myrrh), and more.

Tian Wang Bu Xin Dan

Tian Wang Bu Xin Dan comes from She Sheng Mi Pou (Secret Investigations into Obtaining Health). This formula is mainly used for the treatments of insomnia and palpitation due to the failure of nourishing heart by blood. Other major herbs include Sheng Di Huang (Rehmannia), Suan Zao Ren (Sour Jujube Seed), Bai Zi Ren (Arborvitae Seeds), and so on.

Potential salvia miltiorrhiza side effects and contraindications

1. The uses of salvia miltiorrhiza may lead to individual patients’ suffering from symptoms such as stomach pain, decreased appetite, oropharyngeal drying, nausea, and vomiting. This is associated with the fact that this herb can inhibit the secretion of digestive juices. In this case, the drug should be discontinued and the above-mentioned symptoms will disappear by oral administration of gastropine or probanthine. In severe case, subcutaneous injection of atropine is a better option;
2. In large doses of salvia, gastrointestinal bleeding may occur in individual advanced schistosomiasis hepatosplenomegaly patients. Once it happens, the drug should be discontinued right away and accordingly the patients should be given hemostatic agents and vitamins;
3. This herb may cause allergic reactions, manifested as body itching, rash, hives, chest tightness, and some also sees choking sensation in chest and short of breath, difficulty breathing, and even chills, dizziness, nausea, vomiting, irritability, pale complexion, cold extremities, sweating, declining blood pressure, and even faint due to shock. Hence, immediate injection of antiallergic drugs, such as epinephrine, dexamethasone and phenergan, are highly recommended.

And TCM wise Dan Shen has nearly no toxicity to human body. However, it contradicts Li Lu (Veratrum) and it should be used with care during pregnancy and in the cases of no blood stasis found.

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