Panax Notoginseng Extract improved the function of the blood circulatory system in various ways. Panax Notoginseng saponins content (R1, Rb1, Rg1), which is the key active ingredient, was usually 5%-12%, and it showed a significant inhibitive action on the platelet aggregation rate. A 2021 clinical trial in Journal of Thrombosis and Hemostasis showed that subjects administered 150mg of standardized Notopanax extract daily increased platelet aggregation inhibition rate by 38% to 45%, prothrombin time (PT) by 1.5-2.3 seconds, and fibrinogen degradation product (FDP) concentration by 22%. Insofar as microcirculation improvement is concerned, laser Doppler blood flowmetry showed that after local application of 3% Notoginseng extract gel, the velocity of capillary blood flow increased by 18%-25%, skin oxygen partial pressure (TcPO2) rose by 12mmHg, thereby reducing the wound healing cycle by 30% in patients with diabetic foot ulcer. A study by Seoul National University in South Korea confirmed that Notoginseng saponins increased endothelial nitric oxide synthase (eNOS) expression 2.1 times via the PI3K/Akt signaling pathway activation, and promoted the release of vasodilating NO by 0.8μmol/L, thereby reducing peripheral vascular resistance by 9%-13%.
In the prevention of cardiovascular disease, the market size of compound preparations containing Notoginseng extract will reach 620 million US dollars in 2022, with a compound annual growth rate of 14.7%. For example, Chinese pharmaceutical company Yunnan Baiyao’s “Xuesaitong” injection uses supercritical CO2 extraction technology, containing 50mg of total saponin of Notoginseng each. Phase III clinical trial data showed that after 7 days of treatment in acute myocardial infarction patients, left ventricular ejection fraction (LVEF) increased by 6.2 percentage points, and the myocardial infarction area reduction rate was 19% higher than that of the control group. In terms of cost, the purchase price of raw materials of Notoginseng extract is 120−180/kg, 63% less than the raw material cost of chemical anticoagulant rivaroxaban, and the bioavailability can be raised to 85% by liposome encapsulation technology. A 2023 meta-analysis in the Chinese Journal of Integrative Medicine found that Panax Notoginseng extract increased the probability of reducing systolic blood pressure by 12.7mmHg in hypertensive patients by 76%, and was particularly significant in patients with daytime blood pressure fluctuations of ≥20mmHg.
For hemodynamic parameters, extract of Pantotrichosa Notosantosa decreased whole blood viscosity (from 4.8mPa·s to 3.5mPa·s) and plasma viscosity (from 1.9mPa·s to 1.4mPa·s), and enhanced erythrocyte deformation index (EDI) by 0.12-0.15. The nanoscale notoginseng saponin preparation developed by Kaneka, Japan, has a particle size controlled in the range of 80-120nm, and reaches the peak blood concentration (Cmax=2.3μg/mL) 30 minutes after a single administration, and the half-life is extended to 6.8 hours. As for the improvement of brain circulation, transcranial Doppler (TCD) monitoring showed that the average velocity of the middle cerebral artery blood flow was improved from 62cm/s to 78cm/s at 6 months in patients with carotid plaque who were given 200mg of Notosa extract daily, and the percentage of reduction in plaque volume was 21.4%, which attracted attention at the 2022 European Stroke Congress.
Safety assays showed that LD50 of Panax Notoginseng extract was 3.8g/kg (orally administered by mice), and the incidence of adverse effects was only 3.8% at the clinical dose (100-200mg/day), mainly manifesting as mild gastrointestinal responses. It is worth mentioning that it can inhibit thromboxane A2 (TXA2) production by 58% due to the inhibition of the activity of cyclooxygenase-1 (COX-1), without affecting the inherent function of platelets, and the journal Nature Cardiovascular Research listed this selective mechanism of action as the top ten botanical drug breakthroughs of the year in 2023. The “Compendium of Materia Medica” of the Ming Dynasty, as recorded in history books, has already stated clearly the efficacy of Notoginseng in “dispersing stasis and hemostasis”, and HPLC-MS analysis in modern times confirmed that notoginseng (dencichine) contained in it can enhance the release rate of platelet α particles by up to 17%, and promote blood vessel repair. The recent industry data show that the application of global Notoginseng extract in the circulatory system disease industry is growing at an average rate of 11.4% annually, and it is estimated that the revenue of related products will exceed 850 million US dollars in 2025.