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Panax notoginseng

Panax notoginseng (Sanqi) is a Chinese ginseng species distinct from P. ginseng. Contains unique notoginsenosides plus shared ginsenosides. Used in Traditional Chinese Medicine for cardiovascular conditions and bleeding disorders. Injectable preparations (Xuesaitong, Xueshuantong) widely used in Chinese hospitals for stroke and cardiovascular disease. Oral supplements less studied. Has both hemostatic (stops bleeding) AND blood-activating properties depending on preparation. Meta-analyses suggest benefit for angina and post-stroke recovery when used adjunctively.

Quick Answer

What it is

Panax notoginseng (Sanqi) is a Chinese ginseng species distinct from P. ginseng.

Key findings

  • Grade B: Ischemic Stroke Recovery
  • Grade B: Angina Pectoris Symptoms
  • Grade C: Intracerebral Hemorrhage Recovery

Safety

  • A meta-analysis of 20 RCTs (2,216 patients with coronary heart disease or ischemic stroke) found that Panax notoginseng preparations plus aspirin modulated platelet aggregation compared to aspirin alone, without increasing bleeding risk.
ℹ️ Quick Facts: Panax notoginseng

Quick Facts: Panax notoginseng

  • Best Evidence:Grade B
  • Conditions Studied:1
  • Research Outcomes:6
  • Grade B Findings:2
  • Key Effect:Cardiovascular Disease
Outcomes by grade:
A0
B2
C3
D1
1 conditions · 6 outcomes

Detailed Outcomes

B
Ischemic Stroke Recovery
A large multicenter double-blind RCT published in JAMA Network Open (2023) plus systematic reviews of 43 RCTs (4,170 participants) found that Panax notoginseng saponins (Xuesaitong) added to conventional treatment improved neurological function and activities of daily living in acute ischemic stroke patients. A broader review of 206 studies (21,759 participants) also showed favorable outcomes.
moderate↑Improves
C
Intracerebral Hemorrhage Recovery
A meta-analysis of 20 RCTs (984 PNS-treated vs 907 controls) found statistically significant improvements in effectiveness rate for acute intracerebral hemorrhage at 2, 3, and 4 weeks of PNS injection treatment. All studies used injectable preparations not available as supplements.
moderate↑Improves
D
Neuroinflammation
Preclinical studies in rodent models of cerebral ischemia show PNS reduces microglial activation, inhibits NF-kappaB pathway, and suppresses TXNIP/NLRP3 inflammasome signaling. These anti-neuroinflammatory mechanisms are proposed to underlie clinical stroke recovery benefits, but have not been independently confirmed in human inflammation-specific endpoints.
moderate↓Improves
B
Angina Pectoris Symptoms
Multiple meta-analyses of Chinese RCTs (17-18 trials, ~1800 patients) consistently show that Panax notoginseng preparations added to conventional therapy alleviate angina symptoms (RR 1.23 for improvement), reduce angina frequency and duration, and improve ECG findings. However, trial quality is variable and most studies are from China.
moderate↓Improves
C
Platelet Aggregation
A meta-analysis of 20 RCTs (2,216 patients with coronary heart disease or ischemic stroke) found that Panax notoginseng preparations plus aspirin modulated platelet aggregation compared to aspirin alone, without increasing bleeding risk. In vitro studies show PNS inhibits platelet adhesion to injured endothelium via COX pathway.
small↓Improves
C
Cardiovascular Events
A systematic review of 18 RCTs (1,828 unstable angina patients) found PNS preparations reduced cardiovascular events (RR 0.35; 95% CI 0.13-0.94) as adjunct to conventional therapy. However, the wide confidence interval and small sample sizes limit confidence in this hard endpoint.
moderate↓Improves

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