Supplement
Panax notoginseng is a root used in traditional Chinese medicine, and its saponins are thought to influence blood clotting and inflammation. People most often look at it for recovery after an ischemic stroke, and the evidence is moderate: trials found that adding its saponins to standard care improved neurological function and everyday activities. The large trial was run in China, and ideas about reduced brain inflammation come mostly from animal work.
Sources: PMID 37338907; PMID 34335808
- Updated
- How we grade
- 8 studies cited
- Best evidence
- Grade B
- Conditions studied
- 1
- Outcomes
- 6
- Graded outcomes
- 0231
Evidence by condition
- Strong
- Moderate
- Limited
- Very limited
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| 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. | Improves (the measure goes down) | Moderate effect | 3 studies | 1,828 people | ||
Studies that measured angina pectoris symptoms
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| 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. | Improves (the measure goes down) | Moderate effect | 2 studies | 1,828 people | ||
| 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. | Improves (the measure goes down) | Small effect | 1 study | 2,216 people | ||
General
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| 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. | Improves (the measure goes up) | Moderate effect | 3 studies | 4,170 people | ||
Studies that measured ischemic stroke recovery
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| 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. | Improves (the measure goes up) | Moderate effect | 1 study | 1,891 people | ||
Studies that measured intracerebral hemorrhage recovery | ||||||
| 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. | Improves (the measure goes down) | Moderate effect | 1 study | |||
Studies that measured neuroinflammation | ||||||
Key findings
- Angina Pectoris SymptomsImproves (the measure goes down)
- Ischemic Stroke RecoveryImproves (the measure goes up)
- Cardiovascular EventsImproves (the measure goes down)
Safety notes in the studies
- 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.
Shop the evidence-backed picks
Third-party tested Panax notoginseng products, in the forms the graded studies used where we can match them.
- Grade B
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Studies cited
8 studies from PubMed
- Efficacy and Safety of Panax notoginseng Saponins in the Treatment of Adults With Ischemic Stroke in China: A Randomized Clinical Trial
- Panax notoginseng preparation plus aspirin versus aspirin alone on platelet aggregation and coagulation in patients with coronary heart disease or ischemic stroke: A meta-analysis of randomized controlled trials
- Systematic Review and Meta-Analysis on Randomized Controlled Trials on Efficacy and Safety of Panax Notoginseng Saponins in Treatment of Acute Ischemic Stroke
- Panax notoginseng for Cerebral Ischemia: A Systematic Review
- Efficacy and safety of oral Panax notoginseng saponins for unstable angina patients: A meta-analysis and systematic review
- Panax notoginseng Preparations for Unstable Angina Pectoris: A Systematic Review and Meta-Analysis
- Efficacy and Safety of Panax notoginseng Saponin Therapy for Acute Intracerebral Hemorrhage, Meta-Analysis, and Mini Review of Potential Mechanisms of Action
- Oral Panax notoginseng Preparation for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials