Clinical efficacy and safety of Panax notoginseng saponins in treating chronic obstructive pulmonary disease with blood hypercoagulability: A meta-analysis of randomized controlled trials

Zhou et al., 2024 | Phytomedicine | Meta Analysis

Citation

Zhou Ruiling, Zhang Jie, ... Zhang He. Clinical efficacy and safety of Panax notoginseng saponins in treating chronic obstructive pulmonary disease with blood hypercoagulability: A meta-analysis of randomized controlled trials. Phytomedicine. 2024-Mar;125:155244. doi:10.1016/j.phymed.2023.155244

Abstract

BACKGROUND: Panax notoginseng saponins (PNS) are the primary active components of an ancient Chinese herb Panax notoginseng. Hypercoagulable state of blood (HCS) is an independent risk factor and a cause of death in chronic obstructive pulmonary disease (COPD). Several vivo studies have demonstrated the use of PNS preparations for treating COPD with HCS. PURPOSE: This study aimed to systematically evaluate the clinical efficacy and safety of PNS preparations in treating COPD with HCS. STUDY DESIGN: Meta-analysis of the randomized controlled trials (RCTs) was conducted to review data. METHODS: RCTs on the treatment of COPD with HCS and PNS preparations were searched from PubMed, Cochrane Library, Embase, Web of Science, Chinese National Knowledge Infrastructure, Vip Information Database, Wanfang data, and Chinese Biomedical Literature Database. Relevant data were extracted from the included studies and methodological quality evaluation was performed. R language (version 4.2.3) was applied for the meta-analysis. RESULTS: Twenty RCTs involving 1831 patients were analyzed. The results revealed that PNS preparations considerably increased the total clinical efficiency, improved forced expiratory volume in one second percent of predicted, and forced expiratory volume/forced vital capacity ratio. Further, PNS preparations improved fibrinogen, plasma d-dimer, whole blood viscosity at high cut, whole blood viscosity at low cut, and plasma viscosity levels. The results obtained for activated partial thromboplastin and prothrombin times were not statistically significant. Finally, PNS preparations increased partial pressure of oxygen and decreased carbon dioxide pressure. CONCLUSION: This is the first relatively comprehensive systematic review of the clinical efficacy and safety of PNS preparations for treating COPD with HCS. The study revealed that PNS preparations considerably improve lung function, hypoxia, and blood hypercoagulability in patients with COPD and HCS without increasing the risk of hemorrhage and has a good safety profile; therefore, it can be used as a new modulating agent and anticoagulant.

Key Findings

Twenty RCTs involving 1831 patients were analyzed. The results revealed that PNS preparations considerably increased the total clinical efficiency, improved forced expiratory volume in one second percent of predicted, and forced expiratory volume/forced vital capacity ratio. Further, PNS preparations improved fibrinogen, plasma d-dimer, whole blood viscosity at high cut, whole blood viscosity at low cut, and plasma viscosity levels. The results obtained for activated partial thromboplastin and p

Outcomes Measured

Requires manual extraction

Population

Field	Value
Population	copd and hcs without
Sample Size	1831
Age Range	See abstract
Condition	See abstract

MeSH Terms

Humans
Panax notoginseng
Pulmonary Disease, Chronic Obstructive
Randomized Controlled Trials as Topic
Saponins
Thrombophilia
Treatment Outcome

Evidence Classification

Level: Meta Analysis
Publication Types: Journal Article, Meta-Analysis, Systematic Review
Vertical: ginseng

Provenance

PMID: 38216446
DOI: 10.1016/j.phymed.2023.155244
PMCID: Not in PMC
Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09