The integration of spear and shield: a panoramic analysis of the blood circulation-promoting and hemostatic effects of Panax notoginseng

Abstract Panax notoginseng is a widely used herb in traditional Chinese medicine renowned for its unique dual functionality in promoting blood circulation and stopping bleeding. However, the specific active components and the molecular mechanisms underlying the seemingly contradictory effects of P. notoginseng remain unclear. This article reviews the literature on P. notoginseng focusing on its use in conditions including cardiovascular diseases, promoting blood circulation, and hemostasis. It provides a panoramic view of the regulatory roles of the different active components of P. notoginseng in maintaining vascular homeostasis, inflammatory responses, and coagulation-fibrinolysis during blood-activating/hemostatic conditions. By summarizing the pharmacological effects of P. notoginseng as reported by other studies, we have conducted a preliminary exploration of the medicinal basis and mechanisms that underlie its seemingly contradictory blood-activating and hemostatic effects. This research lays the groundwork for future studies into exploring the underlying mechanisms of P. notoginseng in "stopping bleeding without causing stasis and promoting blood circulation without harming the blood," and its application in preventing and treating cardiovascular diseases. Graphical abstract