Medicinal Plant Research 2025, Vol.15, No.5, 233-243 http://hortherbpublisher.com/index.php/mpr 241 Although preclinical studies and some clinical evidence are encouraging, there is still a lack of large-scale, well-designed clinical trials to comprehensively verify the efficacy and safety of S. miltiorrhiza extract in different patient groups. Most of the existing data are derived from animal models or small-scale clinical studies, which limits their value in transformation and application. Meanwhile, the active components in S. miltiorrhiza are complex, with over 200 compounds identified. The synergistic or antagonistic effects among them have not been fully clarified, and further mechanism research is urgently needed. Future research should rely more on multi-omics techniques (metabolomics, proteomics, single-cell analysis, etc.), to reveal the spatiotemporal dynamics of the active components and their targets of S. miltiorrhiza, thereby clarifying the molecular basis of its cardioprotective effects. Based on this, it is expected that new types of S. miltiorrhiza derived drugs and optimized preparations will be developed, including improved or compound extracts, to enhance efficacy and safety. Continuous interdisciplinary research and clinical validation will be the key to transforming these findings into novel treatment approaches for ischemic heart disease. Acknowledgments The authors sincerely thank Ms. Zhang for her valuable assistance during the research and writing of this manuscript. The authors also extend heartfelt gratitude to the two anonymous reviewers whose comments and suggestions greatly contributed to the improvement of the manuscript. Conflict of Interest Disclosure The authors affirm that this research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest. References Cai K., Zhang W., Su S., Yan H., Liu H., Zhu Y., Shang E., Guo S., Liu F., and Duan J., 2024, Salvia miltiorrhiza stem-leaf of total phenolic acid conversion products alleviate myocardial ischemia by regulating metabolic profiles, intestinal microbiota and metabolites, Biomedicine and Pharmacotherapy, 177: 117055. https://doi.org/10.1016/j.biopha.2024.117055 Chang C.C., Chang Y.C., Hu W.L., and Hung Y.C., 2016, Oxidative stress and Salvia miltiorrhiza in aging-associated cardiovascular diseases, Oxidative Medicine and Cellular Longevity, 2016(1): 4797102. https://doi.org/10.1155/2016/4797102 Cheng Y.C., Hung I.L., Liao Y.N., Hu W.L., and Hung Y.C., 2021, Salvia miltiorrhiza protects endothelial dysfunction against mitochondrial oxidative stress, Life, 11(11): 1257. https://doi.org/10.3390/life11111257 Duan S., Zhang M., Zeng H., Song J., Zhang M., Gao S., Yang H., Ding M., and Li P., 2023, Integrated proteomics and phosphoproteomics profiling reveals the cardioprotective mechanism of bioactive compounds derived fromSalvia miltiorrhiza Burge, Phytomedicine, 117: 154897. https://doi.org/10.1016/j.phymed.2023.154897 Fu R., Shi M., Deng C., Zhang Y., Zhang X., Wang Y., and Kai G., 2020, Improved phenolic acid content and bioactivities of Salvia miltiorrhiza hairy roots by genetic manipulation of RAS and CYP98A14, Food Chemistry, 331: 127365. https://doi.org/10.1016/j.foodchem.2020.127365 Fu Y., Peng X., Zhang C., Jiang Q., Li C., Paulsen B., Rise F., Huang C., Feng B., Li L., Chen X., Jia R., Li Y., Zhao X., Ye G., Tang H., Liang X., Lv C., Tian M., Yin Z., and Zou Y., 2023, Salvia miltiorrhiza polysaccharide and its related metabolite 5-methoxyindole-3-carboxaldehyde ameliorate experimental colitis by regulating Nrf2/Keap1 signaling pathway, Carbohydrate Polymers, 306: 120626. https://doi.org/10.1016/j.carbpol.2023.120626 Guo R., Li L., Su J., Li S., Duncan S.E., Liu Z., and Fan G., 2020, Pharmacological activity and mechanism of tanshinone IIA in related diseases, Drug Design, Development and Therapy, 14: 4735-4748. https://doi.org/10.2147/DDDT.S266911 Hou M., Hu W., Hao K., Xiu Z., Zhang X., and Liu S., 2020, Enhancing the potential exploitation of Salvia miltiorrhiza Bunge: Extraction, enrichment and HPLC-DAD analysis of bioactive phenolics from its leaves, Industrial Crops and Products, 158: 113019. https://doi.org/10.1016/j.indcrop.2020.113019 Hou S., Fan Z., Wang X., Li K., Ding H., Wang X., Li Y., and Gao X., 2025, Study on the mechanism of Salvia miltiorrhiza in the treatment of prostatic hyperplasia based on online pharmacology, Asia Pacific Journal of Clinical Medical Research, 1(1). https://doi.org/10.62177/apjcmr.v1i1.335 Hu Y., Li Q., Pan Y., and Xu L., 2019, Sal B alleviates myocardial ischemic injury by inhibiting TLR4 and the priming phase of NLRP3 inflammasome, Molecules, 24(23): 4416. https://doi.org/10.3390/molecules24234416
RkJQdWJsaXNoZXIy MjQ4ODYzNA==