Salvianolate injection in the treatment of acute cerebral infarction: A systematic review and a meta-analysis

Analysis of online prescription patterns in Chinese patients with sequelae of cerebral infarction: a real-world study

Cerebral infarction (CI) is a common cerebrovascular disease worldwide, and the burden caused by the sequelae of CI has increased significantly. However, current treatment guidelines lack standardized recommendations for pharmacotherapy of sequelae of CI. This retrospective study collected and analyzed 1.98 million prescriptions concerning sequelae of CI from patients admitted to Zhiyun Health Internet Hospital in 2022. The mean age of patients was 66.2 ± 11.4 years, and 52.40% were male. 79.73% had one or more comorbidities. For treatment, the prescriptions of 1-, 2- and ≥ 3-drug accounted for 64.55%, 23.77% and 11.68% respectively. Chinese patent medicine (CPM) prescriptions, western medicine (WM) prescriptions, and CPM and WM combined (CPM + WM) prescriptions accounted for 53.81%, 27.33%, and 18.86% respectively. In CPM prescriptions, the most frequently prescribed medications were Salvia miltiorrhiza (34.81%), Ginkgo biloba (24.96%), Panax notoginseng (20.67%), Gastrodia (7.15%) and Ligusticum Wallichii (4.90%). For WM prescriptions, the most commonly prescribed agents were anti-hypertensive (32.82%), anti-thrombotic (16.06%), vasodilator (15.70%), anti-dementia (10.88%), and lipid-lowering (9.58%) drugs. Among CPM + WM prescriptions, 72.61% had CPM/WM = 1, 21.20% had CPM/WM < 1, and 6.19% had CPM/WM > 1. This research utilized real-world data extracted from internet hospitals in China to present valuable evidence of online prescription patterns among patients experiencing sequelae of CI.

Effects of Argatroban on Hcy, hs-CRP and FIB levels in patients with acute cerebral infarction

OBJECTIVE

To evaluate the effects of argatroban on the levels of Hcy, hs-CRP and FIB in patients with acute cerebral infarction (ACI).

METHODS

A retrospective analysis was performed on 382 patients with ACI who were hospitalized in the Department of Neurology of our hospital from January 2017 to December 2019. Among them, 158 patients received conventional treatment as the control group and 224 patients received combined treatment with argatroban as the study group. NHISS score, mRS score, Hcy, hs-CRP, FIB level, quality of life, adverse reactions were compared between the two groups after treatment. The levels of Hcy and hs-CRP in patients with different mRS scores were compared.

RESULTS

A superior clinical efficacy of the study group was observed than the control group (p < 0.05). The study group witnessed a remarkably lower NHISS score, Hcy, hs-CRP and FIB level as compare to the control group (p < 0.05). The ADL and FMA scores in the study group were higher than those in the control group (p < 0.05). The levels of Hcy and hs-CRP in mRS 0-2 patients were lower than those in mRS 3-6 patients (p < 0.05).

CONCLUSION

Argatroban in ACI patients can significantly enhance the clinical efficacy and improve the quality of life. It is closely related to the reduction of Hcy and hs-CRP levels, but the mechanism needs to be further studied.

FvbHLH1 Regulates the Accumulation of Phenolic Compounds in the Yellow Cap of Flammulina velutipes

Flammulina velutipes is a renowned edible and medicinal fungus. Commercially cultivated F. velutipes occurs in two distinct phenotypes: white and yellow. However, the underlying mechanism contributing to the yellow phenotype and high nutritional value remain uncertain. We reconfirmed that the browning process in F. velutipes is attributable to melanin accumulation, although the initial yellow cap seemed unrelated to melanin. A transcriptomic and metabolomic joint analysis revealed that 477 chemical compounds categorized into 11 classes, among which 191 exhibited significantly different levels of accumulation between different phenotypes. Specifically, 12 compounds were unique to the yellow F. velutipes, including ferulic acid, and 3-Aminosalicylic acid. Free fatty acids and xanthine were identified as the primary compounds correlating with the yellow and oily cap. A total of 44,087 genes were identified, which were more homologous to Pleurotus ostreatus PC15. Structural genes such as PAL (phenylalanine ammonialyase), C4H (cinnamate 4-hydroxylase), C3H (Coumarin-3-hydroxylase), AoMT (caffeoyl coenzyme A-O-methyltransferase), and 4CL (4-coumarate: CoA ligase) were up-regulated, thereby activating the lignin biosynthesis and metabolism pathway. Additionally, FvbHLH1 can lead to the consumption of a huge amount of phenylalanine while generating flavonoids and organic acid compounds. Meanwhile, ferulic acid biosynthesis was activated. Therefore, this study clarifies the chemical and molecular bases for the yellow phenotype and nutritional value of F. velutipes.

The efficacy and safety of post-stroke cognitive impairment therapies: an umbrella review

Background: Stroke survivors are at significantly increased risk of cognitive impairment, which affects patients' independence of activities of daily living (ADLs), social engagement, and neurological function deficit. Many studies have been done to evaluate the efficacy and safety of post-stroke cognitive impairment (PSCI) treatment, and due to the largely inconsistent clinical data, there is a need to summarize and analyze the published clinical research data in this area. Objective: An umbrella review was performed to evaluate the efficacy and safety of PSCI therapies. Methods: Three independent authors searched for meta-analyses and systematic reviews on PubMed, the Cochrane Library, and the Web of Science to address this issue. We examined ADL and Barthel index (BI), Montreal Cognitive Assessment (MoCA), neurological function deficit as efficacy endpoints, and the incidence of adverse events as safety profiles. Results: In all, 312 studies from 19 eligible publications were included in the umbrella review. The results showed that angiotensin-converting enzyme inhibitors (ACEI) and N-methyl-D-aspartate (NMDA) antagonists, cell therapies, acupuncture, and EGB76 can improve the MoCA and ADL, and the adverse effects were mild for the treatment of PSCI. Moreover, Vinpocetine, Oxiracetam, Citicoline, thrombolytic therapy, Actovegin, DL-3-n-Butylphthalide, and Nimodipine showed adverse events or low article quality in patients with PSCI. However, the research evidence is not exact and further research is needed. Conclusion: Our study demonstrated that ACEI inhibitors (Donepezil) and NMDA antagonists (Memantine), EGB761, and acupuncture are the ADL and BI, MoCA, and neurological function deficit medication/therapy, respectively, for patients with PSCI. Clinical Trial Registration: https://inplasy.com/inplasy-2022-11-0139/; Identifier: INPLASY2022110139.

Regulatory mechanisms of natural compounds from traditional Chinese herbal medicines on the microglial response in ischemic stroke

BACKGROUND

Development of clinically effective neuroprotective agents for stroke therapy is still a challenging task. Microglia play a critical role in brain injury and recovery after ischemic stroke. Traditional Chinese herbal medicines (TCHMs) are based on a unique therapeutic principle, have various formulas, and have long been widely used to treat stroke. Therefore, the active compounds in TCHMs and their underlying mechanisms of action are attracting increasing attention in the field of stroke drug development.

PURPOSE

To summarize the regulatory mechanisms of TCHM-derived natural compounds on the microglial response in animal models of ischemic stroke.

METHODS

We searched studies published until 10 April 2023 in the Web of Science, PubMed, and ScienceDirect using the following keywords: natural compounds, natural products or phytochemicals, traditional Chinese Medicine or Chinese herbal medicine, microglia, and ischemic stroke. This review was prepared according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analysis) guidelines.

RESULTS

Natural compounds derived from TCHMs can attenuate the M1 phenotype of microglia, which is involved in the detrimental inflammatory response, via inhibition of NF-κB, MAPKs, JAK/STAT, Notch, TLR4, P2X7R, CX3CR1, IL-17RA, the NLRP3 inflammasome, and pro-oxidant enzymes. Additionally, the neuroprotective response of microglia with the M2 phenotype can be enhanced by activating Nrf2/HO-1, PI3K/AKT, AMPK, PPARγ, SIRT1, CB2R, TREM2, nAChR, and IL-33/ST2. Several clinical trials showed that TCHM-derived natural compounds that regulate microglial responses have significant and safe therapeutic effects, but further well-designed clinical studies are needed.

CONCLUSIONS

Further research regarding the direct targets and potential pleiotropic or synergistic effects of natural compounds would provide a more reasonable approach for regulation of the microglial response with the possibility of successful stroke drug development.

The role of traditional herbal medicine for ischemic stroke: from bench to clinic-A critical review

BACKGROUND

Ischemic stroke (IS) is a leading cause of death and severe long-term disability worldwide. Over the past few decades, considerable progress has been made in anti-ischemic therapies. However, IS remains a tremendous challenge, with favourable clinical outcomes being generally difficult to achieve from candidate drugs in preclinical phase testing. Traditional herbal medicine (THM) has been used to treat stroke for over 2,000 years in China. In modern times, THM as an alternative and complementary therapy have been prescribed in other Asian countries and have gained increasing attention for their therapeutic effects. These millennia of clinical experience allow THM to be a promising avenue for improving clinical efficacy and accelerating drug discovery.

PURPOSE

To summarise the clinical evidence and potential mechanisms of THMs in IS.

METHODS

A comprehensive literature search was conducted in seven electronic databases, including PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, the Chinese National Knowledge Infrastructure, the VIP Information Database, the Chinese Biomedical Literature Database, and the Wanfang Database, from inception to 17 June 2022 to examine the efficacy and safety of THM for IS, and to investigate experimental studies regarding potential mechanisms.

RESULTS

THM is widely prescribed for IS alone or as adjuvant therapy. In clinical trials, THM is generally administered within 72 h of stroke onset and are continuously prescribed for over 3 months. Compared with Western medicine (WM), THM combined with routine WM can significantly improve neurological function defect scores, promote clinical total effective rate, and accelerate the recovery time of stroke with fewer adverse effects (AEs). These effects can be attributed to multiple mechanisms, mainly anti-inflammation, antioxidative stress, anti-apoptosis, brain blood barrier (BBB) modulation, inhibition of platelet activation and thrombus formation, and promotion of neurogenesis and angiogenesis.

CONCLUSIONS

THM may be a promising candidate for IS management to guide clinical applications and as a reference for drug development.

Acupuncture-Moxibustion Combined with Rehabilitation Training Is Conducive to Improving the Curative Effect, Cognitive Function, and Daily Activities of Patients with Cerebral Infarction

Objective

To elucidate the effect of acupuncture-moxibustion combined with rehabilitation training (RHT) on the curative effect, cognitive function (CF), and activities of daily living (ADL) of patients with cerebral infarction (CI).

Methods

This study enrolled 150 patients with CI admitted to the Wuhan Sixth Hospital, Affiliated Hospital of Jianghan University from June 2020 to July 2021. Among them, 80 patients who were treated with acupuncture-moxibustion combined with RHT were included in the research group, and 70 patients who received acupuncture-moxibustion alone were included in the control group. The efficacy, CF, and ADL were observed in both groups, and the influences of the two therapies on serum uric acid (UA), high-sensitivity C-reactive protein (hs-CRP), and cystatin C (Cys-C) were compared. Among the various indexes, the CF of patients was assessed by the Montreal Cognitive Assessment (MoCA), and the ADL was evaluated by the Barthel index.

Results

After treatment, the research group presented significantly better efficacy, CF, and ADL than the control group, with lower levels of serum UA, hs-CRP, and Cys-C than the control group and before treatment.

Conclusion

Acupuncture-moxibustion combined with RHT can inhibit serum UA, hs-CRP, and Cys-C levels of patients with CI while improving the curative effect, CF, and ADL, which is worthy of clinical promotion.

Salvianolate Ameliorates Osteopenia and Improves Bone Quality in Prednisone-Treated Rheumatoid Arthritis Rats by Regulating RANKL/RANK/OPG Signaling

Rheumatoid arthritis (RA) is closely associated with periarticular osteopenia and leads to a high risk of generalized osteoporosis. Although glucocorticoid (GC) treatment ameliorates joint degradation and manages inflammation in RA, GC application may induce further bone quality deterioration in RA patients. Current treatments for RA lack relevant strategies for the prevention and treatment of osteopenia in RA. In this study, we aimed to investigate whether salvianolate treatment ameliorated osteopenia in prednisone-treated RA rats. Lewis rats with collagen-induced arthritis (CIA) were administered prednisone (PDN) or PDN plus salvianolate (PDN+Sal) treatment for 90 days. The effects of Sal were investigated in PDN-treated CIA rats. To further evaluate the effects of Sal under inflammatory conditions, we investigated the effects of Sal treatment on the TNF-α-induced inflammatory response in MC3T3-E1 osteoblasts. Bone histomorphometry, bone mineral density (BMD), bone biomechanical properties, micro-computed tomography (micro-CT), immunohistochemistry, RT-PCR and western blot analyses were performed to evaluate the effects of Sal. The results demonstrated that RA induced bone loss and bone quality deterioration, with high bone turnover in CIA rats. PDN+Sal treatment significantly increased BMD and trabecular/cortical bone mass, suppressed inflammation, and improved bone biomechanical properties compared to CIA control and PDN treatment. PDN+Sal treatment significantly suppressed bone resorption and the RANKL and RANKL/OPG ratios compared to PDN. PDN+Sal and PDN treatment significantly inhibited TNF-α by 82 and 83%, respectively, and both suppressed inflammation in CIA rats. However, there was no significant difference between PDN+Sal and PDN treatment alone in regard to bone formation parameters or the management of inflammation and arthropathy. Sal significantly increased Osterix, OPN, and Col1a1 while decreasing RANKL, TRAF6, and TRAIL gene in TNF-α-induced MC3T3-E1 osteoblasts. Sal significantly increased Osterix, OPN and RUNX2 while decreasing NF-κB, TRAF6 and IL-1β protein in TNF-α-induced MC3T3-E1 osteoblasts. The results suggested that salvianolate treatment ameliorated osteopenia and improved bone quality in prednisone-treated RA rats, and the potential mechanism may be related to the regulation of the RANKL/RANK/OPG signaling pathway, TRAIL-TRAF6-NFκB signal axis, and downregulation of inflammatory cytokines. Salvianolate could be used as a promising supplemental therapeutic strategy to ameliorate osteopenia and improve bone quality in GC-treated RA patients.

Effects of acupuncture on clinical outcome and helper T cell distribution and abundance in patients with convalescent ischemic stroke

OBJECTIVE

To study the effects of acupuncture on clinical outcomes and helper T cell levels in patients with convalescent ischemic stroke.

METHODS

One hundred and thirty-six patients with cerebral ischemic stroke were selected for this prospective study. Patients in the control group were treated with routine therapy, and patients in the observation group were treated with acupuncture for 30 minutes once a day for 14 days plus the treatment of the control group. The clinical efficacy, cognitive function, T cell subsets distribution and inflammatory factors of patients in both groups were recorded before and after treatment.

RESULTS

Total effectiveness rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, CD3⁺ cell percentage, CD4⁺ cell percentage and CD4⁺ cell percentage/CD8⁺ cell percentage of patients in both groups were significantly increased (P<0.05), while CD8⁺ cell percentage in both groups was significantly decreased (P<0.05). Compared to those in the control group, the overall response rate as well as CD3⁺ cell percentage, CD4⁺ cell percentage and CD4⁺/CD8⁺ of patients after treatment in the observation group were higher (P<0.001), while CD8⁺ cell percentage was lower (all P<0.001). Moreover, the improvement in inflammatory factors as well as scores of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in observation group were better than those of the control group (P<0.001) respectively.

CONCLUSION

Treatment of cerebral ischemic stroke by acupuncture can improve clinical outcome and cognitive function, which may be related to its regulation of immune response and reduction of inflammation in vivo.

Influences of a hierarchical nursing model on rescue outcomes and nursing quality of patients with acute cerebral infarction

OBJECTIVE

To investigate the influence of a hierarchical nursing model on rescue outcomes and nursing quality of patients with acute cerebral infarction (ACI).

METHODS

A total of 120 patients with ACI admitted to our hospital from January 2020 and December 2020 were selected as the study subjects and were divided into a study group and a control group, with 60 patients in each group. The study group was treated with a hierarchical nursing model, while the control group was treated with a conventional nursing model. The rescue effects, living abilities, neurological function deficits before and after nursing, nursing quality, families' and physicians' satisfaction with rescue and nursing, and incidence rates of adverse reactions were compared between the two groups.

RESULTS

The time from intravenous injection to thrombolysis (i.e., door-to-needle time, DNT), time from pre-examination to triage for thrombectomy, and retention time in the emergency room of the study group were lower than those of the control group, while the success rate of rescue in the study group was higher than that in the control group (P < 0.05). After nursing intervention, the scores of the National Institutes of Health Stroke Scale (NIHSS) and incidence rate of adverse reactions in the study group were lower than those in the control group, while the scores of Barthel scale and nursing quality and families' and physicians' satisfaction with nursing in the study group were higher than those in the control group (P < 0.05).

CONCLUSION

Hierarchical nursing can remarkably shorten the rescue time, improve the success rate of rescue, neurological function and quality of life of patients with ACI, improve nursing quality of nursing staff, and reduce the incidence rate of adverse reactions.

Effects of an evidence-based nursing intervention on neurological function and serum inflammatory cytokines in patients with acute cerebral infarction: A randomized controlled trial

BACKGROUND

Acute cerebral infarction is a clinically common and critical disease which seriously endangers the life and safety of elderly patients. Evidence-based nursing is an effective way of nursing and has great significance in improving the neurological function and quality of life of patients. In China, evidence-based nursing has been highlighted and highly developed in recent decades.

OBJECTIVES

This research aimed to investigate the effect of evidence-based nursing on the recovery of neurological function and serum inflammatory cytokines in patients with acute cerebral infarction.

METHODS

A total of 116 patients with acute cerebral infarction were randomly divided into two groups: the control group patients (n = 58) received conventional nursing, while the intervention group patients (n = 58) received evidence-based nursing intervention. National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer assessment (FMA) and activities of daily living (ADL) scores, as well as serum TNF-α and IL-6 levels were evaluated and compared between the two groups.

RESULTS

NIHSS scores in the intervention group were significantly lower than the control group. FMA and ADL scores in the intervention group were significantly higher than the control group. TNF-α and IL-6 levels in the serum of the intervention group were significantly lower than the control group.

CONCLUSIONS

In conclusion, evidence-based nursing has a positive effect on the treatment of patients with acute cerebral infarction, which decreases the level of serum inflammatory cytokines and contributes to the recovery of neurological function, motor function and activities of daily living.

The safety and effectiveness of salvianolate in preventing perioperative venous thromboembolism in China: A PRISMA-compliant meta-analysis based on RCTs

BACKGROUND

Salvianolate, a common drug for stabilizing heart disease and Angina Pectoris, is considered to be off-label for preventing venous thromboembolism (VTE) or anticoagulation at present. However, many clinical studies have showed that salvianolate can effectively inhibit the deep-vein thrombosis (DVT) incidence, and prevent VTE of perioperative patients in the real world in China.

OBJECTIVE

This analysis aimed to evaluate the effectiveness and safety of salvianolate in preventing VTE in perioperative patients.

METHODS

Databases of PubMed, Cochrane Library, Embase, CNKI, Wanfang and VIP were searched until July 2019. Literature retrieval, data extraction and quality assessment were independently completed by two researchers and checked with each other. Review Manager 5.2 software was applied for meta-analysis.

RESULTS

A total of 429 studies were retrieved, including 11 randomized controlled trials (RCTs) with a total of 1149 subjects. Compared with low molecular weight heparin (LMWH) group alone, salvianolate combined LMWH group had lower DVT incidence in preventing perioperative thrombosis (2.75% and 14.23%, OR: 0.21, 95% CI:[0.08,0.53]; P = .0009). The incidence of adverse reactions of experimental group was similar to that of control group (1.79% and 2.31%, OR: 0.65, 95% CI:[0.18,2.35]. P = .51). Compared with the control group, D-dimer level (D-D), platelet count (PLT), fibrinogen (FIB), whole blood high shear viscosity (WBHSV), and whole blood low shear viscosity (WBLSV) were all significantly decreased (P < .01), and prothrombin time (PT) was significantly increased (P < .05).

CONCLUSION

Salvianolate combined LMWH has better effectiveness and the same safety in preventing venous thromboembolism in perioperative patients. However, due to the small number of included literatures, large sample studies are still needed to further verify this conclusion.

Effect of family-centered nursing based on timing it right framework in patients with acute cerebral infarction

OBJECTIVE

The purpose of the study was to evaluate the effect of family-centered nursing based on Timing It Right Framework (TIR) on self-management and quality of life in patients with acute cerebral infarction.

METHODS

According to the rules of randomized control, 100 patients with acute cerebral infarction were divided into two groups, including the control group (n=50) received treatment of routine nursing and follow-up, and the research group (n=50) implemented with a family-centered nursing based on TIR. The changes in self-management ability, mental function, social function, psychological resilience, quality of life, and family nursing ability at discharge and 6 months after discharge were compared between the two groups, and the data of patients' adherence to medication and nursing satisfaction were collected.

RESULTS

The overall excellent rate of medication adherence and nursing satisfaction in the research group (96.00%, 98.00%) were significantly higher than those in the control group (80.00%, 78.00%) (P<0.05). The scores of ESCA, CD-RISC, and GQOL-74 in the research group were significantly higher than those in the control group after discharge, while the scores of SDSS, FCTI and NIHSS in the research group were significantly lower than those in the control group (P<0.05).

CONCLUSION

The implementation of the family-centered nursing based on TIR can promote the self-management ability and quality of life, improve psychological resilience, enhance social function and family nursing ability, and improve medication adherence and the nurse-patient relationship in patients with acute cerebral infarction.

Ginkgo biloba Damo injection combined with troxerutin regulates the TLR4/NF-κB pathway and promotes the recovery of patients with acute cerebral infarction

OBJECTIVE

Analysis of the effect of Ginkgo biloba Damo injection combined with troxerutin on patients with acute cerebral infarction (ACI) by regulating the TLR4/NF-κB signaling pathway.

METHODS

150 patients with ACI were recruited for a prospective study. These patients were randomly divided into Ginkgo biloba Damo treatment group (n=75) and combined treatment group (Ginkgo biloba Damo + troxerutin, n=75) bilobabiloba. The patients in both groups were treated with conventional treatment. In addition, patients in the Ginkgo biloba Damo treatment group were treated with Ginkgo biloba Damo injection, and those in the combined treatment group were treated with Ginkgo biloba Damo injection combined with troxerutin. The National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI) of the two groups were compared. The serum levels of GSH-Px, OX-LDL, CAT, TLR4, NF-κB p65, TNF-α, IL-1β and IL-6 were detected. The therapeutic effects of the two groups were compared.

RESULTS

After treatment, compared with the Ginkgo biloba Damo group, the combined treatment group had a lower NIHSS score and lower expression levels of OX-LDL, TLR4, NF-κB p65, TNF-α, IL-1β, and IL-6, but higher Barthel score and total effective rate as well as higher serum levels of GSH-Px and CAT (all P<0.05).

CONCLUSION

Ginkgo biloba Damo injection combined with troxerutin can improve the neurologic function and activities of daily life in patients with ACI, which can also regulate the TLR4/NF-κB signaling pathway and downstream inflammatory factors to reduce brain tissue inflammation and oxidative stress damage.

Liver function monitoring: a prospective nested case-control study of Salvia miltiorrhiza polyphenol injection

Instructions for Salvia miltiorrhiza polyphenol injections indicate abnormal liver function as an occasional adverse reaction, but the incidence of this adverse drug reaction (ADR) has increased in recent years. We assessed S. miltiorrhiza polyphenol ADRs by performing a nested case-control study(NCCS) and meta-analysis. In the NCCS, 2633 patients receiving this treatment in the First Affiliated Hospital of Bengbu Medical College were enrolled. Logistic regression models found that in 58 (2.2%) patients experiencing abnormal liver function, the risk for liver dysfunction was associated with sulfa drug allergy (OR = 7.874, 95%CI (1.280, 48.447), P = 0.026), payment methods (OR = 0.106, 95%CI (0.012, 0.934), P = 0.043), duration of administration (OR = 0.922, 95%CI (0.862, 0.986), P = 0.017), cefathiamidine (OR = 0.441, 95%CI (0.216, 0.900), P = 0.025), human serum albumin (OR = 1.958, 95%CI (1.011, 3.789), P = 0.046), Dazhu Rhodiola injection (OR = 2.599, 95%CI (1.112, 6.070), P = 0.027), or reduced glutathione (OR = 0.394, 95%CI (0.188, 0.826), P = 0.014). Meta-analysis of reports on S. miltiorrhiza polyphenol ADRs in controlled trials and other observational studies included 676 patients, of which 17 (2.17%; 95%CI (0.0105, 0.0358)) presented with liver dysfunction; associated ADR risk factors included co-administration of other drugs. Our NCCS and meta-analysis had similar ADR incidence rates, which were higher than the rate in the drug instructions. This study provides guidance for assessing liver dysfunction risks associated with S. miltiorrhiza polyphenol injections.