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Objective: To systematically evaluate the efficacy of Shengmai San in patients with cardiotoxicity of anthracyclines. Methods: Randomized controlled trials (RCTs) were identified by searching China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), PubMed, Cochrane Library, and Embase Databases from the inceptions until December 2020. The Cochrane Handbook was used to evaluate the risk of bias in the included studies. Data analysis was conducted using RevMan 5.3 software. Results: Totally 19 RCTs with 2,331 participants were included in this review. Results showed that in improving arrhythmia (13 RCTs, n=1,877, RR=0.37, 95%CI 0.25 to 0.52, P<0.00001), the treatment group was superior to the control group. In terms of reducing left ventricular end-diastolic diameter (LVEDD, 2 RCTs, n=128, MD=−0.79, 95%CI −0.93 to −0.65, P<0.00001) and left ventricular end systolic diameter (LVESD, 2 RCTs, n=128, MD=−0.58, 95%CI −0.82 to −0.35, P<0.00001), the treatment group was also better than the control group. In reducing myocardial enzymes such as creatine kinase (CK) [(3 RCTs, n=256, SMD=−0.80, 95%CI −1.16 to −0.44, P<0.0001), (2 RCTs, n=126, SMD=−0.62, 95%CI −0.98 to −0.26, P=0.0007)], the treatment group was superior to the control group. Conclusion: Shengmai San has a positive effect on the treatment of cardiotoxicity from anthracyclines. However, in the future, it is still necessary to conduct high-quality RCTs to verify its efficacy. [ABSTRACT FROM AUTHOR]

Shengmai San (SMS) is a well-known traditional Chinese medicine formula prescribed for patients with coronary heart disease (CHD). Insulin resistance is the most likely explanation for the development and progression of this disease. To investigate the effect of SMS on high-fat diet-induced insulin resistance, inflammatory cytokine production and oxidative stress, male Wistar rats were fed with low-fat control diet, high-fat diet and high-fat diet supplemented with 4% SMS for eight weeks. An oral glucose tolerance test was conducted in the seventh week. Rats fed the SMS diet had significantly lower plasma fructosamine concentration (p < 0.05) and tended to have lower (p < 0.1) AUC values of plasma glucose and insulin concentrations after glucose challenge, compared to those fed the high-fat diet. Moreover, SMS reduced TNF-α and lipid peroxidation levels in the liver and heart. However, SMS had no effect on fasting plasma concentrations of glucose, insulin, triglyceride, non-esterified fatty acids, total cholesterol, HDL-cholesterol and insulin resistance index (homeostasis model assessment; HOMA) in rats. Our results show that SMS may have little or no significant effect on reducing insulin resistance, but display anti-oxidative and anti-inflammatory properties. [ABSTRACT FROM AUTHOR]

Traditional Chinese medicine (TCM) is an attractive model for studying antioxidant-based composite therapy. We previously reported that Shengmai San (SMS), a TCM formulation for treating cardiac disorders, inhibited cerebral oxidative damage in rats when evaluated by both glutathione peroxidase (GPX) activity loss and thiobarbituric acid reactive substance (TBARS) formation after forebrain ischemia-reperfusion. In the present study, we further examined the preventive effect of SMS and related decoctions composed of three component herbs (Panax ginseng, Ophiopogon japonicus and Schisandra chinensis) against oxidative brain injury to rationalize the complex formulation of SMS. Schisandra chinensis itself and decoctions containing it all inhibited TBARS formation in vivo. In contrast, Ophiopogon japonicus itself and formulations containing it had little effect on TBARS formation. GPX activity loss in vivo, on the other hand, was completely prevented only by SMS and Ophiopogon japonicus itself. A comparison of the in vitro antioxidant potential of SMS and related decoctions and in vivo effectiveness in preventing cerebral oxidative damage revealed that all the in vitro antioxidant indices examined here essentially correlated well with inhibition of TBARS formation in vivo. DPPH quenching and crocin bleaching activities showed particularly good correlation, and then, superoxide scavenging activity followed. However, none of them correlated with the inhibition of GPX activity loss in vivo. The role of each component herb is also discussed for the SMS effect. [ABSTRACT FROM AUTHOR]

Shengmai San (SMS) has been commonly used as a traditional Chinese medicine for the treatment of cardiovascular disorders, of which drug interactions need to be assessed for the safety concern. There is little evidence for the alterations of hepatic and intestinal drug-metabolizing enzymes after repeated SMS treatments to assess drug interactions. The studies aim to illustrate the effects of repeated treatments with SMS on cytochrome P450s (CYPs), reduced nicotinamide adenine dinucleotide (phosphate)-quinone oxidoreductase (NQO), uridine diphosphate-glucuronosyltransferase (UGT), and glutathione S-transferase (GST) using in vivo rat model. The SMS was prepared using Schisandrae Fructus, Ginseng Radix, and Ophiopogonis Radix (OR) (1:2:2). Chromatographic analyses of decoctions were performed using ultra-performance liquid chromatography (UPLC) and LC-mass spectrometry. Sprague-Dawley rats were orally treated with the SMS and its component herbal decoctions for 2 or 3 weeks. Hepatic and intestinal enzyme activities were determined. CYP3A expression and the kinetics of intestinal nifedipine oxidation (NFO, a CYP3A marker reaction) were determined. Schisandrol A, schisandrin B, ginsenoside Rb1 and ophiopogonin D were identified in SMS. SMS selectively suppressed intestinal, but not hepatic, NFO activity in a dose- and time-dependent manner. Hepatic and intestinal UGT, NQO and GST activities were not affected. A 3-week SMS treatment decreased the maximal velocity of intestinal NFO by 50%, while the CYP3A protein level remained unchanged. Among SMS component herbs, the decoction of OR decreased intestinal NFO activity. These findings demonstrate that 3-week treatment with SMS and OR suppress intestinal, but not hepatic CYP3A function. It suggested that the potential interactions of SMS with CYP 3A drug substrates should be noticed, especially the drugs whose bioavailability depends heavily on intestinal CYP3A. Image 1 • The 3-week Shengmai San (SMS) treatment decreased intestinal nifedipine oxidation. • SMS treatment decreased the maximal velocity of intestinal nifedipine oxidation. • SMS had no effects on activities of NQO, UGT and GST, and the expression of CYP3A. • The 3-week Ophiopogonis Radix treatment reduced intestinal nifedipine oxidation. [ABSTRACT FROM AUTHOR]