Bioactive components and mechanisms of the traditional Chinese herbal formula Xuefu Zhuyu formula in the treatment of cardiovascular and cerebrovascular diseases.

ETHNOPHARMACOLOGIC RELEVANCE: The rapid increase in cardiovascular and cerebrovascular diseases (CCVDs) is a significant threat to human health. Traditional Chinese medicine (TCM) offers unique therapeutic advantages. Xuefu Zhuyu Formula (XFZYF), a classic TCM prescription, has been widely used in clinical practice to treat CCVDs and other related conditions.

AIM OF THE STUDY: The study aimed to comprehensively elucidate the bioactive components and mechanisms of XFZYF and serve as a reference for future research. The current development, structural characteristics, blood- and intestine-migratory components, quality control measures, pharmacokinetics, pharmacological mechanisms, and clinical applications of XFZYF were systematically summarized.

MATERIALS AND

METHODS

A comprehensive literature search was conducted up to 2024 in PubMed, Web of Science, and the China National Knowledge Infrastructure (CNKI) database using the keywords: "Xuefu Zhuyu", "cardiovascular disease", "cerebrovascular disease", "chemical constituents", "migratory components", "quality control", and "pharmacological properties".

RESULTS

Eight distinct dosage forms of XFZYF have been developed for clinical application. XFZYF consists of 11 medicinal ingredients, and various compounds have been identified or preliminarily characterized. These compounds are broadly classified into phenolic acids, flavonoids, triterpenoid saponins, monoterpene glycosides, spermidines, and phthalides. Clinically, XFZYF is widely applied in both internal medicine and surgical settings.

CONCLUSION

XFZYF may exert protective effects against the onset and progression of CCVDs by modulating amino acid metabolism, non-coding RNAs, inflammatory responses, synaptic plasticity, chemokines, oxidative stress, lipid metabolism, mitochondrial function, platelet aggregation, angiogenesis, and gut microbiota. Additionally, perspectives on current limitations and directions for future research were discussed. 1) Establishment of a comprehensive quality control standard for XFZYF. 2) Enhancement of the clinical safety assessment of XFZYF, especially in combination therapies. 3) Advancement of the systematic study of the interactions and compatibility of migratory components. 4) Promotion of AI-driven strategies in the standardization and modernization of TCM.