<i>Panax notoginseng</i>for Cerebral Ischemia: A Systematic Review

<i>Panax notoginseng</i> is the most widely used Chinese medicinal herb for the prevention and treatment of ischemic diseases. Its main active ingredients are saponins, including ginsenoside Rb1, ginsenoside Rg1, and notoginsenoside R1, among others. This review provides an up-to-date overview on the pharmacological roles of <i>P. notoginseng</i> constituents in cerebral ischemia. The saponins of <i>P. notoginseng</i> induce a variety of pharmacological effects in the multiscale mechanisms of cerebral ischemic pathophysiology, including anti-inflammatory activity, reduction of oxidative stress, anti-apoptosis, inhibition of amino acid excitotoxicity, reduction of intracellular calcium overload, protection of mitochondria, repairing the blood-brain barrier, and facilitation of cell regeneration. Regarding cell regeneration, <i>P. notoginseng</i> not only promotes the proliferation and differentiation of neural stem cells, but also protects neurons, endothelial cells and astrocytes in cerebral ischemia. In conclusion, <i>P. notoginseng</i> may treat cerebrovascular diseases through multiple pharmacological effects, and the most critical ones need further investigation.