Taohong Siwu Decoction: a classical Chinese prescription for treatment of orthopedic diseases

Abstract

The pathogenesis of orthopedic diseases is intimately linked to blood stasis, frequently arising from damage to primary and secondary blood channels. This disruption can lead to “blood leaving the meridians” or Qi stagnation, resulting in blood stasis syndrome. Taohong Siwu Decoction (THSWD) is a renowned classical Chinese medicinal formula extensively used to promote blood circulation and mitigate blood stasis. Clinical studies have demonstrated its significant therapeutic effects on various orthopedic conditions, particularly its anti-inflammatory and analgesic properties, as well as its efficacy in preventing deep vein thrombosis post-surgery. Despite these findings, research on THSWD remains fragmented, and its interdisciplinary impact is limited. This review aims to provide a comprehensive evaluation of the efficacy and pharmacological mechanisms of THSWD in treating common orthopedic diseases. Additionally, we employ bibliometric analysis to explore research trends and hotspots related to THSWD. We hope this review will enhance the recognition and application of THSWD in orthopedic treatments and guide future research into its pharmacological mechanisms.

Keywords

Taohong Siwu Decoction / Classical prescriptions / Orthopedic diseases / Fracture / Femoral head necrosis / Joint replacement

References

[1] Wang X, Lu J, Li G, et al. Established UPLC-MS/MS procedure for multicomponent quantitative analysis of rat plasma: pharmacokinetics of Taohong Siwu Decoction in normal and acute blood stasis models[J]. J Ethnopharmacol, 2023, 305: 116094.

[2] Jiang H, Li M, Du K, et al. Traditional Chinese medicine for adjuvant treatment of breast cancer: Taohong Siwu Decoction[J]. Chin Med, 2021, 16(1): 129.

[3] Ji HR, Park KS, Woo HL, et al. Herbal medicine (Taohong Siwu Tang) for the treatment of primary dysmenorrhea: a systematic review and meta-analysis[J]. Explore, 2020, 16(5): 297-303.

[4] Zhang Y, Zuo C, Han L, et al. Uterine metabolomics reveals protection of Taohong Siwu Decoction against abnormal uterine bleeding[J]. Front Pharmacol, 2020, 11: 507113.

[5] Zhu FP, Li WP, Wang LH, et al. Tao-Hong-Si-Wu Decoction reduces ischemia reperfusion rat myoblast cells calcium overloading and inflammation through the Wnt/IP3R/CAMKII pathway[J]. J Cell Biochem, 2019, 120(8): 13095-13106.

[6] Gui Y, Dai Y, Wang Y, et al. Taohong Siwu Decoction exerts anticancer effects on breast cancer via regulating MYC, BIRC5, EGF and PIK3R1 revealed by HTS2 technology[J]. Comput Struct Biotec, 2022, 20: 3461-3472.

[7] Wang M, Liu Z, Hu S, et al. Taohong Siwu Decoction ameliorates ischemic stroke injury via suppressing pyroptosis[J]. Front Pharmacol, 2020, 11: 590453.

[8] Jung M, Pan X, Cunningham EL, et al. The influence of orthopedic surgery on circulating metabolite levels, and their associations with the incidence of postoperative delirium[J]. Metabolites, 2022, 12(7): 616.

[9] Choi YS, Kim TW, Chang MJ, et al. Enhanced recovery after surgery for major orthopedic surgery: a narrative review[J]. Knee Surg Relat Res, 2022, 34(1): 8.

[10] Shao CL, Cui GH, Guo HD. Effects and mechanisms of Taohong Siwu Decoction on the prevention and treatment of myocardial injury[J]. Front Pharmacol, 2022, 13: 816347.

[11] Wang SM, Xu XY, Zhang WL, et al. Effects of Taohongsiwu Decoction and its separated prescriptions decoction on angiogenesis of chick chorioallantoic membrane[J]. Pharmacol Clin Chin Mater Med, 2005, 21(4): 4-7.

[12] Liu L, Duan JA, Tang Y, et al. Taoren-Honghua herb pair and its main components promoting blood circulation through influencing on hemorheology, plasma coagulation and platelet aggregation[J]. J Ethnopharmacol, 2012, 139(2): 381-387.

[13] Figurová D, Tokárová K, Greifová H, et al. Inflammation, it’s regulation and antiphlogistic effect of the cyanogenic glycoside amygdalin[J]. Molecules, 2021, 26(19): 5972.

[14] Wu X, Cai X, Ai J, et al. Extraction, structures, bioactivities and structure-function analysis of the polysaccharides from safflower (Carthamus tinctorius L.)[J]. Front Pharmacol, 2021, 12: 767947.

[15] Baek SC, Yi SA, Lee BS, et al. Anti-adipogenic polyacetylene glycosides from the florets of safflower (Carthamus tinctorius)[J]. Biomedicines, 2021, 9(1): 91.

[16] Sun L, Shi F, Zhang W, et al. Antioxidant and anti-inflammatory activities of safflower (Carthamus tinctorius L.) honey extract [J]. Foods, 2020, 9( 8): 1039.

[17] Ran X, Ma L, Peng C, et al. Ligusticum chuanxiong Hort: a review of chemistry and pharmacology[J]. Pharm Biol, 2011, 49(11): 1180-1189.

[18] Wang J, Wang L, Zhou H, et al. The isolation, structural features and biological activities of polysaccharide from Ligusticum chuanxiong: a review[J]. Carbohyd Polym, 2022, 285: 118971.

[19] Yu M, Ye F, Ma C, et al. Ligustrazine mitigates chronic venous disease-induced pain hyperalgesia through desensitization of inflammation-associated TRPA1 activity in DRG[J]. J Ethnopharmacol, 2022, 298: 115667.

[20] Jin Y, Qu C, Tang Y, et al. Herb pairs containing angelicae sinensis radix (Danggui): a review of bio-active constituents and compatibility effects[J]. J Ethnopharmacol, 2016, 181: 158-171.

[21] Liu C, Li J, Meng FY, et al. Polysaccharides from the root of Angelica sinensis promotes hematopoiesis and thrombopoiesis through the PI3K/AKT pathway[J]. BMC Complement Altern Med, 2010, 10: 79.

[22] Yan N, Tang Z, Xu Y, et al. Pharmacokinetic study of ferulic acid following transdermal or intragastric administration in rats[J]. AAPS PharmSciTech, 2020, 21(5): 169.

[23] Zhang K, Shen X, Yang L, et al. Exploring the Q-markers of Angelica sinensis (Oliv.) Diels of anti-platelet aggregation activity based on spectrum-effect relationships [J]. Biomed Chromatogr, 2022, 36(9): e5422.

[24] Wu J, Luo Y, Shen Y, et al. Integrated metabonomics and network pharmacology to reveal the action mechanism effect of shaoyao decoction on ulcerative colitis[J]. Drug Des Dev Ther, 2022, 16: 3739-3776.

[25] Kim Y, Cho SH. Danggui-Shaoyao-San for dementia: a PRISMA-compliant systematic review and meta-analysis[J]. Medicine, 2020, 99(4): e18507.

[26] Zhou YX, Gong XH, Zhang H, et al. A review on the pharmacokinetics of paeoniflorin and its anti-inflammatory and immunomodulatory effects[J]. Biomed Pharmacother, 2020, 130: 110505.

[27] Wang XL, Feng ST, Wang YT, et al. Paeoniflorin: a neuroprotective monoterpenoid glycoside with promising anti-depressive properties[J]. Phytomedicine, 2021, 90: 153669.

[28] Ling X, Wang X, Li J, et al. Shu-Di-Huang and Gan-Cao herb pair restored the differentiation potentials of mesenchymal stem progenitors in treating osteoporosis via downregulation of NF-κB signaling pathway[J]. Evid Based Complement Alternat Med, 2021, 2021: 7795527.

[29] Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China: 2020 Edition [M]. Beijing: the Medicine Science and Technology Press of China, 2020.

[30] He Y, Jiang H, Du K, et al. Exploring the mechanism of Taohong Siwu Decoction on the treatment of blood deficiency and blood stasis syndrome by gut microbiota combined with metabolomics[J]. Chin Med, 2023, 18(1): 44.

[31] Han L, Peng D, Xu F, et al. Studies on anti-platelet activation effect and partial mechanisms of Taohong Siwu Decoction[J]. Chin J Chin Mat Med, 2010, 35(19): 2609-2612.

[32] Zhang X, Li P, Hua Y, et al. Urinary metabolomics study the mechanism of Taohong Siwu Decoction intervention in acute blood stasis model rats based on liquid chromatography coupled to quadrupole time-of-flight mass spectrometry[J]. J Chromatogr B, 2018, 1074-1075: 51-60.

[33] Ma Q, Li PL, Hua YL, et al. Effects of Tao-Hong-Si-Wu Decoction on acute blood stasis in rats based on a LC-Q/TOF-MS metabolomics and network approach[J]. Biomed Chromatogr, 2018, 32(4): e4144.

[34] Zheng CS, Xu XJ, Ye HZ, et al. Network pharmacology-based prediction of the multi-target capabilities of the compounds in Taohong Siwu Decoction, and their application in osteoarthritis[J]. Exp Ther Med, 2013, 6(1): 125-132.

[35] Einhorn TA, Gerstenfeld LC. Fracture healing: mechanisms and interventions[J]. Nat Rev Rheumatol, 2014, 11(1): 45-54.

[36] Pountos I, Georgouli T, Pneumaticos S, et al. Fracture non-union: can biomarkers predict outcome[J]. Injury, 2013, 44(12): 1725-1732.

[37] Stegen S, Van GN, Carmeliet G. Bringing new life to damaged bone: the importance of angiogenesis in bone repair and regeneration[J]. Bone, 2015, 70: 19-27.

[38] Rapp AE, Bindl R, Recknagel S, et al. Fracture healing is delayed in immunodeficient NOD/scid-IL2Rγcnull mice[J]. PLoS One, 2016, 11(2): e0147465.

[39] Tian Y, Yao X, Yang G, et al. The effect of small needle knife release combined with Taohong Siwu Decoction in the treatment of postoperative hip dysfunction[J]. Chin Med Herald, 2018, 15(3): 150-154.

[40] Oranger A, Zerlotin R, Buccoliero C, et al. Irisin modulates inflammatory, angiogenic, and osteogenic factors during fracture healing[J]. Int J Mol Sci, 2023, 24(3): 1809.

[41] Bahney CS, Zondervan RL, Allison P, et al. Cellular biology of fracture healing[J]. J Orthop Res Soc, 2019, 37(1): 35-50.

[42] Metsemakers WJ, Morgenstern M, Senneville E, et al. General treatment principles for fracture-related infection: recommendations from an international expert group[J]. Arch Orthop Traum Su, 2020, 140(8): 1013-1027.

[43] Lu J, Chen S. The clinical effect of Taohong Siwu Decoction in the treatment of tibial plateau fracture[J]. Int Med Health Guide, 2016, 22(12): 1722-1724.

[44] Lei H, Ren R, Sun Y, et al. Neuroprotective effects of safflower flavonoid extract in 6-hydroxydopamine-induced model of parkinson’s disease may be related to its anti-inflammatory action[J]. Molecules, 2020, 25(21): 5206.

[45] Magdalou J, Chen LB, Wang H, et al. Angelica sinensis and osteoarthritis: a natural therapeutic link[J]. Bio-Med Mater Eng, 2015, 25(1 Suppl): 179-186.

[46] Zhang S, Zhang J, Zhang X, et al. The protective effect of total glucosides of white paeony capsules on experimental autoimmune encephalomyelitis[J]. Immunobiology, 2023, 228(2): 152313.

[47] Mao H, Tu G, Qiu J, et al. The influence of Taohong Siwu Decoction on postoperative inflammatory factors and hemorheology of femoral shaft fracture[J]. J Nanjing Univ Trad Chin Med, 2016, 32(5): 419-421, 497.

[48] Wu H, Wei B, Fu H, et al. Analysis of the influence of Taohong Siwu Decoction on the initial wound healing and knee joint function score of knee joint fracture[J]. Mod J Integr Tradit Chin West Med, 2018, 27(28): 3126-3129.

[49] Fan L, Li C, Lin X, et al. Taohong Siwu Decoction combined with reduction and external fixation for unstable distal radius fracture[J]. Chin Trad Patent Med, 2019, 41(4): 814-817.

[50] Cui Y. The influence of Taohong Siwu Decoction on the deep vein thrombus and pain medium of lower extremity after the internal fixation of tibial fracture with intramedullary nail[J]. Zhejiang J Tradit Chin Med, 2020, 55(1): 9-10.

[51] Van Munster BC, Korevaar JC, Zwinderman AH, et al. Time-course of cytokines during delirium in elderly patients with hip fractures[J]. J Am Geriatr Soc, 2008, 56(9): 1704-1709.

[52] Kon T, Cho TJ, Aizawa T, et al. Expression of osteoprotegerin, receptor activator of NF-kappaB ligand (osteoprotegerin ligand) and related proinflammatory cytokines during fracture healing[J]. J Bone Miner Res, 2001, 16(6): 1004-1014.

[53] Mountziaris PM, Tzouanas SN, Mikos AG. Dose effect of tumor necrosis factor-alpha on in vitro osteogenic differentiation of mesenchymal stem cells on biodegradable polymeric microfiber scaffolds[J]. Biomaterials, 2010, 31(7): 1666-1675.

[54] Hozain S, Cottrell J. CDllb⁺ targeted depletion of macrophages negatively affects bone fracture healing[J]. Bone, 2020, 138: 115479.

[55] Li WY, Xiong H. Effect of Taohong Siwu Decoction early intervention on mesenchymal stem cells homing in fracture healing in rats[J]. Chin J Orthop Traumatol, 2022, 35(4): 367-374.

[56] Xiong H, Zuo YJ, Ding ZG, et al. The experimental study of Taohong Siwu Decoction on the angiogenesis and VEGF expression of callus[J]. J Chin Physician, 2004, 6(2): 195-197.

[57] Li W, Li T, Tang Z, et al. Taohong Siwu Decoction promotes the process of fracture healing by activating the VEGF-FAK signal pathway and systemically regulating the gut microbiota[J]. J Appl Microbiol, 2022, 133(3): 1363-1377.

[58] Lu X, Li J, Zhou B, et al. Taohong Siwu Decoction enhances human bone marrow mesenchymal stem cells proliferation, migration and osteogenic differentiation via VEGF-FAK signaling in vitro[J]. J Ethnopharmacol, 2023, 307: 116203.

[59] Chen D, Tian W, Li Y, et al. Osteoblast-specific transcription factor Osterix (Osx) and HIF-1α cooperatively regulate gene expression of vascular endothelial growth factor (VEGF)[J]. Biochem Biophys Res Commun, 2012, 424(1): 176-181.

[60] Jiang LM, He J, Xi XY, et al. Effect of early restrictive fluid resuscitation on inflammatory and immune factors in patients with severe pelvic fracture[J]. Chin J Traumatol, 2019, 22(6): 311-315.

[61] Lee D, Lee SH, Lee M, et al. Effects of Siwu Decoction on chondrocyte proliferation of growth plate in adolescent rats[J]. J Ethnopharmacol, 2019, 236: 108-113.

[62] Feng J, Liu Y, Li H, et al. Observation on the effect of blood letting puncture combined with Taohong Siwu Decoction on preoperative detumescence of ankle fracture[J]. World J Integr Tradit Chin West Med, 2022, 17(8): 1593-1596.

[63] Santana DC, Emara AK, Orr MN, et al. An update on venous thromboembolism rates and prophylaxis in hip and knee arthroplasty in 2020[J]. Medicina, 2020, 56(9): 416.

[64] Xing L, Xu HR, Wang QL, et al. Traditional Chinese medicine ointment combined with tuina therapy in treatment of pain and swelling after total knee arthroplasty[J]. World J Orthop, 2022, 13(10): 932-939.

[65] Kurtz SM, Lau EC, Son MS, et al. Are we winning or losing the battle with periprosthetic joint infection: trends in periprosthetic joint infection and mortality risk for the medicare population[J]. J Arthroplasty, 2018, 33(10): 3238-3245.

[66] Cogswell L, Mcculloch R. Extensor mechanism reconstruction in the setting of infected total knee arthroplasty[J]. J Bone Joint Infect, 2020, 5(4): 184-186.

[67] Wang Y, Ye S, Li Y. Clinical study of Taohong Siwu Decoction combined with hip joint replacement in the treatment of femoral neck fracture in the elderly[J]. Chin J Integr Tradit Chin West Med Surg, 2020, 26(5): 883-886.

[68] Huang H, Pan J, Han Y, et al. Chinese herbal medicines for promoting blood circulation and removing blood stasis for preventing deep venous thrombosis after total hip arthroplasty: a systematic review and meta-analysis[J]. Comb Chem High T Scr, 2021, 24(7): 893-907.

[69] Prince N, Penatzer JA, Dietz MJ, et al. Localized cytokine responses to total knee arthroplasty and total knee revision complications[J]. J Transl Med, 2020, 18(1): 330.

[70] Alexander K, Banos A, Abro S, et al. Levels of matrix metalloproteinases in arthroplasty patients and their correlation with inflammatory and thrombotic activation processes[J]. Clin Appl Thromb-Hem, 2016, 22(5): 441-446.

[71] Slovacek H, Khanna R, Poredos P, et al. Interrelationship of MMP-9, proteoglycan-4, and inflammation in osteoarthritis patients undergoing total hip arthroplasty[J]. Clin Appl Thromb Hemost, 2021, 27: 1076029621995569.

[72] Chen Z, He Q, Yuan Y. The clinical efficacy of Taohong Siwu Decoction in facilitating recovery from postoperative unicompartmental knee arthroplasty[J]. Curr Top Nutraceut R, 2022, 20(4): 710-715.

[73] Tan Z, Ma C, Wang H, et al. The influence of Taohong Siwu Decoction on transforming growth factor signaling pathway and bone healing in patients after TKA[J]. Shaanxi Tradit Chin Med, 2021, 42(9): 1243-1246.

[74] Chen H, Yang C, Liang X, et al. Effect of acupoint moxibustion combined with Taohong Siwu Decoction on patients with total knee arthroplasty[J]. China Med, 2018, 13(1): 120-124.

[75] Li H, Wang X, Lv S. Effect of Taohong Siwu Decoction on hip joint function of patients undergoing hip joint replacement[J]. Chin J Info Tradit Chin Med, 2018, 25(10): 31-34.

[76] Wang S, Jiang H, Liu Q, et al. A comparative study on the traditional versus modern yellow rice wine processing methods using Taohong Siwu Decoction for pharmaceutical production[J]. J Ethnopharmacol, 2022, 290: 115114.

[77] Si HB, Yang TM, Zeng Y, et al. Correlations between inflammatory cytokines, muscle damage markers and acute postoperative pain following primary total knee arthroplasty[J]. BMC Musculoskel Dis, 2017, 18(1): 265.

[78] Wang M, Guo D, Han L, et al. Regulative effect of Taohong Siwu Decoction on extracellular matrix of endometrium in drug-induced abortion[J]. J Tradit Chin Med, 2021, 41(1): 98-106.

[79] Xiang WM, Xu WJ. Clinical study on modified Taohong Siwu Tang for the treatment of hidden blood loss after posterior lumbar vertebral fusion Surgery[J]. Yunnan J Tradit Chin Med Mat Med, 2023, 44(2): 53-56.

[80] Vles GF, Corten K, Driesen R, et al. Hidden blood loss in direct anterior total hip arthroplasty: a prospective, double blind, randomized controlled trial on topical versus intravenous tranexamic acid[J]. Musculoskeletal Surg, 2021, 105(3): 267-273.

[81] Qian J. Observation on the therapeutic effect of modified Taohong Siwu Tang on 34 cases of depression after ischemic stroke[J]. J Pract Tradit Chin Int Med, 2009, 23(1): 5-6.

[82] Wang N, Fei C, Chu F, et al. Taohong Siwu Decoction regulates cell necrosis and neuroinflammation in the rat middle cerebral artery occlusion model[J]. Front Pharmacol, 2021, 12: 732358.

[83] Lespasio MJ, Sodhi N, Mont MA. Osteonecrosis of the hip: a primer[J]. Permanente J, 2019, 23: 18-100.

[84] Hofmann A, Fischer B, Schleifenbaum S, et al. Atraumatic femoral head necrosis: a biomechanical, histological and radiological examination compared to primary hip osteoarthritis[J]. Arch Orthop Trauma Surg, 2022, 142(11): 3093-3099.

[85] Huang ZQ, Fu FY, Li WL, et al. Current treatment modalities for osteonecrosis of femoral head in mainland China: a cross-sectional study[J]. Orthop Surg, 2020, 12(6): 1776-1783.

[86] Lin Z, Li Y, Xie X, et al. The influence of Taohong Siwu Decoction on the bone repair and hemorheology of osteonecrosis of the femoral head with Qi stagnation and blood stasis[J]. World Tradit Chin Med, 2018, 13(1): 105-108.

[87] Deng P, Wang X, Ji H, et al. Taohong Siwu Decoction for osteonecrosis of the femoral head clinical efficacy and part of the mechanism[J]. World Tradit Chin Med, 2019, 14(9): 2339-2343.

[88] Chen G, Xie Y, Liu Y, et al. Taohong Siwu Decoction for femoral head necrosis: a protocol for systematic review[J]. Medicine, 2020, 99(13): e19368.

[89] Chen X, Chen LL, Hong G, et al. The effect of Taohong Siwu Decoction on the microstructure of the femoral head of rabbits with steroid induced osteonecrosis of the femoral head and its mechanism[J]. Shandong Med J (Chin), 2017, 57(32): 5-9.

[90] Wu Z, Wu R, Rong S, et al. Based on the BMP/Smads/Runx2 signal pathway to explore the influence of Taohong Siwu Decoction on the osteogenic expression and pathomorphology of rats with traumatic osteonecrosis of the femoral head[J]. Guid J Tradit Chin Med Pharmacol, 2022, 28(9): 7-13.

[91] Yuan S, Zhang C, Wang B. Neohesperidin promotes the proliferation and osteogenic differentiation of BMSCs via BMP2-Wnt/β-catenin pathway[J]. Cell Cycle, 2022, 21(2): 187-201.

[92] Anam AK, Insogna K. Update on osteoporosis screening and management[J]. Med Clin North Am, 2021, 105(6): 1117-1134.

[93] Johnston CB, Dagar M. Osteoporosis in older adults[J]. Med Clin North Am, 2020, 104(5): 873-884.

[94] Aspray TJ, Hill TR. Osteoporosis and the ageing skeleton[J]. Subcell Biochem, 2019, 91: 453-476.

[95] Ebeling PR, Nguyen HH, Aleksova J, et al. Secondary osteoporosis[J]. Endocr Rev, 2022, 43(2): 240-313.

[96] Bellavia D, Dimarco E, Costa V, et al. Flavonoids in bone erosive diseases: perspectives in osteoporosis treatment[J]. Trends Endocrin Met, 2021, 32(2): 76-94.

[97] Abdurahman A, Li X, Li J, et al. Loading-driven PI3K/Akt signaling and erythropoiesis enhanced angiogenesis and osteogenesis in a postmenopausal osteoporosis mouse model[J]. Bone, 2022, 157: 116346.

[98] Di W, Cline-Smith A, Shashkova E, et al. T-cell mediated inflammation in postmenopausal osteoporosis[J]. Front Immunol, 2021, 12: 687551.

[99] Wang J, Liu X, Chen Y, et al. Efficacy evaluation of modified Siwu Decoction to treat osteoporosis in patients with poststroke hemiplegia by using the magnetic resonance imaging features[J]. Concept Magn Reson A, 2022, 2022(9): 1-9.

[100] Li P, Liu X, Jiang L, et al. Taohong Siwu Decoction for the elderly patients with osteoporotic intertrochanteric fracture after PFNA serum RANKL, osteoprotegerin levels and transforming growth factor β1 effect of expression level[J]. Chin J Gerontol, 2018, 38(2): 408-410.

[101] Bao T, Yang K, Long Z, et al. Systematic pharmacological methodology to explore the pharmacological mechanism of Siwu Decoction for osteoporosis[J]. Med Sci Monitor, 2019, 25: 8152-8171.

[102] Li L, Yang N, Nin L, et al. Chinese herbal medicine formula Tao Hong Si Wu Decoction protects against cerebral ischemia-reperfusion injury via PI3K/Akt and the Nrf2 signaling pathway[J]. J Nat Med-Tokyo, 2015, 69(1): 76-85.

[103] Li P, Liu X, Jiang L, et al. The influence and mechanism of Taohong Siwu Decoction on the fracture healing of patients with osteoporotic intertrochanteric fracture after PFNA[J]. Shandong Med J (Chin), 2018, 58(16): 67-69.

[104] Słupski W, Jawień P, Nowak B. Botanicals in postmenopausal osteoporosis[J]. Nutrients, 2021, 13(5): 1609.

[105] Chen WC, Liang XY, Xie LY, et al. Comparative study on the pharmacokinetics of paeoniflorin, white peony root water extract, and Taohong Siwu Decoction after oral administration in rats[J]. Eur J Drug Metab Ph, 2023, 48(3): 301-310.

[106] Zhang L, Wei W. Anti-inflammatory and immunoregulatory effects of paeoniflorin and total glucosides of paeony[J]. Pharmacol Therapeut, 2020, 207: 107452.

[107] Xu Z, Xu J, Qian W, et al. Repair effect and mechanism of Taohong Siwu Decoction on rotator cuff injury in rabbits[J]. Chin Pharmacy (Chin), 2021, 32(24): 2975-2979.

[108] Luo Z, Huang Y. Clinical observation of arthroscopic single row suture technique combined with Taohong Siwu Decoction in the treatment of rotator cuff injury[J]. J Pract Tradit Chin Med (Chin), 2023, 39(03): 559-561.

[109] Wang L, Dai C, Lv H, et al. Effects of Taohong Siwu Decoction combined with external application on pain causing substances, swelling degree and inflammatory factors in patients with acute ankle injury[J]. J Emerg Tradit Chin Med (Chin), 2021, 30(12): 2169-2172.

[110] Wang D, Xiao Y, Zhou X, et al. Study on the mechanism of Taohong Siwu Decoction in the treatment of sports injury with blood stasis syndrome[J]. Hunan J Tradit Chin Med (Chin), 2005, (04): 74-75.

[111] Wang W, Yang A, Wang W, et al. Protective effect and mechanism of Taohong Siwu Decoction on acute soft tissue injury in rats[J]. Chin J Integr Tradit Chin West Med (Chin), 2022, 42(10): 1207-1212.

[112] Ou D. 36 cases of soft tissue defect at the end of the same finger treated by dorsal digital fascia flap combined with Taohong Siwu Decoction[J]. J Guangxi Univ Chin Med (Chin), 2021, 24(02): 42-43.

[113] Chen J, Hu P, Xie X, et al. Free perforator flap combined with Taohong Siwu Decoction in the treatment of limb soft tissue defect[J]. Clin J Tradit Chin Med (Chin), 2020, 32(04): 731-735.

Funding

Science and Technology Development Fund, Macau SAR(0006/2020/AKP)

Xinglin Scholars Postdoctoral Special Fund(BSH2023003)

Fujian Maternal and Child Health Hospital Science and Technology Innovation Launch Fund(Women)

Fujian Maternal and Child Health Hospital Science and Technology Innovation Launch Fund(Children YCXY 20-10)

Fujian Medical University Sailing Fund(2020QH1204)