Download PDF
CC BY 4.0 · Chinese medicine and natural products 2025; 05(01): e30-e34
DOI: 10.1055/s-0045-1806864
Review Article

Interpretation of the Pathological Mechanism of Blood Stasis in Traditional Chinese Medicine in Light of Understanding of Hypercoagulable States in Modern Medicine

Yong Chen
1   Rheumatology and Immunology Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
,
Yujie Zhang
1   Rheumatology and Immunology Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China
› Author Affiliations
Funding This work was supported by the Guizhou Provincial Basic Research Program (Natural Science) Youth Guidance Project {Qian Kehe Foundation-[2024] Youth 307}.
› Further Information
Also available at
  Permissions and Reprints

Abstract

In both Traditional Chinese Medicine (TCM) and modern medicine, they agree that the integrity and healthy structure of the vascular endothelium are essential for normal hemodynamics. Damage to the vascular endothelium can quickly activate the extrinsic coagulation pathway by triggering the tissue factor (TF) and lead to coagulation. This damage, along with a loss of anticoagulant properties through antithrombin III (AT III), TF pathway inhibitors, and the protein C system, can result in a hypercoagulable state and even thrombosis. Hypercoagulability is not only a common feature of many cancers but also an important factor promoting tumor development and metastasis, which corresponds to the TCM theory of “blood stasis leading to tumors.” The pharmacological effects of heparin and aspirin have similarities with TCM's “activating blood circulation and removing blood stasis” theory in improving blood circulation, treating related diseases, and their anti-inflammatory effects.

Keywords

blood stasis - hypercoagulable state - thrombosis - heparin - aspirin - Traditional Chinese Medicine - modern medicine

CRediT Authorship Contribution Statement

Yong Chen: Conceptualization, project administration, funding acquisition, and writing—review and editing. Yujie Zhang: Writing—original draft.




Publication History

Received: 12 November 2024

Accepted: 20 January 2025

Article published online:
08 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

  • References

  • 1 Zheng HX, Yang Z. Basic theory of Traditional Chinese Medicine. 5th ed. Beijing: China Press of Chinese Medicine; 2021
    Search in Google Scholar
  • 2 Pastori D, Cormaci VM, Marucci S. et al. A comprehensive review of risk factors for venous thromboembolism: from epidemiology to pathophysiology. Int J Mol Sci 2023; 24 (04) 3169
    CrossrefPubMedSearch in Google Scholar
  • 3 Li X, Song X, Mahmood DFD, Sim MMS, Bidarian SJ, Wood JP. Activated protein C, protein S, and tissue factor pathway inhibitor cooperate to inhibit thrombin activation. Thromb Res 2023; 230: 84-93
    PubMedSearch in Google Scholar
  • 4 Keller TT, Mairuhu AT, de Kruif MD. et al. Infections and endothelial cells. Cardiovasc Res 2003; 60 (01) 40-48
    CrossrefPubMedSearch in Google Scholar
  • 5 Messner B, Bernhard D. Smoking and cardiovascular disease: mechanisms of endothelial dysfunction and early atherogenesis. Arterioscler Thromb Vasc Biol 2014; 34 (03) 509-515
    CrossrefPubMedSearch in Google Scholar
  • 6 Ding WY, Protty MB, Davies IG, Lip GYH. Relationship between lipoproteins, thrombosis, and atrial fibrillation. Cardiovasc Res 2022; 118 (03) 716-731
    CrossrefPubMedSearch in Google Scholar
  • 7 Varki A. Trousseau's syndrome: multiple definitions and multiple mechanisms. Blood 2007; 110 (06) 1723-1729
    CrossrefPubMedSearch in Google Scholar
  • 8 Ide R, Oda T, Todo Y. et al. Comparative analysis of hyperfibrinolysis with activated coagulation between amniotic fluid embolism and severe placental abruption. Sci Rep 2024; 14 (01) 272
    PubMedSearch in Google Scholar
  • 9 Chen Y, Le YM, Yi XQ. et al. Explaining the basic theories of traditional Chinese medicine with modern medicine: a new pattern in the development of basic theories of traditional Chinese medicine. Chiang-Hsi Chung I Yao 2014; 45 (03) 3-6
    Search in Google Scholar
  • 10 Ząbczyk M, Ariëns RAS, Undas A. Fibrin clot properties in cardiovascular disease: from basic mechanisms to clinical practice. Cardiovasc Res 2023; 119 (01) 94-111
    CrossrefPubMedSearch in Google Scholar
  • 11 Goubran HA, Burnouf T, Radosevic M, El-Ekiaby M. The platelet-cancer loop. Eur J Intern Med 2013; 24 (05) 393-400
    CrossrefPubMedSearch in Google Scholar
  • 12 Campello E, Ilich A, Simioni P, Key NS. The relationship between pancreatic cancer and hypercoagulability: a comprehensive review on epidemiological and biological issues. Br J Cancer 2019; 121 (05) 359-371
    CrossrefPubMedSearch in Google Scholar
  • 13 Wang X, Wang JY, Chen M, Ren J, Zhang X. Clinical association between coagulation indicators and bone metastasis in patients with gastric cancer. World J Gastrointest Oncol 2023; 15 (07) 1253-1261
    PubMedSearch in Google Scholar
  • 14 Guglietta S, Rescigno M. Hypercoagulation and complement: Connected players in tumor development and metastases. Semin Immunol 2016; 28 (06) 578-586
    PubMedSearch in Google Scholar
  • 15 Sheng DD, Li ZQ, Chen Z. et al. Professor Wu Funing's clinical experience in treating primary liver cancer based on the theory of blood stasis. Hebei J Tradit Chin Med 2023; 45 (10) 1597-1600
    Search in Google Scholar
  • 16 Chen Y, Le YM. Relations between TCM symptom diagnosis of lung cancer and its clinical stage, histological type. J Zhejiang Chin Med Univ 2014; 38 (03) 366-370
    Search in Google Scholar
  • 17 Barbhaiya M, Zuily S, Naden R. et al.; ACR/EULAR APS Classification Criteria Collaborators. 2023 ACR/EULAR antiphospholipid syndrome classification criteria. Ann Rheum Dis 2023; 82 (10) 1258-1270
    CrossrefPubMedSearch in Google Scholar
  • 18 Chen Y, Yu BJ, Xuan YN. et al. Taking rheumatoid arthritis as an example to interpret the modern medical essence of limbs bi in TCM. Chin J Integr Tradit West Med 2020; 40 (04) 493-496
    Search in Google Scholar
  • 19 Peshkova AD, Evdokimova TA, Sibgatullin TB, Ataullakhanov FI, Litvinov RI, Weisel JW. Accelerated spatial fibrin growth and impaired contraction of blood clots in patients with rheumatoid arthritis. Int J Mol Sci 2020; 21 (24) 9434
    PubMedSearch in Google Scholar
  • 20 Chopard R, Albertsen IE, Piazza G. Diagnosis and treatment of lower extremity venous thromboembolism: A review. JAMA 2020; 324 (17) 1765-1776
    CrossrefPubMedSearch in Google Scholar
  • 21 Wang P, Chi L, Zhang Z, Zhao H, Zhang F, Linhardt RJ. Heparin: An old drug for new clinical applications. Carbohydr Polym 2022; 295: 119818
    PubMedSearch in Google Scholar
  • 22 Hogwood J, Mulloy B, Lever R, Gray E, Page CP. Pharmacology of heparin and related drugs: an update. Pharmacol Rev 2023; 75 (02) 328-379
    CrossrefPubMedSearch in Google Scholar
  • 23 Jiang Z, Michal JJ, Wu XL, Pan Z, MacNeil MD. The heparan and heparin metabolism pathway is involved in regulation of fatty acid composition. Int J Biol Sci 2011; 7 (05) 659-663
    PubMedSearch in Google Scholar
  • 24 Joury A, Alshehri M, Mahendra A, Anteet M, Yousef MA, Khan AM. Therapeutic approaches in hypertriglyceridemia-induced acute pancreatitis: A literature review of available therapies and case series. J Clin Apher 2020; 35 (02) 131-137
    PubMedSearch in Google Scholar
  • 25 Guo YY, Li HX, Zhang Y, He WH. Hypertriglyceridemia-induced acute pancreatitis: progress on disease mechanisms and treatment modalities. Discov Med 2019; 27 (147) 101-109
    PubMedSearch in Google Scholar
  • 26 Khorana AA. Cancer and coagulation. Am J Hematol 2012; 87 (Suppl 1) S82-S87
    PubMedSearch in Google Scholar
  • 27 Coombe DR, Gandhi NS. Heparanase: A challenging cancer drug target. Front Oncol 2019; 9: 1316
    PubMedSearch in Google Scholar
  • 28 Ma SN, Mao ZX, Wu Y. et al. The anti-cancer properties of heparin and its derivatives: a review and prospect. Cell Adh Migr 2020; 14 (01) 118-128
    PubMedSearch in Google Scholar
  • 29 Mengozzi L, Barison I, Malý M. et al. Neutrophil extracellular traps and thrombolysis resistance: new insights for targeting therapies. Stroke 2024; 55 (04) 963-971
    PubMedSearch in Google Scholar
  • 30 Zhu M, Wu X, Sun J. et al. N-desulfated and reacetylated modification of heparin modulates macrophage polarization. Int J Biol Macromol 2023; 229: 354-362
    PubMedSearch in Google Scholar
  • 31 Poterucha TJ, Libby P, Goldhaber SZ. More than an anticoagulant: Do heparins have direct anti-inflammatory effects?. Thromb Haemost 2017; 117 (03) 437-444
    PubMedSearch in Google Scholar
  • 32 Baumgart DC. CB-01-05-MMX, a novel oral controlled-release low molecular weight heparin for the potential treatment of ulcerative colitis. Curr Opin Investig Drugs 2010; 11 (05) 571-576
    PubMedSearch in Google Scholar
  • 33 Shute JK, Puxeddu E, Calzetta L. Therapeutic use of heparin and derivatives beyond anticoagulation in patients with bronchial asthma or COPD. Curr Opin Pharmacol 2018; 40: 39-45
    PubMedSearch in Google Scholar
  • 34 Qi L, Zhang X, Wang X. Heparin inhibits the inflammation and proliferation of human rheumatoid arthritis fibroblast–like synoviocytes through the NF–κB pathway. Mol Med Rep 2016; 14 (04) 3743-3748
    PubMedSearch in Google Scholar
  • 35 Clausen TM, Sandoval DR, Spliid CB. et al. SARS-CoV-2 infection depends on cellular heparan sulfate and ACE2. Cell 2020; 183 (04) 1043-1057.e15
    CrossrefPubMedSearch in Google Scholar
  • 36 Poli D, Antonucci E, Ageno W, Prandoni P, Palareti G, Marcucci R. START-COVID Investigators. Low in-hospital mortality rate in patients with COVID-19 receiving thromboprophylaxis: data from the multicentre observational START-COVID Register. Intern Emerg Med 2022; 17 (04) 1013-1021
    PubMedSearch in Google Scholar
  • 37 Zhai Z, Kan Q, Li W. et al.; DissolVE-2 Investigators. VTE risk profiles and prophylaxis in medical and surgical inpatients: the identification of Chinese hospitalized patients' risk profile for venous thromboembolism (DissolVE-2)-a cross-sectional study. Chest 2019; 155 (01) 114-122
    CrossrefPubMedSearch in Google Scholar
  • 38 Rentsch CT, Beckman JA, Tomlinson L. et al. Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort study. BMJ 2021; 372 (311) n311
    CrossrefPubMedSearch in Google Scholar
  • 39 Nan H, Hutter CM, Lin Y. et al.; CCFR, GECCO. Association of aspirin and NSAID use with risk of colorectal cancer according to genetic variants. JAMA 2015; 313 (11) 1133-1142
    PubMedSearch in Google Scholar
  • 40 Drew DA, Cao Y, Chan AT. Aspirin and colorectal cancer: the promise of precision chemoprevention. Nat Rev Cancer 2016; 16 (03) 173-186
    PubMedSearch in Google Scholar
  • 41 Liu X, Tao Q, Shen Y. et al. Aspirin eugenol ester ameliorates LPS-induced inflammatory responses in RAW264.7 cells and mice. Front Pharmacol 2023; 14: 1220780
    PubMedSearch in Google Scholar
  • 42 Chen Y, Wang GY, Yi XQ. et al. Understanding ‘thoughts lead to qi stagnation’ from the relationship between mental stress and coronary heart disease. Chin J Tradit Chin Med 2017; 32 (10) 4589-4591
    Search in Google Scholar