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

Yong Chen; Yujie Zhang

doi:10.1055/s-0045-1806864

Chinese medicine and natural products, Inhaltsverzeichnis

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

¹Rheumatology and Immunology Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China

,

Yujie Zhang

¹Rheumatology and Immunology Department, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China

› Institutsangaben

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

Volltext

Referenzen

References
1 Zheng HX, Yang Z. Basic theory of Traditional Chinese Medicine. 5th ed. Beijing: China Press of Chinese Medicine; 2021
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
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
4 Keller TT, Mairuhu AT, de Kruif MD. et al. Infections and endothelial cells. Cardiovasc Res 2003; 60 (01) 40-48
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
6 Ding WY, Protty MB, Davies IG, Lip GYH. Relationship between lipoproteins, thrombosis, and atrial fibrillation. Cardiovasc Res 2022; 118 (03) 716-731
7 Varki A. Trousseau's syndrome: multiple definitions and multiple mechanisms. Blood 2007; 110 (06) 1723-1729
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
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
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
11 Goubran HA, Burnouf T, Radosevic M, El-Ekiaby M. The platelet-cancer loop. Eur J Intern Med 2013; 24 (05) 393-400
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
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
14 Guglietta S, Rescigno M. Hypercoagulation and complement: Connected players in tumor development and metastases. Semin Immunol 2016; 28 (06) 578-586
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
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
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
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
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
20 Chopard R, Albertsen IE, Piazza G. Diagnosis and treatment of lower extremity venous thromboembolism: A review. JAMA 2020; 324 (17) 1765-1776
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
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
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
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
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
26 Khorana AA. Cancer and coagulation. Am J Hematol 2012; 87 (Suppl 1) S82-S87
27 Coombe DR, Gandhi NS. Heparanase: A challenging cancer drug target. Front Oncol 2019; 9: 1316
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
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
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
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
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
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
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
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
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
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
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
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
40 Drew DA, Cao Y, Chan AT. Aspirin and colorectal cancer: the promise of precision chemoprevention. Nat Rev Cancer 2016; 16 (03) 173-186
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
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