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Ejiao Siwu Decoction (EJSW) is a traditional Chinese medicine (TCM) formulation composed of five Chinese medicinal herbs: Angelicae Sinensis Radix, Chuanxiong Rhizoma, Paeoniae Radix Alba, Rehmanniae Radix Praeparata, and Asini Corii Colla. [1] It is traditionally used for blood deficiencies and associated symptoms like anemia, fatigue, and dizziness. [1] EJSW is being investigated as a treatment for primary immune thrombocytopenia (ITP). [1, 2] Its mechanism of action is believed to be multi-targeted, involving the regulation of key ITP targets and pathways. [1] Research suggests it may protect vascular integrity by downregulating inflammatory factors such as tumour necrosis factor-alpha (TNF-α) and interleukin-1 beta (IL-1β), and upregulating vascular endothelial growth factors (VEGF-A and VEGF-D). [1] The therapeutic effects are thought to be mediated through signaling pathways including the AGE-RAGE pathway, complement and coagulation cascades, and the VEGF signaling pathway. [1]
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