Multi‐Target Pharmacological Mechanisms of Salvia miltiorrhiza Bunge in Metabolic Syndrome and Cardiovascular Diseases: A Comprehensive Review Based on the Theory of “Same Treatment for Different Diseases”

ABSTRACT Metabolic syndrome (MetS) represents a clinical disorder characterized by the clustering of conditions including obesity, elevated blood sugar levels, and high lipid levels, which are intricately linked to the onset of cardiovascular diseases (CVDs), such as atherosclerosis, myocardial ischemia‐reperfusion injury (MIRI), and heart failure (HF). Salvia miltiorrhiza Bunge (SM), recognized as a blood‐regulating herb in traditional Chinese medicine (TCM), is renowned for its effects in activating blood and resolving stasis. By summarizing the pharmacological research progress and clinical efficacy of SM and its active components in the management of MetS and CVDs, this review analyzes its multi‐dimensional pharmacological characteristics and multi‐target action pathways, and identifies common pharmacological effects and target networks. Through a comprehensive computational integration of network pharmacology, bioinformatics analyses, ADMET profiling, PASS online bioactivity prediction, and molecular docking, candidate targets and shared signaling pathways underlying the therapeutic potential of SM in MetS and CVDs were explored. These findings were then interpreted in the context of an integrated appraisal of clinical evidence for various SM preparations in managing MetS and CVDs, together with a thorough examination of pharmacological data on SM and its major bioactive compounds. The reviewed clinical and experimental evidence indicates that SM‐containing formulations and major SM constituents may modulate several pathophysiological mechanisms shared by MetS and CVDs, particularly inflammation, metabolic dysregulation, oxidative stress, and tissue remodeling. The exploratory computational integration further prioritized PIK3CG, IKBKB, JAK2, STAT3, and IL1B as candidate shared targets associated with NF‐κB, PI3K/Akt, MAPK, and AGE/RAGE signaling. SM and its active components have shown potential multi‐target, multi‐pathway, and multi‐action effects in MetS and CVDs, providing preliminary evidence for the treatment principle of “same treatment for different diseases.”