Abstract
Thrombocytopenia is a common hematological disorder characterized by reduced platelet counts and an increased risk of bleeding, for which current pharmacological treatments are often limited by adverse effects, drug resistance, or high costs. Traditional Chinese medicinal herbs such as ginseng, notoginseng, peony root, and astragalus have long been used for blood-nourishing and qi-tonifying purposes and are frequently prescribed for conditions associated with blood deficiency and hematopoietic dysfunction. This review systematically summarizes glycoside compounds derived from these herbs, focusing on their structural characteristics and pharmacological activities relevant to thrombocytopenia. Accumulating evidence indicates that glycosylation enhances the solubility, bioavailability, and stability of aglycones, thereby influencing their biological effects. Preclinical studies suggest that glycoside compounds may improve the hematopoietic microenvironment through anti-inflammatory, antioxidant, and immunomodulatory actions, potentially reducing immune-mediated platelet destruction. In addition, they may promote thrombopoiesis by modulating hematopoietic signaling pathways, such as PI3K/AKT, and by restoring immune balance, particularly via regulation of the Treg/Th17 axis. Collectively, these multi-target effects on hematopoiesis and immune regulation highlight glycoside compounds as promising lead candidates for the development of novel therapeutic approaches to thrombocytopenia.