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Herbal pharmacology and
Drug interaction of TCM
Dr. Baisong Zhong M.D(China), Ph.D, L.Ac.
WWW: Painandacupuncture.netfirms.com
E-mail: [email protected]
Preface

In 2002, sales of herbs/botanical supplements increased to an
estimated $4.3 billion per year

From 2001 to 2003, herbal products for women increased by
approximately 25%

In 2005, a secondary analysis of the complementary and
alternative medicine (CAM) supplement to the 2002 National
Health Interview Survey (NHIS)2,3 estimated that more than
38 million Americans use herbs and dietary supplements.
More recent estimates have placed this number as high as 60
million.
http://nccam.nih.gov
Chapter 1
Introduction to Pharmacology of TCM
1.Concept of Pharmacology of TCM
Pharmacology of TCM is the study of the actions, usage, mechanism
and adverse effects of TCM (includes acupuncture, herbs,
qigong, tui-na, TCM theory, etc.) with modern scientific
methods.
2. Tasks of Pharmacology of TCM
(1) Research the functions of TCM
(2) Research how TCM acts on the human body
(3) Research why TCM has those functions
In this course, we will only be studying the herbal pharmacology of
TCM. (HTCM)
3. History and Development of HTCM
4. Research Methodology of HTCM
(1) To analyze the chemical structures of TCM herbs, and to
purify the active structures or even to synthesize them. Then, to
put them into clinical trials methodically after understanding
their pharmacology and toxicology
(2) To research HTCM according to the theory of TCM
i. To explain the crux of TCM according to formula theory
ii. To research TCM syndromes through animal experiments.
iii. To research the behaviors, characteristics and properties of
the herbs in complex TCM formulas.
iv. To help discover new patent herbs or formulas
Research Methodology of HTCM
in vitro studies
animal studies
clinical studies
5 Tastes of HTCM
 (1) Pungent Herbs
 i. Herbs that relieve exterior syndrome:

They mainly contain volatile oils that
 o
Promote sweating
 o
Improve microcirculation
 o
Are anti-bacterial
 o
Are anti-viral
exterior syndrome
 o
Stimulate appetite
 o
Relax spasm
 o
Relieve pain







ii. Herbs that regulate qi:
They mainly contain volatile oils that
o
Regulate digestive function
o
Activate smooth muscle
o
Help secretion of digestive juice
o
Stimulate appetite
o
Relax spasm
o
Relieve pain
(2) Sweet Herbs
Most of them are rich in nutrition (amino acid, sugar, glycoside).
Some of them can improve immune function.
(3) Bitter Herbs
They are rich in alkaloid and glycoside that are antibacterial, anti-viral and anti-inflammatory (Huang Lian
has berberine).
(4) Sour Herbs
They are rich in tannic acid and organic acids that have
strong astringent action.
(5) Salty Herbs
They contain iodine and inorganic salts.
6. Acute Toxic Test of Herbs
Lethal Dose 50 or LD 50 is determined and defined as
that dose of a drug which kills 50%of the animals
to which it is administered. The concept of LD50
suggests that if a whole population (rather than just
an experimental sample) were exposed to this dose
(which is actually the median lethal dose), 50% of
the population would live and 50% would die.
7. Long Term Toxic Test of Herbs – about half a
year
e.g. Chuan Wu and Ma Qian Zi have toxic effect on the
heart, and Mu Tong, and Guang Fang Ji have toxic
effect on the kidney.
Chapter 2 Herbs that Relieve Exterior Syndromes
Properties of HRES
1. Inducing sweating
2. Abating fever
(1) Induce sweating
(2) Dilate blood vessels of skin
(3) Decrease cAMP in brain
(4) Disturb the synthesis of prostaglandin E
(5) Is anti-inflammatory
(6) Treat the cause of fever by means of anti-bacteria
3.
Having analgesic action
4.Regulating immune function and antiinflammation
5.Being anti-anaphylaxis
6.Being anti-bacterial and anti-viral
7.Having anti-tissue and expectorant action,
and anti-asthma action

Questions?
What kinds of actions do the 5 tastes
have?
Ma Huang (Ephedra)
[Main Components]
1.
L-ephedrine
2.
D-pseudo-ephedrine
[Effects & HTCM]
1.
Inducing sweating
(1) Reduce sweat gland’s ability to re-absorb sodium (Na+,
increases the crystal osmotic pressure) and thus increase sweating
(2) Stimulate CNS and a receptor( )
2.
Relieving asthma
(1) Stimulate adrenergic nerve to release adrenaline
(2) Lead to a rise in intraccelluor cAMP levels, make
subsequent bronchial smooth muscle relax
(3) Prevent to release powerful inflammation mediators
3.
Inducing diuresis
(1) Dilate potassium ion (K+) channel of renal tubule
and improve blood circulation
(2) Prevent renal tubule from re-absorbing sodium
4. Having anti-inflammatory and anti-allergenic reaction
5.Stopping cough and expectorating
6.Reducing fever, being anti-bacterial and anti-viral
7.Exciting CNS
8. Stimulating heart & increasing blood pressure(11)
[Indications]
1.
Bronchial asthma
2.
Stuffy nose
3.
Low blood pressure
4.
Urticaria.
[Side Effects]
1. Lead to bleeding of eyes
2. ON nervous and cardiac system(eg:MDMA, CRYSTAL
METH、CRYSTAL、SHABU、GLASS、BASE.
Eg:Nervousness, anxiety, palpitations, headaches, nausea,
hypertension, seizures, strokes, myocardial infarction,
hyperthermia, and death have been reported. )
3. Lead to restlessness, insomnia
[Interaction]
1. avoid with medication that are for lowing blood pressure
2. avoid with medication that are for promoting sweats
Adverse Effects
1.Nervousness, anxiety, palpitations, headaches, nausea, hypertension,
seizures, strokes, myocardial infarction, hyperthermia, and death have
been reported.
2.Myocardial ischemia and infarction, dysrhythmias, and uncontrolled
hypertension have been reported following consumption of ephedra
3.This may be caused by increased oxygen demand of the myocardium
in persons with pre-existing arteriosclerotic heart disease who ingest
this substance
4.Reports of cerebral vascular ischemia, intracranial hemorrhage, and
central nervous system vasculitis have all been reported in
association with the ingestion of ephedra. Seizures have also been
associated with its use. Ephedra extracts have been shown to be toxic
to specific neuronal cell lines.
5.Acute psychosis has been linked with ephedra usage.
Gui Zhi (Cinnamon twig, cinnamomun)
[Main Components]
1.
cinnamic aldehyde
2.
cinnamic acid
3.
phenylpropyl acetate (few)
[Effects & HTCM]
1.
Dilating blood vessels to promote sweating
Cinnamic aldehyde can help blood flow to skin, especially with ephedra
2.
Reducing fever & stopping pain
This action is related to promoting sweating.
It can increase the ability of enduring pain(pain threshold).
3.
4.
5.




Tranquilizing: can anti- convulsion.
Being anti-inflammatory and anti-allergic
Being anti-bacterial (staphylococcus aureus,
pneumococcus) and anti-viral (influenza virus)
It can be anti-staphylococcus aureus, anti-TB.
It can be anti-ECHO11 (V.).
[Indications]
[Side Effects]
Chai Hu (Bupleurum Root)
It is bitter in flavor, slightly cold in nature, and acts on liver
and gallbladder
[Main Components]
1.
Saiko-side a, b, c and d
2.
a-spinastral
3.
Volatile oil
4.
Fatty acid
[Effects & HTCM]
1.
Abate fever. The dosage size of bupleurum root is
directly proportional to its effectiveness in lowering
fevers due to typhoid bacillus and colibacillus. Saikoside and volatile oil have the fever abating effect.
2.Tranquilize, has analgesic effect, and stop cough. The
saiko-side has this effect but is less potent than
codeine.
3.Promote immune function. It can strengthen the action
of Kupffer’s cell and NK cell.
4.Protect liver, cholagogize (benefiting the gallbladder)
and lower cholesterol. The saiko-side has this effect.
Bupleurum root prepared with vinegar is more
effective in lowering cholesterol (especially for
triglyceride)
5.Treat digestive ulcer. The saiko-side can prevent the
mucosa of the stomach from being impaired by acid
and alcohol.
6.Relax the spasm of intestinal muscles.

[Indications]

TCM
Alternate fever and chills
Hypochondriac pain
Irregular menstruation
Prolapse of uterus
Pharmacology
Respiratory infection.
Cough due to different lung diseases
Viral Hepatitis
Hypercholesterolemia
[Side Effects]
Excessive intake would lead to sleepiness, poor appetite,
and abdominal distention.
Injection may lead to allergic reaction.
1.
2.
3.
4.

1.
2.
3.
4.

1.
2.



Interactions
Interactions with Drugs
(1)Bupleurum may increase the risk of bleeding when taken with drugs that
increase the risk of
bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such
as warfarin(Coumadin®) or heparin, anti-platelet drugs such as clopidogrel
(Plavix®), and non-steroidal, anti-inflammatory drugs such as ibuprofen (Motrin®,
Advil®) or naproxen (Naprosyn®, Aleve®).

(2)Bupleurum may stimulate the adrenals and may decrease the effects of
antihypertensives(drugs for high blood pressure). Patients taking blood pressure
medications, including beta-blockers or ACE inhibitors, should use cautiously.

(3)Although not well-studied in humans, bupleurum may reduce cholesterol levels.
Caution is advised in patients taking cholesterol-lowering agents.

(4))Bupleurum may increase the amount of drowsiness caused by some drugs.
Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam
(Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some
antidepressants, and alcohol.
Ge Gen (Kudzu)
Kudzu originated in China and was brought to the United States from Japan in the late 1800s. It is
distributed throughout much of the eastern United States and is most common in the southern
part of the continent.
Kudzu has traditionally been used in China to treat alcoholism, diabetes (high blood sugar),
gastroenteritis (inflamed stomach or intestine), and deafness.
Evidence suggests kudzu may improve signs and symptoms of unstable angina (chest pain),
improve insulin resistance, and have a positive effect on cognitive function in
postmenopausal women. However, most studies have suffered from methodological
weaknesses and small sample sizes.
Chinese healers have used kudzu to treat high blood pressure and chest pain and to minimize
alcohol cravings. Research indicates that puerarin (a constituent of kudzu) may increase blood
flow to the heart and brain which helps explain certain traditional uses.


1.
2.
3.

1.
2.

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Ge Gen (Kudzu, pueraria)
[Main Components]
Daidzin
Daidzein
Puerarin
[Effects & HTCM]
Reducing fever.
Effects on circulatory system
(1) Puerarin can reduce blood pressure
(2) Promote the circulation of the brain
(3) Dilate the coronary vessels. It can relax the spasm
of coronary vessels. Good for coronary heart diseases.
(4) Promote heart function.
3.
4.



1.
2.
3.


Relax the smooth muscles of the intestines
Other actions:
(1) It can reduce the function of platelets
(2) It can lower blood sugar
[Indications]
Hypertension
Coronary Heart Diseases
Migraines
[Side Effects]
1. Side Effects and Warnings
Currently, there are no side effects reported of kudzu treatment when taken by
mouth. Intravenous puerarin has caused intravascular hemolysis
(destruction of red blood cells). Intraperitoneal administration of puerarin
or crude extracts of Pueraria lobata caused hypothermia (low body
temperature).
In theory, intraperitoneal administration of puerarin or crude extracts of
Pueraria lobata may cause hypothermia. Kudzu root may also cause
weight loss, although this has not been well studied in humans.
2. Interaction:
Antidiabetics:
Anticoagulant & antiplatelet drug:
3. Pregnancy & Breastfeeding
Kudzu is not recommended in pregnant or breastfeeding women due to a lack
of available scientific evidence.

Chapter 3
Herbs that clear Heat Syndrome


Properties of herbs that clear heat syndrome

1.


2.


Anti-microbial.
(1) Anti-bacterial and also eliminate bacterial toxin
(e.g. gram-positive Staphylococcus and gramnegative Colibacillus)
(2) Anti-viral (e.g. Influenza virus)
Anti-toxin
(1) Decrease the endotoxin of gram-negative
bacteria.
(2) Anti-bacterial exotoxin `
3.

4.

5.
6.
7.

Anti-pyretic (abating fever)
The action is related to the anti-microbial and antitoxin properties of the herbs.
Effects on immune function
Some of the herbs increase the WBC and their
phagocytic function. (e.g. Huang Lian, Huangqin).
Some of them restrain the phagocytic function.
Anti-inflammation
Anti-cancer
Expelling free radicals: the free radicals are
related to age and cancer.
Examples of herbs that clear heat syndrome
Huang Lian (Coptis root)
“Huang Lian can do no right, Ren Shen can do no
wrong”
[Main Components]
1. Berberine
2. Coptisine
3. Worenine
4. Palmatine
[Effects and HTCM]
1. Anti-microbes
2. Anti-toxin
3. Anti-pyretic (abate fever)
4. Effects on immune function
5. Effects on cardiovascular system
 (1) Reduce ventricular arrhythmia,
ventricular fibrillation and atrial flutter.
 (2) Promote cardiac contractility.
 (3) Reduce heart rate
 (4) Lower blood pressure (especially good
for diastolic pressure)
6. Prevent platelet adhesion
7. Lower blood sugar, anti-cancer (for
leukemia)

1.
2.
3.
4.
5.
6.
7.


1.
2.
[Indications]
Hypertension
Supra-ventricular arrhythmia
Dysentery
Acute Enteritis
Cholecystitis
Respiratory tract infection
Diabetes
[Side Effects]
Little
A few suffer from allergic reactions (drug rashes)
Gastrointestinal effects: fullness, nausea, vomiting
Berberine



Huang lian root contain
berberine 5-7%
Berberine and its relative
derivatives show
antidiarrhtic ,
antimicrobial, anticancer,
antiinflammatory and
antiarrhythmic et al
Berberine



Berberine is a bitter-tasting, yellow, plant
alkaloid.
It is present in the roots, and stem bark of
various plants
Berberine has also been used historically
as a dye, due to its yellow color.
Berberine Activity




Antimicrobial
Cardiovascular effects
Anti-inflammatory effect
others
Antimicrobial Effects




Bacterial Diarrhea
Intestinal Parasites
Ocular infections
Et al
Bacterial Diarrhea




Direct antibacterial effects
Inhibiting the intestinal secreatory response
cause by V. cholerae, and E. coli
Also block the adherence of bacterial to
erythrocytes and epithelial cells
Clinical studies showed that a single dose of
berberine sulfate 200-400mg orally significantly
reduced liquid diarrhea stool compare to control
without side effects (Rabbani et al 1987; 1996)
Dosage and toxicity



The LD 50 of berberin in mice 25mg/kg iv. ;
while no gross toxic effects in dog at 45 mg/kg
High doses may result in lowered BP, dyspnea,
flu-like symptoms, GI discomfort and cardiac
damage
The therapeutic dose of berberine as oral
supplement is typically 200 mg two or three
times daily
pharmacokinetics



Sulfate-conjugated metabolites of berberine were
identified after oral administration at 0.9 g per day, 3
days, in healthy volunteers' urine.
Little berberine was recovered in urine compared with its
metabolites (Pan et al., 2002 ).
Berberine seems to be extensively metabolized
in the body.
there is little information available on
pharmacokinetics following administration. .
Huang qin



Scutellaria baicalensis Georgi
Has antioxidant, antiviral, antibacterial,
antiinflammatory, antiallergic, and sedative
properties.
Major components are flavonoids, such as
baicalin, baicalein, wogonin et al,
dominated by baicalin, which makes up
12-17% of the root
Baicalein

Baicalein, one of the major flavonoids
contained in the dried roots, possesses a
multitude of pharmacological activities.
Baicalein and dosage

In China, baicalin is prepared in injection form for rapid action.

The dosage is 60-120 mg of baicalin intramuscularly, 1-2
times per day; or a daily IV drip containing 500-1200 mg may
be utilized for more severe diseases.

Orally, Huangqin is given in decoction, with dosages of about
6-12 grams per day, yielding baicalin in amounts of 1-2 grams.

Baicalein tablets, and highly purified baicalein extracts in
powder form (with 95% flavonoid content) are used at doses
of 1-2 grams per day. These treatments are usually for acute
syndromes; lower doses of baicalin in complex formulas
would be utilized for prolonged therapy.
Pharmacokinetics



Baicalin orally, slow absorbed, take 7-16
hrs to the peak concentration
im, quick absorb, takes 0.4 hrs to peak
concentration, half time about 0.6 hrs
Kidney excretion
Baicalin activity








Inhibition of infections (especially respiratory tract viral
infections).
Anti-inflammatory (e.g., for asthma or atopic dermatitis)
Inhibition of cancer cell proliferation;
Protecting bone marrow and promoting hemopoiesis during
cancer therapies and protecting the intestines from adverse
chemotherapy effects;
Blood pressure lowering
Sedative,
Bile-secreting,
Neuroprotective and hepatoprotective
Inhibition of infections




Antibacterial and antiviral agents. They are
effective against staphylococci, cholera,
dysentery, pneumococci and influenza virus.
especially respiratory tract viral infections
anti hepatitis B virus. Both Huangqin and
isolated baicalin are widely used in China for
treatment of viral hepatitis and are believed to
have potent protective action against liver
fibrosis caused by viral activity.
Formula



Shuanghuanglian (SHL for short) is a
modern formula
extracts of three herbs: lonicera
(shuanghua, often called jinyinhua), scute
(huangqin), and forsythia (lianqiao). (2:1:1)
treatment of respiratory tract infections,
cases of viral myocarditis et al.
Anti-inflammatory


Cyclooxygenase (COX) and 5lipoxygenase (5-LOX) inhibition in a dosedependent manner
Prostaglandin E2 generation was inhibited
for asthma or atopic dermatitis
Huang qin



anti - histamine effect: huang qin
possesses antihistamine effect. It can
inhibit edema of rats model.
anti allergenic effect: alcohol extract of
huang qin inhibits acute asthma attack
and allergenic eczema.
Baicalein inhibits permeability of
capillaries and anti acetylcholine and anti
anaphylaxis effects.
Anti-tumor




Inhibition of cancer cell proliferation
Induction of apoptosis by baicalin was accompanied with
the marginal generation of intracellular reactive oxygen
species (ROS), the increase of the cytochrome c, and
the disruption of mitochondrial transmembrane potential
prior to the activation of caspase-3.
On the other hand, baicalin showed little toxic effect on
peripheral blood mononuclear cells from healthy
volunteers.
These results indicate that baicalin acts as a prooxidant
and induces apoptosis via mitochondrial pathway.
Antioxidants

Antioxidants play a key role in
cardiovascular disease, cancer, cataract
formation, the aging process, inflammatory
diseases, and a whole variety of
neurological disorders.
Inflammation and cancer

Chronic infection and inflammation
contribute to about 25% of all cancer
cases worldwide
Anti-tumor

Flavones (chrysin, baicalein, and
galangin), flavanones (naringenin) and
isoflavones (genistein, biochanin A) inhibit
the activity of aromatase (CYP19), thus
decreasing estrogen biosynthesis and
producing antiestrogenic effects, important
in breast and prostate cancers.
Others

Protecting bone marrow and promoting
hemopoiesis during cancer therapies and
protecting the intestines from adverse
chemotherapy effects;
lowers blood pressure




Plant-derived baicalein and its analogs are used
to treat arteriosclerosis and hypertension.
In vivo hypotensive effect may be partly
attributed to its inhibition of biosynthesis and
release of arachidonic acid-derived
vasoconstrictor products.
Baicalein may reduce vasoconstricting
sensitivity to receptor-dependent agonists such
as noradrenaline, phenylephrine.
inhibition of the endothelial nitric oxidedependent mechanism.
anti-thrombotic

Baicalein inhibits thrombin-induced
production of plasminogen activator
inhibitor-1, and interleukin-1beta- and
tumor necrosis factor-alpha-induced
adhesion molecule expression in cultured
human umbilical vein endothelial cells.
Anti-ischemia-reperfusion injury in
cardiomyocytes..


The free radical scavenging capacity
When flavonoids were administered during
ischemia/reperfusion, baicalein
significantly reduced cell death.
Anti-atherosclerosis



Atherosclerosis is a multiple factors
disease, in which the main roles play
oxidant stress, endothelium dysfunction
and disorders of hemostasis
Hangqin in the nearest future could be
used in the primary and secondary
prevention of atherosclerosis
Mechanism: anti-oxidant, increase HDL
and reduces TG et al.
Qing Hao(http://www.who.int/mediacentre/factsheets/fs094/en/index.html)
II. WHO RECOMMENDATIONS ON MALARIA
TREATMENT
antimalarial medicines, WHO recommends that all countries experiencing
resistance to conventional monotherapies, such as chloroquine,
amodiaquine or sulfadoxine yrimethamine, should use combination
therapies, preferably those containing artemisinin derivatives (ACTs
artemisinin-based combination therapies) for falciparum malaria (3,
4).
Forms of artemisinin, developed in China from the
wormwood plant, have become the leading treatment —
but only when used together with older medications.
This artemisinin combination therapy, known as ACT is
95 percent effective in curing malaria.
1. Antimalarial: The mechanism is associated with the blocked
utilization of host erythrocyte protein by the plasmodium,
causing starvation and death.
2. Antibiotic: It can inhibit Staphylococcus aureus, Neisserria
catarrhalis.
3. Antihypertensive: It can decrease ht rate, inhibite contraction of
the cardic muscle.
4. Antipyretic:
5. Cholagogic: it can increase the production & excretion of bile in
rates.
WHO currently recommends the following
combination therapies (in alphabetical order):
artemether/lumefantrine
2.
artesunate plus amodiaquine (In areas where the cure
rate of amodiaquine monotherapy is greater than 80%)
3.
artesunate plus mefloquine (Insufficient safety data to
recommend its use in Africa)
4.
artesunate plus sulfadoxine/pyrimethamine (In areas
where the cure rate of sulfadoxine/pyrimethamine is
greater than 80%)
Note: Amodiaquine plus sulfadoxinepyrimethamine may be
considered as an interim option where ACTs cannot be
made available, provided that efficacy of both is high.
1.
Zhi Mu (Radix Anemarrhence)
[Main Components]
Timosaponin, mangiferin, sarssapogenin.
[Effects and HTCM]
1.
2.
Anti-microbes: It has effect against Staphylococcus aureus,
αand β-hemolytic strepcholerace, Salmonella typhi, E.coli,
Bacillus subtilis.
Antidiabetic:
3. Anti-pyretic (abate fever): It has a slow onset but pronged
duration.
[Interaction]
Antidiabetics:
Coptis Detoxicating Decoction (Huang Lian
Jie Du Tang)
 [Ingredients]
1. Huang Lian (Coptis root) 9g
2. Huang Qin (Scutellaria root) 6g
3. Huang Bai (Phellodendron bark)6g
4. Zhi Zi (Capejasmine fruit) 6g



1.
2.
3.
4.


5.
6.
[Effects & HTCM] Purging fire and expelling toxin.
Used for: fire toxin obstructing the three Jiaos.
Anti-microbes and Anti-toxin(anti-bacillus dysenteriae)
Anti-pyretic and sedating
Effects on immune function
Lower blood pressure
Without Huang Lian in the formula , the blood pressure
lowering action is decreased.
Without Huang Qin and Zhi Zi in the formula, the blood
pressure lowering action is increased.
Promotes cerebral circulation. It can treat senile
dementia and dementia due to cerebral ischemia.
Anti-peptic ulcer. It can control the activity of
hydrogen ions in digestion.
[Indications]
1. Septicemia, Pyotoxinemia
2. Tonsillitis
3. Hypertension
4. Diseases of cerebral vessels
5. Sequelae of wind stroke
6. Alzeheimer’s disease
7. Herpes Zoster
 [Side Effects]
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
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2.
3.
4.

Chapter 4
Herbs that purge
Properties of herbs that purge
1. Purging action
(1) Stimulate the movement of the intestine (Da
Huang)
(2) Increase the water content of the intestine (Mang
Xiao)
(3) Moisten the stool (Huo Ma Ren)
Induce urination
Anti-microbes, anti-toxin: Anti-amoebic dysentery
Anti-inflammation
Da Huang accomplished this by decreasing the
prostaglandin (PG)
5.

Anti-cancer
Da Huang can kill breast cancer cells by
means of restraining their protein synthesis


Examples of herbs that purge
Da Huang (Rhubarb)
[Main Components]
1. Anthraquinone (chief component for
purging)
2. Glycoside
3. Rhein
4. Chrysophanol
5. Emodin
6. Acatechin
7. Gallic acid
[Effects & HTCM]
Purge heat to relieve constipation and clear gastrointestinal
tract as well as invigorating blood to remove stasis.
1.
Effects on digestive system
(1) Purging actions: stimulate intestinal movement.
However, it can cause constipation if it is decocted for
a longer time because of tannic acid
(2) Protect liver and cholagogize (benefit the gall bladder)
a. It can help the gall bladder contract promoting bile secretion
b. It can lower serum cholesterol level
c.It can prolong the life of liver cells and promote regeneration of
liver cells
(1) Stimulate pancreatic secretions and restrain the
activity of pancreatic juices
 TCM believes Da Huang is cold and bitter and will
injure the stomach.
 (2) Anti-peptic ulcer
 a. It can control the activity of hydrogen ion in
digestion
 b. It can prevent stress to ulcer by means of promoting
the PGE2
2. Effect on blood
 (1) Stop bleeding
 The a-catechin and gallic acid can increase the
adherence of platelets. They can increase the
contraction of blood vessels
 (2) Reduce blood stasis

3.Promote the renal function
 (1) It can lower the level of BUN and
Cholesterol and triglycerides.
 (2) It has a remarkable suppressive effect on
the growth of both the renal tubules and the
mesangial cells in vitro by suppressing the
production of TNF and IL-1.
4. Anti-infection
(1) The rhein, chrysophanol, emodin can suppress bacteria
and virus
(2) Anti-pyretic and sedating actions
(3) Effects on immune function
5.Anti-cancer
Rhein, chrysophanol, emodin, a-catechin and gallic
acid can suppress the RNA and DNA synthesis of
cancer cells.
[Indications]
1. Constipation
2. Bleeding: Ulcer hematemesis
3. Dysentery and Acute Enteritis
4. Acute Abdominal inflammation
(Pancreatitis, Peritonitis)
5. Renal failure
6. Hyperlipidemia


[Side Effects]
1.
It causes pathologic changes in liver and thyroid with hypertrophy of
tissue cells.
Common adverse effects: nausea, vomiting, diarrhea, and
abdominal pain.
Drug interaction: prolonged use of Da Huang may cause loss of
potassium, leading to increased toxicity of cardiac glycosides, such
as digoxin.
2.
3.
Da Cheng Qi Decoction (Major Order the
Qi Decoction)
 [Ingredients]
1. Da Huang (Rhubarb) 12g
2. Mang Xiao (Mirabilite) 9g
3. Hou Po (Magnolia) 12g
4. Zhi Shi (Unripened bitter orange) 9g




1.
2.
3.


Used for:
Yang Ming fu-organ disorder with dry stool in the
intestines
[Effects & HTCM]
Purging actions
Effects on intestinal obstruction. It can promote
the circulation of vessels of the intestines,
decrease blood deficiency in the intestines, and
help the intestines to regain function after
surgery.
Anti-bacterial. (both gram-positive and gramnegative bacteria)
[Indications]
[Side Effects]
Chapter 5
Herbs that expel dampness
1. Gastrointestinal: To increase peristalsis of the intestines and
production of gastric acid.
2. Antibiotic: Huo Xiang, Cang Zhu, Hou Po, Sha Ren have
effects against Viruses and bacteria.
3. Antiulcer:
Medicinal Uses
Disclaimer Antibacterial; Carminative; Expectorant; Homeopathy;
Stimulant.
The fruit is antibacterial, carminative, diuretic, odontalgic, stimulant,
and stomachic[4, 21, 61, 176, 240]. It is taken internally in the
treatment of abdominal pain, digestive disturbances and complaints
such as lumbago[176, 238]. It is often included in remedies for
digestive disturbances and cough mixtures, in part at least for its
pleasant aniseed flavour[238]. An effective remedy for various
digestive upsets, including colic, it can be safely given to
children[254]. The fruit is also often chewed in small quantities after
meals in order to promote digestion and to sweeten the breath[4, 238].
The fruit has an antibacterial affect similar to penicillin[176]. The
fruit is harvested unripe when used for chewing, the ripe fruits being
used to extract essential oil and are dried for use in decoctions and
powders[238].
A homeopathic remedy is prepared from the seed[4].
Nat Cell Biol. 1999;May:1(1):60
Indirubin(Dian Yu Hong), the active constituent of a
Chinese antileukaemia medicine, inhibits cyclindependent kinases.
Hoessel R, Leclerc S, Endicott JA, Nobel ME, Lawrie A, Tunnah P, Leost M,
Damiens E, Marie D, Marko D, Niederberger E, Tang W, Eisenbrand G,
Meijer L.
Department of Chemistry, University of Kaiserslautern, Germany.
Indirubin is the active ingredient of Danggui Longhui Wan, a mixture of plants
that is used in traditional Chinese medicine to treat chronic diseases. Here we
identify indirubin and its analogues as potent inhibitors of cyclin-dependent
kinases (CDKs). The crystal structure of CDK2 in complex with indirubin
derivatives shows that indirubin interacts with the kinase's ATP-binding site
through van der Waals interactions and three hydrogen bonds. Indirubin-3'monoxime inhibits the proliferation of a large range of cells, mainly through
arresting the cells in the G2/M phase of the cell cycle. These results have
implications for therapeutic optimization of indigoids.
Example of herbs that expel dampness

Huo Xiang Zheng Qi San (Agastache powder
to rectify the qi)
 [Ingredients]
1. Hou Po (Magnolia Officinalis)
 [Components] essential oil and some alkaloids
2. Huo Xiang (Pogostemon Cablin)
 [Components] essential oil, patchouli alcohol,
and pogostone


1.


2.
3.
4.
5.
[Effects & HTCM]
Regulate the function of the stomach and intestines
(1) Relax intestinal spasm
(2) Low dosage can stimulate movement of stomach
and intestines
Promote the digestive function. It can help the
intestines absorb sugar and water
Analgesia. It can stop the pain caused by heat in
rats.
Increase the immune function. It can increase the
lymphocytes in the blood and help injured
intestines to recover.
Anti-bacterial. It can suppress Staphylococcus
aureus, Typhoid, Bacillus, Bacillus dysenteriae.
[Indications]
1. Stomach flu
2. Acute gastroenteriris, acute colitis
 [Side Effects]
 Huo Xiang Zheng Qi Shui can cause drug rash.
When herb intake is discontinued, the rash will
disappear.

Dan Shen
Dan shen



The dried root of Salvia miltiorrhiza
A commonly used traditional Chinese
medicine to improve circulation and
improve blood flow
Used for treating cardiovascular diseases
such as coronary heart disease,
hyperlipidemia and cerebrovascular
disease
Chemical constituents



Lipophilic and hydrophilic compounds
Lipophilic:Tanshinone analogues
(tanshinone IIA et al.)
Hydrophilic: Salvianolic acids, danshensu
et al.
Pharmacokinetics




Major components absorbed rapidly after
oral administration
Metabolized extensively by liver
Excreted from stool and urine,
Some components have low short half life,
low bioavailability, because of extensive
metabolism
Danshensu




Dilates coronary arteries,
Inhibit platelet aggregation
Improve microcirculation
Protect the myocardium from reperfusion
injury
Danshensu





The mechanism
- prevent intracellular calcium increase
- remove oxygen free radicals
- Inhibit myocardial cell apoptosis
- protect the endothelial cells against
homocysteinemia (risk factor for
cardiovascular diseases and
atherosclerosis)
Salvianolic acid B





Protect the brain from ischemiareperfusion injury
Inhibit platelet aggregation
Prevent low density lipoprotein (LDL),
uptake by cells
Stimulate nitric oxide production by
endothelial cells
Remove free radicals
Tanshinone IIA


Free radical scavenger property
Also inhibition of angiotensin II activity,
attenuating cardiac cell hypertrophy
Angina





The commonest herb used to treat angina
Improve microcirculation
Induce coronary vaso-dilation
Inhibit platelet adhesion and aggregation
Suppressing thromboxane formation
Angina




Sublingual nitroglycerin is the gold
standard for acute angina attacks
Provide an exogenous source of
vasodilator- nitric oxide
Induce coronary and peripheral
vasodilation
Prolonged nitrate therapy inhibit
endothelium nitric oxide synthase – cause
nitrate tolerance
Nitrate therapy


Vasodilatory
effects
Reduce
oxygen
demand
Angina


Several research suggests that danshen is
more suitable than isosorbide dinitrate in
long-term treatment for angina
And suggests danshen is more effective
than nitrates in the improvement of
symptoms and ECG tests
Angina


Plus, increased platelet aggregation
occurs in patients with angina, which can
reduce the effect of nitrates therapeutic
The development of tolerance to nitrate
therapy
More therapeutic activities




Coronary artery spasm
Myocardial infarction
- opening and formation of coronary
collateral circulation
- additionally, has sedative, antioxidant,
antiplatelet, and improve microcirculation
effects
Hyperlipidemia


Reduce total cholesterol and LDL, which
are risk factors for coronary
atherosclerosis
Protect endothelial cells from
homocysteine-induced injury
Hypertension




Inhibit angiotensin converting enzyme and
directly inhibit angiotensin II action
Reduce blood viscosity
As a complementary therapy for
pregnancy induced hypertension
Reduce incidence of arrhythmia
Peripheral vascular disease





Dilate peripheral vascular
- reduce smooth muscle contraction
- stimulate vascular dilating molecular
production
Pulmonary vascular disease, protection
against pulmonary thromboembolism
Improve vascular disease of diabetes
patience
Renal disease



Renoprotective effects
Help for recovery of renal function in the
early stage of renal transplantation
Reduce blood viscosity, p;atelet
aggregation and free radicals et al,
Side effects



No major side effects
May hypotension, dizziness, drowsiness,
abdominal discomfort, decrease appetite
and itching..
LD50 of water soluble extract was almost
4000 times higher in mice than the clinical
human oral dosage
Dan shen




Numerous forms of Danshen are available
in China
Fufang Danshen (with Panax notoginseng,
Cinnamomum camphora)
Has been registered as a drug in several
countries
And was the first TCM product approved
by FDA for phase II and phase III clinical
trials
Drug interaction




Warfarin
Potentiate the anticoagulant actionbleeding
Increase the half life (CYP 450)
Avoid patient taking warfarin
Drug interaction




Most drugs are bound to serum proteins to a
various degree.
Only unbound or free drug is pharmacologically
active.
under certain conditions, the equilibrium is
disturbed and the measured free drug
concentration can be significantly, especially for
strongly protein-bound drugs.
In such case a patient may experience drug
toxicity even if the total drug concentration is
within the therapeutic range.
Drug interaction




Danshen (50-70%) strongly bind to protein
Albumin as the major serum protein that
binds Danshen.
Salicylate, which is also strongly bound to
albumin, is a widely used over-the-counter
medicine in the U.S.
Digoxin
More


Reduces alcohol intake in alcoholpreferring rats
Hamper alcohol absorption from GI track
without affect the severity of alcohol
withdrawal syndrome in rats
Sanqi (Panax notoginseng)
Sanqi




The root of Panax Notoginseng
It is the largest ingredient in 云南白药 (Yunnan
Bai Yao), a famous hemostatic herbal remedy
Sweet and slightly bitter in taste, and nontoxic.
The dose in decoction for clinical use is 5-10 g.
It can be ground to powder for swallowing
directly or taking mixed with water: the dose in
that case is usually is 1-3 grams.
Sanqi





Hemostatic effect
Cardiovascular effect
Protect the liver
Anti-inflammatory effects
Anti-carcinogenic effects on some forms of
cancer.
Sanqi


Contains many chemical constituents.
Saponins derivatives (PNS), which is a
mixture of more than 20 types of saponins,
four or five of them are considered as the
principle active ones


Notoginenoside R1, ginsenoside Rg1, Rd, Re
and Rb1 (75-80% total PNS)
Flavonoids et al.
Pharmacokinetics

Oral administration, most Saponins
derivatives (powder) tested in rats,
reached peak concentration in plasma
rapidly within about 0.75 h - hint their
absorption were quick.

Maximum concentration in rat plasma
were low

indicated that it may be poorly absorbed and /
or extensive metabolized (intestinal microflora,
liver) ….
Pharmacokinetics


Half time was changed from 1 to 20 hrs in
rat plasma after oral administration of the
constituents
Iv in rats, most constituents were cleared
quickly except a couple of PNS

the pharmacokinetic profile diversities of
these constituents are probably one of the
mechanisms of the multiple pharmacology
activities
San-qi


Many preparation were used in clinic in
China (tablet, drop pill and injection)
Xuesaitong injection is consisted with only
PNS


Very difficult to evaluate the pharmacokinetic
profile
Pharmacokinetics parameters are different
from individual compounds
San-qi Hemostatic effect


San-qi and a saponin (PNS) extract
provide hemostatic effects. External
application reduces bleeding time
The effect lost significantly after heating
Sanqi

Combination with Salvia miltiorrhiza
(Danshen) and Ligusticum (Chuanxiong)
efficaciously reduces lipoperoxidative
damage to tissues
Thrombogenicity effects


PNS reduces platelet activation, adhesion
and aggregation
Prevent thrombosis and improve
microcirculation in patients with blood
hyperviscosicity syndrome
Thrombogenicity effects

PNS iv or oral 200 mg/kg need 20 days
to appear

hint a slow effect compare to hemostatic
Fibrinolytic effects

Sanqi (the extract as notoginsenoside R1)
increased the fibrnolytic potential in in vivo
lab test, which may be beneficial to
cardiovascular disease
Cardiovascular effects




Dilate the coronary artery
Increase coronary blood flow, providing
more blood to the heart muscle
Improves micro-circulation in and around
damaged heart tissue
Reduces cardiac load, lowers arterial
pressure
Cardiovascular



Decrease the size of myocardial infarction
Anti-arrhythmia
PNS increases PGI2 and reduces
thromboxane A2 in platelets – correct the
unbalance between the two
prostaglandins
Anti-atherosclerotic effect

It helps lower cholesterol and triglycerides,
to prevent the progression of
atherosclerotic lesion
Effects on brain




Protect ischaemic brain damage
Decrease brain edema, infarct size and
neuron damage
Inhibit uptake calcium by neuron cells
isolated from rats
Protect cultured rat cortical neuron from
glutamate neurotoxicity
Ischemic cascade
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Lack of oxygen causes the neuron's normal process for making ATP for energy to fail.
The cell switches to anaerobic metabolism, producing lactic acid.
ATP-reliant ion transport pumps fail, causing the cell to become depolarized, allowing ions,
including calcium (Ca++), to flow into the cell.
The ion pumps can no longer transport calcium out of the cell, and intracellular calcium levels
get too high.
The presence of calcium triggers the release of the excitatory amino acid neurotransmitter
glutamate.
Glutamate stimulates AMPA receptors and Ca++-permeable NMDA receptors, which open to
allow more calcium into cells.
Excess calcium entry overexcites cells and causes the generation of harmful chemicals like
free radicals, reactive oxygen species and calcium-dependent enzymes such as calpain,
endonucleases, ATPases, and phospholipases in a process called excitotoxicity.[5][6] Calcium
can also cause the release of more glutamate.
As the cell's membrane is broken down by phospholipases, it becomes more permeable, and
more ions and harmful chemicals flow into the cell.
Mitochondria break down, releasing toxins and apoptotic factors into the cell.
The caspase-dependent apoptosis cascade is initiated, causing cells to "commit suicide."
If the cell dies through necrosis, it releases glutamate and toxic chemicals into the environment
around it. Toxins poison nearby neurons, and glutamate can overexcite them.
If and when the brain is reperfused, a number of factors lead to reperfusion injury.
An inflammatory response is mounted, and phagocytic cells engulf damaged but still viable
tissue.
Harmful chemicals damage the blood brain barrier.
Cerebral edema (swelling of the brain) occurs due to leakage of large molecules like albumins
from blood vessels through the damaged blood brain barrier. These large molecules pull water
into the brain tissue after them by osmosis. This "vasogenic edema" causes compression of
and damage to brain tissue.
Basic mechanism of excitotoxicity of stroke

It is widely believed that calcium entry into
neurons significantly contributes to
ischemia related toxicity

remove Ca in experimental setting greatly
reduced hypoxic damage to neuron
Therapeutic strategy




Restore blood supply
Minimizing Ca influx into cells
Reducing free radical damage
Promoting neural recovery
Tumor Radio-sensitivity

Taiwanese scientists studied the
sensitization effect of Panax notoginseng
extract and purified Saponin (Rb1) on the
radiation response of an experimental
tumor (KHT sarcoma) in comparison with
its effects on a normal tissue (bone
marrow) in mice
Tumor Radiosensitivity





Panax notoginseng extract at a concentration of 0.1-100
mg/kg produced an increase in tumor radiosensitivity.
Rb1 at a concentration 0.001 to 1 mg/kg produced an
increase in tumor radiosensitivity, with maximum effect
at 1 mg/kg.
The effect was maximal at 10 mg/kg and at 30 minutes
after injection.
Higher doses of notoginseng (not Rb1) were toxic to the
bone marrow stem cells
Further purified or synthetic versions are useful in cancer
therapy.
Toxicity



Low
Esophagitis from consuming tablets (drink
enough water) may occur
Allergic reactions including dermatitis,
shock, purpura, blisters, or other
idiosyncratic reactions

Chapter 6
Herbs that tonify


Properties of herbs that tonify:

1.




Effects on the immune function
(1) It can increase the WBC and prevent the
decrease of WBC caused by chemotherapy
(2) It can promote the phagocytic function of
phagocytes
(3) It can build the function of Th cells
(4) It can regulate or help body produce IgG, IgA,
and SIgA
2. Effects on the nervous system:

(1) Regulate the function of cerebral cortex
( Ginseng, Huangqi)

(2) Excite the nervous function (Ginseng, Lu
Rong)

(3) Promote the circulation of the brain (Dang Gui)

(4) Components of the herbs are rich in proteins,
vitamins, and trace elements which can nourish the
cerebral cells, promote the development of the brain,
prevent cerebral senility.
3. Promote endocrine functions
 There are degenerations or atrophies of endocrine organs in
most of the deficient syndromes.
 (1) Promote the functions of hypothalamus-pituitary glandadrenal gland.
 Ginseng, Huang qi and Wu Jia Pi can stimulate the
hypothalamus and pituitary gland to secrete ACTH which in
turn increases the cAMP (cyclic adrenosine monophosphate)
of the adrenal gland and help it to synthesize cortical
hormone.
 (2) Excite the thalamus-pituitary gland-sexual gland
 Yin Yang Huo, Gou Qi Zi can excite them and promote the
secretion of sexual hormone.
 (3) Excite the thalamus-pituitary gland-thyroid gland
 Some formulas that tonify yang (You Gui Wan) can
stimulate thyroid functions.
4. Effect on the cardiovascular system
 (1) Ren Shen, Huang Qi, Mai Men Dong, Sheng Mai
San, Shen Fu Tang can promote function of the heart.
 (2) Dang Gui, Yin Yang Huo, Mai Men Dong can
dilate coronary artery, promote the circulation of the
coronary artery, and treat myocardial ischemia.
 (3) Dang Gui, shu di Huang, Liu Wei Di Huang Wan
can lower blood pressure.
 (4) Si Jun Zi Tang, Sheng Mai San, Shen Fu Tong
increase the blood pressure.
5. Promote the hematopoietic function
 Dang Shen, Dang Gui et al. can increase RBC by
stimulating the hematopoietic function of bone marrow.
6. Effects on the digestive system
 Dang Shen, Bai Zhu, Si Jun Zi Tong relax
intestinal spasm, and regulate intestinal
movement , anti-peptic ulcer.
7.Prolong life
 (1) Ren Shen, Huang Qi can prolong animal
cell’s life.
 (2) Yin Yang Huo can stimulate the function
of SOD (superoxide dismutase)


Examples of herbs that tonify
Ren Shen (Ginseng)
“Huang lian doesn’t get credit for curing diseases,
and Ren Shen doesn’t get punished even if it kills the
patient”.



1.
2.
3.
4.
5.

[Main Components]
Volatile oil (0.05%)
saponins, known as panaxosides or
ginsenosides
antioxidants
peptides
polysaccharides
fatty acids

[Effects & HTCM]
1. Effects on central nervous system:
It has a stimulating effects in low doses, but an inhibiting effect in large
doses. It increases the amounts of dopamine and norrepinephrine in the
brain stem.
2. cognitive: improve memory and learning ability.
3.Endocrinological: it stimulates pituitary gland to increase the secretion of
ACTH.
4. Immunostimulant:
5: cardiovascular:
6. Hypoglycemic:
7. reproductive:
2. Anti-cancer activity
 (1) It can inhibit several types of cancer cell
growth in vitro
 (2) Mice innoculated with S-180 cancer cells
survive for a longer time if given ginsenosides.
 (3) Has the ability to inhibit the adhesion and
invasion of tumor cells in the lungs primarily
due to their antiangiogenesis activity.
3.Anti –shock

1.
2.
3.
4.
5.
6.
7.


[Indications]
Arrythmia: for atrial fibrillation, sick sinus
syndrome, ventricular arrhythmia.
Angina pectoris
Leukopenia
Hepatitis
Cancer
Diabetes
Prolonged life
[Side Effects]
It could cause eruptions, itching, headache, dizziness,
and body temperature increase as well as bleeding. It
is prohibited in excessive syndromes, and damp-heat
syndromes.
Huang Qi ( Astragalus Membranaceus)
 It is sweet, slightly warm. Enters Lung and
spleen. Tonify qi and stabilze exterior, promote
urination and reduce edema, promote the
discharge of pus and generate the flesh.
 [Main Components]
1. Carbohydrates of astragalus
2. Glycoside
3. Alkaloids
4. amino acids, et al.


1.





[Effects & HTCM]
Effects on the immune function
(1) It can increase the WBC and prevent the decrease of
WBC caused by chemotherapy.
(2) It can promote the phagocytic function of
phagocytes
(3) It can build the function of helper T lymphocytes
(Th cells)
(4) IT can regularte or help body produce IgG, IgA,
SIgA
(5) It can stimulate the lymphocyte activating factor

2. Prolong life
 Huang Qi can prolong the animal cell’s life.
 (1) It can stimulate the function of SOD (superoxide
dismutase)
 (2) It can decrease free radicals
 (3) It can increase catecholamine (CA), it inhibits the
activity of MAO-B
3.Effects on the cardiovascular system
 (1) It can promote function of the heart, especially
heart failure due to toxicity or fatigue.




(2) Dilate blood vessels
a.
It can dilate the peripheral vessels, cerebral
vessels, renal vessels, and coronary vessels as well as
intestinal vessels. However, if the dosage of Huang
Qi is too high, the renal vessels will be contracted due
to a decrease of blood pressure
b. It can promote the microcirculation, strengthen
the defensive function of micro vessels, and prevent
permeability of micro vessels caused by other
diseases
(3) It can lower the blood pressure
4. Effects on the hematopoietic function
 (1) Promote the hematopoietic function
 It can increase the RBC and WBC by stimulating the
hematopoietic function of the bone marrow.
 (2) Inhibit the aggregation of thrombocytes by
means of cAMP of thrombocytes
5. Effects on substance metabolism
 [Indications]
 [Side Effects]

Question?
1. General speaking, which of the following
group herbs they are mainly rich in
alkaloid, and glycoside which posse antibacteium, Viral and inflammation ?.
A. sweet herbs
B. bitter herbs
C. sour herbs
D. salty herbs
2. The pungent herbs have the following actions
except
 A. relieving exterior syndrome:
 B. relaxing spasm
 C. relieving pain
 D. strengthening Qi and blood
3. The following herbs(aristolochic acid) have side
effects on the kidney except


A. Mu tong
B. Han fang ji
C. Chai Hu
D. Ma duo Ling
4. What kinds of side-effects does the Ma
Huang have?
 A.lead to bleeding of eyes, increasing the

blood pressure
 B.exciting central nervous system
 C.lead to restlessness, insomnia.
 D. All A, B, C
5. Gui Zhi (Cinnamon twig, cinnamomun )
has the following actions except




A. dilating Blood-vessels to promote
sweating
B. relieving asthma
C. Reducing fever & stopping pain.
D. Tranquilizing
1. According to the recent research of herbal
pharmacology, Ge Gen (Kudzu, pueraria) not only
can be used for reducing fever, relaxing the
smooth muscle of intestine, but also for treating
A. diseases of lungs
B. diseases of kidney
C. diseases of digestion
D. diseases of circulation system.
2. General speaking, the Herbs that clear heat
syndrome have the following actions except
A.Anti-microrganism, Anti-toxin
B.Effects on immunologic function
C. Reducing edema
D. anti-cancer
3.Huang Lian(coptis root) is mainly used for
acute enteritis and
A. urinary tract infection
B. Dysentery
C. promote platelet adhesion
D. disorder of the bacterium in intestine
4. What is the main side effect of the Huang Lian,
if oral taking.
A.Few of them suffers from allergic reaction.
B.reactions of gastric-intestine.
C.reactions of the heart
D.reactions of the respiration
5.Chai Hu(Bupleurum Root) is mainly used
for the following diseases except
A. infective diseases
B. disorders of immunologic function
C. Diseases of digestion
D. diseases of hemapopoietic system
Questions?
1.Coptis Detoxicating Decoction(Huang Lian Jie
Du Tang) is good for
A. stopping paing
B. Anti-microrganism and Anti-toxin
C. increasing blood pressure
D. promoting the intestinal movement
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2. Purging action of Mang Xiao is by means of
A. stimulating the movement of the intestine
B. increasing the water of the intestine
C. moistening the intestine
D. Decreasing the water of the intestine
3. The component of Da Huang(rhubarb) for
purging is
A. anthraquinone
B. emodin,
C. a-catechin
D. gallic acid.
5.Da Huang can promote the renal function by
means of the following mechanisms except
A. lowing the level of BUN
B. lowing Cholesterol and triglyceride.
C. regulating cardiac functions
D. suppressiving effect on the growth of both
renal tubules and messangial cells
6. Da Huang can be used for
A. constipation
B. Renal failure
C. Dysentery and Acute enteritis.
D. All of A, B and C
7. The Da Huang has the following main
Side-effect possibly except ?
A. it causes pathologic changes in liver and
thyroid with hypertropy of the tissue cells.
B. it leads to bleeding
C. it causes nausea, vomiting
D. it causes abdominal pain.
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Si Jun Zi Tang(Four Gentlemen Decoction)
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[Effects]
 1. Effect on intestine: mainly inhibit the movement of
intestine.
 2. Effects on the immune function:
(1) It can prevent decreased phagocytic function caused
by cyclophosphamide or prednisone.
(2) It can regulate or help body product IgG, IgA.
(3) It can stimulate the lymphocyte activating factor.
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3. Promote the hematopoietic function
(1) It can increase the RBC by means of
stimulate the hematopoietic function of bone
marrow.
4. It has the ability to inhibit the adhesion
and invasion of tumor cells in the lung
[Indications]
1. Chronic diarrhea, ulcer,gastritis.
2. Chronic hepatitis
Liu Wei Di Huang Wan
It can nourish yin and tonify kidney.
[Effects]
1. Promote the immune function
(1) It can promte the weight of immune organs and
phagocytic function of phagocyte, functions of
bone marrow which is decreased by
cyclophosphamide or prednisone.
(2) Increase the function of phagocytic function
of phagocyte.
(3) Stimulate the activity of C3b-receptor
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2. Anti-cancers
(1) Reduce the incidence of cancers by
means of preventing the halmatogenesis
of normal cells and normal cells turning
into cancer cells.
(2) The mechanism for anti-cancers has
something with promoting immune
function, but not due to killing cancer cells.
3. Promote hepatofunction and low blood lipid
(1)low TC and fat in liver.
(2)increase HDL-C and HDL-C/TC.
Ze Xie and Mu Dan Pi are main herbs.
4. Low blood sugar.
Shan Zhu Yu, Mu Dan pi, Shan Yao, and Fu
Ling all can low blood sugar.
5. Effect on calcium-phosphorus metabolism
it can keep the calcium-phosphorus in
normal level, promote the calciumphosphorus in the bone, so it can prevent the
incidence of rickets.
6. Promote sexual function
(1) Increase quantity of sperm
(2) Increase the capacity of coitus
(3) Increase the weight of sexual organs.
[indications]
1. Diabetes
2. Nephritis
3. Chronic Prostatitis
4. Climacteric syndrome
5. Cancer
6. Other diseases
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Chapter 7. Herbs that warm interior
The warming interior herbs have the
function of warming interior, dispersing
cold, warming kidney meridian and
restoring collapse yang.
Properties: Pungent and sweet in flavor, hot
and toxic in nature; it is related to the heart,
kidney and spleen channels.
Functions: Recuperating depleted yang and
rescuing the patient from collapse, restoring
yang and supplementing fire as well as
dispersing cold and relieving pain.
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1. Cardiovascular system: Fu Zi and Sini Tang
(Fu Zi, Gan Jiang, Gan Cao) have the function of
recuperating depleted yang and warming heart yang.
Heart yang deficiency is similar to heart failure, and
arrhythmia of slow irregular pulse. Studies have proven
that Fu Zi, Wu Tou, Gan Jiang and Rou Gui have
obviously functioned on cardiovascular system which is
related to Fu Zi's DMC (dl-demethlcoclaurine).
(1) Promote cardiac contratility Function: Fu Zi can
strengthen cardiac contraction, increase heart beat,
increase cardiac output and increase cardiac muscle
oxygen consumption volume. The main ingredient of
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strengthening heart function in Fu Zi is believed to be
DMC (dl-demethlcoclaurine) which relates to Beta
receptor. If the Beta receptor is blocked, increased
cardiac contraction and heart rate will noticeably be
decreased. DMC can shorten the period between A to
H wave, and there is no change between H and H to
V wave. It can increase the inotropic cardiac
conductivity. The pure extract of Gan Jiang proves to
have direct excitant function on heart.
(2) Promote cardiac frequency and inotropic
conductivity: Fu Zi is proven to have treatment
effect on treating of arrhythmia with slow heart beat
type. Also DMC and Shen Fu Tang have similar
function, too.
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(3) Dilate vessels and improve circulation: Fu Zi
and Rou Gui can dilate coronary vessels, increase
coronary circulation, improving cardiac circulation,
dilate brain vessels, and increase brain vessel
circulation.
(4) Anti-shock function: Collapse syndrome and
minute pulse to almost no pulse condition are similar
to shock in western medicine. Fu Zi, Sini Tang,
Sheng Fu Tang can elevate arterial pressure to
prolong animal's life due to hypovolemic shock
(blood loss), septic shock (infection with endotoxin),
cardiogenic shock (myocardial infarct). And, it
provides protection on shock due to lack of
oxygen or narrowing the vessels.
2. Digestive function: Rou Gui and Wu Ju Yu
are warm and pungent which benefits stomach.
Jiang (ginger)'s aromatic and acrid function
can stimulate oral and intestine membrane and
improve local circulation which leads to
increase stomach secretion, enzyme activity,
increase digestion, increase appetite and
disperse digestive stagnation. Wu Ju Yu and
Gan Jiang also can stop vomiting.
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3. CNS function: Fu Zi, Wu Tou, Hwa Jiao, Hu
Jiao, Gan Jiang, Rou Gui can relieve pain at
different level. Fu Zi, Wu Tou , Hwa Jiao
have analgesic function. Some warm interior
herbs also have tranquilizing function. Sini
Tang can promote sympathetic nerve to
promote heat and disperse cold.
4. Anti-infection, immune function : Fu Zi, Xi
Sin can reduce inflammation due to enzyme,
PE2, etc. in the animal testing. Fu Zi can
promote immunity by increasing IgM or IgG.
Fu Zi (Prepared Aconite Root)
Two types: It is from the root of Wu Tou.
There are two types: Chuan Wu and Cao Wu.
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Properties: Pungent and sweet in flavor,
hot and toxic in nature, it is related to the
heart, kidney and spleen channels.It is the
root of Chuan Wu and Cao Wu.

Modern Researches: This herb contains
aconitine, hypaconitine, talastisamine,
chuanwu base A, chuanwu base A,
racemic norcoclaurine, coryneine, etc.
Monkshood root and its decoction have an
obvious cardiotonic effect and prepared
sliced monkshood root has a more
powerful cardiotonic effect. The longer
monkshood root is decocted, the more
remarkable are its cardiotonic effects and
the lower its toxicity. Its
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cardiotonic effects are closely related to
the racemic norcoclaurine contained
therein. It has obvious anti-inflammatory
effects on formol and protein arthritis. Both
the hypaconitine and aconine that it
contains have tranquilizing and analgesic
effects. It can resist myocardial ischemia
and hypoxia, stimulate the pituitary
adrenocortical system and promote blood
coagulation.
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Functions:
1. Cardiac vascular system function:
(1)Strength heart system
(2)Antiarrhythmia
(3)Dilate vessels, lower blood pressure (dldemethylcoclaurine, higenamine),
(4)increase blood pressure (coryneine
chroiole and salsolinol, SAL)
(5)Protect heart muscle, promote enduring
time of lacking oxygen.
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(6) Anti-shock
2. CNS system function:
(1) Anti cold
(2) Relieve pain
(3) Analgesia
3. Anti-infection, increase immunity:
(1)Anti-infection
(2)Increase immune function
4. Others:
(1) Digestive function
(2) Increase Beta receptor, cAMP system
reaction
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(3)Increase KPTT and PCT time ( Fu Zi's
activating blood function).
Indications:
1. Shock
2. Cardiac disorder (arrhythmia)
3. Arthritis, joint pain, lumbar pain, etc.
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Cautions: Being pungent, hot, dry and drastic, this
drug should be avoided by anyone with
hyperactivity of yang due to yin deficiency or by
pregnant women. It is against pinellia tuber,
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Mongolian snakegourd (Fructus
Trichosanthis), fritillary bulb (Bulbus
Fritillariae Thunbergii), Japanese
ampelopsis (Radix Ampelopsis) and
hyacinth bletilla tuber (Rhizoma Bletillae).
Being toxic, it should be blast-fried for oral
administration. Any excessive oral
administration or any improper blast-frying
or decocting way may lead to poisoning.
Thank You