Monday, June 13, 2016

Coursework: Research Study on Radix Bupleuri (Chai Hu)


Research Study on Radix Bupleuri (Chai Hu)
 Herbology I 
                                                                   AOMA Fall 2013        
           
            The Chinese herb known as Chai Hu is the root of Bupleurum Root Radix Bupleuri. It is part of the Umbelliferae family and is collected in the spring and autumn. Its preparation is to dry it in the sun, slice and use raw. It can also be bake-fried with wine or vinegar to produce different effects. It has aromatic qualities which disperse and lift, it is bitter for purgation and pungent for dispersion. These qualities release half-interior half-exterior pathogenetic heat, regulate the circulation of Qi, sooth the liver and elevate Yang to treat Qi sinking in the middle Jiao (Zhixian & Xingdong, 2004).
            Chai Hu is considered the key herb for treatment of a Shaoyang syndrome. When the pathogenic factor is halfway between interior and exterior the condition is rather complex since the patient can exhibit both interior related and exterior related symptoms (Zhixian & Xingdong, 2004). Of all the symptoms exhibited the most essential one for diagnosis of Shaoyang Syndrome is “alternating chills and fever.” In TCM diagnosis, Malaria is sometimes considered a shaoyang disorder due to patients often exhibiting alternating chills and fever. Chai Hu guides the trapped pathogenic factor outwards and harmonizes the interior and exterior (Chen & Chen, 2004).
            Chai Hu’s ascending and dispersing characteristics are also commonly used to spread Liver Qi and unblock Liver Qi stagnation. It can be combined with many different herbs to treat specific manifestations of Liver Qi stagnation such as emotional distress, hypochondriac fullness and pain, cold extremities, migraine, eye pain and swelling, irregular menstruation with cramps and jaundice (Chen & Chen, 2004).
            It’s ascending nature is also excellent for lifting Yang Qi. If there is a Qi or Yang deficiency causing prolapse of internal organs Chai Hu can be used to raise and tonify Qi, especially if paired with Sheng Ma and Huang Qi. Chai Hu treats prolapse of the rectum and uterus, hypermenorrhea, lingering diarrhea and polyuria caused by deficiency and sinking Qi in the middle Jiao (Chen & Chen, 2004).
            Chai Hu is part of a formula called Long Dan Xie Gan Tang which clears and drains damp-heat from the lower Jiao and drains excess fire from the liver and gallbladder. Due to Chai Hu’s dispersing quality it is added to the formula to dissipate the excess heat being retained. Having this function qualifies it to be the second deputy of the formula. Together Huang Qin and Zhi zi make up the first deputy because they not only clear heat but also drain damp, a quality Chai Hu doesn’t possess. Chai Hu is especially vital to the formula because it plays a second role as an envoy. One of the jobs of an envoy is to guide the effects of the other herbs to specific channels. Chai Hu enters the liver and gallbladder channels, so as an envoy in this formula it leads the other herbs to those channels (Kim, 2008).
            Chai Hu has been used in Chinese medicine to treat Liver Qi stagnation for thousands of years but in 2005 it’s chemical effects relating to Liver Qi stagnation were tested by doctors at the Beijing University of TCM (Chen, Ji, Lu, Hu, 2005). The study examined the effects of Xiao Yao San containing Chai Hu on patients with Liver Stagnation and Spleen Deficiency Syndrome (LSSDS). The study looked at 58 patients suffering from depression, hypochondriac pain, listlessness, flatulence and loose stools. They assessed changes in the plasma indices of norepinephrine(NE), epinephrine(E), dopamine(DA), beta-endorphin(beta-EP), adrenocorticotropin hormone(ACTH), estradiol(E2), testosterone(T), immunoglobulin A (Ig A) and G (Ig G) (Chen, Ji, Lu, Hu, 2005). After subjects in the experimental group had been taking Xiao Tao San containing Chai Hu for one month there was a significant decrease in their self-rated anxiety scale (Chen, Ji, Lu, Hu, 2005).  Blood samples of the experimental group showed their plasma beta-EP was enhanced and their E and DA were decreased. These finding suggests that Xiao Yao San containing Chai Hu treats patients with LSSDS by it’s regulation of beta-EP, E and DA (Chen, Ji, Lu, Hu, 2005). Beta-EP has a close relationship with emotional disorders and imbalance. One of Chai Hu’s actions in the Long Dan Xie Gan Tang formula has to do with it’s relationship to the liver and gallbladder. This study supports Chai Hu in this formula because all the studied plasma hormones have important biological connections to the liver and specifically deal with emotions which could be linked to Liver Stagnation.
            In 2012, two studies were published in which the effects of Chai Hu was investigated. The first one looked at how Vinegar-Baked Chai Hu (VBCH) treats obesity and hyperlipidemia. In previous studies it was shown that VBCH had a much stronger effect on migrating pain and bile secretion than with raw Chai Hu, but little was known about it’s effect on lipid regulation (Tzeng, Lu, Liou, Chang & Liu, 2012).  The 2012 study found that VBCH suppressed the growth of adipose tissue mass as well as bodyweight gain. These finding suggest that it may inhibit lipid accumulation in adipose tissues, most notably in the liver (Tzeng, Lu, Liou, Chang & Liu, 2012). This is an important finding because ectopic accumulation of lipids in the liver is associated with many diseases including metabolic syndrome and type 2 diabetes (Tzeng, Lu, Liou, Chang & Liu, 2012). Though Long Dan Xie Gan Tang wouldn’t specifically be used to treat obesity, type 2 diabetes and hyperlipidemia, many symptoms it treats could be secondary indications for those disorders; such as, glaucoma, uveitis, pyelonephritis, eczema, headaches, etc. (Kim, 2008).
            The second 2012 research paper is directly related to Long Dan Xie Gan Tang as it has to do with the treatment of hyperthyroidism. Hyperactivity of the thyroid promotes an accumulation of oxidatively damaging molecules and since the liver is a major target organ for thyroid hormone, this directly leads to liver damage (Kim, Kim, Chung, Cheon, Ku, 2012). Researchers induced hyperthyroidism in rats and administered Chai Hu to the experimental group. Chai Hu significantly inhibited histopathological changes in the thyroid by reducing the thickness of the follicular lining of the epithelium (Kim, Kim, Chung, Cheon, Ku, 2012). This shows that Chai Hu has direct control on hyperthyroid states. By decreasing epididymal fat, liver damage was inhibited and liver antioxidant defense were enhanced (Kim, Kim, Chung, Cheon, Ku, 2012). Long Dan Xie Gan Tang can be prescribed for hyperthyroidism already, so these findings further enforce its effectiveness in this pursuit. Chai Hu’s actions of dispersing heat and focusing the other herbs towards the liver and gallbladder are now even more significant.
            There are currently no herb-drug interactions for single Chai Hu, though their are a few for the formula which Chai Hu is a part,  Xiao Chai Hu Tang (Minor Bupleurum Decoction). It was shown that after administering Xiao Chai Hu Tang the bioavailability of Tolbutamide, a type 2 diabetes treatment, was reduced. It was also reported that Xiao Chai Hu Tang may cause an increased risk of acute pneumonitis. The formula did not directly produce any lung tissue damage but may be over stimulating the neutrophils which cause damage which is then repaired by fibroblasts leading to an increase in pulmonary fibrosis (Chen & Chen, 2004).
            Chai Hu’s functions are useful for overall health as well as treating more specific syndromes. The liver is an important organ for detoxing the body, so Chai Hu’s actions of both expelling pathogens and treating imbalance in the liver and spleen makes it an extremely functional herb.



Chen, J. K., & Chen, T. T. (2004). Chinese medical herbology and pharmacology. City of Industry, CA: Art of Medicine Press, Inc.

Chen, J., Ji, B., Lu, Z., Hu, L. (2005). Effects of Chai Hu (Radix Burpleuri) Containing Formulation on Plasma β-endorphin, Epinephrine and Dopamine in Patients. American Journal Of Chinese Medicine, 33(5), 737-745.

Kim, H. (2008). Handbook of Oriental Medicine. (4th ed). Anaheim, CA: QPuncture.

Kim, S., Kim, S., Chung, I., Cheon, W., Ku, S. (2012). Antioxidant and Protective Effects of Bupleurum falcatum on the l-Thyroxine-Induced Hyperthyroidism in Rats. Evidence-Based Complementary & Alternative Medicine (Ecam), 1-12.     

Tzeng, T., Lu, H., Liou, S., Chang, C., Liu, I. (2012). Vinegar-Baked Radix Bupleuri Regulates Lipid Disorders via a Pathway Dependent on Peroxisome-Proliferator-Activated Receptor-α in High-Fat-Diet-Induced Obese Rats. Evidence-Based Complementary & Alternative Medicine (Ecam), 1-12.         
  
Zhixian, L., & Xingdong, H. (2004). The chinese materia medica. (2nd ed.). Beijing: Academy Press (Xue Yuan).

No comments:

Post a Comment