Bupleurum
  


INTRODUCTION

Bupleurum (Bupleurum falcatum, Bupleurum fruticescens) has been widely used for over 2,000 years in Asia and is today used n Australia, Japan and China mainly to treat hepatitis, cirrhosis, and other inflammatory and neurological conditions associated with stress. Traditional uses include treatment for deafness, dizziness, diabetes, wounds and vomiting. The root of Bupleurum is an important ingredient in xiao-chai-hu-tan/sho-saiko-to (also known as Minor Bupleurum Decoction), a combination of nine herbs, including ginseng, ginger, and licorice, which is used in traditional Chinese and Japanese herbal medicine for hepatitis and cirrhosis.

HISTORICAL MEDICINAL USES OF BUPLEURUM

Bupleurum is a traditional Chinese herb used to treat alternating chills and fever, liver enlargement, prolapse of the uterus and rectum and irregular menstruation. Traditional texts list its properties as bitter and cool and it acts as a diaphoretic and to regulate and restore gastrointestinal and liver function. Recent pharmacological research on Bupleurum has highlighted its anti-inflammatory activity. This anti-inflammatory action appears to be mediated through the enhanced release and potentiation of hormones from the adrenal cortex. In this sense, Bupleurum has a similar effect to (although milder and safer) medical steroidal anti-inflammatory drugs.

MEDICAL USES OF BUPLEURUM

Bupleurum falcatum is the main Chinese herb used for liver disharmony. Bupleurum is anti-inflammatory, adaptogenic, hepatoprotective, antitussive and a mild sedative. Bupleurum is indicated for liver stasis, hepatomegaly, splenomegaly, indigestion and common cold with chills and fever. It is also important for debility and prolapse (often combined with Astragalus).

Reduced Stress

Single administrations of the Bupleurum formula have been found to have a very similar acute anti-stress effect as the medical anti-stress drug diazepam, which is commonly used to reduce severe anxiety. The effect was as strong as that of diazepam but without the side effects (eg. addiction and day time drowsiness).
Positive mood effects have been found with a Bupleurum formula. In a one-month single- human study, plasma β-endorphin levels (a brain chemical associated with euphoria) was significantly increased, while the stress related hormones (adrenaline and dopamine) were markedly decreased after the administration of this formula. Clinically, many mood symptoms improved, including temper, irritability, sadness and premenstrual irritability, with significant improvements in anxiety. There were also improvements in insomnia and the physical symptoms of dizziness, a distending feeling in the head, dryness and discomfort in the eyes and chest, abdominal discomfort, fatigue, sighing, menstrual discomfort, sexual dysfunction, and loose stools or constipation.

Depression

Bupleurum has also been found to be an effective adjunctive treatment in the depressive phase of bipolar disorder. In a double-blind, randomised, placebo-controlled trial, 124 bipolar depressed, and 111 manic patients were randomised to treatment with
(i) carbamazepine alone (a medical drug used for the treatment of depression),
(ii) carbamazepine plus Bupleurum, or (iii) placebo for 12 weeks. Compared to the drug on its own, the adjunctive treatment of carbamazepine plus the Bupleurum resulted in significantly better outcomes on the three measures of depression at Week 4 and Week 8, and a significantly greater clinical response rate in depressed subjects. Interestingly, there was a reduced incidence of the side effects of dizziness and fatigue in the combination of the drug and Bupleurum, when compared to carbamazepine taken on its own.

PMS

In a 12-week trial on the management of menopausal mood disorders, 147 menopausal women with mood symptoms were given either an anti-depressant, a placebo or Bupleurum. After 12 weeks of treatment, the herbal combination significantly improved mood in the women, except in the placebo group where there was no significant.

Reducing inflammation

Inflammation is present in many medical conditions, including arthritis, Alzheimer’s disease, cancer, heart disease and most skin conditions. The anti-inflammatory activity of Bupleurum appears to be related, at least in part, to its ability to both induce secretion of the body’s own anti-inflammatory chemical, corticosterone, while also potentiating its anti-inflammatory activity.

Hepatitis

Hepatitis is an inflammation of the liver, which is often caused by a viral infection. The most dangerous infections which affect the liver are Hepatitis B and C. Bupleurum has been found to significantly improve 100 cases of infectious hepatitis. In chronic hepatitis patients who have enlarged livers, Bupleurum was taken for 10 days. After treatment, most patients showed a marked improvement in their mental state, appetite, and subjective symptoms. Amazingly, amelioration or disappearance of pain over the liver area was achieved in 4-5 days in most patients.

Pregnancy warning

This herb should only be taken during pregnancy under close professional supervision. While there are no listable side effects noted for Bupleurum, it potentially may alter hormonal status, which may be detrimental for a pregnancy.

THERAPEUTIC/SAFE DOSAGES OF BUPLEURUM

The most commonly recommended therapeutic dosage for Bupleurum is 3,000 - 4,000 mg per day and the usual therapeutic dosage of 1:1 fluid extract of Bupleurum is 3 - 4 ml per day. Studies have found that short and long term consumption is beneficial for the treatment of all of the benefits listed above. Doses of up to 10 grams have been taken for extended periods of time (months) without adverse effects. It has been traditionally prescribed at this dose however; as Western herbs contained concentrated (standardised) components, it is prudent not to exceed 4g per day.

OTHER HERBS THAT CAN BE USED WITH BUPLEURUM

As with many herbs, combinations can be used to add to the therapeutic value. The following is a list of herbs that can be prescribed with Bupleurum to boost its therapeutic properties:

  • Milk Thistle. For any liver condition, milk thistle is highly beneficial. Research has indicated that it has the ability to rebuild damaged liver cells and would be the perfect addition if the patient was suffering from hepatitis.
  • Turmeric. This classic Indian spice is probably one of the best herbs for curbing inflammation. It combines beautifully with Bupleurum not only for conditions with inflammation, but also for the treatment of hepatitis.
  • Hemidesmus. Hemidesmus indicus root (also known as Indian Sarsaparilla) is regarded in Ayurvedic medicine as a depurative and tonic. It has been used to treat chronic rheumatism, kidney and skin disorders and constitutional debility. Its main action is for depression of the immune function, which would be beneficial in individuals suffering with arthritis.
  • Hypericum. Hypericum is best combined with Bupleurum if there is a need to improve depressive symptoms. Hypericum works by increasing the levels of serotonin in the brain, which is associated with elevated moods.
  • Withania. One of the best all round herbal adaptogens, withania is a brilliant anti-stress herb. It will also help to improve sporting performance and reduce cardiovascular disease and help with blood pressure. This is an excellent herb to take if you are suffering from any type of stress.

CONCLUSION

Bupleurum is a highly popular herbal medicine for those who need to reduce inflammation in the body or for people experiencing liver problems. Such conditions include hepatitis, arthritis, bronchitis/asthma, and dermatitis. Bupleurum is probably one of the best herbs for the treatment of mood disorders and stress. Whilst it is generally regarded as a safe herb, as with all herbs, it is best to consult with a healthcare professional to determine your individual requirements.

References

1. Mizowaki M, Toriizuka K, Hanawa T. Anxiolytic effect of Kami-Shoyo-San (TJ-24) in mice: possible mediation of neurosteroid synthesis. Life Sci 2001;69(18):2167-77.
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2.Chen JX, Ji B, Lu ZL, Hu LS. Effects of chai hu (radix burpleuri) containing formulation on plasma beta-endorphin, epinephrine and dopamine on patients. Am J Chin Med 2005;33(5):737-45.
3. Zhang ZJ, Kang WH, Tan QR, Li Q, Gao CG, Zhang FG, Wang HH, Ma XC, Chen C, Wang W, Guo L, Zhang YH, Yang XB, Yang GD. Adjunctive herbal medicine with carbamazepine for bipolar disorders: A double-blind, randomized, placebo-controlled study. J Psychiatr Res 2007;41(3-4):360-9.
4. Ushiroyama, T. et al. Changes in serum tumor necrosis factor (TNF-α) with Kami-Shoyo-San administration in depressed climacteric patients. Am J Chin Med 2004; 32(4): 621–629.
5. Yokoyama, H. et al: Chem Pharm Bull (Tokyo) 29, 500 (1981)
5. Chang, H. and But, P.: Pharmacology and Applications of Chinese Medica,World Scientific, Singapore (1987)

This article was written by Stephen Eddey and appeared in Vol 2 Issue 27.


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