Ku Shen Pian

Functions

According to traditional Chinese medicine, Ku Shen Pian clears away heat, eliminates dampness, detoxifies, kills parasites, and induces diuresis. This formula is mainly used to treat stagnation of qi in the chest and abdomen, masses in the abdomen, dysentery of heat type, blood stasis, edema, jaundice, leukorrhea with reddish discharge, swelling of vulva, pruritus vulvae, eczema, damp sores, itching skin, sarcoidosis, and ringworm.

Dosage Info

Extract tablets are taken 0.25g per tablet, 3 to 5 tablets a time. Matrine tablets are taken after meals, 50mg per tablet, 2 to 4 tablets, 3 times daily. A suppository is inserted deep into the vagina or according to the doctor’s directions, one piece every evening.

Ingredients

• Ku Shen

Precautions

Experiments on the effect of matrine on isolated papillary muscles of the right ventricle of guinea pigs have shown that toxification occurs when the concentration reaches 3X10^-3mol/L. (1) Experiments on acute toxicity have shown that LD50 of matrine intravenously injected to the tail of mice is 5.29±0.36ml/kg and LD50 of matrine injected to the abdominal cavity is 15.21±2.05ml/kg. (2)

According to TCM, those with insufficiency of spleen-yang should not take the herb.

The herb should not be used together with veratrum root (Radix Veratro Nigri). It is reported that a large dose of Ku Shen has caused one case of spasm (3) and an excessive amount of Ku Shen has caused one case of adverse reaction. (4)

Pharmacology

Regulating immune function: A Ku Shen Pian perfusion (50-200mg/ml) administered to mouse stomach can significantly induce splenic cells to produce interferons. (5) A Ku Shen mixture (3ml/kg/d) can strengthen the immune functions of rats infected with pneumocystis. (6)

Counteracting Coxsackie virus B (CVB): Ku Shen’s total alkaloids, between the concentrations of 200mg/ml and 3,125mg/ml, can significantly counteract the CVB. (7) Liu Jing Xing, et al. reported Ku Shen’s in vivo and in vitro effects in resisting CVB. In vitro, the raw extract solution from Ku Shen diluted to more than 1:4, had no toxic effects on HeLa cells. At a dilution of 1:32, it still resisted the effects of CVB (with the exception of CVB1) that cause pathological changes in cells. After Balb/C mice had been infected with CVB1 through the abdominal cavity, 12 mice in a contrast group survived for an average of 126 hours. Among the 12 mice treated with Ku Shen, 2 mice completely recovered and the remaining 10 mice lived for 161 hours. (8)

Counteracting hepatic injury and fibrosis: Stomach perfusions of matrine, at 100mg/kg and 150mg/kg for 3 days, can significantly reduce the occurrence of jaundice in mice, and ALT, AST, and bilirubin levels. (9) It can reduce LPS/D-Gain induced increases in serum ALT activity and the sensitivity of mice to the lethal toxicity of LPS-Gain. It can also inhibit LPS induced release of TNF by PMf (microphage) in mice abdominal cavity. (10) Matrine perfusion in rat stomachs, at 150mg/kg and 100mg/kg, can significantly alleviate degeneration and necrosis of liver cells, the formation of fibrous tissue, and reduce serum levels of ALT and HA (hyaluronic acid), and Hypoxanthine in liver tissue at different experimental stages. (11)

Antineoplastic effect: Cell cultures were used to study in vitro induced differentiation of matrine (the active chemical in Ku Shen) on human liver cancer cells SMMC-7721. As a result, cell proliferation was inhibited, subcellular structure approaches were normal, the secretion of AFP (alpha-fetoprotein) was significantly lower than that in the contrast group, r-GT vitality declined everyday, and TAT vitality was higher than that in the contrast group. 6 days after the treatment, DNA level decreased and the number of cells at the S stage increased. (12) Matrine can lower serum TNF and ALT levels, reduce the sensitivity of mice to the lethal dosage of lipopolysaccharide (LPS) and inhibit, in vitro, the release of TNF by macrophage in the abdominal cavity of mice induced by LPS and stimulated by PA (Propionibacterium). (13)

Effect on myocardial function: Matrine had a significant positive inotropic action on isolated papillary muscles of the right ventricle in guinea pigs, but has no inotropic actions on guinea pigs with propanol-induced heart failure. (14)

Effect on central nerve system: An intra-abdominal injection of matrine and matrine oxide to mice increased beta-aminobutyric acid and glycine in mice brain, thus having sedative effect. (15)

Anti-fertility effect: Du Jun Jie reported that the effects of matrine can kill sperm outside the body with its minimum effectiveness concentration for instantly inactivating the sperm being 0.85-3.15g/L. Huang Zi Ming reported that matrine inhibits sperm activity in vitro with a significant dose-effect dependency. At low concentrations, it can inhibit the movement of sperm. At higher concentrations, its inhibitory effect is stronger. (16)

Asthma-relieving effect: Bao Shu Juan reported that matrine could significantly antagonize the effect of histamine, acetylcholine, and barium chloride to excite the smooth muscles in isolated trachea and ileum of rats and guinea pigs. The antagonizing effect without Ca²⁺ is more significant than that with Ca²⁺. (17)

Induced differentiation on human promyelocytic leukemia cells: Experiments have shown that a Ku Shen decoction at 8mg/ml can significantly induce differentiation of in vitro cultured human promyelocytic leukemia cells towards mononuclear macrophage. (18)

Clinical Applications

Treating vaginitis
Wang Ya Juan, et al. used a Ku Shen decoction to treat vaginitis. The formula consisted of Ku Shen (Sophora Root), Tu Fu Ling (Smilax), She Chuang Zi (Cnidium Fruit), Zi Cao (Lithospermum), Di Fu Zi (Kochia), Bai Xian Pi (Dittarny Bark), Chi Shao (Red Peony Root), Cang Zhu (Atractylodes Rhizome), and Huang Bo (Phellodendron). 3,000ml of water was added and decocted to steam and wash. One dose of the decoction was used a day in 3 administrations, each being 30 minutes. After steaming and washing, dyclone ointment was applied on the vulva and a dyclone suppository was inserted into the vagina. The results showed full recovery in all 120 cases. (19)

Treating trichomonal vaginitis
Zhang Xiu Yun, et al. clinically observed the therapeutic effects of a Ku Shen decoction in treating trichomonal vaginitis. The formula consisted of Ku Shen (Sophora Root), Tu Fu Ling (Smilax), Bai Xian Pi (Dittarny Bark), Di Fu Zi (Kochia), Ye Ju Hua (Wild Chrysanthemum Flower), Huang Bo (Phellodendron), Bai Bu (Stemona), Cang Zhu (Atractylodes Rhizome), Hua Jiao (Zanthoxylum Peel), and Lang Du (Landu Root). 1,000 ml of the decoction was used to wash the affected area, once every evening. One dose was used in 3 administrations, and a course of treatment lasted for 6 to 10 days. Sheng Ji San (a powder formula for skin conditions) and erythromycin ointment were applied to areas of broken skin. The results showed a therapeutic rate of 98% among the 100 cases in the group. Among them, 10 cases with complicated fire-toxin were resolved one week after external application of the herbal formula. (20)

Treating skin disease pustulosis palmaris et plantaris
Zhu Yao Hua used a Ku Shen decoction to treat the skin disease pustulosis palmaris et plantaris. The formula consisted of Ku Shen (Sophora Root), She Chuang Zi (Cnidium Fruit), Bai Xian Pi (Dittarny Bark), Huang Bo (Phellodendron), Bai Bu (Stemona), Ye Ju Hua (Wild Chrysanthemum Flower), Wei Ling Xian (Clematis), and Hua Jiao (Zanthoxylum Peel). The decoction was used to soak the affected area, 15 to 20 minutes, twice a day. 15 days constituted one course of treatment. During the treatment, the patients did not come in contact with soap, washing powder, or other alkaline substances. The results showed that, among the 74 cases in the group, 49 cases were resolved, 13 cases improved, and 12 cases had not improved. (21)

Treating oral mycotic infection
Jiang Yun used a Ku Shen decoction to treat oral mycotic infections in patients with malignant tumors. The formula consisted of Ku Shen (Sophora Root), She Chuang Zi (Cnidium Fruit), Jin Yin Hua (Lonicera Flower), Ju Hua (Chrysanthemum Flower), Huang Bo (Phellodendron), Shi Chang Pu (Grassleaved Sweetflag Rhizome), Bai Zhi (Angelica), and Di Fu Zi (Kochia). 1,000ml of the decoction was taken as one dose each day. After meals, patients gargled with clean water first, then with the decoction (at 40-50oC) twice. During the second gargle, the decoction was retained in the mouth for 1 to 5 minutes. The process was repeated once every half an hour. For those who could not gargle, a disposable syringe was used to flush the oral cavity with the decoction 2 to 3 times, once every half an hour. 7 days constituted as one course of treatment. After 1 to 2 courses, 31 cases were resolved and 2 cases had no improvement. The total effectiveness rate was 93.94%. (22)

Treating chronic ulcerative colitis
Li Li used modified a Ku Shen decoction to treat chronic ulcerative colitis. The formula consisted of Ku Shen (Sophora Root), Bai Tou Weng (Pulsatilla Root), Chun Gen Pi (Ailanthus Bark), Zi Cao (Lithospermum), and Huang Lian (Coptis). The decoction was taken for intestinal perfusion as one dose a day, divided into 2 administrations. After each dose, the patient laid still for an hour. The results showed that 19 cases were resolved, 8 cases improved, and 1 case had not improved. Among the 28 cases in the group, the total effectiveness rate was 96.5%. (23)

Chen Zhen, et al. used a Ku Shen decoction to treat 12 cases of chronic ulcerative colitis. The formula consisted of Ku Shen (Sophora Root), Di Yu (Sanguisorba Root), Fang Feng (Siler), and Bai Ji (Bletilla Tuber). 10 cases in the contrast group were treated with hydrocortisone or hydrocortisone succinate (50mg) combined with normal saline (100ml). Both groups were treated with intestinal perfusions before going to bed every evening for 2 consecutive weeks. The results for the treatment and contrast groups were, respectively: 4 and 1 case were resolved, 4 and 5 cases improved, and 4 and 4 cases had no improvement. (24)

Treating viral cholestatic hepatitis
Modified Ku Shen decoction was used to treat 31 cases of viral cholestatic hepatitis. As a result, total serum bilirubin reduced to below 171mmol/L, less than 85.5mmol/L, and normal value in 8.1±1.9 days, 14.3±2.8 days and 43±3.6 days respectively in the treatment group and in 15.2±2.7 days, 20.3±4.1 days and 57.2±8.1 days respectively in the contrast group. The difference between the two groups was significant. (25)

Treating leukoplakia vulvae
Liu Yan Xiu used a Ku Shen decoction to treat leukoplakia vulvae. The formula consisted of Huang Bo (Phellodendron), Cang Zhu (Atractylodes Rhizome), Ku Shen (Sophora Root), Chuan Xiong (Cnidium Fruit), Jing Jie (Schizonepeta), and Dan Shen (Salvia). For sclerotic Lichen type, Huang Bo (Phellodendron) and Dan Shen (Salvia) were removed and Huang Qi (Astragalus Root), Chi Shao (Red Peony Root), and E Zhu (Zedoary) were added. The herbal decoction was used for bathing, once a day. During the treatment, pungent foods were prohibited. After 1 to 2 courses of treatment, 10 cases were resolved, 9 cases had some improvement, and 1 case had no improvement. (26)

References

1. Jin Chao Jun, et al. Matrine’s effect on cardiac contraction in guinea pigs. Journal of Medical Research. 1997;26(10):20-23.
2. Xie Jin Zhou, et al. Observation on Ku Shen injection toxicity. Journal of Chinese Patented Medicine Research. 1985;(10):41.
3. Wang Shi Ming, et al. One report of spasm induced by large dosage of Ku Shen. Henan Journal of TCM. 1995;15(4):225.
4. Xu Wen Tao. One case of adverse reaction caused by Ku Shen overdosage. Sichuan Journal of TCM. 1991;9(9):42-43.
5. Feng Ya Zhen, et al. Ku Shen’s suppressive effects on mice immune function. Henan Journal of TCM. 1997;17(5):277-278.
6. Shi Chang Song, et al. Ku Shen formula’s effect on cellular mediated immune function in rats infected with CPS. China Journal of Diseases Common to Humans and Animals. 1999;15(6):77-78.
7. Chen Ting Ting, et al. Ku Shen total alkaloids’ protective effects on cocksackie B3m virus infected HeLa cell. China Journal of Experimental Clinical Immunology. 197;9(1):18-21.
8. Liu Jin Xing, et al. Preliminary research on Ku Shen’s effect in counteracting Cocksackie B virus. Journal of Shanghai Second Medical University. 1991;11(2):140-142.
9. Xin Shun Mei, et al. Preliminary observation on clinical application and liver protective effects of Ku Shen oral administration. Journal of Pharmacology and Clinical Application of TCM. 1998;14(1):42-44.
10. Hu Zhen Lin, et al. Matrine’s effect on LPS/D-Gain induced hepatitis and in vitro macrophages release of TNF. China Journal of Pharmacology. 1996;17(4):351-353.
11. Chen Wei Zhong, et al. Matrine’s effect on rat experimental liver fibrosis. Journal of Second Military Medical College. 1996;17(5):424-426.
12. Zhang Ye Jun, et al. Matrine’s effect on SMMC-7721 cell system’s proliferation. Journal of Fourth Military Medical College. 1998;19(3):340-343.
13. Hu Zhen Lin, et al. Matrine’s effect on LPS/PA induced mice hepatitis and on production of TNF. Journal of Pharmacy. 1996;31(9):662-665.
14. Jin Chao Jun, et al. Matrine’s effect on cardiac contraction in guinea pigs. Journal of Medical Research. 1997;26 (10):20-23.
15. Geng Jun Mei, et al. Matrine and matrine oxide’s effect on b-aminobutyric acid and glycine levels in mice brain. Inner Mongolia Journal of Medicine. 1993;13(1):3-4.
16. Huang Zi Ming, et al. Matrine’s anti-pregancy effects and effects on normal flora and lactobaccilus in human vagina. Journal of Henan Medical University. 1996;31(3):67-68.
17. Bao Zhu Juan, et al. Examining the mechanism of matrine’s asthma-relieving effects. Journal of Pharmacology and Clinical Application of TCM. 1995;11(5):33-34.
18. Xu Jian Guo, et al. Research on Ku Shen decoction’s effect on inducing differentiation in uman promyeolcytic leukemia cells. China Journal of Chinese Medicine. 1990;15 (10): 625-626.
19. Wang Ya Juan, et al. Treating 120 cases of colpomycosis with Ku Shen Tang. Shaanxi Journal of TCM. 1999;20.
20. Zhang Xiu Yun, et al. Clinical observation on treating trichomonal vaginitis by fumigating and soaking with Ku Shen Decoction. Journal of Traditional Chinese Medicine and Herbs. 1993;(6):32.
21. Zhu Yao Hua. Treating skin disease palmaris et plantaris: Treating 74 cases of skin diseasepalmaris et plantaris with Ku Shen Tang. Journal of External Application of TCM. 1999;8(4):54.
22. Jiang Yun, et al. Using Ku Shen Tang to treat oral mycotic infection in patients with malignant tumor. Journal of External Application of TCM. 1999;8(2):46-47.
23. Li Li. Clinical observation on treating chronic ulcerous colitis with modified Ku Shen Tang. Gansu Journal of TCM. 1999;8(2):46-47.
24. Chen Zheng, et al. Treating chronic ulcerous colitis with intestinal perfusion of Ku Shen Tang. Journal of Traditional Chinese Medicine. 1990;31(12):33.
25. Xu Wei. Clinical observation on treating 31 cases of viral cholestatic hepatitis. Journal of Zhejiang College of TCM. 1997;21(2):51-52.
26. Liu Yan Qiu. Treating 20 cases of leukoplakia vulvae with Ku Shen Tang. Journal of Applied Integrated Medicine. 1995;8(6):343.