Billings Clinic
Especially For:

Complementary Medicine - Cam

Bupleurum

Bupleurum

Uses

Common names:
Hare’s Ear, Thorowax
Botanical names:
Bupleurum chinense, Bupleurum falcatum

Parts Used & Where Grown

These Asian plants are part of the Apiaceae (Umbelliferae) family, and resemble dill or fennel. However, bupleurum has long thin leaves rather than the lacy appearance of fennel and dill leaves. The Chinese name for bupleurum, chai hu, means “kindling of the barbarians.” The origin of this name is unclear. The roots of the plant are used in herbal medicine.

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

This supplement has been used in connection with the following health conditions:

Used for Why
2 Stars
Epilepsy (Asian Ginseng, Cassia Bark, Chinese Scullcap, Ginger, Jujube, Licorice, Peony, Pinellia)
2.5 grams a day of sho-saiko-to or saiko-keishi-to in tea or capsules
The Chinese herb bupleurum is included in two herbal formulas, sho-saiko-to and saiko-keishi-to. Both have been shown to be helpful for epilepsy.

The Chinese herb bupleurum is included in two similar Chinese herbal formulae known as sho-saiko-to and saiko-keishi-to; these combinations contain the same herbs but in different proportions. The other ingredients are peony root, pinellia root, cassia bark, ginger root, jujube fruit, Asian ginseng root, Asian scullcap root, and licorice root. Both formulas have been shown in preliminary trials to be helpful for people with epilepsy.3 , 4 , 5 No negative interactions with a variety of anticonvulsant drugs were noted in these trials. The usual amount taken of these formulas is 2.5 grams three times per day as capsules or tea. People with epilepsy should not use either formula without first consulting with a healthcare professional.

2 Stars
Hepatitis (Asian Ginseng, Cassia Bark, Chinese Scullcap, Ginger, Jujube, Licorice, Peony, Pinellia)
Take 2.5 grams of sho-saiko-to three times per day
Trials have shown that the bupleurum-containing formula sho-saiko-to can help reduce symptoms and blood liver enzyme levels in people with chronic active viral hepatitis.

Preliminary trials have shown that the bupleurum -containing formula sho-saiko-to can help reduce symptoms and blood liver enzyme levels in children and adults with chronic active viral hepatitis.6 , 7 , 8 , 9 Most of theses trials were in people with hepatitis B infection, though one preliminary trial has also shown a benefit in people with hepatitis C.10 Sho-saiko-to was also found, in a large preliminary trial to decrease the risk of people with chronic viral hepatitis developing liver cancer. However, people who had a sign of recent hepatitis B infection were not as strongly protected in this trial.11 The usual amount of sho-saiko-to used is 2.5 grams three times daily. Sho-saiko-to should not be used together with interferon drug therapy as it may increase risk of pneumonitis - a potentially dangerous inflammation in the lungs.12

2 Stars
Liver Cirrhosis (Asian Ginseng, Cassia Bark, Chinese Scullcap, Ginger, Jujube, Licorice, Peony, Pinellia)
2.5 grams of the Chinese herbal formula sho-saiko-to three times daily
The Chinese herb bupleurum is a component of the formula sho-saiko-to, which was shown in one preliminary trial to liver cancer risk in people with liver cirrhosis.

The Chinese herb bupleurum is an important component of the formula known as sho-saiko-to. Sho-saiko-to was shown in one preliminary trial to reduce the risk of liver cancer in people with liver cirrhosis.13 The amount of this formula used was 2.5 grams three times daily.

1 Star
HIV and AIDS Support (Asian Ginseng, Cassia Bark, Chinese Scullcap, Ginger, Jujube, Licorice, Peony, Pinellia)
Refer to label instructions
The herbal formula sho-saiko-to has been shown to have beneficial immune effects on white blood cells in people infected with HIV.

The Chinese herb bupleurum , as part of the herbal formula sho-saiko-to, has been shown to have beneficial immune effects on white blood cells taken from people infected with HIV.14 Sho-saiko-to has also been shown to improve the efficacy of the anti-HIV drug lamivudine in the test tube.15 One preliminary study found that 7 of 13 people with HIV given sho-saiko-to had improvements in immune function.16 Double-blind trials are needed to determine whether bupleurum or sho-saiko-to might benefit people with HIV infection or AIDS. Other herbs in sho-saiko-to have also been shown to have anti-HIV activity in the test tube, most notably Asian scullcap .17 Therefore studies on sho-saiko-to cannot be taken to mean that bupleurum is the only active herb involved. The other ingredients are peony root, pinellia root, cassia bark, ginger root, jujube fruit, Asian ginseng root, Asian scullcap root, and licorice root.

1 Star
Irritable Bowel Syndrome (Dan Shen, Ginger, Schisandra, Wormwood)
Take a Chinese herbal formula containing wormwood under the guidance of a qualified practitioner
A standardized Chinese herbal combination containing extracts from plants including wormwood, ginger, bupleurum, schisandra, and dan shen reduced IBS symptoms in one study.

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.18

Traditional Use (May Not Be Supported by Scientific Studies)

Bupleurum has been used in Traditional Chinese Medicine for thousands of years to help relieve numerous conditions. Most particularly, infections with fever, liver problems, indigestion , hemorrhoids , and uterine prolapse.1

Bupleurum is a key ingredient in the formula known as sho-saiko-to. This is a Japanese kampo or traditional herbal medicine formula based on the traditional Chinese formula xiao-chai-hu-tang. In English, it has been called minor bupleurum formula. Bupleurum makes up 16% of the formula for sho-saiko-to (see below for the complete contents of the formula). Results reported for sho-saiko-to cannot be attributed solely to bupleurum because the other herbs in the formula also contribute.2

Sho-saiko-to (xao-chai-hu-tang or minor bupleurum formula) contains the following:

How It Works

Common names:
Hare’s Ear, Thorowax
Botanical names:
Bupleurum chinense, Bupleurum falcatum

How It Works

Bupleurum contains constituents known as saikosaponins that appear to account for much of the medicinal activity of the plant. Test tube studies have shown that the sho-saiko-to combination can increase production of various chemicals (known as cytokines) that immune cells use to signal one another.19 Test tube studies have also found that saikosaponins can inhibit growth of liver cancer cells,20 and are anti-inflammatory.21 , 22

Human trials, only one double-blind, have shown that the bupleurum-containing formula sho-saiko-to may help reduce symptoms and blood liver enzyme levels in children and adults with chronic active viral hepatitis .23 , 24 , 25 , 26 Most of these studies were in people with hepatitis B infection, though one preliminary human trial has also shown a benefit in people with hepatitis C.27 Sho-saiko-to was also found, in a large, preliminary (but not double-blind), study to decrease the risk of people with chronic viral hepatitis developing liver cancer.28

Sho-saiko-to has also been used to reduce symptoms of and possibly decrease the severity of liver cirrhosis , though clinical studies on this condition are generally lacking. One randomized trial (it was unclear if this trial was double-blind) found that sho-saiko-to could reduce the rate of liver cancer in people with liver cirrhosis.29

Several uncontrolled trials in Japan have shown that sho-saiko-to or very similar traditional Japanese and Chinese herbal formulas (all containing bupleurum) can reduce seizure frequency and/or severity in people with epilepsy that does not respond to anti-seizure medications.30 , 31 , 32 , 33 However, double-blind trials are still needed to determine the importance of these findings.

Sho-saiko-to has been found to inhibit human immunodeficiency virus ( HIV ) in the test tube.34 Yet, it is unclear to what degree bupleurum or saikosaponins contributed to this effect. Sho-saiko-to also increased the efficacy of the standard anti-HIV drug lamivudine in the test tube.35 Human data are lacking on the benefit of sho-saiko-to or bupleurum in people with HIV infection or acquired immunodeficiency syndrome (AIDS).

How to Use It

Generally 500–2,000 mg bupleurum dry root are taken three times daily in capsules.36 Traditionally, and in some clinical studies, bupleurum was prepared as a tea in which the root is decocted or cooked for hours before use. Some people take 1–4 grams per cup of water, three times daily. Sho-saiko-to formula is typically given in capsules (1.8–2.5 grams) three times per day. The amount given to children should be proportionally reduced based on individual weight and height as compared to adults.37

Interactions

Common names:
Hare’s Ear, Thorowax
Botanical names:
Bupleurum chinense, Bupleurum falcatum

Interactions with Supplements, Foods, & Other Compounds

Sho-saiko-to has been used alone and with interferon to treat hepatitis . Eighty or more cases of drug-induced pneumonitis (inflammation of the lungs) have been associated with the use of sho-saiko-to alone or with interferon.38 , 39 , 40 , 41 , 42 Until more is known, sho-saiko-to should not be combined with interferon.

Interactions with Medicines

Certain medicines interact with this supplement.

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • none

Reduce Side Effects

  • none

Support Medicine

  • Lamivudine

    Test tube studies show that the herbal combination sho-saiko-to enhances the antiviral activity of lamivudine.43 Sho-saiko-to contains extracts of seven herbs, including Bupleuri radix, Pinelliae tuber, Scutellariae radix, Zizyphi fructus, ginseng (Ginseng radix), licorice  (Glycyrrhizae radix), and ginger  (Zingibers rhizoma). Controlled studies are needed to determine whether taking sho-saiko-to might enhance the beneficial effects of lamivudine.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduces Effectiveness

  • none

Potential Negative Interaction

  • none

Explanation Required

  • none

The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Common names:
Hare’s Ear, Thorowax
Botanical names:
Bupleurum chinense, Bupleurum falcatum

Side Effects

Bupleurum and sho-saiko-to taken as a tea can upset the stomach, an effect that tends to be lessened by taking them with food or in capsules. Bupleurum and sho-saiko-to are not recommended during pregnancy and breast-feeding.

References

1. Bensky D, Gamble A, Kaptchuk T. Chinese Herbal Medicine Materia Medica, rev ed. Seattle: Eastland Press, 1993, 49-50.

2. Watanabe K, Fujino H, Morita T, et al. Solubilization of saponins of Bupleuri radix with ginseng saponins: Cooperative effect of dammarene saponins. Planta Med 1988;54:405-8.

3. Yarnell EY, Abascal K. An herbal formula for treating intractable epilepsy: a review of the literature. Alt Compl Ther 2000;6:203-6 [review].

4. Narita Y, Satowa H, Kokubu T, et al. Treatment of epileptic patients with the Chinese herbal medicine “saiko-keishi-to” (SK). IRCS Med Sci 1982;10:88-9.

5. Nagakubo S, Niwa S-I, Kumagai N, et al. Effects of TJ-960 on Sternberg's paradigm results in epileptic patients. Jpn J Psych Neur 1993;47:609-19.

6. Hirayama C, Okumura M, Tanikawa K, et al. A multicenter randomized controlled clinical trial of Shosaiko-to in chronic active hepatitis. Gastroent Jap 1989;24:715-9.

7. Fujiwara K, Ohta Y, Ogata I, et al. Treatment trial of traditional Oriental medicine in chronic viral hepatitis. In: Ohta Y (ed) New Trends in Peptic Ulcer and Chronic Hepatitis: Part II. Chronic Hepatitis. Tokyo: Excerpta Medica, 1987, 141-6.

8. Tajiri H, Kozaiwa K, Osaki Y, et al. The study of the effect of sho-saiko-to on HBeAg clearance in children with chronic HBV infection and with abnormal liver function tests. Acta Paediatr Jpn 1991;94:1811-5.

9. Gibo Y, Nakamura Y, Takahashi N, et al. Clinical study of sho-saiko-to therapy for Japanese patients with chronic hepatitis C (CH-C). Prog Med 1994;14:217-9.

10. Gibo Y, Nakamura Y, Takahashi N, et al. Clinical study of sho-saiko-to therapy for Japanese patients with chronic hepatitis C (CH-C). Prog Med 1994;14:217-9.

11. Oka H, Yamamoto S, Kuroki T, et al. Prospective study of chemoprevention of hepatocellular carcinoma with sho-saiko-to (TJ-9). Cancer 1995;76:743-9.

12. Mizushima Y, Oosaki R, Kobayashi M. Clinical features of pneumonitis induced by herbal drugs. Phytother Res 1997;11:295-8.

13. Yamamoto S, Oka H, Kanno T, et al. Controlled prospective trial to evaluate Shosaiko-to in preventing hepatocellular carcinoma in patients with cirrhosis of the liver. Gan To Kagaku Ryoho (Jpn J Cancer Chemother) 1989;16:1519-24 [in Japanese].

14. Inada Y, Watanabe K, Kamiyama M, et al. In vitro immunomodulatory effects of traditional Kampo medicine (sho-saiko-to: SST) on peripheral mononuclear cells in patients with AIDS. Biomed Pharmacother 1990;44:17-9.

15. Piras G, Makino M, Baba M. Sho-saiko-to, a traditional kampo medicine, enhances the anti-HIV-1 activity of lamivudine (3TC) in vitro. Microbiol Immunol 1997;41:835-9.

16. Fujimaki M, Hada M, Ikematsu S, et al. Clinical efficacy of two kinds of kampo medicine on HIV infected patients. Int Conf AIDS 1989;5:400 [abstract no. W.B.P.292].

17. Li BQ, Fu T, Yan YD, et al. Inhibition of HIV infection by baicalin—a flavonoid compound purified from Chinese herbal medicine. Cell Mol Biol Res 1993;39:119-24.

18. Westphal J, Hörning M, Leonhardt K. Phytotherapy in functional upper abdominal complaints. Results of a clinical study with a preparation of several plants. Phytomedicine 1996;2:285-91.

19. Yamashiki M, Nishimura A, Nomoto M, et al. Herbal medicine sho-saiko-to induces tumor necrosis factor-alpha and granulocyte colony-stimulating factor in vitro in peripheral blood mononuclear cells of patients with hepatocellular carcinoma. J Gastro Hepatol 1996;11:137-42.

20. Motoo Y, Sawabu N. Antitumor effects of saikosaponins, baicalin and baicalein on human hepatoma cell lines. Cancer Lett 1994;86:91-5.

21. Yamamoto M, Kumagai A, Yamamura Y. Structure and actions of saikosaponins isolated from Bupleurum falcatum L. I. Anti-inflammatory action of saikosaponins. Arzneim Forsch 1975;25:1021-3.

22. Utrilla MP, Zarzuelo A, Risco S, et al. Isolation of a saikosaponin responsible for the antiinflammatory activity of Bupleurum gibralticum Lam root extract. Phytother Res 1991;5:43-5.

23. Hirayama C, Okumura M, Tanikawa K, et al. A multicenter randomized controlled clinical trial of Shosaiko-to in chronic active hepatitis. Gastroent Jap 1989;24:715-9.

24. Fujiwara K, Ohta Y, Ogata I, et al. Treatment trial of traditional Oriental medicine in chronic viral hepatitis. In: Ohta Y (ed) New Trends in Peptic Ulcer and Chronic Hepatitis: Part II. Chronic Hepatitis. Tokyo: Excerpta Medica, 1987, 141-6.

25. Tajiri H, Kozaiwa K, Osaki Y, et al. The study of the effect of sho-saiko-to on HBeAg clearance in children with chronic HBV infection and with abnormal liver function tests. Acta Paediatr Jpn 1991;94:1811-5.

26. Gibo Y, Nakamura Y, Takahashi N, et al. Clinical study of sho-saiko-to therapy for Japanese patients with chronic hepatitis C (CH-C). Prog Med 1994;14:217-9.

27. Gibo Y, Nakamura Y, Takahashi N, et al. Clinical study of sho-saiko-to therapy for Japanese patients with chronic hepatitis C (CH-C). Prog Med 1994;14:217-9.

28. Oka H, Yamamoto S, Kuroki T, et al. Prospective study of chemoprevention of hepatocellular carcinoma with sho-saiko-to (TJ-9). Cancer 1995;76:743-9.

29. Yamamoto S, Oka H, Kanno T, et al. Controlled prospective trial to evaluate Shosaiko-to in preventing hepatocellular carcinoma in patients with cirrhosis of the liver. Gan To Kagaku Ryoho (Jpn J Cancer Chemother) 1989;16:1519-24 [in Japanese].

30. Narita Y, Satowa H, Kokubu T, et al. Treatment of epileptic patients with the Chinese herbal medicine ‘saiko-keishi-to' (SK). IRCS Med Sci 1982;10:88-9.

31. Nagakubo S, Niwa S-I, Kumagai N, et al. Effects of TJ-960 on Sternberg's paradigm results in epileptic patients. Jpn J Psych Neur 1993;47:609-19.

32. Packer M, Kligler B. Bupleurum for the treatment of epilepsy. Int J Chin Med 1984;1:55-8.

33. Hiramatsu M, Edamatsu R, Kohno M, et al. The possible involvement of free radicals in seizure mechanism. Jpn J Psych 1986;40:349-52.

34. Buimovici-Klein E, Mohan V, Lange M, et al. Inhibition of HIV replication in lymphocyte cultures of virus-positive subjects in the presence of sho-saiko-to, an oriental plant extract. Antiviral Res 1990;14:279-86.

35. Piras G, Makino M, Baba M. Sho-saiko-to, a traditional kampo medicine, enhances the anti-HIV-1 activity of lamivudine (3TC) in vitro. Microbiol Immunol 1997;41:835-9.

36. Bone K. Bupleurum—a natural steroid effect, part 2. MediHerb Professional Newsletter 1996;51:1-2.

37. Tajiri H, Kozaiwa K, Osaki Y, et al. The study of the effect of sho-saiko-to on HBeAg clearance in children with chronic HBV infection and with abnormal liver function tests. Acta Paediatr Jpn 1990;94:1811-5.

38. Nakagawa A, Yamaguchi I, Takao T, Amano H. Five cases of drug-induced pneumonitis due to sho-saiko-to or interferon alpha or both. Nippon Kyobu Shikkan Gakkai Zasshi 1995;33:1361-6 [in Japanese].

39. Ishizaki T, Sasaki F, Ameshima S, et al. Pneumonitis during interferon and/or herbal drug therapy in patients with chronic active hepatitis. Eur Respir J 1996;9:2691-6.

40. Sugiyama H, Nagai M, Kotajima F, et al. A case of interstitial pneumonia with chronic hepatitis C following interferon-alpha and sho-saiko-to therapy. Arerugi 1995;44:711-4 [in Japanese].

41. Sato A, Toyoshima M, Kondo A, et al. Pneumonitis induced by the herbal medicine Sho-saiko-to in Japan. Nippon Kyobu Shikkan Gakkai Zasshi 1997;35:391-5 [in Japanese].

42. Miyazaki E, Ando M, Ih K, et al. Pulmonary edema associated with the Chinese medicine shosaikoto. Nihon Kokyuki Gakkai Zasshi 1998;36:776-80 [in Japanese].

43. Piras G, Makino M, Baba M. Sho-saiko-to, a traditional kampo medicine, enhances the anti-HIV-1 activity of lamivudine (3TC) in vitro. Microbiol Immunol 1997;41:835-9.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

Print This Page
Email to a Friend
Home | Contact | Site Map | Site Privacy Policy | Terms & Conditions | Patient Privacy Policy | Medical Records | Fast Command
2800 10th Ave. North | P.O. Box 37000 | Billings, Montana 59107 | 406.238.2500
© Copyright 2014 Billings Clinic. All Rights Reserved.