Table 1 Ingredients of commonly used TCM formulas for the treatment of Gout
From: Chinese herbal medicine for gout: a review of the clinical evidence and pharmacological mechanisms
Formulas | Components | TCM efficacy | Pharmacological mechanism |
|---|---|---|---|
Jiawei Simiao Powder together with external application of Jinhuang Cream [18] | Jiawei Simiao Powder: Cortex Phellodendri Amurensis, Semen Coicis, Radix Achyranthes Root, Rhizoma Atractylodes Lanceae and the composition of the formula should be adjusted according to clinical manifestations Jinhuang Cream: Radix Angelicae Formosanae, Cortex Phellodendri Amurensis, Radix et Rhizoma Rhei Palmati, Rhizoma Curcumae Longae, Rhizoma Atractylodes Lanceae, Pericarpium Citri Reticulatae, Fied Rhizoma Arisaematis,Radix Trichosanthis, Cortex Magnoliae Officinalis, Radix et Rhizoma Glycyrrhizae | Jiawei Simiao Powder: clearing away heat and draining dampness, promoting blood circulation and relieving swelling and pain Jinhuang Cream: clearing away heat and detoxifying, relieving swelling and pain, and dredging the collaterals to stop pain | Reducing the levels of CRP, ESR, IL-8 and SUA and relieving body inflammation |
Tongfeng Decoction [19] | Cortex Phellodendri Amurensis, Pseudobullbus Cremastrae, Radix Scrophulariae, Semen Coicis, Sclerotium Poriae Cocos, Rhizoma Alismatis, Herba Plantaginis, Caulis Lonicerae, Radix Stephaniae Tetrandrae, Radix Paeoniae Rubra, Radix Rehmanniae, Cortex moutan Radicis, Radix Angelica sinensis, Radix Achyranthes root, Radix et Rhizoma Glycyrrhizae Praeparata cum Melle | Clearing away heat and draining dampness, eliminating turbid and dredging the collaterals to stop pain | Effectively reducing the acute inflammation index in the patient’s blood, inhibiting the body’s inflammatory response, inhibiting the progression of the disease, and reducing uric acid level |
Danxi Tongfeng Decoction [20] | Arisaema With Bile, Rhizoma Atractylodes Lanceae, Cortex Phellodendri Amurensis, Massa Medicata Fementata, Rhizoma Chuanxiong, Radix Stephaniae Tetrandrae, Semen Persicae, Radix Angelicae Formosanae, Ramulus Cinnamomi, Radix et Rhizoma Clematidis Chinensis, Rhizoma et Radix Notopterygii, Flos Carthami, Radix et Rhizoma Gentianae | Invigorating spleen to eliminate dampness, dispelling wind and draining dampness, clearing away heat and detoxifying, and dredging the collaterals to stop pain | Reducing ESR and promoting uric acid excretion, and strong analgesic effect |
Wuwei Xiaodu Decoction [51] | Flos Lonicerae, Flos Dendranthematis Indici, Herba Taraxaci Mongolici, Herba Violae Philippicae, Radix Semiaquilegiae | Clearing away heat and detoxifying | Reducing the IL-10 level to be normal, increasing phagocytosis index and phagocytosis rate of macrophages, thereby enhancing immune function |
Modified Wuwei Xiaodu Decoction [21] | Flos Lonicerae, Rhizoma Alismatis, Rhizoma Dioscoreae, Cortex Phellodendri Amurensis, Sclerotium Polypori Umbellati, Rhizoma Atratylodis Macrocephalae, Sclerotium Poriae Cocos, Herba Plantaginis, Herba Taraxaci Mongolici, Herba Violae Philippicae, Nudicaulous Grounsel Herb, Flos Dendranthematis Indici | Clearing away heat and detoxifying, relieving swelling, dredging the collaterals to stop pain | Enhancing the immunity of inflammatory mice, reducing the IL-10 level to be normal, increasing the phagocytosis index and phagocytosis rate of macrophages, adjusting the balance of microflora, and thus enhancing the immune function |
The combined appication of Guizhi Fuling pills and Wuwei Xiaodu Decoction [22] | Ramulus Cinnamomi, Sclerotium Poriae Cocos, Radix Paeoniae Rubra, Cortex moutan Radicis, Semen Persicae, Flos Lonicerae, Flos Dendranthematis Indici, Herba Violae Philippicae, Radix Semiaquilegiae, Fructus Forsythiae Suspensae, Herba Leonuri Japonici, Rhizoma Alismatis | Clearing away heat and detoxifying, activating blood and dredging the collaterals to stop pain | Reducing SUA and CRP levels, shortening the treatment time and reducing clinical side effects |
Zhuye Shigao Decoction [23] | Folium Phyllostachydis Henonis, Gypsum Fibrosum, Rhizoma Pinelliae Praeparatum, Radix Ginseng, Radix Ophiopogonis, Oryza Sativa L., Radix et Rhizoma Glycyrrhizae | Clearing away heat and nourishing Yin, invigorating the spleen and excreting dampness | Improving erythrocyte sedimentation rate, C-reactive protein levels, and reducing the incidence of adverse reactions |
The modified Zhuye Shigao Decoction [54] | Folium Phyllostachydis Henonis, Gypsum Fibrosum, Rhizoma Pinelliae Praeparatum, Radix Adenophoreae Strictae, Radix Ophiopogonis, Rhizoma Anemarrhenae, Caulis Piperis Kadsurae, Cortex Erythrinae Variegatae, Caulis Mahoniae Japonicae, Herba Epimedii Brevicomus, Semen Coicis, Radix Angelicae Biserratae, Radix Achyranthis Bidentatae, Radix et Rhizoma Glycyrrhizae | Clearing away heat and draining dampness, nourishing yin and dredging the collaterals to stop pain | Down-regulating the serum levels of IL-1β and Caspase-1 and the expression levels of Pro-IL-1 and Pro-caspase-1, inhibiting the inflammation induced by sodium urate crystal. |
Herba Aristolochiae Mollissimae, Caulis Sinomenii, Radix Cudraniae Cochinchinensis, Rhizoma Atractylodes Lanceae, Rhizoma Anemarrhenae | Dispelling wind and draining dampness, and dredging the collaterals to stop pain | Reducing leukocytes, ESR, CRP, inhibiting NF-κB expression, releasing IL-1β, TNF-α and inhibiting monocyte activity | |
Caulis Sinomenii, Caulis Piperis Kadsura Ramulus Mori, Radix Stephaniae Tetrandrae, Herba Lycopi Hirti, Radix et Rhizoma Clematidis Chinensis, Rhizoma Smilacis Glabrae, Lumbricus | Dispelling wind and draining dampness, and dredging the collaterals to stop pain | ||
Tongfengshu capsule [28] | Radix et Rhizoma Rhei Palmati, Herba Plantagini, Rhizoma Alismatis, Radix Cyathulae, Radix Stephaniae Tetrandrae | Promoting blood circulation and dredging the collaterals to stop pain, inducing diuresis and excreting dampness, and relieving swelling and pain | Reducing uric acid level; inhibiting HMGB1 and RAGE levels, reducing the level of PG in local inflammatory tissue by inhibiting the synthesis or release of PGE2, reducing the production of inflammatory cytokine TNF-α and anti-lipid oxidation, decreasing the levels of IL-1β and TNF-α, inhibiting the expression of MDA and NO, and promoting the release of SOD |
The modified Guizhi Shaoyao Zhimu Decoction [30] | Rhizoma Smilacis Glabrae, Radix Achyranthis Bidentatae, Rhizoma Dioscoreae, Rhizoma Zingiberis Recens, Rhizoma Atratylodis Macrocephalae, Radix Ssaposhnikoviae, Ramulus Cinnamomi, Radix Aconiti Praeparata, Rhizoma Anemarrhenae, Radix Ranunculi Polii, Ramulus Mori, Herba Ephedrae Sinicae, Radix et Rhizoma Glycyrrhizae | Clearing away heat and nourishing yin, dispelling wind and cold, draining dampness and dredging the collaterals to stop pain | Reducing the levels of leukocyte, CRP, IL-6, IL-8, ESR, and SUA, and inhibiting inflammation and uric acid metabolism |
Guizhi Shaoyao Zhimu Decoction [70] | Ramulus Cinnamomi, Radix Ranunculi Polii, Radix et Rhizoma Glycyrrhizae, Herba Ephedrae Sinicae, Rhizoma Zingiberis Recens, Rhizoma Atratylodis Macrocephalae, Rhizoma Anemarrhenae, Radix Saposhnikoviae, Radix Aconiti Praeparata | Dredging the collaterals to stop pain, dispelling cold and draining dampness, and clearing away heat and nourishing yin | Reducing the expression of TLR-2, TLR-4, NLRP3 receptor, My D88 and ASC protein, increasing the expression of PPAR-γ and IκB-α, inhibiting the differentiation and maturation of IL-1β and the activation of NF-κB, and reducing the expression of inflammatory factors like My D88 and NLRP3 |
Tongyang Mizhuo Decoction [34] | Radix Ginseng, Rhizoma Zingiberis, Ramulus Cinnamomi, Rhizoma Atratylodis Macrocephalae, Sclerotium Polypori Umbellati, Sclerotium Poriae Cocos, Rhizoma Alismatis, Rhizoma Dioscoreae, Rhizoma Smilacis Glabrae, Radix et Rhizoma Clematidis Chinensis, Radix Achyranthis Bidentatae | Warming yang and discharging dampness | |
Tongfengan mixture [32] | Herba Lysimachiae, Semen Sinapis, Thallus Ulvae Fasciatae, Spora Lygodii, Rhizoma Smilacis Glabrae, Flos Carthami, Radix Paeoniae Rubra, Pseudobullbus Cremastrae, Rhizoma Alismatis, Rhizoma Corydalis | Softening hard lumps and dispel nodes, clearing heat and draining dampness, promoting blood circulation and dredging the collaterals to stop pain | Relieving the swelling of the ankle joint of rats, reducing the number of MSU crystals in the ankle joint of rats, inhibiting the secretion of inflammatory factors like IL-1β, TNF-α and NF-κB in the synovial tissue of the ankle joint of rats by clearing urate crystals, and reducing the inflammation in gout arthritis |
Quzhuo Tongbi Decoction A [72] | Rhizoma Smilacis Glabrae, Rhizoma Dioscoreae, Stigma Maydis, Semen Coicis, Rhizoma Curcumae Longae, Herba Taxilli Chinensis, Rhizoma Corydalis, Folium Pyrrosiae, Herba Plantaginis | Invigorating spleen and kidney, promoting blood circulation and dredging the collaterals to stop pain, and draining dampness | Regulating some intestinal bacteria with abnormal uric acid metabolism, such as Staphylococcus which encodes uricase, reduces uric acid level, serum Cr and serum XOD levels |
Quzhuo Tongbi Decoction B [74] | Radix Aconiti, Rhizoma Smilacis Glabrae, Radix Bupleuri Chinensis, Rhizoma Atratylodis Macrocephalae, Radix Astragali, Caulis Lonicerae, Radix Paeoniae Rubra | Invigorate the spleen and draining dampness, clearing away heat and detoxifying, dredging the collaterals to stop pain | Blocking the sensation of peripheral nerve to pain and inhibiting the production of PGE2 in inflammatory mediators |
Peiyuan Huazhuo formula [35] | Rhizoma Polygonatum Sibirici, Semen Cuscutae, Radix Astragali Mongolici, Rhizoma Smilacis Glabrae, Semen Coicis, Rhizoma Corydalis | Strengthening healthy qi and inducing diuresis | Relieving lipid metabolism disorders, inhibiting inflammatory reactions, preventing gout attacks, and preventing renal damage in patients with gout |