In 1993, fifty-three women from Belgium were diagnosed as having renal failure, later known as “Chinese Herb Nephropathy” (CHN), due to taking diet pills that containing Chinese herbs of stephania tetrandra and magnolia officinalis. Though these two herbs were proved innocent later by capturing the true culprit of Aristolochia Fangchi (Guang Fang Ji), Han Fang Ji still receives widespread suspicion because it shares that same name of Fang Ji. As a matter of fact, they are two different species in different families. More importantly, their chemical compositions are entirely different – the former contains multiple alkaloids like tetrandrine and demethyl tetrandrine; the latter contains menisine, menisidine, and multiple aristolochic acids. For that reason, Chinese pharmacopoeia respectively sets up entries for these two herbs and clear defines.
What is stephania tetrandra?
It refers to the dry root of Stephania tetrandra S. Moor, instead of Aristolochia fangchi Y. C. Wu ex L. D. Chou et S. M. Hwang. So, medicinally its common names include stephania root, radix stephaniae tetrandrae, stephaniae tetrandrae radix, and so on. It is mainly produced in Anhui, Zhejiang, Jiangxi, Fujian and other places. In ensure high medicinal quality, it is usually harvested during autumn, and then washed clean, removed tertia, cut into sections, and dried in the sun.
Stephania tetrandra plant is a perennial twining vine. Root is cylindrical or massive sometimes, and with light brown or tan skin. Stems are flexible, cylindrical, slightly twisted sometimes, up to 2.5 to 4 meters, and with pinstripes. Branches are glabrous and with slightly red base. Leaves are alternate, soft and thin. Petiole is peltate and as long as blade. Blade is nearly round, with 3 to 5 angles, 4 to 6cm long, and 4.5 to 6cm wide. Small flowers are dioecious and forms cephaloid cymes. Pedicels are about 0.5 to 1cm. Drupe is globose, red when ripe, and 3 to 5mm in diameter. It flowers from April to May and fruits from May to June. Main habitats are mountains hills, bushes or the edges of low forest.
Tetrandra root contains 1.2% alkaloids, among which most are bisbenzylisoquinoline alkaloids. And related studies think that it contains Tetrandrine or Hanfangchin A, Fangchinoline (Hanfangchin B or Demethyl tetrandrine), Hanfangchin C, Menisine, Menisidine, and Cyclanoline. Others include berbamine, Oxofangchirine, stephanthrine, glycosides, phenols, organic acids, volatile oil, and sugar and so on.
Stephania tetrandra health benefits
Being one of Chinese herbs that are commonly used for edema, this herb is usually used in the form of decoction. And now more and more related commercial products are easily accessible, such as stephania tetrandra root extract, capsules, powder, tincture, and others. And its pharmacological actions can explain the reason why it is so popular.
Modern stephania herb pharmacology
1. It can significantly increase urine production;
2. Its total alkali, liquid extract and decoction have analgesic effect;
3. Tetrandrine has immunosuppressive, anti-inflammatory, anti-bacterial and anti-amoeba, anti-tumor, and extensive anti-allergic effects;
4. Tetrandrine has a protective effect on the myocardium. It can expand coronary blood vessels, increase coronary blood flow, lower blood pressure, and antagonize arrhythmia;
5. Tetrandrine can significantly inhibit platelet aggregation, promote fibrinolysis, and inhibit thrombin-induced blood coagulation;
6. Tetrandrine can prevent and treat experimental silicosis. And it can also greatly relax the uterine contractions;
7. Low concentration of tetrandrine can increase the bowel tension, strengthened rhythmic contractions. On the contrary, high concentration can reduce tension and diminish rhythmic contraction;
8. Tetrandrine can significantly lower blood glucose in normal rats, and tremendously increase serum insulin.
Stephania root herbal remedies
According to Chinese pharmacopoeia, it is bitter in flavor and cold in properties. And it goes to two meridians of bladder and lung. Key functions are inducing diuresis to alleviate edema and expelling wind to alleviate pain. Prime stephania tetrandra uses and indications include edema, beriberi, inhibited urination, eczema, boils, pain in rheumatoid arthritis, and hypertension. Recommended dosage is from 4.5 to 9 grams in decoction.
1. Fang Ji Yin. This formula comes from Sheng Ji Zong Lu (Complete Record of Holy Benevolence). It is primarily formulated for wind-cold-damp type of arthralgia and hypertonicity of the limbs. Other major herbal ingredients include Ma Huang (Ephedra), Rou Gui (Dried Cinnamon Bark), Fu Ling (Poria), and more.
2. Xuan Bi Tang. Xuan Bi Tang comes from Wen Bing Tiao Bian (Systematic Differentiation of Warm Disease). It is mainly designed for rheumatism presenting as excessive damp-heat, sore heavy body and limbs, swelling red joints and body pain. Other prime herbs are Hua Shi (Talcum Powder), Yi Yi Ren (Seeds of Job’s Tears), Can Sha (Silkworm Feces), Zhi Zi (Cape Jasmine Fruit), and so on.
3. Fang Ji Huang Qi Tang. This prescription is from Jin Gui Yao Lue (Essential Prescriptions of the Golden Coffer). It is mainly made for wind-induced edema manifested as floating pulse, heavy body, sweating, and aversion to wind. Other essential herbs are Huang Qi (Astragalus Root), Bai Zhu (Atractylodes), Gan Cao (Licorice Root), and more.
4. Fang Ji Fu Ling Tang. This is an herbal recipe, from Jin Gui Yao Lue, that usually treats swollen body and oliguria urinary symptoms. Important herbs are Poria, Astragalus, Gui Zhi (Cinnamon Twig), and others.
5. Ji Jiao Li Huang Wan. It is from Essential Prescriptions of the Golden Coffer and mainly used for damp-heat abdominal distension and edema. Basic herbs include Jiao Mu (Zanthoxyli Semen), Ting Li Zi (Descurainia Seeds), Da Huang (Rhubarb), and more.
Stephania tetrandra side effects and contraindications
Stephania tetrandra is with no toxicity and was rated as class 1 by AHPA. In other words, this herb is safe if consumed in recommended daily dosage. However, from the perspective of TCM (Traditional Chinese medicine), because of its bitter, cold nature, large dose is inadvisable so as not to damage stomach qi. Besides, it shouldn’t be used in cases of loss of appetite and yin deficiency without damp-heat.