Pharmacological Effects of ‘Si Wu Tang’

Chinese herbal medicine is usually composed of a combination of 3 to 5 different herbs. Since herbal medicine is widely use throughout the Southeast Asian countries, traditional Chinese herbal medicine has become one of the main interests in pharmacological studies. 

‘Si Wu Tang’ a.k.a the ‘Four-Agents-Decoction’ is a good example of Chinese herbal medicine that can nourish the human blood.  Available in the market for more than 800 years, Si Wu Tang is composed of four Chinese herbs which can treat dysmenorrhoea or menstrual discomfort.

Dysmenorrhoea is one of the most common gynaecological complaints of adolescent girls and women of reproductive age. Dysmenorrhoea can be classified as either primary or secondary. Primary dysmenorrhoea occurs when there is no identifiable pathological condition which usually starts after the period of menarche or during the early part of the ovulation cycle. Secondary dysmenorrhoea occurs when menstrual pain is associated with organic pathology such as endometriosis.

Oestrogens stimulates the release of vasopressin whereas progesterone functions by controlling the presence of vasopressin. In most cases, the over production of the uterine prostaglandins and vasopressin are the main causes of menstrual cramps. Women can also experience dysmenorrhoea in case ovarian hormones is not balance.

Purpose of Si Wu Tang

Si Wu Tang is effective in terms of enriching the blood and regulating women’s menstruation cycle. The combination of four major Chinese herbs is commonly use in treating irregular menstruation, lower abdominal pain associated with menstruation cycle, and the formation of blood mass at the time of menstruation period.

Aside from treating menstruation-related symptoms, Si Wu Tang can also cure symptoms of blood stasis wilting such as atrophy, limpness, difficulty in moving, and pain in the limbs or vessel wilting (i.e. inability to lift the lower limbs or weakness of the legs).

Four Major Composition of Si Wu Tang

Originally listed in the Prescriptions of People’s Welfare Pharmacy in China, the four major components of Si Wu Tang include the dry roots of: (1) Radix Rehmanniae praeparata (Soe Dee Huang); (2) Radix Paeoniae Alba (Bai Sau); (3) Radix Angelicae Sinensis (Dang Guay); and (4) Rhizoma Ligustici Chuanxiong (Tsuan Chyong). These herbs are readily available in Mainland China or some Chinese medicine shops. Based on the original pharmacopoeia, these major herbal components should be prepared in equal proportion and extracted in water using the ratio of 1:13.

Other Clinical Applications and Pharmacological Effects of Si Wu Tang

Protects the Bone Marrow from Damages Caused by Radiation

The intake of 20 mg of Si Wu Tang per 20g of body weight over a period of seven (7) days before irradiation can protect the bone marrow from damages caused by 1 to 9 Gy dose of radiation (Hsue-Yin et al., 1996). In fact, the four major components of Si Wu Tang (specifically the extract of Danggui and Baishaoyao) may have a major radioprotective effect on human beings (Lee et al., 1999). 

Treats Common Colds and Flu

Often characterized by the symptoms of sore throat, fever and malaise, Si Wu Tang can treat the initial stage of common colds and flu among the perimenstrual and pregnant women. The liver and spleen should have sufficient blood flow to enable the body protect itself from external factors that causes symptoms of illnesses (Han & Huang, 2007). What happens during the menstruation cycle is that a large volume of blood accumulates in the uterus. This causes the upper portion of the human body to experience insufficient blood flow.

Prevents Pre-menstrual Acne and Skin Aging

Pre-menstrual acne is associated with hormonal imbalance among women. Si Wu Tang can treat hormonal imbalance. Therefore, this herb can help us prevent the development of pre-menstrual acne. Furthermore, a regular consumption of Si Wu Tang herbal soup is effective in counteracting the health consequences of poor nutrition, environmental pollution and stress (Brown, 2005). Therefore, a premature skin aging can easily be prevented.

Improves Hematopoiesis on Patients with Blood Deficiency

Inducing Si Wu Tang decoction on mice with blood deficiency could significantly improve hematopoiesis (Tan et al., 2005). When induced by compound method of bleeding, the researcher noted a significant increase in the red blood cells from a normal volume of 4.6 x 10(12) up to 6.5 x 10(12) (ibid).   

When mice with blood deficiency were induced with cyclophosphamide (CIX) and Si Wu Tang decoction, the subjects could effectively restore up to 12 up-regulated and 3 down-regulated proteins in the bone marrow (Liu et al., 2006).

Anti-inflammation and Anti-pruritic Effects on Skin

The components of Si Wu Tang were clinically proven to be effective in treating cutaneous (skin) pruritis, chronic inflammation of the skin and other skin diseases. Antipruritic and anti-inflammatory effects can be observed when 250, 500 and 1000 mg/kg of Si Wu Tang decoction compound was administered to several mice with skin diseases (Dai et al., 2002). As little as 50 to 500 microg/ml of Si Wu Tang concentration could effectively inhibit the release of histamine from the rat’s peritoneal mast cells.

Adverse Effects of Si Wu Tang

Increase Women’s Risk of Breast Cancer

Women at risk of breast cancer should be aware that some components of Si Wu Tang could stimulate cell proliferation of MCF7 cells which causes the activation of the human epidermal growth factor receptor 2 (HER-2) positive breast cancer and downstream signaling molecules of AKt pathways and estrogen receptor (ER) K1/2 (Chang et al., 2006). Furthermore, the external domain of HER-2 should be blocked in order to effectively reduce the downstream ER K1/2 MAPK which signals the inhibiting cell growth (Knowlden et al., 2003). 

Conclusion

Si Wu Tang is one of the most commonly used Chinese herbal medicine in treating menstrual cramps and other illnesses related to blood deficiency. Si Wu Tang decoction can protect our bone marrow from damages caused by radiation. This particular chinese herbal medicine also works well in treating common colds and flu, preventing pre-menstrual acne, improving hematopoiesis on patients with blood deficiency, and protecting the skin from inflammation and pruritic.  However, Si Wu Tang should be subjected to further study because of its adverse effects related to increased risk of breast cancer.

References

Brown, R. (2005, November / December). Nexus Colorado's Holistic Journal. Retrieved April 18, 2008, from Journeys in Health, Healing and Our Search for Meaning: http://www.nexuspub.com/journeys/natural_beauty.htm

Chang, C.-J., Chiu, j.-H., Tseng, L.-M., Chang, C.-H., Chien, T.-M., Chen, C.-C., et al. (2006). Si-Wu-Tang and Its Constituents Promote Mammary Duct Cell Proliferation by Up-Regulation of HER-2 Signaling. Menopause, 13(6):967 - 976.

Dai, Y., But, P. P.-H., Chan, Y.-P., Matsuda, H., & Kubo, M. (2002). Antipruritic and Anti-inflammatory Effects of Aqueous Extract from Si-Wu-Tang. Biological Pharmaceutical Bulletin, 25(9):1175 - 1178.

Han, X.-g., & Huang, Q.-c. (2007). The Relationship between the Liver and the Disease Causes, Disease Mechanisms, and Treatment of Rheumatoid Arthritis. Journal of Chinese Medicine, 1:9 - 11.

Hsue-Yin, H., Yau-Hui, H., & Chun-Ching, L. (1996). Protection of Mouse Bone Marrow by Si-Wu-Tang Against Whole Body Irradiation. Journal of Ethnopharmacology , 52(2):113 - 117.

Knowlden, J., Hutcheson, I., Jones, H., Madden, T., Gee, J., Harper, M., et al. (2003). Elevated Levels of Epidermal Growth Factor Receptor/c-erbB2 Heterodimers Mediate an Autorcrine Growth Regulatory Pathway in Tamoxifenresistant MCF-7 Cells. Endocrinology, 144(3):1032 - 1044.

Lee, S., Oh, H., Yang, J., Jo, S., Byun, M., Tee, S., et al. (1999). Radioprotective Effects of Two Traditional Chinese Medicine Prescriptions: Si-Wu-Tang and Si-Jun-Zi-Tang. The American Journal of Chinese Medicine, 27(3 - 4):387 - 396.

Liu, L., Ma, Z., Wang, Y., Qin, H., Tan, H., Xiao, C., et al. (2006). Effects of Siwu Decoction on Bone Marrow Protein Expression of Blood Deficiency Mice Induced by Cyclophosphamide. China Journal of Chinese Materia Medica, 31(14):1172 - 1175.

Tan, W., Song, C., Tan, H., Liu, L., Ma, Z., Wang, Y., et al. (2005). Hematopoietic Effect of Siwu Decoction in the Mice with Blood Deficiency Induced by Compound Method of Bleeding, Starved Feeding and Exhausting. China Journal of Chinese Materia Medica, 30(12):926 - 929.