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PHARMACOLOGICAL EFFECTS AND
HERB-DRUG INTERACTIONS OF
BLOOD MOVING HERBS

By John Chen, L.Ac., O.M.D., Pharm.D., Ph.D.

Below is a section from Dr. John Chen’s Chinese Medical Herbology and Pharmacology. It describes in details the pharmacological effects and possible herb-drug interactions of blood moving herbs.

Definition: Herbs that invigorate blood circulation and eliminate blood stasis function to open blood vessels, activate blood circulation, disperse blood stagnation, and break blood stasis.

Blood-invigorating and stasis-removing herbs are mostly acrid, bitter and warm. The acrid taste promotes movement of blood and disperses stagnation, the bitter taste descends and drains stagnation, and the warm property helps to invigorate and facilitate the movement of blood. All of these herbs are ‘moving’ by nature, and function to activate blood circulation, disperse stasis, regulate menstruation, and open channels and collaterals, as well as help to heal wounds, relieve bi zheng (painful obstruction syndrome), and reduce swelling and pain. Clinical manifestations of blood stagnation include: stabbing pain in a fixed location or all over the body, numbness of the limbs and extremities, lumps found on the skin or internal palpable masses, swelling caused by traumatic injuries or internal bleeding, internal bleeding with visible blotches of bruises, purpura of the skin, and purple spots on the tongue.

PHARMACOLOGICAL EFFECTS

Cardiovascular: Many of these herbs exert profound influence on the cardiovascular system. They dilate blood vessels, increase blood perfusion to smaller blood vessels, inhibit platelet aggregation, delay coagulation, and treat angina and ischemia.

Herbs that dilate coronary arteries include Hong Hua (Flos Carthami), Dan Shen (Radix Salviae Miltiorrhizae), Chuan Xiong (Rhizoma Ligustici Chuanxiong), San Qi (Radix Notoginseng), Yan Hu Suo (Rhizoma Corydalis), Chi Shao (Radix Paeoniae Rubrae), and Ji Xue Teng (Caulis Spatholobi).

Herbs that dilate veins include Chi Shao (Radix Paeoniae Rubrae), Tao Ren (Semen Persicae), and Dan Shen (Radix Salviae Miltiorrhizae).

Herbs that dilate arteries include Chuan Shan Jia (Squama Manis), Shui Zhi (Hirudo), E Zhu (Rhizoma Curcumae), Tao Ren (Semen Persicae), and Yi Mu Cao (Herba Leonuri).

Herbs that improve micro-circulation include Chuan Xiong (Rhizoma Ligustici Chuanxiong), Dan Shen (Radix Salviae Miltiorrhizae), Pu Huang (Pollen Typhae), Jiang Huang (Rhizoma Curcumae Longae), Hong Hua (Flos Carthami), Dang Gui (Radicis Angelicae Sinensis) and Yi Mu Cao (Herba Leonuri).

Hematological: Many herbs have anticoagulant and antiplatelet effects. Blood clots form in the veins mainly due to coagulation, while blood clots form in the arteries mainly due to aggregation of platelets. Therefore, anticoagulant substances are prescribed to stop formation of clots in veins, and antiplatelet medicines are prescribed to stop formation of clots in arteries. Many herbs have excellent inhibitory influence on thrombus formation, and are used in treatment of angina, stroke and embolism.

Herbs with anticoagulant properties include Dan Shen (Radix Salviae Miltiorrhizae) and Chi Shao (Radix Paeoniae Rubrae).

Herbs exerting antiplatelet activity include Dan Shen (Radix Salviae Miltiorrhizae), Chuan Xiong (Rhizoma Ligustici Chuanxiong) and Hong Hua (Flos Carthami).

Herbs with thrombolytic effects include Chi Shao (Radix Paeoniae Rubrae), Dan Shen (Radix Salviae Miltiorrhizae), Yi Mu Cao (Herba Leonuri), Dang Gui (Radicis Angelicae Sinensis), San Leng (Rhizoma Sparganii), E Zhu (Rhizoma Curcumae), and Hong Hua (Flos Carthami).

Metabolic: Some blood-invigorating herbs lower plasma cholesterol levels to various degrees. Examples are Yu Jin (Radix Curcumae), Hong Hua (Flos Carthami), Jiang Huang (Rhizoma Curcumae Longae), Dan Shen (Radix Salviae Miltiorrhizae) and Pu Huang (Pollen Typhae).

Immunologic: Blood-moving herbs act on the immune system in a number of ways. Some inhibit the immune system to treat allergy or hyperactivity of the immune system, such as Yi Mu Cao (Herba Leonuri), Dang Gui Wei (Extremitas Radicis Angelicae Sinensis), and Chuan Xiong (Rhizoma Ligustici Chuanxiong). Others enhance the immune system to treat patients who have compromised immune systems, such as Dan Shen (Radix Salviae Miltiorrhizae), Chi Shao (Radix Paeoniae Rubrae), Tao Ren (Semen Persicae), San Leng (Rhizoma Sparganii), and E Zhu (Rhizoma Curcumae).

Antineoplastic: Herbs that address blood stagnation have shown promise in inhibiting the growth of cancer cells in vitro, such as Chuan Xiong (Rhizoma Ligustici Chuanxiong), E Zhu (Rhizoma Curcumae), Hong Hua (Flos Carthami), Yu Jin (Radix Curcumae), Yan Hu Suo (Rhizoma Corydalis), Ru Xiang (Gummi Olibanum), Mo Yao (Myrrha) and San Leng (Rhizoma Sparganii).

Analgesic and anti-inflammatory: Many blood-moving substances have an analgesic action via their effect on the central nervous system, including Dan Shen (Radix Salviae Miltiorrhizae), Dang Gui (Radicis Angelicae Sinensis), Chi Shao (Radix Paeoniae Rubrae), Ru Xiang (Gummi Olibanum), Mo Yao (Myrrha), Yan Hu Suo (Rhizoma Corydalis), Yu Jin (Radix Curcumae) and Wu Ling Zhi (Excrementum Trogopteri seu Pteromi). Others reduce inflammation by reducing the permeability of the capillaries.

Antibiotic: Many herbs inhibit the growth of bacteria, such as Chi Shao (Radix Paeoniae Rubrae), Mu Dan Pi (Cortex Moutan), and Chuan Xiong (Rhizoma Ligustici Chuanxiong).

POTENTIAL HERB-DRUG INTERACTIONS

Antihypertensives: Herbs that dilate the blood vessels may potentiate the effect of antihypertensive drugs and cause hypotension.

Antiplatelets and anticoagulants: Herbs that treat blood stasis may enhance the actions of antiplatelet and anticoagulant medications, and prolong bleeding or increase bruising.

Analgesics: Herbs with analgesic effects may cause drowsiness, therefore accentuating the sedative effect of many drugs and of alcohol.

As described above, herbs that invigorate blood circulation and eliminate blood stasis have a wide variety of pharmacological effects. This also implies possibilities for theoretical or actual clinical herb-drug interactions. Additional information on possible interactions is given in individual herb monographs.

Note: Blood-invigorating and stasis-removing herbs are tremendously important and effective substances in the Chinese materia medica. Practitioners ought not to shy away from using them for fear of their potency or of herb-drug interactions. Instead, being well-informed about the nature of each of these substances and aware of the pharmaceuticals each patient is taking will allow practitioners the confident exercise of superior herbal care.

ABOUT THE AUTHOR

John Chen, L.Ac., O.M.D., Pharm.D., Ph.D.

Dr. John Chen is a recognized authority in both western pharmacology and Chinese Herbal Medicine, having combined formal training in both fields with extensive research ‘on the ground’ in China. He teaches at the USC School of Pharmacy, Emperor’s College, Yo San University of TCM, OCOM, Five Branches, AOMA and ACTCM, and has taught numerous professional seminars across the U.S. and internationally. Dr. Chen’s published works include Chinese Medical Herbology and Pharmacology (2003, AOM Press) and the upcoming Chinese Herbal Formulas and Applications (2008, AOM Press) for which works he is lead author.

This article was taken from Dr. Chen’s book Chinese Medical Herbology and Pharmacology. To order a copy, click here.

To learn more about herbs, John Chen is speaking on the following topic for Lotus Institute. The class is approved for 8 CEUs/PDAs by the California Acupuncture Board and NCCAOM.

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