HE SHOU WU CASES

OF LIVER INJURY
Aleksandra
 Property
Bitter, sweet and astringent, slightly
warm; kidney and liver meridians
entered.
Actions
Tonify blood, supplement essence,
check malaria, relieve toxicity,
moisten intestine.
Indications
1. Blood and essence deficiency
syndrome (vertigo and tinitus,
soreness and flaccidity of lumbar
and knees, early white of beard and
hair)
2. Chronic malaria (supply blood
and qi) ( both raw and stir-baked He
Shou Wu can check malaria)

3. Ulcers and tuberculosis (because

it can relieve toxicity, dissipate
nodulation, in addition, it also has
action of relieving itching)
 raw HSW
➤detoxification
➤eliminating carbuncle
➤preventing malaria
➤relaxing bowel.
processed HSW
➤nourishing liver and kidney,
➤supplementing essence and blood,
➤ blackening hair,
➤ strengthening bones and muscles,
➤eliminating dampness,
➤and reducing lipid.

Modern pharmacological studies

➤reducing blood lipid
➤antiarteriosclerosis
➤protecting liver
➤enhancing immunologic functions
➤ improving memory,
➤protecting nerve cells
➤antioxidation
➤anti-aging
SOURCE
[Modified from:  Panis B, Wong DR, Hooymans PM, De Smet
PAMG, Rosias PPR. Recurrent toxic hepatitis in a Caucasian girl
related to the use of Shou Wu Pian, a Chinese herbal
preparation. J Pediatr Gastroenterol Nutr 2005; 41: 256-8. 
PubMed Citation]
 CASE.

A 5-year-old previously healthy Caucasian

girl with normal growth and development
presented with a 2-day history of jaundice, dark urine
and pale stools. After examination and tests no
obvious reason was discovered.
Liver biochemistry showed elevated serum levels
of bilirubin and liver enzymes.
After 1 month, jaundice disappeared and liver
function tests normalized. 2 months after the first
presentation she returned to the hospital with a
relapse of jaundice. She used Shou-wu-pian for 4
months before the first episode(three tablets a day),
and stopped when the jaundice occurred. After
resolution she used it again, but the dosage was
lower (2 tablets). Stopped after second presentation,
liver function recovered slower.
CASES . SECONDARY STUDY SOURCE
450 cases of liver injury.
seven (7/450, 1.6%) - died.
two (2/450, 0.4%) - received liver transplant.
441 (441/450, 98%) - cases recovered or had liver function improvement
after discontinuing HSW products and conservative care.

Liver damage type.

132 (132/221, 59.7%) cases of hepatocytes type
34 (34/221, 15.4%) cases of cholestatic type (reduction in bile flow)
55 (55/221, 24.9%) cases of mixed type.
 RECURRENCE AND FAMILY HISTORY.
AGE AND GENDER
3 (3/72, 4.2%) cases had family history of HSW induced
hepatitis.

53 (53/138, 38.4%) cases with liver damage related to HSW

many times

In 450 cases, 224 (49.78%) were male

and 226 (50.22%) were female.

In 72 cases of case reports, patients ranged

in age from 5 to 78 years.
“DOSE-TIME-TOXICITY” RELATIONSHIP.
RECOVERY
when daily dose is less than 12 g
-the median time is 60 days

more than 12 g - the median time

is 30 days

Recovery
In case reports, the length of 72
patients' hospitalization ranged
from 6 to 120 d, with a median of
29.5
The mechanism of HSW unclear:
toxic substances unknown
DISCUSSI
few animal experiments did not find ON
hepatotoxicity
of HSW

Other Issues
related to patient self-medication,
arbitrarily increase in the dose
long-term use

30% of patients reported liver damage

occurred many times
few cases have a family history of liver
damage induced by HSW

related to personal body factors of

patients
 CONCLUSION.
Herb is still useful! Should
monitor the patients symptoms
and proscribe the right dosage.

Symptoms
➤ Abdominal pain
➤ vomiting
➤ diarrhea
➤ fatigue
➤ nausea
➤ yellowing of skin and sclera
➤ yellow urine

Dosage
In the Chinese Pharmacopoeia
(2010), predetermined daily dose
of raw HSW is 3–6 g and of
processed HSW is 6–12 g
REFERENCES
Xiang Lei, 1 Jing Chen, 1 Jingtian Ren, 2 Yan Li, 1 Jingbo Zhai, 1 Wei Mu, 3 Li Zhang, 3 Wenke Zheng, 1 Guihua Tian,4 and 

Hongcai Shang 1 , 5 , *

1. Chen Q. T., Zhuo L. H., Xu W., Huang Z. H., Qiu X. H. Content changes of 5

components in Polygohum muhiflorum during processing. Chinese Journal of

Experimental Traditional Medical Formulae. 2012;18(5):66–71. 

2. National Pharmacopoeia Committee. Chinese Pharmacopoeia.Beijing, China: China Medical Science Press; 2010.
3. Han X., Wu C. A., Wang W., Liu S., Wang L. Y. Mechanism research of stilbene glucoside from Polygonum

multiflovum thunb on hyperlipemia. Chinese Archives of Traditional Chinese Medicine. 2008;26(8):1687–1689.

4. Gao X., Hu Y.-J., Fu L.-C. Blood lipid-regulation of stilbene glycoside from Polygonum

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC
multiflorum . Zhongguo Zhongyao Zazhi. 2007;32(4):323–326

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