Anti-Cancer, Anti-Rheumatic and Analgesic Effects of Han Fang Ji (Stephania tetrandra)
Fang Ji (Stephania root) is an herb used in Chinese medicine since very early times. In the writings of Zhang Zhongjing of the Han dynasty and Sun Simiao of the Tang dynasty, there are formulas composed of Fang Ji. In particular, in Zhang Zhongjing's Jin Gui Yao Lue (Essential Prescriptions from the Golden Cabinet), several famous formulas are named after Fang Ji, such as Fang Ji Fu Ling Tang, Fang Ji Huang Qi Tang, Ji (Ji means Fang Ji) Jiao Li Huang Wan, and Fang Ji Di Huang Tang. Sun Simiao's Qian Jin Yao Fang also contains Fang Ji Tang, showing that TCM in the Han and Tang eras was very fond of using Fang Ji.
However, the Fang Ji used in different historical periods was not always the same plant. The earliest Fang Ji used in China was mainly Mu Fang Ji (Japanese snakeroot), produced in the Hanzhong region and also called Hanzhong Fang Ji. It is the rhizome of Aristolochia manshuriensis of the birthwort family. The Shen Nong Ben Cao Jing records Fang Ji as "also named Jie Li, growing in streams and valleys," which is consistent with Mu Fang Ji from Hanzhong, whose tuber is black inside like a cart-spoke cross-section.
But Tao Hongjing of the Liang dynasty wrote in the Ben Cao Jing Bie Lu that the Fang Ji of his time "now comes from Yidu (northwestern Hubei today) and Jianping (southeastern Sichuan today); the large, blue-white, soft and spongy ones are best." This Fang Ji is no longer an Aristolochiaceae plant but a Menispermaceae plant, also called Han Fang Ji or Fen Fang Ji. This kind has no cart-spoke-like black markings inside; the large, starchy roots are considered best. This matches the Fen Fang Ji we use today.
All Aristolochiaceae plants are strongly nephrotoxic, so we no longer recommend using Mu Fang Ji medicinally. Han Fang Ji (Fen Fang Ji) is much safer than Mu Fang Ji (Hanzhong Fang Ji). The main active constituent of Han Fang Ji is tetrandrine (also called hanfangchin A). Modern pharmaceutical companies have already formulated it into tetrandrine tablets and tetrandrine injection. These finished preparations are convenient to use and avoid confusing Mu Fang Ji with Han Fang Ji, ensuring medication safety. Therefore, when patients use Han Fang Ji on their own, they may simply choose tetrandrine tablets.
Traditional Chinese medicine holds that the main actions of Fang Ji are to promote urination and reduce edema, to expel wind and relieve pain; it is indicated for edema, difficult urination, rheumatic arthralgia, beriberi swelling and pain, and scabies, tinea and sores. Today, tetrandrine tablets are mainly used for rheumatic pain, joint pain and neuralgia, or combined with low-dose radiation for lung cancer; they may also be used for simple silicosis stages I, II and III and coal worker's pneumoconiosis at all stages. In addition, the Chinese herb Han Fang Ji and the finished tetrandrine tablets also lower blood pressure and treat angina pectoris, so they are often used in hypertension and angina.
Modern pharmacological research has found that tetrandrine (hanfangchin A) is a bisbenzylisoquinoline alkaloid. Tetrandrine has a good effect on reversing multidrug resistance in leukemia. Scholars such as Xu Wenlin treated drug-resistant leukemia K562/ADM cells with tetrandrine, after which the intracellular concentration of doxorubicin (ADM) rose markedly. After tetrandrine treatment, the fluorescence intensity of K562/ADM resistant cells increased and the number of apoptotic cells grew. This shows that tetrandrine can cause intracellular accumulation of anti-cancer drugs, raise their concentration and induce apoptosis, producing a clear adjunctive anti-cancer effect.
Therefore, tetrandrine tablets have been listed as a clinical adjunctive anti-cancer drug. Tetrandrine tablets can raise the peak plasma concentration after oral cyclosporine A. At the same time, tetrandrine tablets can also alleviate the gastrointestinal reactions and limb numbness caused by chemotherapy drugs, and protect against chemotherapy-induced damage to hemoglobin and white blood cells.
Pharmacological experiments show that tetrandrine has marked effects on the heart, coronary vessels, coronary flow, vasculature and blood pressure; it also inhibits platelet aggregation, antiarrhythmically inhibits the immune system's allergic reactions, and has anti-inflammatory and anti-tumor actions.
Tetrandrine has broad-spectrum anti-tumor activity. It exerts varying degrees of inhibitory effects on the DNA, RNA and protein metabolism of HeLa cervical cancer cells, human transplanted hepatoma BEL7402 and BEL7405 cells, and mouse sarcoma S180 cells. Tetrandrine has lung-selective and fibrinolytic effects, can dilate blood vessels, and—combined with its direct killing of cancer cells—is therefore classified as a radiosensitizer of the first class.
Attentive readers may notice that many of the prescriptions in my case records contain Han Fang Ji, often at 30 g or more. I frequently use it to treat pleural and ascites in cancer patients. Han Fang Ji has a strong diuretic effect and can increase urine output in patients with ascites, pleural effusion and pelvic effusion, reducing the volume of fluid. It can also relieve joint pain and neuralgia in cancer patients.