Usage and Toxic Side Effects of the Anticancer Chinese Herbal Medicine Zhongjiefeng (Sarcandra glabra)
Zhongjiefeng is the whole plant of Sarcandra glabra, a member of the Chloranthaceae family; it is also known as Caoshanhu (Sarcandra), Jiujiecha, and Jiegu Jinshulan. Folk people named it Zhongjiefeng (literally "swelling-node-wind") because of its efficacy in dispersing swelling and nodules. Traditional Chinese medicine holds that Zhongjiefeng is slightly cold in nature, bitter and pungent in taste, and mildly toxic; it has the actions of clearing heat and resolving toxin, expelling wind and unblocking the collaterals, activating blood and dissipating nodules, and resolving phlegm and calming wheezing. It is commonly used to treat lung abscess, rheumatic arthralgia, traumatic injuries, and unnamed swellings and toxins.
Modern pharmacological studies have found that Zhongjiefeng has antibacterial, anti-inflammatory, immunomodulatory, and antitumor effects. It can be used to treat various inflammatory diseases such as pneumonia, appendicitis, and cellulitis, and can also serve as adjuvant therapy for various cancers. Especially when cancer patients have concurrent infections, using Zhongjiefeng as an adjunct anti-infection treatment can produce a synergistic effect.
Zhongjiefeng is also made into modern preparations; the clinically common ones are Zhongjiefeng tablets and Zhongjiefeng injection. Zhongjiefeng tablets and injection mainly contain succinic acid, fumaric acid, flavonoid glycosides, tannins, resins, and so on. The manufactured products Zhongjiefeng tablets and injection are mainly used for pneumonia, appendicitis, cellulitis, and other diseases belonging to the syndrome of exuberant heat-toxin, and can also be used as adjuvant therapy for cancer.
In vitro tests show that the volatile oil of Zhongjiefeng has a strong direct killing effect on leukemia 615 cells and can prolong the survival time of mice with spontaneous ascites-type leukemia 771. The volatile oil of Zhongjiefeng has a 30-40% tumor-inhibition rate against Ehrlich ascites carcinoma, sarcoma S180, Walker carcinosarcoma, and sarcoma S37. The dried extract of Zhongjiefeng also has an inhibitory effect on mouse sarcoma S180, Walker carcinosarcoma, and mouse spontaneous adenocarcinoma.
The anticancer mechanism of Zhongjiefeng may be related to its inhibition of cancer-cell nuclear division. Zhongjiefeng can inhibit the proliferation and replication of cancer cells and can also induce widespread apoptosis of cancer cells. Pharmacological experiments show that Zhongjiefeng has a strong in vitro cytotoxic effect on human tumor cell lines A-549, HCT-29, and BGC-823, and this effect becomes more pronounced at higher concentrations. Clinical trials show that Zhongjiefeng injection has antitumor effects on mouse hepatoma HepA-22 and mouse forestomach carcinoma FC.
Zhongjiefeng not only directly induces tumor-cell apoptosis and inhibits tumor-cell proliferation, but also has a marked synergistic effect on radiotherapy and chemotherapy. Therefore, Zhongjiefeng is now widely used in the treatment of gastrointestinal tumors such as gastric cancer, esophageal cancer, pancreatic cancer, colorectal cancer, liver cancer, and gallbladder cancer, as well as various solid tumors such as lung cancer, breast cancer, bladder cancer, and prostate cancer. When treating cancer, Zhongjiefeng tablets or Zhongjiefeng injection may be used alone, or combined with other drugs according to traditional Chinese medicine methods.
Zhongjiefeng also has a biphasic immunomodulatory effect: a low dose can enhance a patient's immunity, while a high dose can suppress immune function in those with immune hyperactivity. Zhongjiefeng also has broad-spectrum antibacterial effects: it is extremely sensitive to Staphylococcus aureus and Shigella dysenteriae type 1, and highly sensitive to drug-resistant Staphylococcus aureus, Shigella boydii type C-2, Salmonella typhi H901, and Salmonella paratyphi A; it also has some effect on Shigella flexneri type 3, Escherichia coli, and Pseudomonas aeruginosa. In addition, Zhongjiefeng has the effect of setting bones and healing injuries, and folk people use it to treat traumatic injuries.
The toxic component of Zhongjiefeng is cyanogenic glycoside, which hydrolyzes in the gastrointestinal tract into hydrocyanic acid, thereby blocking cellular metabolism and causing cell asphyxiation, which can ultimately lead to death from respiratory paralysis. Therefore, Zhongjiefeng must not be used in excess. In Chinese herbal decoctions, the daily dosage of Zhongjiefeng is 10-30 g, and safety should be observed when using it long-term. There have been reports that a small number of patients developed allergic reactions such as skin papules, urticaria, dizziness, and fatigue when using Zhongjiefeng injection. Therefore, patients with hepatic or renal insufficiency and those with allergic constitutions should use Zhongjiefeng injection with caution, and pregnant women are contraindicated. The traditional Chinese medicine method of using Zhongjiefeng as a water decoction is relatively safe; taking Zhongjiefeng decoction causes no more serious side effects than occasional gastrointestinal discomfort in individual patients.
When using Zhongjiefeng to treat cancer, Chinese medicine also combines it with other Chinese herbs of similar effect to enhance efficacy and reduce toxic side effects.
When Zhongjiefeng treats gastric cancer, liver cancer, and pancreatic cancer, it may be combined with Biejia (Carapax Trionycis), Yinchenhao (Herba Artemisiae Scopariae), Chishao (Radix Paeoniae Rubra), Dangshen (Radix Codonopsis), Yujin (Radix Curcumae), Wulingzhi (Faeces Trogopterori), Zhizi (Fructus Gardeniae), Sanleng (Rhizoma Sparganii), Ezhu (Rhizoma Curcumae), Sumu (Lignum Sappan), Honghua (Flos Carthami), Danshen (Radix Salviae Miltiorrhizae), Huangqi (Radix Astragali), etc. When treating colorectal cancer, it may be combined with Baijiangcao (Herba Patriniae), Mutouhui (Herba Siphonostegiae), Baihuasheshecao (Herba Hedyotidis Diffusae), Huaihua (Flos Sophorae), Huaijiao (Fructus Sophorae), Taoren (Semen Persicae), Honghua, Yiyiren (Semen Coicis), Dongguaren (Semen Benincasae), Daxueteng (Caulis Sargentodoxae), etc. When treating prostate cancer, it may be combined with Wangbuliuxing (Semen Vaccariae), Liujinu (Herba Artemisiae Anomalae), Taoren, Danshen, etc. When treating osteosarcoma, it may be combined with Hetaopishu (walnut bark), Nuzhenzi (Fructus Ligustri Lucidi), Dihuang (Radix Rehmanniae), Tougucao (Herba Speranskiae Tuberculatae), Buguzhi (Fructus Psoraleae), Gusuibu (Rhizoma Drynariae), Sumu, and Zirantong (Pyritum), etc.