Chaihu (Bupleurum) and Huangqin (Scutellaria) in Combination: Effective for Cancer, Asthma, Hepatitis B, Tuberculosis, and Chronic Inflammation

Chaihu (Bupleurum Root) and Huangqin (Scutellaria Root) are two very important herbs for harmonizing the Shaoyang. When used appropriately, they can treat many difficult and complicated diseases, with good effects on cancer, asthma, hepatitis B, pulmonary tuberculosis, uterine fibroids, and various chronic inflammations.

The Chinese patent medicines Chaihuang Tablets or Chaihuang Granules are made by combining these two herbs and extracting them. Chaihuang Granules have the effect of clearing heat and releasing the exterior, and can be used for fever caused by colds, generalized discomfort, headache and dizziness, sore throat, etc. (indications per *New Compilation of National Chinese Patent Medicines*). Therefore, when Chaihu and Huangqin are used together at sufficient dosage, a common patient reaction is fever and sweating, with the pathogen being resolved through the sweat.

For fever in children caused by colds, when the child cannot cooperate with taking decoctions, I often use the patent medicine Chaihuang Granules with very good results. Incidentally, cancer fever and fever caused by pulmonary tuberculosis can both be addressed by adding Chaihu and Huangqin to the formula to achieve antipyretic effects. If a cancer patient has not yet developed cancer fever, early use of Chaihu and Huangqin can effectively prevent its occurrence. For pulmonary tuberculosis patients, combining Chaihu and Huangqin with other medications can improve efficacy.

One point to note: when Chaihu and Huangqin are used to induce sweating and reduce fever, the patient must experience relief rather than worsening of symptoms after taking them. If symptoms worsen, it indicates an error in medication and should be corrected early. Either change the formula or, based on the patient's specific condition, add other appropriate herbs. For example, if sweating leads to loss of yang after using Chaihu and Huangqin, they should be combined with herbs that secure the exterior and generate fluids, such as Baizhu (Atractylodes), Huangqi (Astragalus), Fangfeng (Saposhnikovia), and Renshen (Ginseng).

Chaihu and Huangqin are an excellent pair for liver protection and have good efficacy for poor liver function. In treating hepatitis B, liver cancer, and various cancers that have progressed to liver metastasis, I often use Chaihu and Huangqin as the principal herb pair. For general abnormal liver function, adding Chaihu and Huangqin to the formula often produces immediate results.

However, for some cases of drug-induced liver injury, Chaihu and Huangqin may not have the same effect. For example, liver damage caused by cancer patients taking targeted drugs or endocrine therapy often fails to respond to Chaihu and Huangqin. This is because such liver injury is more difficult to reverse, and the patient cannot discontinue the targeted or endocrine drugs; even if temporarily effective, it often recurs.

Chaihu and Huangqin in combination have good anti-inflammatory, antibacterial, antihistamine, and anti-allergic effects. Therefore, for various chronic inflammations—such as chronic pneumonia, bronchitis, chronic otitis media, chronic hepatitis, chronic gynecological inflammation, chronic prostatitis, chronic gastroenteritis, and even various chronic inflammatory lesions caused by cancer and multiple allergic diseases—Chaihu and Huangqin have good therapeutic effects.

Long-term illness is often accompanied by inflammatory lesions. For some chronic patients who do not respond to routine medication, I often add an appropriate amount of Chaihu and Huangqin to the original formula, and the efficacy quickly becomes obvious and definite, greatly shortening the treatment course.

I not only always use Chaihu and Huangqin when treating hepatitis B, but also frequently use them for chronic pneumonia, chronic otitis media, and some chronic gynecological inflammations. When treating long-standing asthma patients, I also like to add an appropriate amount of Chaihu and Huangqin to standard asthma formulas for more pronounced efficacy.

Chaihu and Huangqin in combination also have a very good effect on pleural and ascitic fluid caused by cancer. When using corresponding spleen-fortifying, water-draining herbs, aromatic dampness-transforming herbs, and qi-moving herbs, adding Chaihu and Huangqin can significantly improve the patient's pleural and ascitic fluid and shorten the treatment course.

I first began using Chaihu and Huangqin inspired by a now-deceased old TCM doctor who excelled in treating cancer. I noticed that in almost every formula he prescribed, he used Chaihu and Huangqin, and his cancer treatment results were excellent, with many patients surviving for a long time. So I later emulated his prescribing habits and favored Chaihu and Huangqin when treating cancer patients.

Later, when treating chronic patients with lingering illnesses who did not respond well to conventional formula approaches, I tried adding Chaihu and Huangqin to standard formulas and sometimes achieved remarkable results. In recent years, I have become quite proficient in using Chaihu and Huangqin and have self-designed several formulas that are quite effective for certain common conditions. I share them below for colleagues' review and correction.

Modified Chaihuang Siwu Decoction (self-designed formula)

Chaihu 12g, Huangqin 12g, Shudihuang (rehmannia, prepared) (or Shengdihuang, raw rehmannia) 12g, Danggui 12g, Baishao 12g, Chuanxiong (Sichuan Lovage Rhizome) 12g, Danshen 15–40g, Huanglian (Coptis) 3–6g

I commonly use this formula for uterine fibroid conditions with very good results. For amenorrhea or excessive menstrual bleeding caused by uterine fibroids, when using Modified Chaihuang Siwu Decoction, adding or subtracting herbs based on corresponding symptoms often yields unexpected results. For heavy bleeding, consider adding Mohanlian (Eclipta) and Nüzhenzi (Ligustrum Fruit); for amenorrhea, consider adding Dibiechong (Eupolyphaga) and Shudahuang (prepared Rhubarb); for concurrent yellow, thick vaginal discharge, consider adding Tufuling (Smilax Glabra) and Kusen (Sophora Flavescens).

Chaihuang Renshen Wuweizi Decoction (self-designed formula)

Chaihu 12g, Huangqin 12g, Renshen (Ginseng) 6–9g, Baizhu 9g, Fuling 9g, Zhi Gancao (honey-fried Licorice) 3g, Maidong (Ophiopogon) 3g, Wuweizi (Schisandra) 1.5g

This formula adds Chaihu and Huangqin to Renshen Wuweizi Tang (Ginseng and Schisandra Decoction), used for treating persistent chronic cough and allergic asthma, and chronic bronchitis of the qi deficiency and spleen deficiency pattern, with excellent results. Renshen Wuweizi Tang comes from *Youyou Jicheng* (Collection of Infant Care), and is based on Sijunzi Tang (Four Gentlemen Decoction) plus Maidong and Wuweizi. The original formula treats cough and wheezing due to deficiency of both spleen and lung, rickets, sparse hair, and weak constitution. With the addition of Chaihu and Huangqin, it can be used for intractable cough and wheezing.

Shugan Jianpi Yiqi Huayu Decoction (my self-designed base formula for treating hepatitis B)

Chaihu 10g, Huangqin 10g, Baizhu 20g, Fuling 20g, Baishao 20g, Chishao 20g, Danshen 20–40g, Chao Zhizi 15g, Lianqiao 20g, Wuweizi 15g, Muxiang 10–15g

When treating hepatitis B patients, various cancer patients with a history of hepatitis B, or patients with liver metastasis from cancer, I often use this base formula with modifications; it has a certain efficacy.

Historically, there are many classic famous formulas combining Chaihu and Huangqin, such as Da Chaihu Tang (Major Bupleurum Decoction), Xiao Chaihu Tang (Minor Bupleurum Decoction), and Chaihu Dayin Yin (Bupleurum Decoction to Reach the Origin)—all renowned formulas with outstanding clinical efficacy, which need no detailed elaboration.

When using Chaihu and Huangqin, attention must be paid to dosage. Chaihu used for relieving stagnation and raising yang requires only 1–6g; for expelling pathogen and clearing heat, 9–15g is needed. If Chaihu is used in large doses—above 30g—it has a more pronounced menstruation-unblocking and viscera-clearing effect. I have also used large-dose Chaihu to treat constipation and amenorrhea with good results.

When using Chaihu and Huangqin, the physician must closely monitor the patient's response after taking them. Chaihu and Huangqin in combination have a strong sweating effect, which is also an expression of their pathogen-expelling and detoxifying efficacy. But some patients do not feel comfortable after sweating from Chaihu and Huangqin. In that case, one must take care not to blindly push ahead.

TCM has a saying that 'Chaihu depletes liver yin,' but when Chaihu is used together with liver-softening Baishao, yin-nourishing Biejia (Turtle Shell), and Guiban (Turtle Plastron), this harm is not pronounced. Moreover, herbs are fundamentally used to treat specific conditions; as long as there are indications for Chaihu and Huangqin, they should be used boldly, without worrying about their side effects.