Rupixiao Tablets for the Treatment of Proliferative Breast and Uterine Diseases
Rupixiao Pian (Rupixiao Tablets) is a commonly used Chinese patent medicine listed in the Pharmacopoeia of the People's Republic of China, Volume I, 2005 edition. It is composed of Lujiao (deer antler), Pugongying (dandelion), Kunbu (kelp), Tianhuafen (trichosanthes root), Jixueteng (spatholobus stem), Sanqi (pseudoginseng), Chishao (red peony root), Haizao (sargassum), Lulu (rhaponticum), Muxiang (aucklandia), Xuanshen (scrophularia), Mudanpi (moutan bark), Xiakucao (selfheal spike), Lianqiao (forsythia), and Honghua (safflower). It is manufactured by several pharmaceutical companies and can be purchased directly from pharmacies. It is essentially covered by medical insurance nationwide and can also be prescribed at designated medical-insurance hospitals.
As the name suggests, Rupixiao is a medicine for proliferative breast diseases. It softens hard masses and disperses nodulation, activates blood and reduces swelling, and clears heat and resolves toxin. It is indicated for breast nodular masses (rupi), early-stage breast abscess (yong), cystic hyperplastic breast disease, and the pre-mastitis stage, and may also be used for uterine fibroids.
Modern pharmacological studies show that Rupixiao has anti-breast-hyperplasia and anti-uterine-fibroid effects. Animal experiments have shown that Rupixiao Tablets can inhibit proliferation of the mammary duct epithelium and acinar epithelium in estradiol-induced rabbit models of breast hyperplasia, and can also inhibit uterine fibroids induced in guinea pigs by long-term intramuscular injection of exogenous estrogen and progesterone, as well as reduce uterine contractility.
Lujiao, Tianhuafen, and other herbs in this formula all have some anti-estrogen/anti-progesterone action. From a modern medical perspective, such anti-gonadal-hormone drugs regulate the endocrine system and can treat proliferative breast and uterine diseases caused by estrogen and progesterone. Estrogen/progesterone imbalance may arise from internal causes, from menstrual irregularity or amenorrhea, or — simply out of a desire to look good — from long-term use of estrogen and progesterone. This is the root cause of many cases of breast hyperplasia and uterine fibroids; suppressing estrogen and progesterone therefore treats the root.
Once proliferative disease develops in the breast or uterus, masses form. For such swelling and ulcerative conditions, TCM typically combines softening-hardness/dispersing-nodules, activating-blood/resolving-stasis, and clearing-heat/resolving-toxin methods. In this formula, Pugongying, Lulu, Xuanshen, and Lianqiao clear heat, resolve toxin, scatter nodules, and reduce swelling; Kunbu, Haizao, and Xiakucao soften hardness and disperse nodules; Sanqi, Chishao, Jixueteng, Honghua, and Mudanpi activate blood and resolve stasis. Thus the composition of Rupixiao Tablets is rational from both modern and traditional medical perspectives.
However, the clinical effective rate of Rupixiao Tablets is not especially high, and many patients report poor results. Judging from its composition, the drug is more suitable for TCM yang-pattern or heat-pattern patients, since most of its ingredients are cooling in nature. Patients with deficiency-cold constitutions or spleen deficiency with loose stools should not use it. For clearly heat-type patients, in my experience, brewing 60 g of Jinyinhua Teng (honeysuckle vine) in water and taking it together with Rupixiao Tablets yields better results than using Rupixiao alone.
Rupixiao can also serve as an adjuvant for breast cancer, uterine cancer, ovarian cancer, and other gynecologic tumors. Most herbs in the formula have some tumor-inhibiting action, but Rupixiao alone is unlikely to treat such diseases. When treating breast cancer and similar cancers, Rupixiao Tablets may be combined with Xiaojin Wan, Xihuang Wan, or Fufang Banmao Jiaonang.