Tripterygium wilfordii for rheumatoid arthritis

As a Chinese herbal medicine, Tripterygium wilfordii has the effects of removing rheumatism, anti-inflammation and sterilization, and has a good effect in treating rheumatic diseases and lupus erythematosus. However, Tripterygium wilfordii is not completely non-toxic. Its ingredients actually contain a certain amount of toxins. If the dosage is not properly controlled, it is likely to cause poisoning problems, triggering a series of side effects, which will have a relatively large adverse effect on the human body.

The pros and cons of Tripterygium wilfordii in treating rheumatoid arthritis

The oral administration of Tripterygium wilfordii for the treatment of rheumatoid arthritis was first reported in domestic literature in 1974 by the Second Hospital of Sanming District, Fujian Province. In the same year, a Chinese medicine hospital in Hubei Province used this medicine to treat rheumatoid arthritis based on Zhou's experience and achieved good results. In 1976, through clinical observations of more than 500 cases in Wuhan, Zhongxiang and other places, the efficacy of Tripterygium wilfordii on rheumatoid arthritis was verified. The total effective rate was between 91% and 95%.

1. The properties, meridians and functions of Tripterygium wilfordii

Tripterygium wilfordii tastes bitter, is cool (or cold) in nature, and is highly toxic; a small number of documents also believe that it is warm in nature. It enters the liver and spleen meridians and runs through the twelve meridians; it has the functions of clearing away heat and detoxifying, killing insects, dispelling wind and dampness, relaxing muscles and tendons, activating blood circulation and dredging collaterals, reducing swelling and relieving pain; it is used for bruises, rheumatic arthralgia, rheumatism, furuncles, furuncles, skin itching and other symptoms.

2. Main pharmacological effects

Experimental research results show that Tripterygium wilfordii has definite anti-inflammatory, analgesic and immunosuppressive effects. In addition, it has the effects of anticoagulation, improving the physical and chemical properties of blood and microcirculation. Because it has an inhibitory effect on tissues and cells with a faster renewal rate, it is considered to be a cytotoxic alkylating agent, and thus has anti-leukemia, anti-fertility, antibacterial, and insecticidal effects. The effective dose of Tripterygium wilfordii for treating rheumatoid arthritis is very close to the toxic dose. The toxic and side effects are closely related to the direct stimulation and cytotoxic effects of the drug.

3. Main dosage forms and usage

According to the degree of refinement of the preparations, they can be divided into three categories: ① crude drugs and crude extracts, such as decoctions, tinctures, wine preparations, granules, syrups, water extracts and alcohol extracts, which are currently more widely used; ② re-products, which are mostly products after separation and extraction, and contain high levels of effective ingredients, such as tripterygium wilfordii tablets and polyglycoside tablets; ③ effective monomers, such as tripterygium wilfordii. The main dosage forms and usage are described below according to common clinical administration routes.

(1) Decoction: Cut the whole root (including the root bark) or the xylem of the rhizome (with the root bark removed) into pieces and simmer in water over low heat for 2 hours (longer simmering may destroy the active ingredients). The general dosage of the whole root is 10-15 grams per day, not exceeding 15 grams; the dosage of the rhizome and xylem is larger, 20-40 grams per day. Decoction in water and take 2-3 times after meals. In addition, it can be combined with other Chinese medicines for better therapeutic effect.

(2) Alcoholic beverage:

① Tripterygium wilfordii wine: 250 grams of Tripterygium wilfordii, 2500 milliliters of water, simmer until 1000 milliliters of sweat are reduced, filter out the residue, add 250 grams of rock sugar or white sugar to melt, cool down, add 1000 milliliters of white wine. The crude drug content is 12.5%. Take 15-25 ml each time, 2-3 times a day.

②Compound Tripterygium wilfordii wine (Huangteng mixture): 250 grams of Tripterygium wilfordii, 60 grams of raw Chuanwu, 60 grams of raw Caowu, 20 grams each of Angelica sinensis, safflower, cinnamon twig, Chuanxiong, papaya, Notopterygium wilfordii, Eucommia ulmoides, and Rehmannia root bark, add 2500 ml of water, simmer until 1000 ml remains, filter out the residue, add 250 grams of rock sugar or white sugar to dissolve, cool and add 1000 ml of wine (about 50 degrees) (containing 12*5% of raw medicinal materials). Adults should take 20-30 ml each time, up to 40 ml, three times a day, after meals.

(3) Tincture: Dry the whole root and cut it into 2-3 mm thin slices. Take 125 g and soak it in 1000 ml of 46-60% liquor. Stir and seal the container. Filter and use after two weeks (this will become a 12.5% ​​tincture). Adults should take 10-15 ml each time, not more than 20 ml, 3 times a day.

(4) Tablets: Currently, Phellodendron chinense extract tablets, Tripterygium wilfordii tablets, and Tripterygium wilfordii polyglycoside tablets are available on the market. Patients can take them according to the instructions.

4. Toxic and side effects and treatment

(1) Toxic and side effects: related to factors such as the quality of medicinal materials, preparation, dosage and individual factors.

① Gastrointestinal reactions: common. The main symptoms are dry mouth, poor appetite, epigastric discomfort or burning sensation, abdominal distension, diarrhea or constipation. In more severe cases, patients may experience nausea, vomiting, abdominal pain, and positive occult blood in the stool. It can be combined with other Chinese medicines for better efficacy.

② Skin and mucous membrane reactions: rash, pruritus, conjunctivitis, hair loss, etc.

③Effects on the heart, liver and kidneys: Most data report no obvious adverse effects. However, a few drugs may affect the cardiac conduction system and myocardium, such as conduction block and toxic myocarditis. Some people experience elevated alanine aminotransferase, discomfort or pain in the liver area. A small number of people experience lower limb edema and elevated non-protein nitrogen in the blood.

5. When using Leigonglei, please remember to follow the doctor's instructions and do not increase or decrease the dosage on your own. Proper dosage combination can achieve good results. Men of childbearing age should not take it.