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Gentiana Complex

CLINICAL APPLICATIONS

* Hypertension (excess-type) with anger, flushed face, dizziness, and throbbing headache

* Viral infection, such as genital herpes and herpes zoster

* Bacterial or fungal infections, such as urinary tract infection, vaginal infection, yeast infection, herpes infection, boils, carbuncles, acute cystitis, urethritis, and related discomforts or dysfunctions

* Liver and gallbladder disorders, such as acute icteric hepatitis, and acute cholecystitis

 

WESTERN THERAPEUTIC ACTIONS

* Antihypertensive effect to lower blood pressure

* Antibiotic, antibacterial, antiviral, and antifungal effects for a variety of infections

* Hepatoprotective and cholagogic functions to treat liver and gallbladder disorders

* Anti-inflammatory properties to treat inflammation of the internal organs and soft tissue

 

CHINESE THERAPEUTIC ACTIONS

* Drains fire from the Liver and the Gallbladder channels

* Clears damp-heat from the lower jiao

* Nourishes yin

 

DOSAGE

Take 4 capsules three times daily. For treatment of infections and inflammation of internal organs, the dosage may be increased to 6 to 8 capsules three to four times daily. Treatment is most effective if herbal therapy begins immediately with the first sign of outbreak and continues throughout the entire course of infection. Advise the patients to take the herbs with meals if they experience stomach discomfort.

 

INGREDIENTS


Che Qian Zi (Semen Plantaginis)

Da Huang (Radix et Rhizoma Rhei)

Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae)

Di Huang (Radix Rehmanniae)

Ge Gen (Radix Puerariae Lobatae)

Hua Shi (Talcum)

Huang Bo (Cortex Phellodendri Chinensis)

Huang Qin (Radix Scutellariae)

Long Dan (Radix et Rhizoma Gentianae)

Niu Xi (Radix Achyranthis Bidentatae)

Shi Jue Ming (Concha Haliotidis)

Ze Xie (Rhizoma Alismatis)

Zhen Zhu Mu (Concha Margaritiferae)

Zhi Zi (Fructus Gardeniae)


 

BACKGROUND

Gentiana Complex contains herbs with multiple therapeutic functions. Primary clinical applications include cardiovascular disorders, infectious diseases, inflammatory disorders, and disorders affecting the liver, gallbladder and pancreas. From traditional Chinese medicine perspectives, heart, liver, gallbladder and pancreas disorders are considered as fire in the Liver and the Gallbladder channels, while infection and inflammation are diagnosed as damp-heat of the affected area(s) or organ(s).

 

FORMULA EXPLANATION

Gentiana Complex is formulated to treat fire in the Liver and the Gallbladder channels and damp-heat in the lower jiao. Fire in the Liver and Gallbladder is characterized by headache, red eyes, hypochondriac pain, a bitter taste in the mouth, deafness, and swollen or painful inner ears. Damp-heat in the lower jiao manifest with swelling and itching of the external genitalia, sweating in the groin, dysuria, turbid urine, and yellow, foul-smelling leukorrhea in women.

        Shi Jue Ming (Concha Haliotidis) and Zhen Zhu Mu (Concha Margaritiferae) descend and anchor the rising Liver yang to treat dizziness and headache. Da Huang (Radix et Rhizoma Rhei) eliminates damp-heat and purges toxic fire. The active ingredient puerarin in Ge Gen (Radix Puerariae Lobatae) has been found to effectively relieve neck stiffness, pain, headache, and dizziness associated with hypertension. Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) adjusts the heart rate and improves microcirculation and myocardial contraction.

        Damp-heat is considered to be the cause of various bacterial, viral, and fungal infections in traditional Chinese medicine. A large quantity of Long Dan (Radix et Rhizoma Gentianae) is used in this formula to drain damp-heat in the Liver channel and the lower jiao, to treat herpes, urinary tract infection, cystitis, and other infections. Huang Qin (Radix Scutellariae), Huang Bo (Cortex Phellodendri Chinensis) and Zhi Zi (Fructus Gardeniae) clear heat and drain dampness. Ze Xie (Rhizoma Alismatis), Che Qian Zi (Semen Plantaginis), Hua Shi (Talcum) and Niu Xi (Radix Achyranthis Bidentatae) eliminate damp-heat in the lower jiao and drain the damp-heat out of the body through urination. Di Huang (Radix Rehmanniae) protects the Liver from the strong sedative nature of the rest of the herbs in this formula.

        In summary, Gentiana Complex is a great formula that clears fire in the Liver and the Gallbladder channels and damp-heat in the lower jiao to treat numerous Western biomedical disease such as hypertension, infection, and liver and gallbladder disorders.

 

CAUTIONS & CONTRAINDICATIONS

* Herbal treatment is ineffective for malignant hypertension and some secondary hypertension, such as renal stenosis or pheochromocytoma. Refer the patient to a medical doctor, as surgical intervention may be necessary.

* Gentiana Complex should be taken for approximately one to two weeks when treating viral, bacterial or fungal infection. Once the infection subsides, the patient should be placed on a maintenance regimen using Nourish to prevent future attacks.

* Gentiana Complex is contraindicated for long-term use when treating viral, bacterial or fungal infection. This formula is designed to treat only the acute conditions, and should not be used for long-term or prophylactic treatments.

* Some patients may experience mild stomach discomfort or loose stools, which may be alleviated by reducing the dosage of herbs or taking the herbs with food.

* This formula is contraindicated during pregnancy and nursing.

* This herbal formula contains herbs that invigorate blood circulation, such as Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae). Therefore, patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (warfarin), should use this formula with caution, or not at all, as there may be a higher risk of bleeding and bruising.[1]

* The following warning statement is required by the State of California: “This product contains Da Huang (Radix et Rhizoma Rhei). Read and follow directions carefully. Do not use if you have or develop diarrhea, loose stools, or abdominal pain because Da Huang (Radix et Rhizoma Rhei) may worsen these conditions and be harmful to your health. Consult your physician if you have frequent diarrhea or if you are pregnant, nursing, taking medication, or have a medical condition.”

 

CLINICAL NOTES

* Western medicine classifies hypertension into two types: “red” and “pale” high blood pressure. “Red” high blood pressure corresponds with the TCM diagnosis of excess, and generally occurs in energetic and stressed individuals with marked redness and vascularized skin. “Pale” high blood pressure corresponds with the TCM diagnosis of deficiency, and generally occurs in individuals with compromised kidneys, glands, or metabolism.

* Gentiana Complex may be applied topically for treatment of genital herpes. Break open the capsules and apply the powder directly onto the lesion. Or, mix the powder with water to make a paste and apply to the lesions.

* Gentiana Complex and V-Support are very similar in treating damp-heat of the lower jiao. Gentiana Complex has an additional function to treat hypertension. Therefore, in patients who have normal blood pressure or low blood pressure suffering from damp-heat of the lower jiao, V-Support would be a more appropriate formula to use. In patients who have both hypertension (Liver yang rising) and also damp-heat in the lower jiao, Gentiana Complex should be used.

* Gentiana Complex and V-Support both have strong effect to treat damp-heat affecting the lower jiao:

§ Gentiana Complex has a broader effect to treat damp-heat along the Liver and Gallbladder channels from the head to the genital area.

§ V-Support has a localized effect to treat damp-heat in the genital area.

* Vaginitis may be caused by different micro-organisms:

§ Viral vaginitis is best treated with Gentiana Complex.

§ Bacterial vaginitis is more effectively treated with V-Support.

* Gentiana Complex incorporates numerous antibiotic herbs for two important reasons. First, the use of multiple herbs within an herbal formula has been shown to increase the antibiotic effect more than tenfold. Second, isolated use of single ingredients is often ineffective and increases the risk of development of bacterial and viral resistance.[2] Given these two reasons, it is necessary to combine herbs with appropriate properties to ensure effectiveness in treating the infection and minimizing the potential risk of the micro-organisms developing resistance and/or mutation.

* For treatment of hypertension, it is important to monitor the blood pressure and adjust the dosage based on age, body weight, severity of condition, and response of treatment.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Big pulse, a thick, expanding, forceful, and fast pulse on all three pulse positions, cun, guan, and chi. The harder the pulse, the higher the blood pressure and the more severe the condition.

 

SUPPLEMENTARY FORMULAS

* For long-term treatment of hypertension, use Gastrodia Complex.

* For coronary heart disorders, combine with Circulation.

* For cardiovascular and circulatory disorders throughout the entire body, combine with Circulation (SJ).

* For high blood pressure and fast heart rate due to excess fire, add Gardenia Complex.

* For severe blood stagnation, add Circulation (SJ).

* For hypertension with edema and water accumulation, combine with Herbal DRX.

* For hypertension with high cholesterol and triglycerides, add Cholisma.

* For hypertension with high cholesterol and triglycerides in individuals with fatty liver and obesity, add Cholisma (ES).

* For acute headache, add Corydalin (AC).

* For chronic headache, add Corydalin (CR).

* To treat shingles and herpetic lesions, add Dermatrol (HZ).

* To relieve post-herpetic pain, add Flex (NP).

* To prevent herpes attacks, use Nourish and Immune + when the patient is asymptomatic.

* To treat ear infection, combine with Herbal ENT.

* To enhance the antibacterial effect, combine with Herbal ABX.

* To enhance the antiviral effect, add Herbal AVR.

* For icteric hepatitis, acute cholecystitis or liver cirrhosis, combine with Liver DTX.

* For cholecystitis or gallstones, combine with Dissolve (GS).

* For visual disturbances, add Lycium Support.

* For increased thirst and constipation, combine with Gentle Lax (Excess).

* To address any dermatological disorders that are wet in appearance, add Dermatrol (Damp).

* To address any dermatological disorders that are dry in appearance, add Dermatrol (Dry).

* For more dampness/phlegm in the body, add Pinellia Complex.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Quchi (LI 11), Hegu (LI 4), Taichong (LR 3), Renying (ST 9)

* Taichong (LR 3), Qihai (CV 6), Zhongwan (CV 12), Fenglong (ST 40), Geshu (BL 17), Renzhong (GV 26), Ganshu (BL 18), Pishu (BL 20), Danshu (BL 19)

 

Classic Master Tung's Points:

* Hypertension: Linggu (T 22.05), Dabai (T 22.04), Xinling (T 33.17)*, Quchi (LI 11), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Sanzhong (T 77.07), Yizhong (T 77.05), Erzhong (T 77.06), Sihuashang (T 77.08), Sihuazhong (T 77.09), Sihuaxia (T 77.11), Zhengjin (T 77.01), Zhengzong (T 77.02), Sansheng (T 55.07)*, Weizhong (BL 40), Huoying (T 66.03), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tongtian (T 88.03). Bleed the back of the neck, LU and HT, LR and SP, ST areas with cupping. Bleed dark veins nearby the ST, BL channels on the lower limbs. Bleed before needling for best result.

* Viral infection (genital herpes and herpes zoster): Linggu (T 22.05), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Shuitong (T 1010.19), Shuijin (T 1010.20)

* Herpes of the eyes: Shangbai (T 22.03), Tianhuangfu [Shenguan] (T 77.18), Huoying (T 66.03), Simazhong (T 88.17). Bleed the LU area below the knees. Bleed before needling for best result.

* UTI: Libai (T 44.12), Yunbai (T 44.11), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Tongbei (T 88.11), Tongwei (T 88.10), Tongshen (T 88.09), Liukuai (T 1010.16), Qikuai (T 1010.17), Tianhuangfu [Shenguan] (T 77.18). Bleed dark veins nearby the KI channel on the lower limb. Bleed before needling for best result.

* Yeast infection: Fuke (T 11.24), Linggu (T 22.05), Yunbai (T 44.11), Libai (T 44.12), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14)

* Cystitis: Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Tongbei (T 88.11), Tongwei (T 88.10), Tongshen (T 88.09), Liukuai (T 1010.16), Qikuai (T 1010.17), Liuwan (T 66.08), Fenzhishang (T DT.01), Yunbai (T 44.11), Libai (T 44.12), Tianhuangfu [Shenguan] (T 77.18). Bleed tender points on the KI area of the back between L1-L5 with cupping. Bleed before needling for best result.

* Genital swelling and infection: Huanchao (T 11.06), Fuke (T 11.24), Yunbai (T 44.11), Jiemeiyi (T 88.04), Jiemeier (T 88.05), Jiemeisan (T 88.06), Haibao (T 66.01). Bleed sacral area with cupping. Bleed before needling for best result.

* Boil and carbuncle: Jianzhong (T 44.06), Waisanguan (T 77.27), Zhiwu (T 11.26)

 

Master Tung’s Points by Dr. Chuan-Min Wang:

* High systolic pressure, hypertension due to Liver deficiency, dizziness: Fuding (T 44.04), Houzhi (T 44.05)

* High diastolic pressure, hypertension due to Kidney deficiency: Tianhuang (T 77.17), Tianhuangfu [shenguan] (T 77.18)

* High systolic and diastolic pressure: Bleed Wuling (T DT.04) first. Then needle Quchi (LI 11), Huoying (T 66.03).

 

Balance Method by Dr. Richard Tan:

* Left side: Bleed Dadun (LR 1). Needle Taichong (LR 3) and Hegu (LI 4).

* Right side: Bleed Zhongchong (PC 9). Needle Neiguan (PC 6) and Zulinqi (GB 41).

* Left and right sides can be alternated from treatment to treatment.

 

Ear Acupuncture:

* Hypertension: Adrenal gland, bleed the depression groove in the back of the ear to lower blood pressure, Heart, Shenmen, Endocrine, Taiyang, Liver, Kidney. Select four or five points for each treatment, which lasts three days. Ten treatments equal one treatment course. Rest for one week in between treatment courses.

* Eczema of the rectum: Rectum, Anus, Spleen, Lung, and Adrenal Gland. Embed steel balls or ear needle and switch ears every three to five days. Instruct the patient to massage the points three to four times daily for two minutes each time.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Reducing blood pressure: Heart, Shenmen, Occiput, Kidney, Liver, Coronary Vascular Subcortex, Decrease BP. Bleed Ear Apex.

* Hypertension: Shenmen, Kidney, Liver, Heart, Occiput, Forehead, Decrease BP, Sympathetic, Coronary Vascular Subcortex. Bleed Ear Apex.

* Cystitis: Bladder, Urethra, Lower Jiao, Endocrine. Bleed Ear Apex.

* Auditory vertigo: Internal Ear, Dizziness Area, Occiput, San Jiao, Liver, Kidney, Gallbladder. Bleed Ear Apex.

* Conjunctivitis: Eye, Vision 2, Lower Lung. Bleed Ear Apex.

* Cataract: Kidney, Liver, Eye, Vision 2, Endocrine, Sympathetic. Bleed Ear Apex.

* Glaucoma: Eye, Decrease BP, Kidney, Liver, Occiput, Vision 1, Coronary Vascular Subcortex. Bleed Ear Apex.

 

NUTRITION

* Increase the intake of fresh, raw vegetables and fruits to control blood pressure. Nuts and seeds should be consumed daily as a source of protein. Vitamin C and bioflavonoids help to reduce blood pressure by stabilizing the blood vessel walls. Garlic is also effective to lower blood pressure and thin the blood.

* Patients with hypertension should minimize intake of salt from the diet. Avoid MSG, baking soda, meat, fat, aged foods, alcohol, diet soft drinks, preservatives, sugar substitutes, meat tenderizers, and soy sauce. Aspartame should also be avoided, since a high level may increase blood pressure. Over-the-counter medications, such as Advil or Motrin (ibuprofen), should not be used because they may increase the blood pressure.

* Individuals with cystitis should increase the intake of cranberries or cranberry juice. Cranberry produces hippuric acid in the urine that prohibits the growth of bacteria, thus preventing bacteria from adhering to the lining of the bladder. Juices that contain a large percentage of high-fructose syrup, sugar or sweeteners, on the other hand, should be avoided as they provide nutrients for bacterial growth.

* Patients should drink plenty of fluids, as it helps to flush out the bacteria in the bladder. Women are encouraged to empty the bladder before and after intercourse, and wash the genitalia thoroughly.

* For patients with herpes infection, avoid citrus fruits and juices while the virus is active.

 

The Tao of Nutrition by Dr. Maoshing Ni and Cathy McNease:

* Hypertension

§ Recommendations: celery, spinach, garlic, bananas, sunflower seeds, honey, tofu, mung beans, bamboo shoots, seaweed, vinegar, tomatoes, water chestnuts, corn, apples, persimmons, peas, buckwheat, jellyfish, watermelon, hawthorn berries, eggplant, plums, mushrooms, lemons, lotus root, chrysanthemums, and cassia seeds.

§ Steam or bake jellyfish about 12 minutes, add vinegar, soy sauce, and sesame oil; take daily for about two months.

§ Make tea from chrysanthemum flowers and cassia seeds and drink daily.

§ Take black or white mushrooms and cook soup daily.

§ Avoid smoking, alcohol, spicy foods, coffee, caffeine, all stimulants, fatty or fried foods, salty foods, stress, constipation, potatoes, strong emotions, pork, and overeating.

* Candida yeast infection

§ Recommendations: dandelions, beet tops, carrot tops, barley, garlic, rice vinegar, mung beans, citrus fruits.

§ Avoid sugar, excessive fruits, yeast-containing foods, processed foods, cheese, fermented foods, soy sauce, smoking, alcohol, caffeine, and constipation.

* Chronic bladder infections

§ Recommendations: watermelon, pears, carrots, celery, corn, mung beans, corn silk, squash, wheat, water chestnuts, barley, red beans, millet, oranges, cantaloupe, grapes, strawberries, lotus roots, loquats, and plenty of water.

§ Avoid heavy proteins, meat, dairy products, onions, scallions, ginger, black pepper, and alcohol.

 

LIFESTYLE INSTRUCTIONS

* Weight loss is highly recommended to help lower blood pressure.

* Normal bowel and urinary functions help to reduce blood pressure. Diuretics and stool softeners should be taken as needed.

* Maintain a positive attitude and outlook. Control emotions and reduce stress. Emotional fluctuations should be reduced whenever possible.

* Stop alcohol consumption and cigarette smoking.

* Exercise such as swimming and brisk walking are excellent exercises for hypertension.

* Practices such as meditation, tai chi chuan [tai ji chuan], and yoga are also beneficial to relax, reduce stress, and lower blood pressure.

* Individuals with herpes should stay away from heat, over-exertion, stress, spicy and greasy foods, alcohol, coffee, or anything else that may trigger an attack. Patients should keep the infected area clean and dry in order to promote healing and avoid secondary infections. It is also recommended that patients abstain from sex during the outbreak period.

* For leukorrhea, yogurt and sour products should be included in the diet.

* Cotton underwear, instead of nylon, is recommended to promote air circulation in the genital region.

* Ointments containing cortisone or petroleum jelly should not be used on genital sores as oil-based products reduce air flow and slows healing. Cortisone inhibits the immune system and can encourage the virus to grow.

* Advise the patient to wipe from front to back after a bowel movement to avoid infection.

* Strengthening the immune system is the key to preventing another herpes attack. See Supplementary Formulas for an appropriate formula.

 

CASE STUDIES

* S.S., a 38-year-old female, presented with recurring genital herpes breakouts. Symptoms included painful burning sores along the inner surface of the thigh and buttocks which flare-up during menses and cause pain along the nerve radiating down the leg. The patient also experienced constipation and hemorrhoids during the event of a breakout. Her menses were heavy with bright red blood and bad cramps. She had also been trying to get pregnant and had not succeeded, leading to more stress. The TCM diagnosis was damp-heat in the Liver channel. This condition was treated with Gentiana Complex, four spoons twice daily when the symptoms occur. After taking the herbs the patient reported that the sores and nerve pain were subsiding within a few days of starting them. She continued to keep the formula available throughout the year as it continued to help with the outbreaks. Submitted by M.M., Alameda, California.

* J.B., a 68-year-old female, presented with post-herpetic neuralgia. The pain was felt especially along the Gallbladder channel on the head, above the ear. There was sharp pain following the shingles outbreak. Other objective findings were small red spots along the Gallbladder channel around Wangu (GB 12) area. The practitioner diagnosed the condition as damp-heat in the Gallbladder and Liver. The patient was given Gentiana Complex at three capsules three times a day and took the herbs for three months. With Gentiana Complex, the post-herpetic neuralgia went away, although the change was gradual. Submitted by L.M., Lafayette, Colorado.

* M.G., a 30-year-old female, presented with chronic sinus infection and sore throat. It was noted that she was not well rested and was experiencing digestive disorders as well, including belching, burping, and acid reflux. Objective findings were wiry pulse and mild acne on the face. The practitioner diagnosed this condition as damp-heat in the Liver. For treatment, the patient was first prescribed Magnolia Clear Sinus, followed by a bottle of Gentiana Complex and Calm combined. She was directed to take three capsules at three times per day. With taking the herbs, the patient reported not having felt this good in years. Her sleep has improved and she no longer experienced digestive or sinus issues. Submitted by T.W., Perrysburg, Ohio.

* C.K., a 61-year-old female, presented with pelvic pain during intercourse at a level of 8 out of 10. Additional symptoms were digestive symptoms such as gas and bloating, nail fungus, and bad breath. She had a history of candida, low libido and fatigue. The practitioner diagnosed this condition as Liver and Gallbladder heat, damp-heat in the lower jiao, and Spleen qi deficiency. For treatment the patient was given a combination of Gentiana Complex, Herbal ABX, and Yin Care for one week; secondly, V-Support and Herbal ABX for the week after. Within 20 days the patient reported no more pain with intercourse or digestive issues. The patient continues to use the Yin Care for her nails as they are still healing. Submitted by T.W., Perrysburg, Ohio.

* A 27-year-old female with a history of genital warts due to HPV (human papilloma virus) presented with small growths around the perineum. The patient reported this as the third or fourth outbreak. After six rounds of Gentiana Complex, three capsules, three times daily, the patient reported that the genital warts were completely resolved. Furthermore, the patient did not suffer from another outbreak for nine years following this treatment. Submitted by C.L., Chino Hills, California.

* L.L., a 56-year-old female, presented with frustration, anger and sadness over losing her home in the hurricanes. She was unable to move through these emotions. She was also diagnosed with hypertension, high cholesterol, and post-traumatic stress syndrome recently, and refused to take medications. Her blood pressure was 138/78 mmHg and her heart rate was 82 beats per minute. She also suffered from headaches in the temporal region and the vertex. Other symptoms included twitching of the eyes, agitation, red eyes, and a scalloped tongue with thick yellow tongue coating. TCM diagnoses were damp-heat in the Liver and Gallbladder, Kidney yin deficiency, and excess fire and wind rising. She was prescribed the following formulas: Calm (ES) at 1 to 3 capsules, as needed, Cholisma at 4 capsules twice daily, and Gentiana Complex at 5 capsules twice daily. The patient gained control of her emotions immediately after taking Calm (ES). Blood pressure gradually reduced over time to 120/72 mmHg. The practitioner commented that the combination of these formulas is phenomenal. Submitted by M.H., West Palm Beach, Florida.

* A 27-year-old female healthcare provider presented with genital herpes. The affected area in the genital region was itchy, red and swollen with thick white discharge. She was also having menstrual pain. Her pulse was slippery, deep and strong. Her tongue was pale purple with a red tip, and the sides were swollen with scalloped edges. The practitioner diagnosed the condition as damp-heat in the Liver and Liver qi stagnation. After taking Nourish and Gentiana Complex, there was a decrease in symptoms. Symptoms flared up when the patient stopped using the formulas. Submitted by B.H., Pearl City, Hawaii.

* A 36-year-old female patient presented with a yeast infection characterized by vaginal itching for two days. The TCM diagnosis was damp-heat in the lower jiao. Gentiana Complex was prescribed at three capsules, three times daily. Within a couple of doses, the patient reported that both the vaginal discharge and itching were resolved. Submitted by C.L., Chino Hills, California.

* A.T., a 34-year-old female, had a history of oral herpes outbreaks that usually lasted two to three weeks. She presented with tingling sensations of the lips, progressing to burning sensation, with eruption of fever blisters. The TCM diagnosis was damp-heat in the middle jiao with Stomach fire. Gentiana Complex was prescribed at three capsules, three times daily. After one or two doses, the patient reported the symptoms were relieved without further exacerbation of fever blisters. Furthermore, there was no return or spread of lesions to other areas of the lips. Gentiana Complex was discontinued after only three days. Submitted by C.L., Chino Hills, California.

* A 41-year-old female presented with headaches that had been persistent for almost two weeks. She noted that her headache was more localized to the top of her head. Aside from the headaches, she also reported having large amounts of yellowish, foul-smelling, vaginal discharge. The practitioner diagnosed her condition as damp-heat in the lower jiao with underlying excess Liver fire. Within two weeks of taking Gentiana Complex, the fetid discharge had stopped along with the headaches. Although the patient experienced some diarrhea during the first three days of treatment, her condition improved overall. Submitted by T.G., Albuquerque, New Mexico.

* E.P., a 32-year-old female, presented with a 2½-year history of vertigo, associated with insomnia, palpitations, anxiety and nausea. She also suffered from irritable bowel syndrome with alternating diarrhea and constipation. She had an unsteady gait and was unable to drive. For the Western diagnosis of anxiety disorder, the TCM diagnosis was Liver fire. Initially, Calm and Gentiana Complex were prescribed at two capsules each, three times daily, but then the dosage was increased to three capsules of each, three times daily. After three weeks, the signs and symptoms of irritable bowel syndrome were resolved, and Gentiana Complex was discontinued. On the sixth treatment, the patient reported all symptoms improved. However, work-related stress anxiety remained. On the 15th visit, Calm was changed to Schisandra ZZZ to help with her insomnia. After taking this formula for nine days, the patient reported much improvement in her sleeping patterns, from five to six hours of interrupted sleep to six to seven hours of uninterrupted sleep. The patient was treated with acupuncture five times throughout the course of herbal treatment. Submitted by C.L., Chino Hills, California.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Gentiana Complex has multiple therapeutic functions and clinical indications. It treats hypertension by using herbs with antihypertensive effect to lower blood pressure. It treats various types of infections by using herbs with antibacterial, antiviral, and antifungal effects. It also treats liver and gallbladder disorders with herbs that have hepatoprotective and cholagogic functions.

        Hypertension: Long Dan (Radix et Rhizoma Gentianae) and Ze Xie (Rhizoma Alismatis) both have a diuretic effect to eliminate water and lower blood pressure.[3],[4] Long Dan (Radix et Rhizoma Gentianae) has been used in an herbal formula with an 80.4% rate of effectiveness to treat 56 patients with hypertension (24 with significant improvement, 21 with moderate improvement, and 11 with no effect).[5] Ge Gen (Radix Puerariae Lobatae) has shown a marked effectiveness in lowering blood pressure by dilating coronary artery and relieving spasms of blood vessels.[6],[7],[8] In one study, 222 patients with hypertension accompanied by neck stiffness and pain were treated with Ge Gen (Radix Puerariae Lobatae) with a rate of effectiveness between 78 and 90%.[9] Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) dilates blood vessels and increases blood perfusion to peripheral blood vessels.[10] It has a significant protective effect on conditions such as cerebral infarct,[11] coronary artery disease,[12] angina,[13] and many others. Huang Qin (Radix Scutellariae) lowers blood pressure through dilation of blood vessels and inhibition of the sympathetic nervous system.[14] It has been used to treat 51 patients with hypertension with good results.[15] Huang Bo (Cortex Phellodendri Chinensis) demonstrates marked effectiveness to lower blood pressure via its effect on the central nervous system.[16] Zhi Zi (Fructus Gardeniae) exerts its antihypertensive action through the stimulation of the parasympathetic nervous system.[17] Che Qian Zi (Semen Plantaginis) also has significant angiotensin-converting enzyme inhibitory activity to lower blood pressure.[18] Clinically, administration of Che Qian Zi (Semen Plantaginis) as tea showed a marked effect to treat 50 patients with elevated blood pressure.[19] Lastly, Da Huang (Radix et Rhizoma Rhei) has various impacts on the cardiovascular system. It has been shown to lower blood pressure, reduce heart rate, and decrease peripheral vascular resistance.[20],[21]

        Bacterial infection: Huang Qin (Radix Scutellariae) has a wide-spectrum inhibitory effect against many bacteria, but is most effective against Staphylococcus aureus and Pseudomonas aeruginosa. Furthermore, it has been discovered that the effectiveness of standard antibiotics such as ampicillin, amoxicillin, methicillin and cefotaxime can be potentiated with the addition of baicalin, a flavone isolated from this herb. With the addition of baicalin, the effectiveness of these beta-lactam antibiotics was restored against beta-lactam-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA).[22],[23] Huang Bo (Cortex Phellodendri Chinensis) has antibacterial action against Staphylococcus aureus, Diplococcus pneumoniae, Corynebacterium diphtheriae, Bacillus dysenteriae, beta-hemolytic streptococcus, Diplococcus meningitidis, Vibrio cholerae, Bacillus anthracis, and others.[24],[25] Berberine, a compound present in Huang Bo (Cortex Phellodendri Chinensis), has antimicrobial activity against numerous strains of MRSA. Furthermore, berberine markedly lowered the minimum inhibition concentrations of ampicillin and oxacillin against MRSA. Berberine and ampicillin exhibited an additive effect, and berberine and oxacillin showed a synergistic effect against MRSA. These results suggest that berberine may have antimicrobial activity and the potential to restore the effectiveness of beta-lactam antibiotics against MRSA. [26],[27] Other herbs with antibacterial effects include Da Huang (Radix et Rhizoma Rhei),[28] Long Dan (Radix et Rhizoma Gentianae),[29] and Zhi Zi (Fructus Gardeniae).[30]

        Viral infection: Huang Qin (Radix Scutellariae) has a wide spectrum of antiviral activity. Specifically, baicalein and wogonin, two compounds from the herb, boost innate antiviral immunity by stimulating the production of cytokines and increasing the resistance to viral infection in human leukocytes.[31] Huang Bo (Cortex Phellodendri Chinensis) has antiviral activity against herpes simplex virus type 1 (HSV-1).[32] The polysaccharide sulfate derived from Niu Xi (Radix Achyranthis Bidentatae) has an antiviral effect against many viruses, including simple herpes virus type-I and human immunodeficiency virus type 1 (HIV-1).[33],[34] Che Qian Zi (Semen Plantaginis) has a strong antiviral effect against a series of viruses, namely herpesviruses (HSV-1 and HSV-2) and adenoviruses (ADV-3, ADV-8 and ADV-11).[35] Lastly, Ge Gen (Radix Puerariae Lobatae) has antiviral and cytotoxic effects, and can inhibit enterovirus 71 (EV71) when given before, simultaneously with, or after viral infection.[36]

        Fungal infection: The aqueous extract of Huang Qin (Radix Scutellariae) has an in vivo antifungal effect against Candida albicans.[37] Genipin and geniposide, two compounds from Zhi Zi (Fructus Gardeniae), have a potent inhibitory effect on pathogenic fungi, such as Pleurotus ostreatus, Fusarium oxysporum and Corynespora cassiicola.[38]

        Liver and gallbladder disorders: Long Dan (Radix et Rhizoma Gentianae) has a hepatoprotective effect to protect the liver in acute liver injury and against carbon tetrachloride-induced liver damage. [39],[40] Long Dan (Radix et Rhizoma Gentianae) also has cholagogic effects to increase the production and excretion of bile.[41] According to one report, 26 patients with chronic infectious hepatitis and persistent high liver enzymes levels were treated with an herbal formula with Long Dan (Radix et Rhizoma Gentianae) as the main herb, with good results.[42] Da Huang (Radix et Rhizoma Rhei) has a hepatoprotective effect to treat chemical-induced liver damage.[43] It also has cholagogic effect to increase the flow and excretion of bile.[44] Clinically, Da Huang (Radix et Rhizoma Rhei) has been used in formulas to effectively treat acute icteric hepatitis in 80 patients,[45] acute hepatitis A in 67 patients,[46] and acute cholecystitis in 10 patients.[47] Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) has a marked hepatoprotective effect to lower liver enzyme and to  treat liver cirrhosis. The hepatoprotective function of Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) is attributed in part to its effect at improving blood circulation and promoting regeneration of liver cells.[48],[49],[50] Clinically, Dan Shen (Radix et Rhizoma Salviae Miltiorrhizae) has been used effectively to treat 104 patients with acute viral hepatitis and 22 patients with chronic active hepatitis.[51],[52] Huang Qin (Radix Scutellariae) has a remarkable effect to protect and prevent various types of liver injuries. It protects against mutagenesis of liver cells induced by the mycotoxin aflatoxin-B1,[53] it protects against fibrosis and lipid peroxidation in liver induced by bile duct ligation and scission or carbon tetrachloride,[54] and it inhibits hemin-nitrite-H2O2 induced liver injury in dose-dependent manners.[55] Use of Huang Qin (Radix Scutellariae) was associated with a 63.6% and a 73.3% rate of effectiveness to treat infectious hepatitis and chronic hepatitis among 268 patients, respectively.[56] Lastly, administration of Zhi Zi (Fructus Gardeniae) is associated with a marked hepatoprotective function as it lowers serum bilirubin, liver enzymes, and prevents the death of hepatocytes.[57],[58] Zhi Zi (Fructus Gardeniae) also has a marked cholagogic effect to stimulate the production of bile, enhance contraction of the gallbladder, and increase excretion of bile into the intestines.[59]

        Pancreatic disorders: Zhi Zi (Fructus Gardeniae) has a marked effect to protect the pancreas. Therapeutic benefits included reduction in pancreatic edema, neutrophil infiltration, serum amylase and lipase levels, serum cytokine levels, and mRNA expression of multiple inflammatory mediators.[60] Clinically, Da Huang (Radix et Rhizoma Rhei) is effective to treat acute pancreatitis in 100 patients. Initial treatment included decoction of 30 to 60 grams of Da Huang (Radix et Rhizoma Rhei) every one to two hours until symptoms returned to normal. After the condition stabilized, they were switched to tablets of Da Huang (Radix et Rhizoma Rhei), 3 grams twice daily. The total dosage of Da Huang (Radix et Rhizoma Rhei) per patient was 450 grams. The study reported close to 100% effectiveness. The time required was two days for normalization of amylase in urine and three days for pain relief.[61]

     In summary, Gentiana Complex is an herbal formula with a wide range of clinical applications, including but not limited to cardiovascular disorders, infectious diseases, inflammatory disorders, and disorders affecting the liver, gallbladder, and pancreas.

 

COMPARATIVE ANALYSIS

Hypertension: Hypertension is one of the most common disorders in developed countries. In Western medicine, many different categories of drugs may be used to treat hypertension, including but not limited to diuretics [Lasix (furosemide) and hydrochlorothiazide], beta-blockers [Tenormin (atenolol) and Inderal (propranolol)], calcium channel blockers [Procardia (nifedipine) and Calan (verapamil)], ACE inhibitors [Vasotec (enalapril)] and Capoten (captopril)], and vasodilators [hydralazine and minoxidil]. All these drugs have benefits and risks, and may be given individually or in combinations to control blood pressure.

 The main advantage of drug therapy is its potency to suppress blood pressure. The main disadvantages, however, are that the drugs cause a great number of side effects, and they do not change the underlying constitution of the patient. Therefore, while they are effective to suppress blood pressure, they must be used continuously and cannot be stopped. Discontinuing use of these drugs often leads to rebound hypertension.

        In TCM, hypertension may be characterized by both excess and deficiency. Excess refers to Liver yang rising, and deficiency refers to Liver and Kidney yin deficiencies. Both conditions may be treated effectively with herbal medicine. The main advantage of using herbs is the effective ability to change the fundamental constitution of the body, thereby achieving long-term efficacy to reduce blood pressure, even after the herbs are discontinued. The main disadvantage, however, is that herbs are less immediately potent than drugs for the treatment of hypertensive crisis, and should not be used in lieu of drugs for these cases or for individuals with secondary hypertension.

        Both drugs and herbs are effective to treat hypertension, and they have their distinct advantages and disadvantages. In addition to choosing either drugs or herbal therapy, it is also important to make diet and lifestyle changes to ensure successful long-term management of hypertension.

 

Infection and inflammation: There are many disorders characterized by infection and inflammation of genital regions, including vaginitis, cystitis, pelvic inflammatory disease, and urinary tract infection. In Western medicine, these conditions are generally treated with antibiotic drugs, including antibacterial, antiviral, and antifungal agents. As a category, these drugs are effective to treat such infections and inflammations. However, these drugs are very potent, and may cause many side effects, such as secondary infection.

        Herbal therapy is also very effective for treating these infections and inflammations. Many herbs have been shown to have marked antibacterial, antiviral, and antifungal properties. Furthermore, some have an analgesic effect to relieve pain, and others have a diuretic effect to relieve dysuria. Lastly, though these herbs are generally safe, they should be discontinued once the desired effects are achieved, as extended use may consume and weaken the body.

        Drugs and herbs are both effective for treating infections and inflammations of the genitourinary system. In general, drugs are more effective for bacterial and fungal infections, but their safety profiles vary depending on the exact antibiotic prescribed. Herbs are equally effective for bacterial, viral, and fungal infections. For severe infections and inflammations, they are slightly less immediately potent than drugs, but are much safer and have significantly fewer side effects. Lastly, in both therapies, the chosen substance(s) should always be taken until the course of therapy is completed. Those who have weakness and deficiency from the infection and/or its treatment should take herbs to strengthen the body and facilitate recovery.

 

Liver and gallbladder disorders: Liver diseases, such as hepatitis, are serious and very complicated diseases. In Western medicine, these conditions are usually treated with interferon therapy. These drugs, however, have limited success, but are extremely expensive and create significant number of serious side effects, including dizziness, confusion, coma, arrhythmia, heart failure, leukopenia, thrombocytopenia, and many others. In severe and life threatening cases, such as liver cirrhosis and liver cancer, surgery may be performed.

        In traditional Chinese medicine, treatment of liver disorders is also a very challenging and complicated matter. These conditions are usually treated with herbs that drain damp-heat from the Liver. Pharmacologically, these herbs have hepatoprotective effects that remove toxins from the liver, prevent the entrance of toxins into liver cells, and increase blood circulation to the liver to facilitate recovery. In most cases, herbs are most effective in the early stage of liver disorders characterized by increased liver enzymes. Immediate and aggressive treatment with herbs generally lowers liver enzyme levels and reverses the illness. Once the disease progresses into various stages of hepatitis and/or liver cirrhosis, individualized treatments specific to the clinical manifestations of the patient should be considered for maximum effectiveness.

        Liver diseases, such as hepatitis, are serious and very complicated diseases that are challenging to both Western and traditional Chinese medicines. Herbal treatment is generally more effective for early stages of liver diseases, and ones with mild to moderate severity. Drug treatments, such as interferon therapy, are generally not utilized unless there is moderate to severe liver disease, because the risks of side effects are generally greater than the potential benefits. Unfortunately, severe cases of liver diseases are extremely difficult to manage for both Western medicine and traditional Chinese medicine. Under these circumstances, customized treatment with careful supervision is most effective.

 



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