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Pinellia XPT

 

CLINICAL APPLICATIONS

* Profuse yellow or green sputum from infection and/or inflammation of the respiratory tract

* Cough and dyspnea from pneumonia or bronchitis

* Chest congestion and fullness from respiratory disorders

* Post-nasal drip 

 

WESTERN THERAPEUTIC ACTIONS

* Expectorant effect to expel phlegm and sputum from the upper respiratory tract

* Antitussive function to relieve cough 

* Antibiotic effect to treat bacterial and viral infections

 

CHINESE THERAPEUTIC ACTIONS

* Clears Lung heat

* Regulates Lung qi

* Lowers the adverse rising qi and relieves cough

* Transforms phlegm

 

DOSAGE

Take 4 to 6 capsules three times daily on an empty stomach with warm water.

 

INGREDIENTS


Ban Xia (Rhizoma Pinelliae)

Chen Pi (Pericarpium Citri Reticulatae)

Da Zao (Fructus Jujubae)

Dan Nan Xing (Arisaema cum Bile)

Dong Gua Zi (Semen Benincasae)

Fu Ling (Poria)

Huang Qin (Radix Scutellariae)

Jie Geng (Radix Platycodonis)

Ku Xing Ren (Semen Armeniacae Amarum)

Ting Li Zi (Semen Descurainiae)

Yi Yi Ren (Semen Coicis)

Zhi Shi (Fructus Aurantii Immaturus)

Zhu Ru (Caulis Bambusae in Taenia)


 

BACKGROUND

Phlegm and sputum are secretion and discharge of the respiratory tract associated with infection and inflammation. Phlegm contains mucus with bacteria, debris, and inflammatory cells. When phlegm is expectorated via cough, it is called sputum. Phlegm and sputum generally indicates infection and inflammation of the respiratory tract. The presence of phlegm and sputum interferes with normal functions of the lung, and therefore, should be expelled via coughing or use of herbs.

 

FORMULA EXPLANATION

Pinellia XPT addresses the secondary stage of lung infection in which the superficial symptoms are no longer present. Instead there is an internal stagnation of phlegm and fire, which interferes with the descending function of Lung qi. Therefore, cough and profuse yellow or green sputum are the predominant symptoms.

        Dan Nan Xing (Arisaema cum Bile) has a strong effect to treat blockage due to fire and phlegm. Huang Qin (Radix Scutellariae), Ting Li Zi (Semen Descurainiae) and Jie Geng (Radix Platycodonis) work together to drain Lung fire while transforming phlegm. Bai Jie Zi (Semen Sinapis) and Ku Xing Ren (Semen Armeniacae Amarum) eliminate phlegm, reverse rebellious Lung qi, and relieve cough. Chen Pi (Pericarpium Citri Reticulatae) and Zhi Shi (Fructus Aurantii Immaturus) regulate Lung qi and relieve chest congestion and fullness. Zhu Ru (Caulis Bambusae in Taenia) clears phlegm-heat to expel sputum and relieve the stifling sensation in the chest. Fu Ling (Poria), Yi Yi Ren (Semen Coicis) and Dong Gua Zi (Semen Benincasae) strengthen the Spleen and dispel phlegm through urination. Da Zao (Fructus Jujubae) is used to harmonize the Stomach and moderate the strong properties of Dan Nan Xing (Arisaema cum Bile) and Ting Li Zi (Semen Descurainiae).

        In short, Pinellia XPT clears Lung heat and transforms phlegm to treat various respiratory tract with infection and inflammation.

 

CAUTIONS & CONTRAINDICATIONS

* This formula is designed for respiratory infections characterized by chest congestion with profuse yellow phlegm. It is not suitable for the initial stage of wind-heat or wind-cold.

* Some patients may experience stomach discomfort as a result of taking this formula. Should this occur, reduce the dosage or take the herbs with food.

* This formula is contraindicated during pregnancy and nursing.

* This formula is not recommended for long-term use. It should be discontinued when the desired effects are achieved.

 

CLINICAL NOTES

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Upper respiratory tract infection: superficial and forceful pulse on the right cun.

* Lower respiratory tract infection: shapeless yangwei pulse, a pulse extending distally from the cun position towards the thumb, on the left hand. It is one of the eight extra meridian pulses.

 

SUPPLEMENTARY FORMULAS

* With more underlying damp and phlegm due to Spleen qi deficiency, add Pinellia Complex.

* For infection with fever, chest congestion, and dyspnea characterized by Lung heat, add Respitrol (Heat).

* For cough, add Respitrol (CF).

* For high fever, add Gardenia Complex.

* To enhance the overall antibiotic effect, add Herbal ABX.

* To enhance the overall antiviral effect, add Herbal AVR.

* To treat infection of ear, nose and throat, add Herbal ENT.

* For sinus infection with yellow nasal discharge, add Pueraria Clear Sinus.

* For tonsillitis with swollen throat, add Resolve (AI) and Herbal ENT.

* For wind-heat, add Lonicera Complex.

* Immune + can be taken on a daily basis to build-up the immune system and prevent bacterial or viral infections. Start taking Immune + after symptoms of cold and influenza have subsided.

* For plum-pit syndrome, add Ban Xia Hou Po Tang (Pinellia and Magnolia Bark Decoction).

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Feishu (BL 13), Shanzhong (CV 17), Dazhui (GV 14), Zusanli (ST 36)

* Shanzhong (CV 17), Feishu (BL 13), Yuji (LU 10)

 

Classic Master Tung's Points:

* Pneumonia: Linggu (T 22.05), Dabai (T 22.04), Chongzi (T 22.01), Chongxian (T 22.02), Quling (T 33.16), Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Zhongjian (T 11.05). Bleed dark veins nearby the ST channel on the lower limb. Bleed the HT and LU areas on the upper back with cupping. Bleed before needling for best result.

* Bronchitis: Linggu (T 22.05), Dabai (T 22.04), Fenjin (T 44.01), Renshi (T 33.13), Dishi (T 33.14), Tianshi (T 33.15), Shuijin (T 1010.20), Shuitong (T 1010.19), Simazhong (T 88.17), Feiqiyi (T 44.25)*, Feiqier (T 44.26)*, Zhongjian (T 11.05). Bleed the HT and LU area in the back. Bleed before needling for best result.

 

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

* Yellow phlegm, post-nasal drip: Bleed Sihuawai (T 77.14). Needle Xiaojian (T 11.02), Dabai (T 22.04).

 

Balance Method by Dr. Richard Tan:

* Left side: Ligou (LR 5), Taibai (SP 3), Yinlingquan (SP 9), Zhubin (KI 9), Sanyinjiao (SP 6), Sanjian (LI 3), Hegu (LI 4), Quchi (LI 11)

* Right side: Chize (LU 5), Yuji (LU 10), Taiyuan (LU 9), Fenglong (ST 40), Chengshan (BL 57)

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

 

Auricular Medicine by Dr. Li-Chun Huang:

* Bronchial asthma: Bronchus, Trachea, Lung, Chest, Stop Asthma, Sympathetic, Adrenal Gland, Allergic Area, Endocrine. Bleed Ear Apex.

* Bronchiectasis: Bronchus, Lung, Chest, Stop Asthma, Allergic Area, Sympathetic, Adrenal Gland, Spleen

* Snoring and apnea: Trachea, San Jiao, Lower Lung, Pharynx, Larynx, Sympathetic, Nasopharynx, Chest, Mouth, Esophagus, Larynx and Tooth

* Nasopharyngitis, post-nasal drip: Nasopharynx, Sympathetic, Allergic Area, Lung, Endocrine, Trachea. Bleed Ear Apex.

 

NUTRITION

* Avoid foods that are greasy or spicy in nature as they create more dampness and heat.

* To avoid infection, a diet high in garlic, onions, and water is recommended.

* Adequate intake of vitamin C is important as it is greatly consumed by white blood cells when fighting infections.

* Avoid smoking and exposure to second-hand smoke, alcohol, seafood, and phlegm-producing foods such as sweets, dairy products, heavy or greasy foods.

* Eat plenty of foods that contain vitamin A and C, which strengthen the lung tissue and improve resistance to infection, respectively.

* Spleen is responsible for generating post-natal qi and good Spleen function also contributes to a healthy immune system. Foods that damage the Spleen should be avoided:

§ Avoid any and all foods that contain sugar, such as cake, dessert, candy, chocolate, canned juice, soft drinks, caffeinated drinks, stevia, sugar substitutes, agave, xylitol, and corn syrup.

§ Avoid raw or uncooked meats, such as sashimi, sushi, steak tartar, and seared meat. Minimize consumption of foods that are cooling in nature, including tofu, tomato, celery, asparagus, bamboo, seaweed, kelp, bitter melon, cucumber, gourd, luffa, eggplant, winter melon, watermelon, honeydew, citrus, oranges, guava, grapefruit, pineapple, plums, pear, banana, papaya, watermelon, white radish, mustard leaf, potherb mustard, Chinese kale, napa, bamboo sprout. Do not eat foods straight from the refrigerator. Long-term intake of cold fruits and vegetables like the ones listed above may be damaging to the Spleen. The cooling property of foods can be neutralized by cooking or adding 20 pieces of Gou Qi Zi (Fructus Lycii).

§ Avoid carbohydrates like white rice or bread as they may produce dampness.

§ No seafood especially shellfish, like crabs, oyster, scallops, clams, lobster and shrimp (they enter the yangming Stomach channel).

§ Avoid fermented foods like cheese or fermented tofu.

§ Do not eat dairy products, such as milk, cream, yogurt, cheese, and ice cream.

§ Avoid fried or greasy foods.

* Warm and hot natured foods that damage qi and yin should be avoided, such as:

§ certain fruits like mango and durian that produce heat.

§ stimulants like coffee, alcohol, and energy drinks.

§ spicy/pungent/aromatic vegetables such as pepper, garlic, onions, basil, rosemary, cumin, funnel, anise, leeks, chives, scallions, thyme, saffron, wormwood, mustard, chili pepper, and wasabi.

* Avoid food and drinks with artificial coloring.

* Consume as few meat products as possible. Do not eat processed meats, such as lunch meats, hot dogs and sausages, as they contain nitrites that are associated with inflammation and chronic disease.

 

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

* Dry cough with yellow sputum: Take warm daikon and water chestnut juice with one teaspoon honey.

* Cough with yellow sputum: Drink apple juice.

* Cough, mucus, and upper respiratory infection: Put slices of onion over the nose like a mask and inhale the aroma for 30 minutes. Or steam the sliced onion and apply warm as a poultice to the chest area; cover to keep warm and leave on for 20 to 30 minutes.

 

LIFESTYLE INSTRUCTIONS

* Patients are encouraged to expel sputum out so that the airway can be cleared to facilitate normal respiration and relieve chest congestion.

* Installation of an air purifier at home is recommended for recurrent respiratory disorders.

* A humidifier will increase moisture in the air, hydrate the mucous membranes of the nose and the lung, and hence increase resistance to infection.

 

CASE STUDIES

* A 59-year-old female presented with copious congestion, chest tightness and yellow-greenish phlegm. The patient’s condition was diagnosed as heat in the Lung with phlegm congestion. The practitioner prescribed Pinellia XPT. Subsequently, the patient’s phlegm resolved as well as her chest tightness and pain. Submitted by V.G., Carlsbad, California.

* A 59-year-old male physician presented with extreme fever (over 104°F), extreme difficulty breathing, pain in the chest, shortness of breath aggravated by exertion, unsteady walk, dizziness, and inability to speak more than one word per breath. His tongue was pale with a red tip and body, and his pulse was rapid and superficial. The diagnosis was phlegm heat in the Lung. The patient was treated with Pinellia XPT (6 capsules four times daily) and Immune + (6 capsules four times daily), along with other homeopathics and drugs [Combivent (albuterol/ipratropium) and aspirin]. The patient had a definite response to the herbs. The respiration became much easier, energy level and sense of vitality enhanced, and cough was no longer productive. The practitioner commented: “While all protocols employed resulted in benefit – it is without question that the herbal formulas generated imminent benefit and long term recuperation.” Submitted by I.B.J., Miami, Florida.

* D.C., a 50-year-old female, presented common cold symptoms of cough, chest congestion and difficult to expectorate phlegm. She had a slight fever. The tongue was red with yellow coating. The pulse was rapid and slippery. The doctor diagnosed her with Lung heat. The two formulas prescribed were Respitrol (Heat) and Pinellia XPT. In three days, the heat was relieved and the phlegm was cleared. Submitted by B.F., Newport Beach, California.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Pinellia XPT is an expectorant formula designed to stop the production and eliminate the storage of phlegm in the respiratory tract. This formula contains herbs with expectorant effects to eliminate phlegm, antitussive effects to relieve cough, anti-inflammatory effects to reduce swelling and inflammation, and antibiotic effects to treat infection.

        Many herbs in Pinellia XPT have an expectorant effect to eliminate phlegm, and an antitussive effect to suppress cough. Ban Xia (Rhizoma Pinelliae) has strong and prolonged antitussive effects, with the duration of action of approximately five hours.[1] Dan Nan Xing (Arisaema cum Bile) has expectorant properties and increases secretion of mucus in the respiratory tract. Jie Geng (Radix Platycodonis) has marked antitussive and expectorant effects to suppress and relieve cough.[2] Bai Jie Zi (Semen Sinapis) also has an expectorant effect.[3] Most importantly, Ku Xing Ren (Semen Armeniacae Amarum) has a remarkable antitussive effect, with its mechanism attributed to inhibition of the respiratory reflex in the brain.[4] Since the presence of phlegm in the lungs affects breathing, Pinellia XPT has herbs with antiasthmatic effects to facilitate breathing. The combination of Ban Xia (Rhizoma Pinelliae) and Chen Pi (Pericarpium Citri Reticulatae) shows a marked effect to treat artificially-induced asthma in one study.[5] Clinically, use of Ban Xia (Rhizoma Pinelliae) and Ku Xing Ren (Semen Armeniacae Amarum) exhibited a good effect in treating coughing from an exterior condition in 119 patients (82 with marked effect, 28 with moderate effect, and 6 with no effect).[6] An herbal formula with Ting Li Zi (Semen Descurainiae seu Lepidii) also showed a good effect to treat 30 children with cough and dyspnea from bronchitis.[7] Finally, one study of 10 patients showed that pulmonary abscesses can be treated with satisfactory results using Jie Geng (Radix Platycodonis) and Gan Cao (Radix et Rhizoma Glycyrrhizae).[8]

        Pinellia XPT incorporates many herbs with anti-inflammatory effects to reduce the swelling and inflammation in the lungs. Chen Pi (Pericarpium Citri Reticulatae) decreases the permeability of the blood vessels and reduces inflammation from allergy.[9] Jie Geng (Radix Platycodonis) illustrates its anti-inflammatory effect by decreasing capillary permeability and suppressing sensitivity from allergic reactions.[10] Finally, Huang Qin (Radix Scutellariae) demonstrates significant and potent anti-inflammatory properties via inhibition of nitric oxide (NO), inducible NOS (iNOS), cyclo-oxygenase-2 (COX-2), prostaglandin E2 (PGE2), and proinflammatory cytokines.[11]

        Lastly, Pinellia XPT contains many herbs with marked antibiotic effects to treat respiratory tract infections. For example, Huang Qin (Radix Scutellariae) has broad antimicrobial effects against Staphylococcus aureus, beta-hemolytic streptococcus, Diplococcus pneumoniae, Pseudomonas aeruginosa, Bacillus dysenteriae, E. coli, Bordetella pertussis, Vibrio cholerae, Diplococcus meningitidis, leptospira and various species of dermatophytes and influenza viruses. Huang Qin (Radix Scutellariae) is most effective against Staphylococcus aureus and Pseudomonas aeruginosa. Furthermore, it was discovered that the effectiveness of standard antibiotics such as ampicillin, amoxicillin, methicillin and cefotaxime can be potentiated with 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).[12],[13] In addition, Huang Qin (Radix Scutellariae) has antiviral activities and suppresses the replication of influenza A and B viruses.[14] Specifically, baicalein and wogonin, two compounds from Huang Qin (Radix Scutellariae), boost innate antiviral immunity by stimulating the production of cytokines and increasing the resistance to viral infection in human leukocytes.[15] Furthermore, pinelloside, an antimicrobial cerebroside isolated from Ban Xia (Rhizoma Pinelliae), inhibited the growth of Bacillus subtilis, Staphylococcus aureus, Aspergillus niger and Candida albicans.[16] Lastly, Zhu Ru (Caulis Bambusae in Taenia) also has an inhibitory effect against many pathogens, such as Staphylococcus albus, Bacillus subtilis, E. coli, and Salmonella typhi.[17]

        In summary, Pinellia XPT is an excellent formula to treat sputum, cough, dyspnea, chest congestion, and fullness from respiratory tract infections.

 

COMPARATIVE ANALYSIS

Respiratory tract disorders (such as cough, dyspnea, and lung infection) are often complicated with the presence of phlegm, and swelling and inflammation of the lungs. Because the presence of phlegm in the lungs creates discomfort and delays recovery, it is often necessary to expectorate the phlegm.

        There is only one approved expectorant available for treatment of phlegm – guaifenesin. This drug is mixed with other drug combinations, such as Robitussin and Triaminic, to treat the overall cold and flu complex of cough, nasal obstruction, chest congestion, and runny nose. Guaifenesin is relatively safe and free from side effects, but its potency is also limited.

        Many herbs are extremely effective to stop the production, loosen the viscosity, and facilitate the elimination of phlegm. Similar to Western medicine, these herbs are often combined with others to treat other accompanying symptoms of illness, such as cough, nasal obstruction, and chest congestion.

        Expectorants are effective to assist the elimination of phlegm in the chest, and are most effective when used with other medicinal substances to enhance the overall effect to treat various symptoms of respiratory tract disorders. Guaifenesin is the only drug option available, and is rather mild in potency. On the other hand, there are many herbs available to stop the production of phlegm and facilitate its elimination.

 



[1] Zhong Yao Yao Li Yu Ying Yong (Pharmacology and Applications of Chinese Herbs), 1983: 383.

[2] Zhong Yao Yao Li Yu Ying Yong (Pharmacology and Applications of Chinese Herbs), 1983; 866.

[3] Zhong Yao Xue (Chinese Herbology), 1998; 608:610.

[4] Life Sci, 1980; 27(8):659.

[5] Ok IS, Kim SH, Kim BK, Lee JC, Lee YC. Pinellia ternata, Citrus reticulata, and their combinational prescription inhibit eosinophil infiltration and airway hyperresponsiveness by suppressing CCR3+ and Th2 cytokines production in the ovalbumin-induced asthma model. Mediators Inflamm. 2009;2009:413270.

[6] An Hui Zhong Yi Xue Yuan Xue Bao (Journal of Anhui University School of Medicine), 1992; 1:45.

[7] Zhong Yi Za Zhi (Journal of Chinese Medicine), 1984; 10:43.

[8] Jiang Su Zhong Yi Za Zhi (Jiangsu Journal of Chinese Medicine), 1981; 3:35.

[9] Zhong Yao Yao Li Yu Ying Yong (Pharmacology and Applications of Chinese Herbs), 1983; 567.

[10] Zhong Yao Yao Li Yu Ying Yong (Pharmacology and Applications of Chinese Herbs), 1983; 866.

[11] Kim EH, Shim B, Kang S, Jeong G, Lee JS, Yu YB, Chun M. Anti-inflammatory effects of Scutellaria baicalensis extract via suppression of immune modulators and MAP kinase signaling molecules. Department of Biological Sciences, Seoul National University, Seoul 151-742, Republic of Korea. J Ethnopharmacol. 2009 Nov 12;126(2):320-31.

[12] Zhong Yao Xue (Chinese Herbology), 1988; 137:140.

[13] J Pharm Pharmacol 2000 Mar;52(3):361-6.

[14] Nagai et al. antiviral activity of plant flavonoid, 5,7,4’-trihydroxy-8-methoxyflavone, from scutellaria baicalensis against influenza A (H3N2) and B viruses. Biol Pharm Bull; 18(2):295-9. Feb. 1995.

[15] Błach-Olszewska Z, Jatczak B, Rak A, Lorenc M, Gulanowski B, Drobna A, Lamer-Zarawska E. Production of cytokines and stimulation of resistance to viral infection in human leukocytes by Scutellaria baicalensis flavones. Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland. J Interferon Cytokine Res. 2008 Sep;28(9):571-81.

[16] Chen J.H., Cui G.Y., Liu J.Y. Tan R.X. Pinelloside, an antimicrobial cerebroside from Pinellia ternata. Phytochemistry. 2003, 64(4): 903-906.

[17] Zhong Yao Xue (Chinese Herbology), 1998; 623:625.