CLINICAL APPLICATIONS

* Skin disorders: itching, rash, urticaria, dermatitis, and eczema

* Skin allergies induced by drugs, chemicals or foods

 

WESTERN THERAPEUTIC ACTIONS

* Antihistamine and antipruritic effects to relieve itching and neutralize allergic reactions

* Anti-inflammatory effect to relieve swelling and inflammation

* Antibiotic properties to treat skin infections

 

CHINESE THERAPEUTIC ACTIONS

* Disperses the wind to relieve itching

* Clears heat, cools the blood

* Drains dampness

 

DOSAGE

Take 5 to 6 capsules with warm water on an empty stomach every six hours as needed. Using Silerex prior to exposure to the allergen may prevent or reduce the risk of developing an allergy.

 

INGREDIENTS


Bai Xian Pi (Cortex Dictamni)

Che Qian Zi (Semen Plantaginis)

Dang Gui (Radix Angelicae Sinensis)

Di Fu Zi (Fructus Kochiae)

Di Huang (Radix Rehmanniae)

Fang Feng (Radix Saposhnikoviae)

Ji Li (Fructus Tribuli)

Jing Jie (Herba Schizonepetae)

Ku Shen (Radix Sophorae Flavescentis)

Lian Qiao (Fructus Forsythiae)

Mu Dan Pi (Cortex Moutan)

Niu Bang Zi (Fructus Arctii)

Zhi Zi (Fructus Gardeniae)


 

BACKGROUND

Itching is a symptom that may be caused by external or internal disorders. External disorders that cause itching include atopic dermatitis, contact dermatitis, dry skin, infection, and urticaria. Internal disorders that cause itching include allergic reactions (i.e., to foods, drugs, chemicals), cholestasis, chronic renal failure, and others. While the symptom of itching can be treated effectively with herbs, efforts must be made to identify and eliminate the cause.

 

FORMULA EXPLANATION

Silerexis formulated to treat various dermatological disorders, including rash, itching, urticaria, eczema, dermatitis, and skin allergies to drugs, chemicals or foods. Silerex is comprised of herbs that disperse wind, clear heat, cool blood, and drain damp.

        Commonly known as siler, Fang Feng (Radix Saposhnikoviae) is one of the best herbs to extinguishes wind and treat skin disorders such as itching, rash, urticaria, and eczema. Jing Jie (Herba Schizonepetae) and Ji Li (Fructus Tribuli) also release external wind to relieve itching. Zhi Zi (Fructus Gardeniae) clears heat to reduce redness and inflammation of the affected areas. Mu Dan Pi (Cortex Moutan), Niu Bang Zi (Fructus Arctii) and Lian Qiao (Fructus Forsythiae) cool and detoxify the blood to relieve itching. Ku Shen (Radix Sophorae Flavescentis), Che Qian Zi (Semen Plantaginis), and Di Fu Zi (Fructus Kochiae) drain dampness through urination and treat weepy lesions. Bai Xian Pi (Cortex Dictamni) has antifungal effects to relieve fire toxicity. Finally, Dang Gui (Radix Angelicae Sinensis) and Di Huang (Radix Rehmanniae) tonify and move the blood to extinguish wind to relieve rashes and itching.

        In conclusion, Silerex dispels wind-heat from the exterior to treat rash, itching, urticaria, eczema, dermatitis, and other skin disorders.

 

CAUTIONS & CONTRAINDICATIONS

* The optimal treatment of allergies is to avoid the allergens. Silerex relieves the symptoms, but does not cure the allergy. Therefore, it is not recommended to take this formula for a long time simply to suppress the symptoms. Every effort should be made to identify and avoid the allergen.

* If the condition does not improve after using Silerex for two to three weeks, consider modifying the herbal formula.

* This herbal formula contains herbs that invigorate blood circulation, such as Dang Gui (Radix Angelicae Sinensis). 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],[2],[3]

 

CLINICAL NOTES

* For itching of the genital region, use Gentiana Complex both internally and externally. For external treatment, wash the affected area with mild soap first. Then mix 5 grams each of Ku Shen (Radix Sophorae Flavescentis), She Chuang Zi (Fructus Cnidii Monnieri), and Gentiana Complex, with 2 cups of warm water. Soak the affected area in the herbal solution for five minutes before rinsing off with water. Repeat the process once daily until itching is relieved.

* The optimal approach to address allergy is prevention, not treatment. Empirical wisdom suggests isolating the allergen and minimizing the patient’s exposure to said allergen as much as possible.

 

Pulse Diagnosis by Dr. Jimmy Wei-Yen Chang:

* Allergy lesions due to fire and dryness in the Lung, Large Intestine and Liver: floating, forceful, and jumpy on the right cun and left guan.

* Toxic lesions due to Liver fire: thick, long, wiry, forceful, and jumpy on both chi; and floating, forceful, and jumpy on the left guan.

* Skin problems due to stress: forceful on the left guan.

* Wet skin lesions due to damp-heat accumulation: deep and forceful pulse on all three pulse positions (cun, guan, chi).

* Dry skin lesions due to dryness and heat accumulation in the Lung and Large Intestine: floating and forceful pulse on the right cun.

 

SUPPLEMENTARY FORMULAS

* For signs and symptoms of excess fire, add Gardenia Complex.

* For psoriasis, add Dermatrol (PS).

* For weepy skin conditions, add Dermatrol (Damp).

* For dry skin conditions, add Dermatrol (Dry).

* For heavy metal poisoning, chemical allergy or any other unknown allergy, combine with Herbal DTX.

* For chronic cases of allergy due to accumulation of allergen in the body, use it with Liver DTX.

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

* To enhance the overall antibacterial function, use Herbal ABX.

* For pus or swelling on the lesions, add Resolve (AI).

* For respiratory discomfort associated with allergies, add Respitrol (Heat) or Respitrol (Cold).

* For headache, add Corydalin (AC) or Corydalin (CR).

* If the allergy is due to ingestion of food, cleanse the colon with GI DTX.

* For itching that worsens with stress, add Calm or Calm (ES).

* With yin deficiency and heat, add Nourish.

 

ACUPUNCTURE TREATMENT

Traditional Points:

* Xuehai (SP 10), Geshu (BL 17), Fengchi (GB 20), Chize (LU 5)

* Quchi (LI 11), Xuehai (SP 10)

 

Classic Master Tung's Points:

* Eczema: Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Linggu (T 22.05), Minghuang (T 88.12), Tianhuang (T 88.13), Qihuang (T 88.14), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Jinqianshang (T 88.24), Jinqianxia (T 88.23) 

* Atopic dermatitis: Simashang (T 88.18), Simazhong (T 88.17), Simaxia (T 88.19), Linggu (T 22.05), Zhisima (T 11.07)  

* 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)

* Tinea versicolor: Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Simashang (T 88.18), Simaxia (T 88.19), Simazhong (T 88.17), Shuijin (T 1010.20), Shuitong (T 1010.19). Bleed the LR area T5 – T9 and KI area T9 – T12 on the back with cupping. Bleed before needling for best result.

* Hives: Simashang (T 88.18), Simaxia (T 88.19), Simazhong (T 88.17), Tianhuang (T 77.17), Dihuang (T 77.19), Renhuang (T 77.21), Tianhuang (T 88.13), Minghuang (T 88.12), Qihuang (T 88.14), Zhisima (T 11.07)

* Poisoning from drugs or chemicals: Fenzhishang (T DT.01), Fenzhixia (T DT.02), Qihuang (T 88.14), Simazhong (T 88.17), Zhongjiuli (T 88.25), Zhisima (T 11.07)

 

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

* Eczema, rash, urticaria: Bleed Ear Apex. Needle Simazhong (T 88.17), Simashang (T 88.18), Simaxia (T 88.19).

 

Balance Method by Dr. Richard Tan:

* Left side: Sanjian (LI 3), Quchi (LI 11), Gongsun (SP 4), Yinlingquan (SP 9), Taichong (LR 3)

* Right side: Fenglong (ST 40), Jiexi (ST 41), Diwuhui (GB 42), Taiyuan (LU 9), Chize (LU 5)

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

 

Ear Acupuncture:

* Lung, Large Intestine, Adrenal Gland, corresponding point of the affected area(s)

* Pruritus: Shenmen, Lung, Subcortex, Adrenal Gland, Urticaria Point. Adjunct points: Liver, Spleen, Heart, Endocrine, Pancreas, Gallbladder, Ovary, Testicles. Select three to five points and needle both ears every other day. Five to ten days is one treatment course. Rest for one week in between treatment courses.

* Urticaria: Lung, Urticaria, Adrenal Gland, Pingchuan, Liver. Needle one to two points each time every other day. Ten treatments equal one course.

 

Auricular Medicine by Dr. Li-Chun Huang:

* Rash and itching: Allergy Area, Shenmen, Sympathetic, Occiput, Nervous Subcortex, Lung, Diaphragm, Spleen, Liver. Bleed Ear Apex.

* Contact dermatitis: Allergic Area, Sympathetic, Adrenal Gland, Liver, Spleen, Lung, Endocrine, corresponding points (to the area affected). Bleed Ear Apex.

§ For dermatitis with severe pain, add Shenmen and Occiput.

* Eczema: Allergic Area, Lung, Sympathetic, Spleen, Shenmen, Endocrine, Occiput, Diaphragm, corresponding points (to the area affected). Bleed Ear Apex.

* Cutaneous pruritis: Shenmen, Occiput, Liver, Spleen, Lung, Endocrine, Diaphragm, Allergic Area. Bleed Ear Apex.

* Urticaria: Liver, Lung, Spleen, Diaphragm, Shenmen, Occiput, Allergic Area, Sympathetic, Endocrine, Adrenal Gland. Bleed Ear Apex.

* Severe itching: Prick five times on the ear apex, five times each on the helix near the Great Auricular Nerve and Lesser Occipital Nerve.

 

NUTRITION

* Avoid seafood, sushi, duck, goose, onions, garlic, sugar, alcohol, and foods that are raw, spicy, fried, and greasy. Many meats and dairy products increase skin irritation by increasing the acidity of body tissue.

* Increase the consumption of flax seed oil, which helps to reduce inflammation in the body.

 

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

* Eczema

§ Recommendations: potatoes, broccoli, dandelion, mung bean, seaweed, pearl barley, cornsilk, water chestnut, winter melon, and watermelon.

§ Make fresh potato and apply locally, changing every four hours, for three days.

§ Apply honey to area.

§ Apply mashed daikon radish to area.

§ Make tea from mung beans and pearl barley and drink.

§ Boil soup from seaweed and winter melon, drinking at least once a day for ten days.

* Hives

§ Recommendations: winter melon rind, chrysanthemum, vinegar, papaya, ginger, dried prunes, black sesame, black beans, and pearl barley.

§ Take a sea salt bath, rubbing salt on the hives.

§ Cook together papaya, ginger, and rice vinegar until vinegar dries up. Eat the ginger and papaya twice daily for at least ten days.

§ Mix honey with rice wine and steam. Drink two tablespoons on an empty stomach every morning.

§ Cook together black sesame seeds, black beans, and Chinese black dates and eat at least once daily.

§ Eat two to three dried prunes daily.

§ Avoid shellfish and allergic foods.

* Allergy

§ Recommendations: ginger, onions, garlic, bamboo shoots, cabbage, beets, beet top tea, carrots, leafy greens, yams, ganoderma mushroom.

§ Drink ginger tea to induce sweating.

§ Drink beet top tea as a water source.

§ Avoid wheat, citrus fruits, chocolate, shellfish, dairy products, eggs, potatoes, polluted meats, and polluted air.

 

LIFESTYLE INSTRUCTIONS

* The best long-term treatment is to identify and avoid the allergen. In addition, balancing and strengthening one’s health and immunity will also reduce the frequency of allergic reactions while strengthening the patient’s immunological balance.

* Cotton or silk clothing is recommended over synthetic fibers for better ventilation.

 

CASE STUDIES

* K.B., a 62-year-old patient, presented with a chronic bilateral rash located on her arms. The rash occurred daily with a description of purple and dark in color. Daily lifestyle habits consisted of light alcohol drinking, cigarette smoking, and eating spicy foods. Other symptoms included pain with itching and peeling of the skin towards the end of the day. The TCM diagnosis was Lung and Liver fire. The practitioner administered Gardenia Complex and Silerex, both at four capsules three times a day. Within two weeks, the patient reported that her skin had completely cleared up. The patient continued with the same herbal combination for an additional two months. Submitted by A.I., Hilo, Hawaii.

* S.T., a 39-year-old female, presented with hives, which included symptoms of redness, itchiness, and blotchiness. Tongue was red and quivering, with a thin coat. The practitioner diagnosed this condition as wind-heat with dampness. Silerex was prescribed at 4 capsules three times a day. After two months of taking the herbs, she reported that the hives had lessened; however, if she stopped taking them the hives would come back strongly. The patient never found out the source of what caused the allergy but still continued taking the herbs. Submitted by S.L., Yuma, Arizona.

 

PHARMACOLOGICAL AND CLINICAL RESEARCH

Itching is a symptom associated with many external and internal disorders, including but not limited to dermatitis, contact dermatitis, infection, urticaria, and allergic reactions to foods, drugs, chemicals and other allergens. Proper treatment requires use of herbs with antipruritic effects to relieve itching, antiallergic and antihistamine activities to alleviate hypersensitivity reactions, and anti-inflammatory function to reduce swelling and inflammation.

        Silerexcontains many herbs with excellent antipruritic, antiallergic and antihistamine effects to directly stop itching associated with internal or external disorders. Ku Shen (Radix Sophorae Flavescentis) has an antipruritic effect to inhibit scratching in a dose-dependent manner.[4] The antipruritic effect of Ku Shen (Radix Sophorae Flavescentis) is attributed in part to its effect to reduce several eicosanoid-related skin inflammation disorders, such as atopic dermatitis.[5] Jing Jie (Herba Schizonepetae) exerts its antipruritic effect to inhibit itch-scratch response induced by substance P.[6] Di Huang (Radix Rehmanniae) has marked antiallergic activities to treat atopic dermatitis by suppressing the expression of cytokines, chemokines, and adhesion molecules.[7] Niu Bang Zi (Fructus Arctii) shows a marked antiallergic effect to inhibit the scratching behavior associated with atopic dermatitis and other allergy-related diseases. Niu Bang Zi (Fructus Arctii) also shows a marked effect to treat allergic diseases, including atopic dermatitis, by inhibiting the expression of IL-4 and IL-5.[8] Lastly, Mu Dan Pi (Cortex Moutan) has both antiallergic and antihistamine effects to treat allergy as it significantly suppresses histamine release and prostaglandin D(2) synthesis from mast cells.[9]

        Silerexalso contains many herbs with anti-inflammatory effects to reduce the swelling and inflammation of the skin. Fang Feng (Radix Saposhnikoviae) and Che Qian Zi (Semen Plantaginis) both exert their anti-inflammatory effects via their inhibitory effects on nitric oxide production.[10],[11] Mu Dan Pi (Cortex Moutan), Dang Gui (Radix Angelicae Sinensis) and Bai Xian Pi (Cortex Dictamni) demonstrate anti-inflammatory effects by inhibiting prostaglandin synthesis and decreasing permeability of the blood vessels.[12],[13],[14] Lastly, Di Fu Zi (Fructus Kochiae) and Zhi Zi (Fructus Gardeniae) have strong anti-inflammatory activity as they suppress vascular inflammation via inhibition of tumor necrosis factor-alpha (TNF-α).[15],[16]

        Clinically, herbs in Silerex have been used to treat many skin disorders successfully. According to one study of 148 patients, dermatological disorders, such as rashes, itching and eczema, were treated with Ku Shen (Radix Sophorae Flavescentis) through oral decoction or intramuscular injection with a 79% effective rate.[17] According to another study, using Di Huang (Radix Rehmanniae) as the main ingredient in decoction, 37 patients with rashes, urticaria and contact dermatitis were treated, making a complete recovery in 28 cases, significant improvement in 3 cases, slight improvement in 5 cases, and no effect in one case.[18] In addition, 353 patients with various dermatological disorders were treated with a 90.7% effective rate, using injection of Dang Gui (Radix Angelicae Sinensis) on ear points every other day for 10 to 20 days per course of treatment.[19] Furthermore, application of Jing Jie (Herba Schizonepetae) powder topically showed a marked effect to treat various dermatological disorders, such as measles, pruritic rash and itching.[20] Finally, topical application of Bai Xian Pi (Cortex Dictamni) in fine powder form was 100% effective in treating 33 cases of suppurative dermatological disorders.[21]

        In summary, Silerex contains herbs with antipruritic, antiallergic and antihistamine activities, and can be used successfully to treat various dermatological conditions.

 

COMPARATIVE ANALYSIS

Skin disorders such as rash, itching, dermatitis, and eczema commonly occur as a result of oral ingestion of or direct physical contact with an incompatible substance. As a result, allergic and hypersensitive reactions occur either in localized areas or throughout the entire body. In Western medicine, these skin disorders are treated with drugs that symptomatically relieve itching and irritation. Commonly used drugs include antihistamines [such as Benadryl (diphenhydramine)] and corticosteroids [such as hydrocortisone]. In most cases, these drugs are used topically for a short period of time, and are therefore associated with limited side effects. However, oral use of these drugs is likely to cause more side effects. Furthermore, it is important to remember that the best way to avoid allergic skin reactions is to avoid the allergens whenever possible.

        In TCM, skin disorders such as rash and eczema are characterized by wind-heat. Certain herbs that treat wind-heat have been shown to have marked antihistamine effects, and are excellent to alleviate skin itching and discomfort. Furthermore, many herbs also have anti-inflammatory effects to reduce swelling and inflammation. In short, oral ingestion of herbs is very effective to alleviate signs and symptoms of general skin disorders such as rash, eczema and dermatitis.

        Drugs and herbs are both effective for treating skin disorders such as rash, dermatitis, and eczema. Though neither therapy “cures” allergy, they both effectively alleviate symptoms. Topical use of drugs alleviates symptoms safely and effectively, but oral use of the drugs tends to cause more side effects. On the other hand, herbs can be used safely and effectively via both oral and topical administrations.

 



[1] Chan K, Lo AC, Yeung JH, Woo KS. Journal of Pharmacy and Pharmacology 1995 May;47(5):402-6.

[2] Pharmacotherapy 1999 July;19(7):870-876.

[3] European Journal of Drug Metabolism and Pharmacokinetics 1995; 20(1):55-60.

[4] Yamaguchi-Miyamoto T, Kawasuji T, Kuraishi Y, Suzuki H. Antipruritic effects of Sophora flavescens on acute and chronic itch-related responses in mice. Japan Society for the Promotion of Science, Domestic Research Fellow, Hon-machi, Kawaguchi, Saitama, Japan. Biol Pharm Bull. 2003 May;26(5):722-4.

[5] Kim DW, Chi YS, Son KH, Chang HW, Kim JS, Kang SS, Kim HP. Effects of sophoraflavanone G, a prenylated flavonoid from Sophora flavescens, on cyclooxygenase-2 and in vivo inflammatory response. College of Pharmacy, Kangwon National University, Chunchon, Korea. Arch Pharm Res. 2002 Jun;25(3):329-35.

[6] Tohda C, Kakihara Y, Komatsu K, Kuraishi Y. Inhibitory effects of methanol extracts of herbal medicines on substance P-induced itch-scratch response. Research Center for Ethnomedicines, Institute of Natural Medicine, Toyama Medical and Pharmaceutical University, Sugitani, Japan. Biol Pharm Bull. 2000 May;23(5):599-601.

[7] Sung YY, Yoon T, Jang JY, Park SJ, Kim HK. Topical application of Rehmannia glutinosa extract inhibits mite allergen-induced atopic dermatitis in NC/Nga mice. Center of Herbal Resources Research, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea. J Ethnopharmacol. 2011 Mar 8;134(1):37-44.

[8] Sohn EH, Jang SA, Joo H, Park S, Kang SC, Lee CH, Kim SY. Anti-allergic and anti-inflammatory effects of butanol extract from Arctium Lappa L. Department of Pediatrics, College of Medicine, Hanyang University, Seoul, 133-792, Korea. Clin Mol Allergy. 2011 Feb 8;9(1):4.

[9] Chan BC, Hon KL, Leung PC, Sam SW, Fung KP, Lee MY, Lau HY. Traditional Chinese medicine for atopic eczema: PentaHerbs formula suppresses inflammatory mediators release from mast cells. J Ethnopharmacol. 2008 Oct 30;120(1):85-91.

[10] Wang CC, Chen LG, Yang LL. Inducible nitric oxide synthase inhibitor of the Chinese herb I. Saposhnikovia divaricata (Turcz.) Schischk. Cancer Lett. 1999 Oct 18;145(1-2):151-7.

[11] Tezuka Y., Irikawa S., Kaneko T., Banskota A.H., Nagaoka T., Xiong Q., Hase K., Kadota S. Screening of Chinese herbal drug extracts for inhibitory activity on nitric oxide production and identification of an active compound of Zanthoxylum bungeanum. J Ethnopharmacol. 2001, 77(2-3): 209-217.

[12] Sheng Yao Xue Za Zhi (Journal of Raw Herbology), 1979; 33(3):178.

[13] Chao WW, Kuo YH, Li WC, Lin BF. The production of nitric oxide and prostaglandin E2 in peritoneal macrophages is inhibited by Andrographis paniculata, Angelica sinensis and Morus alba ethyl acetate fractions. Department of Biochemical Science and Technology, Institute of Microbiology and Biochemistry, National Taiwan University, Taipei 106, Taiwan, ROC. J Ethnopharmacol. 2009 Feb 25;122(1):68-75.

[14] Kim JH, Park YM, Shin JS, Park SJ, Choi JH, Jung HJ, Park HJ, Lee KT. Fraxinellone inhibits lipopolysaccharide-induced inducible nitric oxide synthase and cyclooxygenase-2 expression by negatively regulating nuclear factor-kappa B in RAW 264.7 macrophages cells. Biol Pharm Bull. 2009 Jun;32(6):1062-8.

[15] Shin KM, Kim YH, Park WS, Kang I, Ha J, Choi JW, Park HJ, Lee KT. Inhibition of methanol extract from the fruits of Kochia scoparia on lipopolysaccharide-induced nitric oxide, prostaglandin [correction of prostagladin] E2, and tumor necrosis factor-alpha production from murine macrophage RAW 264.7 cells. Biol Pharm Bull. 2004 Apr;27(4):538-43.

[16] Hwang SM, Lee YJ, Yoon JJ, Lee SM, Kang DG, Lee HS. Gardenia jasminoides inhibits tumor necrosis factor-alpha-induced vascular inflammation in endothelial cells. Professional Graduate School of Oriental Medicine, Wonkwang University, Chonbuk, Republic of Korea. Phytother Res. 2010 Jun;24 Suppl 2:S214-9.

[17] Zhong Cao Yao Tong Xun (Journal of Chinese Herbal Medicine), 1976; 1:35.

[18] Tian Jing Yi Xue Za Zhi (Journal of Tianjing Medicine and Herbology), 1966; 3:209.

[19] Shan Xi Yi Yao Za Zhi (Shanxi Journal of Medicine and Herbology), 1975; 5:69.

[20] Zhong Yi Za Zhi (Journal of Chinese Medicine), 12:18.

[21] Chi Jiao Yi Sheng Za Zhi (Journal of Barefoot Doctors), 1975; 6:21.