Shi Quan Da Bu Tang

• How It Works

  Current evidence is insufficient to support use of Shi quan da bu tang for cancer treatment.

  Shi quan da bu tang is an herbal formula that consists of Panax ginseng (Ginseng), Angelica sinensis (Dong quai), Paeonia lactiflora (Peony), Atractylodes macrocephala (Atractylodes), Poria cocos (Hoelen), Cinnamomum cassia (Cinnamon), Astragalus membranaceus (Astragulus), Liqusticum wallichii (Cnidium), Glycyrrhiza uralensis (Licorice), and Rehmannia glutinosa (Rehmannia).

  It is used in traditional Asian medicine to treat fatigue, anemia, loss of appetite, dry or scaly skin, night sweating, dryness of mouth, and cancer. Breast cancer patients should consult with their physicians before using this formula because dong quai and ginseng may stimulate the growth of breast cancer cells.

• Purported Uses
  • Loss of Appetite
    Evidence is lacking to support this claim.
  • Anemia
    Clinical data show that the formula helps improve anemia.
  • Cancer treatment
    Studies in mice suggest that shi quan da bu tang has anticancer and antimetastatic effects.
    Small studies of cancer patients showed that it may help improve survival and decrease chemotherapy-associated side effects.
  • Dry skin
    Evidence is lacking to support this claim.
  • Dryness of mouth
    Evidence is lacking to support this claim.
  • Fatigue
    This formula is traditionally used for fatigue. A clinical trial is underway to determine the effectiveness.
  • Night sweating
    Evidence is lacking to support this claim.
• Do Not Take If
  • You have hypersensitivity to any of the components in the formula.
• Clinical Summary

  Shi quan da bu tang is an herbal formula that consists of 10 herbs: Panax ginseng (Ginseng), Angelica sinensis (Dong quai), Paeonia lactiflora (Peony), Atractylodes macrocephala (Atractylodes), Poria cocos (Hoelen), Cinnamomum cassia (Cinnamon), Astragalus membranaceus (Astragalus), Liqusticum wallichii (Cnidium), Glycyrrhiza uralensis (Licorice), and Rehmannia glutinosa (Rehmannia) ⁽¹⁾. Also known as Juzen-taiho-to in Japan, it is used in traditional medicine to alleviate fatigue, anemia, appetite loss, dry or scaly skin, night sweating, dryness of mouth, and to treat cancer. Supporters believe the formula’s beneficial effects are due to interactions between its components.

  Preclinical studies have shown that shi quan da bu tang protects against Alzheimer’s disease ⁽¹³⁾; prevents muscle atrophy by lowering oxidative stress ⁽¹⁹⁾; has antitumor and antimetastatic effects ^{(2) (3) (4) (5) (6) (12)}; exerts radioprotective effects ⁽⁷⁾; and protects against myelosuppression induced by anticancer drugs ⁽¹⁷⁾. Clinical data indicate that it helps improve anemia ^{(14) (15) (16)}; and is effective in preventing recurrent acute otitis media in children ⁽²⁰⁾.
  In oncology settings, the formula has been reported to exert immunomodulatory effects in pancreatic cancer patients ⁽²¹⁾; to increase survival time in patients with advanced lung cancer ⁽⁸⁾; and to alleviate hematotoxicity in patients with breast carcinoma receiving chemotherapy ⁽¹⁸⁾. Additional trials are underway to determine effectiveness against cancer-related fatigue ⁽²²⁾ and anorexia ⁽²³⁾; as well as cold hypersensitivity in hands and feet ⁽²⁴⁾.

  Breast cancer patients should consult their physicians before using this formula because dong quai and ginseng may stimulate the growth of breast cancer cells ⁽¹¹⁾.

• Purported Uses
  • Loss of Appetite
  • Anemia
  • Cancer treatment
  • Dry Skin
  • Dryness of mouth
  • Fatigue
  • Night Sweating
• Mechanism of Action

  Studies using murine models suggest that shi quan da bu tang has antitumor and antimetastatic effects ^{(2) (3) (4) (6)} that are mediated by stimulation of macrophages and natural killer cells. The formula also showed radioprotective effects evidenced by an increase in spleen colony forming units in mice exposed to radiation ⁽⁷⁾; along with stimulating hemopoiesis, in vitro ⁽⁹⁾.

• Contraindications
  • Hypersensitivity to any of the components in the formula.
• Herb-Drug Interactions
  • S-1(Tegafur/gimeracil/oteracil): In a murine model, repeated doses of shi quan da bu tang were shown to inhibit the absorption of gimeracil, an inhibitor of 5-FU metabolism, leading to increased elimination and reduced plasma level of 5-FU. Clinical relevance is not known ⁽²⁵⁾.
• References

  1. Zee-Cheng RK. Shi-quan-da-bu-tang (ten significant tonic decoction), SQT. A potent Chinese biological response modifier in cancer immunotherapy, potentiation and detoxification of anticancer drugs. Methods Find Exp Clin Pharmacol 1992; 14(9):725-36.

  2. Niwa K, et al. Preventive effects of Juzen-taiho-to on N-methyl-N-nitrosourea and estradiol-17beta-induced endometrial carcinogenesis in mice. Carcinogenesis 2001; 22(4):587-91.

  3. Saiki I. A Kampo medicine “Juzen-taiho-to”—prevention of malignant progression and metastasis of tumor cells and the mechanism of action. Biol Pharm Bull 2000; 23(6):677-88.

  4. Tagami K, et al. Preventive effect of Juzen-taiho-to on endometrial carcinogenesis in mice is based on Shimotsu-to constituent. Biol Pharm Bull 2004; 27(2):156-61.

  5. Dai Y, et al. T-cell-immunity-based inhibitory effects of orally administered herbal medicine juzen-taiho-to on the growth of primarily developed melanocytic tumors in RET-transgenic mice. J Invest Dermatol 2001; 117(3):694-701.

  6. Ohnishi Y, et al. Oral administration of a Kampo (Japanese herbal) medicine Juzen-taiho-to inhibits liver metastasis of colon 26-L5 carcinoma cells. Jpn J Cancer Res 1998; 89(2):206-13.

  7. Ohnishi Y, et al. Effects of juzen-taiho-toh (TJ-48), a traditional Oriental medicine, on hematopoietic recovery from radiation injury in mice. Exp Hematol 1990; 18(1):18-22.

  8. Satoh H, et al. Japanese herbal medicine in patients with advanced lung cancer: prolongation of survival. J Altern Complement Med 2002; 8(2):107-8.

  9. Hisha H, et al. Treatment of Shwachman syndrome by Japanese herbal medicine (Juzen-taiho-to): stimulatory effects of its fatty acids on hemopoiesis in patients. Stem Cells 2002; 20(4):311-19.

  10. Honso Professional Catalog 2002. Honso USA Inc.

  11. Amato P, et al. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause 2002 Mar-Apr;9(2):145-50.

  12. Kamiyama H, Takano S, Ishikawa E, Tsuboi K, Matsumura A. Anti-angiogenic and immunomodulatory effect of the herbal medicine “Juzen-taiho-to” on malignant glioma. Biol Pharm Bull. 2005 Nov;28(11):2111-6.

  13. Hara H, Kataoka S, Anan M, et al. The therapeutic effects of the herbal medicine, Juzen-taiho-to, on amyloid-beta burden in a mouse model of Alzheimer’s disease. J Alzheimers Dis. 2010;20(2):427-39.

  14. Sho Y, Fujisaki K, Sakashita H, et al. Orally administered Kampo medicine, Juzen-taiho-to, ameliorates anemia during interferon plus ribavirin therapy in patients with chronic hepatitis C. J Gastroenterol. 2004 Dec;39(12):1202-4.

  15. Nakamoto H, Mimura T, Honda N. Orally administrated Juzen-taiho-to/TJ-48 ameliorates erythropoietin (rHuEPO)-resistant anemia in patients on hemodialysis. Hemodial Int. 2008 Oct;12 Suppl 2:S9-S14.

  16. Kishida Y, Nishii T, Inoue T, et al. Juzentaihoto (TJ-48), a traditional Japanese herbal medicine, influences hemoglobin recovery during preoperative autologous blood donation and after hip surgery. Int J Clin Pharmacol Ther. 2009 Dec;47(12):716-21.

  17. Ogawa K, Omatsu T, Matsumoto C, et al. Protective effect of the Japanese traditional medicine juzentaihoto on myelosuppression induced by the anticancer drug TS-1 and identification of a potential biomarker of this effect. BMC Complement Altern Med. 2012 Aug 9;12:118.

  18. Huang SM, Chien LY, Tai CJ, Chiou JF, Chen CS, Tai CJ.Effectiveness of 3-Week Intervention of Shi Quan Da Bu Tang for Alleviating Hematotoxicity Among Patients With Breast Carcinoma Receiving Chemotherapy. Integr Cancer Ther. 2012 Jul 16. [Epub ahead of print]

  19. Ishida T, Iizuka M, Ou Y, et al. Juzentaihoto hot water extract alleviates muscle atrophy and improves motor function in streptozotocin-induced diabetic oxidative stress mice. J Nat Med. 2019 Jan;73(1):202-209.

  20. Ito M, Maruyama Y, Kitamura K, et al. Randomized controlled trial of juzen-taiho-to in children with recurrent acute otitis media. Auris Nasus Larynx. 2017 Aug;44(4):390-397.

  21. Ikemoto T, Shimada M, Iwahashi S, et al. Changes of immunological parameters with administration of Japanese Kampo medicine (Juzen-Taihoto/TJ-48) in patients with advanced pancreatic cancer. Int J Clin Oncol. 2014 Feb;19(1):81-6.

  22. Cheon C, Kang S, Ko Y, Kim M, Jang BH, Shin YC, Ko SG. Sipjeondaebo-tang in patients with breast cancer with fatigue: a protocol for a pilot, randomised, double-blind, placebo-controlled, cross-over trial. BMJ Open. 2018 Jul 6;8(7):e021242.

  23. Ko Y, Sun SH, Han IS, et al. The efficacy and safety of Sipjeondaebo-tang in Korean patients with cold hypersensitivity in the hands and feet: a protocol for a pilot, randomized, double-blind, placebo-controlled, parallel-group clinical trial.Trials. 2019 Apr 15;20(1):217.

  24. Cheon C, Park S, Park YL, et al. Sipjeondaebo-tang in patients with cancer with anorexia: a protocol for a pilot, randomised, controlled trial. BMJ Open. 2016 May 12;6(5):e011212.

  25. Kim TH, Shin S, Shin JC, et al. Effect of Sipjeondaebo-Tang on the Pharmacokinetics of S-1, an Anticancer Agent, in Rats Evaluated by Population Pharmacokinetic Modeling. Molecules. 2017 Sep 7;22(9). pii: E1488.