Research Advances in Pharmacology, Safety, and Clinical Applications of Yunnan Baiyao, a Traditional Chinese Medicine Formula

Ethnopharmacology relevance: Yunnan Baiyao (YNBY), a traditional Chinese medicine formulae, has some significant properties including activating blood circulation to dissipate blood stasis (Huo-Xue-Hua-Yu), eliminating swelling and alleviating pain (Xiao-Zhong-Zhi-Tong), and eliminating necrotic tissues and promoting granulation (Qu-Fu-Sheng-Ji).Aim of this study: This paper intends to provide a comprehensive and critical analysis of studies on YNBY, proposing new possible therapeutic directions of this formula.Materials and methods: Relevant data on YNBY were retrieved from available databases and a hand-search by searching the keywords such as “Yunnan Baiyao,” “pharmacology,” “toxicity,” and “clinical applications.”Results: Traditionally, YNBY has been used to cure hemorrhage, bruises, swelling, and pain caused by injuries in the Chinese folk. Modern pharmacological studies show that YNBY possesses pharmacological activities including hemostasis, invigorating the circulation of blood, wound healing, anti-inflammation, analgesia, antibiosis, infection prevention, and other effects. Toxicological studies demonstrate that YNBY has a certain toxicology, which is mainly caused by Aconitum alkaloids from Cao-wu (CW, Aconiti Kusnezoffii Radix). The developmental non-toxic reaction dose (NOAEL) of YNBY for embryos and fetuses is 0.5 g/kg in rats. In addition, the NOAEL for fertility and early embryo development toxicity is 4.0 g/kg in rats. Clinical trials have confirmed the safety of YNBY in a large number of patients, and adverse drug reactions (ADRs) such as abdominal pain, diarrhea, allergy, and others in very few people. YNBY is routinely used in clinic to cure bleeding, pain, swelling, upper digestive tract ulcer, postoperative wound, arthritis, mouth ulcers, ulcerative colitis, etc.Conclusions: Hemostasis is a conspicuous effect of YNBY. Except for this effect, analgesia and anti-infection may be new research directions of this formula. In addition, the in vitro and in vivo pharmacology and mechanisms of action of YNBY are encouraged as well as the pharmacokinetics of this formulae. Furthermore, the material basis of the pharmacological effects of YNBY also needs clear identification.

Treatment of Yunnan Baiyao plus Kangfuxin Solution Reduces Inflammatory Response and Prevents Patients with Nasopharyngeal Carcinoma against Radiation-Induced Oral Mucositis

Oral mucositis refers to secondary mucosal damage, which usually occurs during cancer treatment. Generally, patients with head and neck cancers receiving radiotherapy will develop mucositis. Oral mucositis usually begins with mucosal inflammation and is characterized by erythema and confluent ulcers. The purpose of the study is to explore the therapeutic effects of Yunnan Baiyao combined with Kangfuxin solution on radiation-induced oral mucositis and the influence on production of inflammatory factors in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Clinical variables of 90 NPC patients were retrospectively analyzed. All patients underwent combined treatment (normal saline and inhalation of dexamethasone, gentamicin, and vitamin B12) 1st after radiotherapy, among which 45 patients received additional treatment of Yunnan Baiyao plus Kangfuxin solution and assigned as the study group. We found that additional treatment of Yunnan Baiyao plus Kangfuxin solution remarkably attenuated pain and dry mouth and reduced the degree of mucosal hyperaemia, edema, and ulceration in NPC patients undergoing radiotherapy ( P < 0.05 ). It was also found that additional treatment of Yunnan Baiyao plus Kangfuxin solution notably inhibited the release of inflammatory factors and cancer-related markers, as evidenced by lower serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), matrix metalloproteinase-9 (MMP-9), serum hypoxia-inducible factor-1 α (HIF-1α), and vascular endothelial growth factor (VEGF) detected in the study group than the control group ( P < 0.05 ). Additionally, the numbers of CD+3 and CD+4 subpopulations of T lymphocytes and the ratio of CD+4/CD+8 in the study group were significantly higher than those in the control group ( P < 0.05 ), and the number of CD+8 subpopulations in the study group was significantly lower than those in the control group ( P < 0.05 ). In conclusion, these results indicated that additional treatment of Yunnan Baiyao plus Kangfuxin solution reduces inflammatory response and prevents patients with NPC against radiation-induced oral mucositis.

Administration of Yunnan Baiyao improved clinical prognosis of emergency craniotomy in patients with moderate-to-severe TBI: a randomized controlled trial

Background: Although emergency craniotomy has been performed to reduce the mortality of traumatic brain injury (TBI), it is associated with secondary injury and poor prognosis. The efficacy of a wound-healing medicine Yunnan Baiyao (YB) was compared with a TBI medicine Xingnaojing (XNJ) and orthodox therapy (OT). Method: Eighty patients (39±7 yrs.) with moderate-to-severe TBI (Glasgow Coma Scale(GOS), 3-12) received craniotomy before randomly assigned to (n=20) 7 days treatment of: 1) OT; 2) OT+XNJ (20 ml i.v. drip/daily); 3) OT+low dose-YB (oral, 1,000 mg/day); 4) OT+high dose-YB, 2,000 mg/day). Serum S100B and superoxide dismutase (SOD), Glasgow Outcome Scale (GOS) and Karnofsky Performance Scale (KPS) were evaluated.Results: GCS score was lowest on admission that improved more quickly and became significantly higher in XNJ, l-YB, h-YB groups than in OT group (P<0.01). S100B peaked higher but declined more slowly and became significantly higher in OT than in other groups (P<0.01). By Day 7, S100B declined to 20% below baseline in other groups but remained 19.4% above baseline in OT group. OT lost 38% SOD activity on Day 3 and regained 69% of SOD activity on Day 7 whereas other groups lost 16.7%~23.4% SOD on Day 3 but regained 91.8%~99.5% activity on Day 7 (P<0.01). GOS and KPS scores were significantly greater (~25%~30%) in the XNJ, l-YB, h-YB groups than in OT group 1-3 months post-surgery. Conclusion: YB is significantly better than OT and non-inferior to XNJ in improving postoperative recovery and clinical prognosis after emergency craniotomy in patients with moderate-to-severe TBI.

Investigation of China’s Yunnan pharmaceutical industry derived from two ethnomedicines, Yi medicine and Dai medicine

Background: Yunnan Province is a multi-ethnic area located in the southwest of China, and she also is rich in Chinese matiera medica resources, known as the ‘kingdom of plants’. There is abundant of ethnomedicine resources in Yunnan province and many ethnic minorities inherit and retain numerous knowledge of traditional medicine. The biomedicine and big health industry have been the pillar industry of Yunnan since 2016, which is the important pharmaceutical industrial base for Dai Medicine and Yi Medicine in China, for example Yunnan Baiyao with “amazing efficacy” and originating from a Yi medical formula. Yi medicine and Dai medicine of Yunnan Province were investigated in this work focusing on the basic information of Dai patent medicine (DPM) and Yi patent medicine (YPM), including the clinical indications, herbal resources and their sources of traditional knowledge. Methods: The data and information were collected from the published literatures and some public service websites, and the data base of DPM and YPM was established including the information about manufacturer, approval number, clinical indication, prescription composition, dosage form of drug, etc. We investigated the references and literatures including the publicly available pharmaceutical instructions ensuring the authenticity and reliability of the investigation. Results: The results showed that there were 28 varieties of DPMs and 73 varieties of YPMs approved to use in clinical according to the drug regulatory laws of China. In the DPMs and YPMs, about 109 and 197 herbal medicines are recorded in China Pharmacopoeia, 18 and 52 herbs are recorded in Standards for Chinese medicinal materials in Yunnan Province respectively. Nearly 20 herbs have not any quality standard. Among these herbal medicines, there are 10 herbs considered as Dai Medicine and 30 herbs as Yi Medicine. In order to produce these DPMs and YPMs, about 16 animal medicines and 17 rare and endangered medicinal materials would be collected and used. Conclusions: The investigation would provide a more detailed report on Yunnan ethnic medicine industry, and it should be believed reasonably that the ethnomedicine of Yunnan Province will give more choices for human health through scientific experiments and dealing with the sustainable utilization of medicine resources.

Research on Financial Efficiency of Yunnan Baiyao Based on Big Data

The analysis of corporate financial efficiency can meet the different decision needs of users of accounting information. Big data transforms accounting information from real-time data to real-time cloud computing platforms, providing a rich information foundation for financial efficiency analysis of enterprises. This article uses the financial data of Yunnan Baiyao in the past six years, and analyzes the problems and countermeasures of its financial management by analyzing the company’s operating capacity, profitability, solvency and development ability, in order to provide useful reference for enterprise management.