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Gastrointestinal Health

These two preparations are designed to promote healthy digestive motility, reduce inflammation, and create conditions for the digestive tract to heal. One more precisely targets the upper gastrointestinal region and the other the lower, but both have an overall healing effect on all the gastrointestinal organs and tissues.

Upper GI Preparation--what's in the bottle:

Generational clinical experience using citrus peel (chen pi) which is known for its gastroprotective and hepatoprotective effects, is now backed up by recent research confirming strong protection against inflammation and ulcer formation in the stomach. (1) Likewise, immature bitter orange (zhi shi) also protects and heals the lining of the upper digestive tract, regenerates healthy mucosal lining, and improves recovery from stomach ulcers. (2) The jujube fruit (da zao) is high in polyphenols, which have been demonstrated in research to improve gastrointestinal health via anti-inflammatory, anti-viral, antibacterial, antioxident and anticarcinogenic effects(3), and may also help in lowering cholesterol and stabilizing glucose levels. (4) It is highly saturated in polyphenols, triterpenic and fatty acids which create a variety of healthy responses in the body. Research on ophiopogon root (mai men dong) showed alleviation and prevention of gastrointestinal motility dysfunctions (5) as well as anti-proliferative effects on gastric tumor cell lines (6). Overall it is highly concentrated in steroidal saponins and flavonoids, which research suggests are responsible for a variety of effects, including a reduction in total cholesterol, cardiac protection, improvement of cardiac function,  anti-inflammatory effects, anti-diabetic effects, neuroprotective effects, and more. (7) In oriental medical theory, ophiopogon root is classified as nourishing yin and used to clear dry-heat while moisturizing and restoring fluids. Poria (fu ling) and Pinellia (ban xia) is a classic combination for controlling upset stomach and nausea, they help restore the downward motility of the upper gastrointestinal mechanisms.  Bamboo shavings (zhu ru) also clear heat from the stomach and research has shown it may protect the digestive tract while also restoring normal motility. (8) The other ingredients, including ginger root (sheng jiang), licorice root (gan cao), and ginseng (ren shen) protect the stomach and aid in smooth digestion. Interestingly recent research has also shown that ginseng upregulates heme-oxygenase-1, which is a homeostatic pathway in the digestive tract, regulating inflammation and promoting healing. (9)

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1. Abou Baker DH, Ibrahim BMM, Abdel-Latif Y, Hassan NS, Hassan EM, El Gengaihi S. Biochemical and pharmacological prospects of Citrus sinensis peel. Heliyon. 2022 Jul 21;8(8):e09979. doi: 10.1016/j.heliyon.2022.e09979. PMID: 36039135; PMCID: PMC94

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2. Polo CM, Moraes TM, Pellizzon CH, Marques MO, Rocha LR, Hiruma-Lima CA. Gastric Ulcers in Middle-Aged Rats: The Healing Effect of Essential Oil from Citrus aurantium L. (Rutaceae). Evid Based Complement Alternat Med. 2012;2012:509451. doi: 10.1155/2012/509451. Epub 2012 Nov 1. PMID: 23243451; PMCID: PMC3518767.

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3. Dryden GW, Song M, McClain C. Polyphenols and gastrointestinal diseases. Curr Opin Gastroenterol. 2006 Mar;22(2):165-70. doi: 10.1097/01.mog.0000208463.69266.8c. PMID: 16462174; PMCID: PMC4216723.

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4.  Lu, Yang et al. “Research advances in bioactive components and health benefits of jujube (Ziziphus jujuba Mill.) fruit.” Journal of Zhejiang University. Science. B vol. 22,6 (2021): 431-449. doi:10.1631/jzus.B2000594

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5. Kim HJ, Park SY, Kim DG, Park SH, Lee H, Hwang DY, Jung MH, Ha KT, Kim BJ. Effects of the roots of Liriope Platyphylla Wang Et tang on gastrointestinal motility function. J Ethnopharmacol. 2016 May 26;184:144-53. doi: 10.1016/j.jep.2016.03.012. Epub 2016 Mar 8. PMID: 26969403.

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6. Zhang W, Zhang Q, Jiang Y, Li F, Xin H. Effects of ophiopogonin B on the proliferation and apoptosis of SGC‑7901 human gastric cancer cells. Mol Med Rep. 2016 Jun;13(6):4981-6. doi: 10.3892/mmr.2016.5198. Epub 2016 Apr 27. PMID: 27121658; PMCID: PMC4878565.

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7. Lei F, Weckerle CS, Heinrich M. Liriopogons (Genera Ophiopogon and Liriope, Asparagaceae): A Critical Review of the Phytochemical and Pharmacological Research. Front Pharmacol. 2021 Dec 3;12:769929. doi: 10.3389/fphar.2021.769929. PMID: 34925027; PMCID: PMC8678496.

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8. Juqing Huang, Bin Lin, Ying Zhang, Zhenglu Xie, Yi Zheng, Qi Wang, Hang Xiao, Bamboo shavings derived O-acetylated xylan alleviates loperamide-induced constipation in mice, Carbohydrate Polymers,Volume 276,2022,

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9. Mancuso, Cesare, and Rosaria Santangelo. “Panax ginseng and Panax quinquefolius: From pharmacology to toxicology.” Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association vol. 107,Pt A (2017): 362-372. doi:10.1016/j.fct.2017.07.019

Lower GI Preparation--what's in the bottle:

Coptis (huang lian) and Scute root (huang qin) independently and more powerfully when combined together have anti-diarrhea(1), anti-inflammatory,  anti-microbial, and anxiolytic effects(2). Coptis has a high concentration of berberine, a phytochemical which has been shown to improve symptoms of irritable bowel syndrome in disease models (3). Similarly, baicalin the active component in scute root, has been heavily researched and shown to control symptoms of gastrointestinal diseases by controlling inflammation, reducing damage to the intestinal wall, and restoring gut microbiota homeostasis (4). Research on pueraria root (ge gen) backs up clinical experience, validating its use for gastrointestinal diseases via activity on the mucosal layer of the gastrointestinal tract, as well as regulating cardiac and hypothalamus-adrenal axis for an anti-stress response. (5) Poria (fu ling) is commonly used to calm diarrhea, it aids in fluid reabsorption in the lower GI tract which helps decrease the excessive frequency of bowel movements and promotes a more formed stool. An in-depth 2022 experimental study confirmed its metabolites to be powerful prebiotics, regulating the gut microbiota and increasing the concentration of lactobacillus in animal models. (6) Similarly, atractylodes (cang zhu) is used clinically for symptoms of IBS. Through its bi-directional effect on the colon it regulates movement and contractility while improving symptoms of water-like stools. Atractylodes has also been shown to prevent and repair intestinal mucosal injury and promote the rebalancing of healthy gut microflora. (7) Triterpenoids of Alismatis (ze xie) have known prebiotic effects, thus restoring healthy gut microbial activity, and simultaneously solidifying intestinal barrier integrity. (8)(9) The trifecta of poria, atractylodes and alismatis have overlapping effects, which in combination, synergize to create a calming and homeostatic effect on the gastrointestinal system. The final ingredient is licorice root (gan cao) an anti-inflammatory, pro-digestive, commonly used herb. Reserach has shown a dose-dependent dual decrease in inflammation and edema of the colon in ulcerative colitis induced mice. (10)

 

The above research results give a basic understanding for the selection of these herbs in this preparation. But more importantly with any Oriental medicine formula, it is best to think of it as a whole unit of combined effects. All of the pieces overlapping and synergizing. In 2021, a study was done to that ends. Looking at pueraria root, scute, coptis, and licorice root used in combination, it is shown "effective against inflammatory intestinal diseases, including diarrhea, ulcerative colitis, and intestinal adverse reactions caused by chemotherapeutic agents." (11)​

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1. Kim HJ, La JH, Kim HM, Yang IS, Sung TS. Anti-diarrheal effect of Scutellaria baicalensis is associated with suppression of smooth muscle in the rat colon. Exp Ther Med. 2019 Jun;17(6):4748-4756. doi: 10.3892/etm.2019.7469. Epub 2019 Apr 5. PMID: 31105793; PMCID: PMC6507508.

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2. Qi Y, Ni S, Heng X, Qu S, Ge P, Zhao X, Yao Z, Guo R, Yang N, Zhang Q, Zhu H. Uncovering the Potential Mechanisms of Coptis chinensis Franch. for Serious Mental Illness by Network Pharmacology and Pharmacology-Based Analysis. Drug Des Devel Ther. 2022 Feb 9;16:325-342. doi: 10.2147/DDDT.S342028. PMID: 35173416; PMCID: PMC8841750.

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3. Chen C, Lu M, Pan Q, Fichna J, Zheng L, Wang K, Yu Z, Li Y, Li K, Song A, Liu Z, Song Z, Kreis M. Berberine Improves Intestinal Motility and Visceral Pain in the Mouse Models Mimicking Diarrhea-Predominant Irritable Bowel Syndrome (IBS-D) Symptoms in an Opioid-Receptor Dependent Manner. PLoS One. 2015 Dec 23;10(12):e0145556. doi: 10.1371/journal.pone.0145556. PMID: 26700862; PMCID: PMC4689480.

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4. Ganguly R, Gupta A, Pandey AK. Role of baicalin as a potential therapeutic agent in hepatobiliary and gastrointestinal disorders: A review. World J Gastroenterol. 2022 Jul 14;28(26):3047-3062. doi: 10.3748/wjg.v28.i26.3047. PMID: 36051349; PMCID: PMC9331529.

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5. Bharti R, Chopra BS, Raut S, Khatri N. Pueraria tuberosa: A Review on Traditional Uses, Pharmacology, and Phytochemistry. Front Pharmacol. 2021 Jan 27;11:582506. doi: 10.3389/fphar.2020.582506. PMID: 33708108; PMCID: PMC7941752.

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6. Lai Y, Yu H, Deng H, Fang Q, Lei H, Liu L, Wu N, Guo X, Song C. Three main metabolites from Wolfiporia cocos (F. A. Wolf) Ryvarden & Gilb regulate the gut microbiota in mice: A comparative study using microbiome-metabolomics. Front Pharmacol. 2022 Aug 3;13:911140. doi: 10.3389/fphar.2022.911140. PMID: 35991887; PMCID: PMC9382301.

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7. Yang L, Yu H, Hou A, Man W, Wang S, Zhang J, Wang X, Zheng S, Jiang H, Kuang H. A Review of the Ethnopharmacology, Phytochemistry, Pharmacology, Application, Quality Control, Processing, Toxicology, and Pharmacokinetics of the Dried Rhizome of Atractylodes macrocephala. Front Pharmacol. 2021 Nov 3;12:727154. doi: 10.3389/fphar.2021.727154. PMID: 34803677; PMCID: PMC8595830.

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8. Xia F, Xiang S, Chen Z, Song L, Li Y, Liao Z, Ge B, Zhou B. The probiotic effects of AB23A on high-fat-diet-induced non-alcoholic fatty liver disease in mice may be associated with suppressing the serum levels of lipopolysaccharides and branched-chain amino acids. Arch Biochem Biophys. 2021 Dec 15;714:109080. doi: 10.1016/j.abb.2021.109080. Epub 2021 Nov 4. PMID: 34742934.

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9. Xia F, Li Y, Deng L, Ren R, Ge B, Liao Z, Xiang S, Zhou B. Alisol B 23-Acetate Ameliorates Lipopolysaccharide-Induced Intestinal Barrier Dysfunction by Inhibiting TLR4-NOX1/ROS Signaling Pathway in Caco-2 Cells. Front Pharmacol. 2022 Jun 14;13:911196. doi: 10.3389/fphar.2022.911196. PMID: 35774596; PMCID: PMC9237229.

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10.  Takhshid, M. A., et al. "The healing effect of licorice extract in acetic acid-induced ulcerative colitis in rat model." Comparative Clinical Pathology 21.6 (2012): 1139-1144.

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11. Lu JZ, Ye D, Ma BL. Constituents, Pharmacokinetics, and Pharmacology of Gegen-Qinlian Decoction. Front Pharmacol. 2021 May 7;12:668418. doi: 10.3389/fphar.2021.668418. PMID: 34025427; PMCID: PMC8139575.

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