Analysis of TCM Herbal Formula Xian Fang Huo Ming Yin for Rheumatoid Arthritis

Traditional Chinese Medicine Herbal Formulas have tremendous value for any number of conditions when properly applied. Clinically many of the functions of these formulas are well understood within their own domain. But scientific biochemical and functional analysis is often very useful to illuminate more the "how they work" as the "that it works" is already agreed upon.

The formula I'm writing about today is Xian Fang Huo Ming Yin Wan or the "sublime decoction to sustain life". This is a commonly used formula for a range of hot and/or painful skin lesions - boils, acne, etc. But there are potential uses for many other conditions. Rheumatoid arthritis (RA) is one of these conditions in patients with appropriate underlying factors. And it is the biochemical reactions of this formula related to rheumatoid arthritis contained in the study that I'm citing.

Using a rheumatoid induced rat model, researchers from the Beijing University of Chinese Medicine and other Beijing area universities conducted a study analyzing the affects of Xian Fang Huo Ming Yin Wan. They found over 20 different chemical constituents in the formula itself. To isolate the affects they looked only at the metatarsophalangeal joint. When applied to the rat model the formula slowed the pathological/arthritic changes in the joint. They also found it down regulated the following autoimmune/inflammatory markers which are a part of the destructive messaging in RA.

• CD3+ T Cells - these immune marker cells are most often found in large numbers in patients with RA and other chronic inflammatory diseases ( 1 ).
• CD3-CD19+ B cells - most often found elevated in any number of autoimmune conditions, down regulation of these markers effectively shuts off the inflammatory/attack feedback loop. This is a sought after target for potential immunotherapy treatments ( 2 ).
• Also suppressed NF-κB and JAK/STAT signaling - proteins that regulate genetic messaging for inflammation and other biological functions ( 3 ).

The researchers concluded that the herbal formula can "regulate and maintain the immunologic balance of lymphocytic immunity and inhibit the production of pro-inflammatory cytokines, thus suppressing the pathological changes of RA." Another related study came to a similar conclusion; xian fang huo ming yin can "restore the balance of T lymphocytes and reestablish the immunological tolerance to inhibit auto inflammatory disorder of RA... taken together, XFHM can be used as a complementary or alternative traditional medicine to treat RA."

Now in clinical reality, this formula is very likely not appropriate for many patients diagnosed with rheumatoid arthritis. Reasoning for this is due to the underlying Chinese Medicine diagnostic framework which in general makes the western medical diagnosis somewhat meaningless. In short, there are many potential contributing factors for the development of RA and Chinese Medicine looks at those in very minute ways (for general info on this, read "What Does Acupuncture Treat?" which is applicable to herbs as well). Diagnosis and treatment from a fully trained Chinese Medicine practitioner is always best with complex conditions for this reason.

There are host of other formulas that could potentially be useful with rheumatoid arthritis, some of these and possibly underlying TCM diagnoses are found on our rheumatoid arthritis treatment options page.

Ideally a patient with RA will consult with a licensed Chinese Medicine practitioner and obtain acupuncture, herbal medicine, moxibustion, medical massage and/or other techniques as appropriate for their diagnosis, constitution and symptoms. Generally speaking the full gamut of Chinese Medicine, not just herbal medicines, is shown to down regulate inflammation and autoimmune manifestations which are at the heart of this range of conditions. For example, this study found that moxibustion suppressed many of the same inflammatory communication pathways discussed above in another RA induced rat model. A more technical electroacupuncture study that I had written about previously found that high intensity electroacupuncture also modulated many of those same signaling pathways.

All things considered these studies indicate that Chinese Medicine offers strong potential for aid with rheumatoid arthritis and other autoimmune/inflammatory based conditions.