The Tibetan Uterotonic Zhi Byed 11: Mechanisms of Action, Efficacy, and Historical Use for Postpartum Hemorrhage

Table 2

Potential mechanisms of action of Zhi Byed 11.

Tibetan name^a	Mechanism of action
lcum rtsa	Anthranoids: laxative due to direct colon irritation, purgative potentially due to abnormal expression of aquaporins [27].
	Emodins: dose-dependant smooth muscle contraction [28] due to increased concentration of calcium in smooth muscle and the activation of calcium chloride channels via enhancement of membrane Gi/Go protein signal transducer pathway [29]. CaCl2 can reverse effects. Heightens effects of Acetylcholine [28].
	Sennosides: animal studies demonstrate intestinal peristalsis due to depolarization of cell membranes, quickened burst slow wave potential, and increased frequency of spike potentials [30].
ma nu	Highly potent tracheal and ileal smooth muscle relaxant in animal studies [30].
sga skya	Decreases nausea and vomiting [31] and prokinetic activity in digestive system of animal models due to effects on muscarinic M3 receptors of stomach fundus [32].
star bu	Anthranoids: Laxative due to direct colon irritation [19].

^aStudies on sbrul sha, ol mo’se, rgya tsha, a ru, bul tog, cong zhi, and sdig srin are not found.