Review Article

Review of Traditional Chinese Medicines for Common Complications Related to Hemodialysis: An Evidence-Based Perspective

Table 2

Summary of Chinese herbal medicine formulas: main effects, mechanisms, and possible toxicity profiles.

NameCompositionDesignDosage and route of administrationMain effectMechanismToxicity profiles

Shen Fu injection (SFI) [18]Rx. Ginseng, Rx. Aconiti Lateralis PreparataCase20–30 ml, IVD↑BPIncrement of heart rate and cardiac contractilityAconite poisoning with arrhythmia and shock [18]

Sheng Mai Yin (SMY) and modified Si Miao San (SMS) decoction [27]Rx. Ginseng, Tub. Ophiopogonis, and Fr. Schisandrae, Sm. Coicis, Cx. Phellodendri, Rz. Atractylodis, Rx. CyathulaeCase controlA: SMY + SMS 200 ml, BID PO plus Sheng Mai injection (SMI) 30 ml, IVD 12 weeks; B: SMI 30 ml, IVD 12 weeks↑BP, hemoglobin, and albumin ↓CRPElevation of BP and plasma colloid osmotic pressure, improvement of the microinflammatory stateNot reported

Shao Yao Gan Cao Tang (SYGCT) [43]Rx. Paeoniae Alba, Rx. Glycyrrhizae PreparataCase series and animal6 GM, PO QD 4 weeks↓Episodes of muscle cramp, ↑sural NCV, ↓contraction of skeletal muscles in ratsDirect inhibition of muscle contraction due to nerve stimulationMild hyperkalemia (5.5–6 mEq/L) [18] or pseudoaldosteronism in long-term use [44]
Shao Yao Gan Cao Tang (SYGCT) [44]UCTA: 2.5 g, PO once at home; B: 2.5 g, PO once before HD 4 weeks↓Episodes and duration of muscle cramp, ↓amount of saline infusion, ↑VASInhibitory effect on excessive muscle contraction and promotion of plasma refilling in muscle

Dang Gui Si Ni Tang (DGSNT) plus Fr. Evodiae and Rz. Zingiberis Recens [50]Rx. Angelica Sinensis, Rx. Paeoniae Alba, Ram. Cinnamomi, Hb. cum Rx. Asari, Rx. Glycyrrhizae Preparata, Fr. Jujube, Caul. Akebiae, Fr. Evodiae, Rz. Zingiberis RecensCase3-4 g, PO TID 14 days↓N/V, BUNReduction of BUN level, balancing of the PH value of the GI tractFr. Evodiae-hepatotoxicity in rat [51] antiplatelet effect in vivo [52]

She Xiang Bao Xin Pill (SXBXP) [56]Moschus, Rx. Ginseng, Cx. Cinnamomi, Calculus bovis, Styrax, Venenum Bufonis, BorneolumRCTA: SXBXP 2 pills, SL PRN; B: isosorbide dinitrate 10 mg, SL PRN; C: SXBXP 2 pills + isosorbide dinitrate 5 mg, SL PRN↓Chest pain and associated symptoms, ↓BP and HRDilation of coronary artery, increment of myocardial contractility, and reduction of heart rateCoagulation dysfunction [58]; toad venom has digoxin-like effects [59]

Wu Ling San (WLS) decoction [64]Rz. Alismatis, Poria, Scl. Polypori, Rz. Atractylodis Macrocephalae, Ram. CinnamomiRCTA: WLS 100–150 ml, BID, PO once before HD; B: 50% glucose 40–60 ml, IVD once before HD↓DDS symptoms (headache, nausea, anxiety, blurred vision)Improvement of cerebral edema and decrement of CSF pressureNot reported

Wen Yang Li Shui tang (WYLST) [65]Rx. Aconiti Lateralis Preparata, Poria, Rz. Atractylodis Macrocephalae, Ram. Cinnamomi, Rz. Zingiberis, Rx. Paeoniae Alba, Sm. Lepidii, Fr. Jujube, Rx Pseudostellariae, Tub. Ophiopogonis, Fr. Schisandrae, Fr. Amomi, Rx. Astragali, Rhodobryum roseum, Rx. Glycyrrhizae PreparataRCTA: 20 GM, PO once upon DDS attack; B: Conventional therapy upon DDS attack↑Response rate of DDS symptoms (96% versus 80%)Increment of plasma osmolality and simultaneous decrement of further osmotic shift to brainNot reported

BID: twice daily; BP: blood pressure; BUN: blood urea nitrogen; CRP: C-reactive protein; CSF: cerebrospinal fluid; DDS: dialysis disequilibrium syndrome; EKG: electrocardiogram; EMG: electromyogram; GI: gastrointestinal; HR: heart rate; IDH: intradialytic hypotension; IVD: intravenous drip; NA: not applicable; NCV: nerve conduction velocities; N/V: nausea and vomiting; PH: potential of hydrogen; PO: oral; PRN: pro re nata; QD: once daily; RCT: randomized controlled trial; SL: sublingual; TID: three times daily; UCT, uncontrolled trial; VAS: visual analogue scale.