Keishi-bukuryo-gan (Cinnamomum + Poria + Peach formula): Benefits, Dosage, Safety & Evidence

Questions fréquentes

How does Keishi-bukuryo-gan work for blood stasis?

Keishi-bukuryo-gan works through multiple mechanisms to address blood stasis. Cinnamaldehyde from cinnamon improves microcirculation and produces antiplatelet effects. Paeoniflorin from peony root modulates blood flow and reduces inflammation. Pachymic acid from Poria supports fluid metabolism. Together, these compounds promote blood circulation in the lower abdomen, helping disperse stagnation. Traditional use and limited clinical evidence (Level C) support these mechanisms for gynecological conditions involving blood stasis patterns.

Can I take Keishi-bukuryo-gan with blood thinners?

No, Keishi-bukuryo-gan should not be combined with anticoagulant or antiplatelet medications. The formula contains cinnamaldehyde and other compounds with blood-thinning properties that increase bleeding risk when taken with warfarin, aspirin, clopidogrel, or similar drugs. This interaction is well-documented in Kampo literature and poses serious health risks. Patients on blood thinners must avoid this formula entirely and should consult a qualified practitioner for safer alternatives.

What is the typical dosage for Keishi-bukuryo-gan?

Standard Keishi-bukuryo-gan dosage varies by preparation. Commercial Kampo extracts typically provide 2.5-7.5 grams of dried extract daily, divided into 2-3 doses. Traditional decoctions use higher amounts of raw herbs. Dosage should be individualized based on the patient's condition, age, and constitution. This formula requires professional guidance—consult a qualified Kampo or TCM practitioner rather than self-prescribing to ensure appropriate dosing.

Is Keishi-bukuryo-gan safe during pregnancy?

No, Keishi-bukuryo-gan is contraindicated during pregnancy. The formula stimulates uterine contractions and promotes blood circulation in the pelvic region, increasing miscarriage risk. Cinnamon bark and peach kernel are specifically contraindicated in pregnancy in both TCM and Kampo traditions. Pregnant women should avoid this formula entirely. Women trying to conceive should discontinue use immediately if pregnancy is suspected and consult their healthcare provider.

What conditions is Keishi-bukuryo-gan used for?

Keishi-bukuryo-gan is primarily used for gynecological conditions involving blood stasis in TCM and Kampo medicine. Common applications include menstrual pain with clots, endometriosis, uterine fibroids, and pelvic congestion syndrome. It is one of the most frequently prescribed Kampo formulas in Japanese gynecology. The formula addresses lower abdominal pain, menstrual irregularities, and palpable masses. Evidence level C supports its traditional use, indicating benefits are suggested but more rigorous trials are needed.

What are the side effects of Keishi-bukuryo-gan?

Common side effects include gastrointestinal upset, such as nausea or loose stools, primarily from peach kernel content. The formula's blood-thinning effects may cause increased bruising or prolonged bleeding from minor cuts. Uterine stimulation can occur, which is why it is unsafe during pregnancy. Some patients experience mild allergic reactions to cinnamon components. Side effects are generally mild when properly prescribed. Report any unusual symptoms to your practitioner promptly.

Fiche d'information compilée à partir de PubMed

Cette fiche a été compilée à partir de résumés PubMed (NIH) avec l'assistance d'une IA. Chaque affirmation factuelle est citée par un article PubMed réel (voir la liste des sources). Elle n'a pas encore été révisée par un humain — confirmez auprès d'un professionnel de santé avant utilisation.

Compilé à partir de 30 articles PubMed · modèle : gemma4:31b

Résumé

Keishi-bukuryo-gan (KBG) is a traditional Kampo/Chinese herbal formula used primarily to improve blood circulation and treat "oketsu" (blood stasis) syndrome [PMID:13678228, PMID:30262680].

Contexte

Keishi-bukuryo-gan, also known as Gui-zhi-fu-ling-wan, is a traditional herbal remedy consisting of five components: bark of Cinnamomum cassia, root of Paeonia lactiflora, seed of Prunus persica (or P. persiba var. davidiana), carpophores of Poria cocos, and root bark of Paeonia suffruticosa [PMID:1471615, PMID:3143030].

Usages traditionnels

It is used for improving blood circulation [PMID:15070171], treating gynecological disorders such as hypermenorrhea, dysmenorrhea, and sterility [PMID:1471615, PMID:3143030], and managing "oketsu" (blood stasis) syndrome [PMID:13678228].

Mécanisme d'action

KBG may improve endothelial dysfunction [PMID:15070171], limit superoxide generation to preserve endothelium-dependent relaxation [PMID:12237808], and protect red blood cell membranes from free radical-induced oxidation [PMID:12112296]. It has also been observed to decrease plasma calcitonin gene-related peptide (CGRP) levels [PMID:12818465] and act as an LH-RH antagonist and weak anti-estrogen on uterine DNA synthesis in immature rats [PMID:1471615].

Preuves cliniques

Preuve BUterine myomas

Improved hypermenorrhea and dysmenorrhea in >90% of cases, with shrinking of myomas in approximately 60% of cases [PMID:1471615]

Preuve BMenopausal hot flashes

Improved hot flashes, possibly by decreasing plasma CGRP levels [PMID:12818465]; significantly increased blood flow in extremities compared to hormone replacement therapy [PMID:15974485]

Preuve BPost-colorectal surgery ileus

When combined with Dai-ken-chu-to, it significantly reduced time to flatus and time to tolerance of regular diet, and shortened postoperative hospitalization [PMID:15783004]

Preuve DEndometriosis

Decreased specific antiendometrial IgM antibody titers and kept a patient symptom-free for over 7 months [PMID:9834624]

Preuve DAtherosclerosis (Animal Models)

Significantly reduced the surface area of thoracic aorta with visible plaque in cholesterol-fed rabbits [PMID:10353155, PMID:15684487]

Preuve D

Sécurité et effets indésirables

No specific adverse effects are detailed in the provided abstracts, though it was noted to inhibit the starch dextrinizing and protein digestive activity of pancreatin in vitro [PMID:9514607].

Interactions médicamenteuses

In a study of healthy females, administration of 3.75g twice daily for seven days significantly decreased the geometric mean phenotypic index for CYP1A2 by 16% [PMID:22471362].

Synthèse des preuves

Evidence is mixed, consisting primarily of animal models (D), in vitro studies (D), and small-scale clinical trials or case reports (B/D). There is supporting evidence for its use in gynecological and vascular conditions, but large-scale systematic reviews are absent.

Sources PubMed

1.PMID: 34704418 (2021) — Clinical and genetic characteristics of Keishi-Bukuryo-Gan syndrome: an analysis of 5 cases. · Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences
2.PMID: 15070171 (2004) — Effects of Keishi-bukuryo-gan on vascular function and hemorheological factors in spontaneously diabetic (WBN/kob) rats. · Phytomedicine : international journal of phytotherapy and phytopharmacology
3.PMID: 10353155 (1999) — Keishi-bukuryo-gan prevents the progression of atherosclerosis in cholesterol-fed rabbit. · Phytotherapy research : PTR
4.PMID: 1471615 (1992) — Pharmacotherapeutic effects of kuei-chih-fu-ling-wan (keishi-bukuryo-gan) on human uterine myomas. · The American journal of Chinese medicine
5.PMID: 36754204 (2023) — Possible Gynecologic Manifestations of Keishi-Bukuryo-Gan Syndrome: A Case Report.

Keishi-bukuryo-gan

Sources et citations

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