- Yun Nan Pai Yao
For Patients & Caregivers
Yunnan Baiyao is a traditional Chinese Medicine formula used for wound healing, as a pain releiver and to stop bleeding. It has not yet been shown to treat cancer.
Yunnan Baiyao (YNBY; “White medicine from the Province of Yunnan” in Mandarin) is a well-known proprietary traditional Chinese medicine product. The original formula is believed to contain several herbs with notoginseng as the major ingredient. It is promoted as a dietary supplement that can be used both externally and internally to stop bleeding and to treat cancer in humans and in animals. It is also claimed to provide relief from minor aches and pains of muscles and joints associated with backache, arthritis, strains, bruises, sprains, and frostbite.
Studies done in the lab and in animals show that YNBY and notoginseng have hemostatic, anti-inflammatory and antimicrobial effects. Notoginseng also demonstrated anticoagulant properties.
Clinical studies suggest that YNBY may be effective in treating bleeding in the uterus, ulcer in the colon and on the skin. It also reduced blood loss during some surgical procedures. Case reports indicate that YNBY reduced bleeding in cancer patients, but it has not been studied as a cancer treatment.
- Stop bleeding
Clinical studies and case reports show that YNBY is useful in decreasing blood loss during some surgical procedures, and in cancer patients.
- Relieve pain and bruises
Although claimed to relieve pain, scientific data are not available to support this use.
YNBY showed anti-inflammatory effects in lab studies. But clinical studies have not been conducted to establish this use in humans.
- Oral health
Lab studies show YNBY can reduce the break down of bone tissues. Human studies are needed to confirm this effect.
YNBY may help to bring relief from pain of frostbite and help promote healing. There are no human data to support this claim.
YNBY has not been studied as a cancer treatment. Case reports show that YNBY may be useful in decreasing blood loss in cancer patients.
- You are taking anticoagulant or antiplatelet drugs: Notoginseng may increase the risk of bleeding when used along with these drugs..
- You are taking drugs that are substrates of CYP3A: Notoginseng may increase the risk of side effects of these drugs.
- You are taking drugs that are substrates of CYP1A2, 2E1 substrates: Notoginseng saponins may decrease the effectiveness of these drugs.
- You are taking drugs that are substrates of Glutathione-S-transferase (GST): Notoginseng may increase the risk of side effects of these drugs.
- You have a bleeding disorder: YNBY can increase the risk of bleeding.
- You are pregnant
For Healthcare Professionals
Yunnan Baiyao (YNBY; “White medicine from the Province of Yunnan” in Mandarin), is among the well-known proprietary traditional Chinese medicine products. It was formulated a century ago and became a popular remedy for wound healing during the Vietnam War. In the last few decades, the trade name YNBY has been expanded into a product line that includes pills, tincture, and toothpaste. The original formula is believed to contain multiple herbs with notoginseng as the main ingredient. It is also promoted as a dietary supplement that can be used both externally and internally to stop bleeding and to treat cancer in humans and in animals. Other claims include relief from minor aches and pains of muscles and joints associated with backache, arthritis, strains, bruises, sprains, and frostbite (1).
In vitro and animal studies indicate that YNBY and notoginseng have hemostatic (2) (3) (4) (5), anti-inflammatory (8) (9) (10) (11) (12) and antimicrobial (5) effects. Notoginseng by itself demonstrated anticoagulant, antiplatelet (6), and fibrinolytic (7) activities.
Clinical studies suggest that YNBY may be effective in treating uterine hemorrhage, ulcerative colitis and skin ulcers (13). It also reduced intraoperative blood loss during transurethral resection of prostate (14) and during oral surgery (15). Case reports indicate that YNBY reduced bleeding in cancer patients (29). But YNBY has not been studied as a cancer treatment.
YNBY demonstrates hemostatic effects when applied topically on open wounds (2). Microscopic examination identified nanofiber components in YNBY which may help to activate blood clotting. This carbon-based nanofiber also acts as a scaffolding for tissue repair and prevents infection by sealing up the wound (4).
An in vitro study on the wound-healing effects of YNBY suggests anti-inflammatory activity through suppression of lymphocyte growth and expression of pro-inflammatory cytokines (11). Another study showed modulation of COX and LOX pathways (30). YNBY extract may be useful for rheumatoid arthritis by activating intracellular prostaglandin E(2) and thromboxane B(2) in osteoblasts (8).
When taken internally, YNBY can improve circulation and reduce swelling and bruises. The effects may be due to the anticoagulant and antiplatelet effects (6) exerted systemically by notoginseng via reduction of fibrinogen in blood (7). Notoginseng also was found to protect endothelial function (19) and vascular integrity by regulating Focal Adhesion Kinase (FAK), integrin expression and NF-kappa B functions (20); and to inhibit vascular intimal hyperplasia by lowering the expression of Proliferating Cell Nuclear Antigen (PCNA), cyclinE, cyclinD1, FN and MMP-9. (21).
YNBY also showed antimicrobial activity. In a Pseudomonas aeruginosa model, a water extract of YNBY reduced bacterial virulence by affecting the quorum-sensing (QS) signaling circuit and by reducing the formation of biofilm (5).
In other studies, notoginsenoside Ft1, a saponin constituent of notoginseng, induced platelet aggregation by binding to platelet P2Y12 receptors (3). It demonstrated anti-inflammatory effects by inhibiting neutrophil function and NO and PGE2 production, through reduced expression of iNOS and COX-2 (10). A study conducted on peritoneal macrophages found that notoginseng inhibits COX-2 expression at an early stage, elevating it at a later stage (22). Data also suggest it can inhibit expression of NF-kappaB activity and TNF-alpha mRNA (12). Notoginseng may play a role in the treatment of periodontal diseases by suppressing MMP-2 expression and by inhibiting breakdown of bone tissue (9). In another study, Ginsenoside-Rd, isolated from notoginseng, has been shown to reduce atherosclerosis by inhibiting LDL uptake and cholesterol accumulation in macrophages (23).
Some studies report that notoginseng and the constituent ginsenosides mimic estrogen (16) by binding and activating the estrogen receptor (18) and ER-alpha pathway (17). In an animal study, notoginseng selectively sensitized tumor cells to radiation (24). However, this effect has not been demonstrated in humans.
- Anticoagulant or antiplatelet drugs: Notoginseng has anticoagulant, antiplatelet (6), and fibrinolytic (7) activities, and may increase the risk of bleeding when used with these drugs.
- CYP3A substrates: Notoginseng saponins can inhibit CYP3A activity and may affect the metabolism of substrate drugs (25).
- CYP1A2, 2E1 substrates: Notoginseng saponins can induce CYP1A2 and may affect the metabolism of substrate drugs (26) (27).
- Glutathione-S-transferase (GST) substrates: Notoginseng inhibits the glutathione-S-transferase activity and may interfere with the metabolism of substrate drugs (28).