Zhi Sou San
Purported Benefits, Side Effects, and More
Common Names
- Platycodon & Schizonepeta Formula
- Stop coughing powder
- Zhisou powder
For Patients & Caregivers
Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.
What is it?
Zhi Sou San (ZSS) is a traditional Chinese medicine (TCM) formula. It’s made up of seven different herbs.
What are the potential uses and benefits?
Zhi Sou San is used to treat:
- Cough
- Asthma (condition in which airways swell and narrow making it difficult to breathe)
- Chronic obstructive pulmonary disease (lung disease that makes it hard to breathe)
Talk with your healthcare providers before taking herbal formulas. They can interact with some medications and affect how they work. For more information, read the “What else do I need to know?” section below.
What are the side effects?
Side effects have not been reported.
For Healthcare Professionals
Clinical Summary
Zhi Sou San (ZSS) is a traditional Chinese medicine formula with a history of use as a treatment for chronic cough. First described in the classic text, Wan Bing Hui Chun, this formula consists of seven herbs: Platycodon grandiflorum, Schizonepeta, Tatarian Aster root, Stemona root, Willowleaf Swallowwort Rhizome, tangerine peel, and licorice root.
Zhi Sou San is among the commonly used formulas for treating cough (1), asthma (2), and chronic obstructive pulmonary disease (COPD) (3). Meta-analyses reported it to affect greater improvements in cough and pulmonary function (4) and laryngeal cough (5), with fewer adverse effects and lower recurrence rate compared to conventional treatments (4).
A modified Zhi Sou San formula was also found to be superior to conventional medicine in improving post-infectious cough (6).
Large studies with rigorous methodology are needed to strengthen the current evidence.
Purported Uses and Benefits
- Cough
- Asthma
- Chronic obstructive pulmonary disease
Mechanism of Action
Zhi Sou San is thought to exert its anti-asthma effects by regulating inflammatory and immune responses involving IL-17, TNF, Toll-like receptor, MAPK, and T-cell receptor signaling pathways, as well as Th17 cell differentiation (7). It was also found to have anti-airway inflammatory effects by inhibiting TRPA1/TRPV1 channels that regulate neuropeptides to alleviate cough hypersensitivity in a murine model with post-infectious cough (8). In another murine study, ZSS improved symptoms of chronic obstructive pulmonary disease (COPD) and lung function (9).
Adverse Reactions
None reported.
References
- Lin PY, Chu CH, Chang FY, Huang YW, Tsai HJ, Yao TC. Trends and prescription patterns of traditional Chinese medicine use among subjects with allergic diseases: A nationwide population-based study. World Allergy Organ J. 2019;12(2):100001. doi:10.1016/j.waojou.2018.11.001
- Meng FP, et al. Modern literature research on prescription prescription of Chinese medicine for asthma treatment based on Text Mining. China Journal of Traditional Chinese Medicine and Pharmacy. 2105;10:3490–3493.
- Lin TH, Chen SI, Su YC, Lin MC, Lin HJ, Huang ST. Conventional Western Treatment Combined With Chinese Herbal Medicine Alleviates the Progressive Risk of Lung Cancer in Patients With Chronic Obstructive Pulmonary Disease: A Nationwide Retrospective Cohort Study. Front Pharmacol. 2019;10:987.
- Cheng N, Zhu J, Ding P. Clinical Effects and Safety of Zhi Sou San for Cough: A Meta-Analysis of Randomized Trials. Evid Based Complement Alternat Med. 2017;2017:9436352.
- Wang Y, et al. Meta-analysis of zhisou powder in the treatment of laryngeal cough. Asia-Pacific Traditional Medicine. 2017;13(2)
- Jing J, et al. Zhisou san in treatting cough induced by infections based on randomized clinical trials meta-analysis. Chinese Journal of Experimental Traditional medical Formulae. 2013;19(16):343-348.
- Guo DH, Hao JP, Li XJ, Miao Q, Zhang Q. Exploration in the Mechanism of Zhisou San for the Treatment of Cough Variant Asthma Based on Network Pharmacology. Evid Based Complement Alternat Med. 2022;2022:1698571.
- Xu Y, Cao S, Wang SF, Ma W, Gou XJ. Zhisou powder suppresses airway inflammation in LPS and CS-induced post-infectious cough model mice via TRPA1/TRPV1 channels. J Ethnopharmacol. Apr 24 2024;324:117741.
- Gao Z, Li FS, Wang J, et al. [Effect of Modified Zhisou Powder on the lung function of chronic obstructive pulmonary disease model rats of northwest China cold dryness syndrome]. Zhongguo Zhong Xi Yi Jie He Za Zhi. May 2014;34(5):556-61.