Review of the effects of the traditional Chinese medicine Rehmannia Six Formula on diabetes mellitus and its complications

Journal of Diabetes

Volumn 3, Issue 3, 2011, Pages 184-200

  Poon, Terry Yam Chuen ^a   Ong, Kwok Leung ^a   Cheung, Bernard Man Yung ^a  

^a UNIVERSITY OF HONG KONG   (Hong Kong)

Author keywords

Alisma orientalis; Dioscorea opposita; Fructus Corni; Paeonia suffruticosa; Poria cocos

Indexed keywords

ALISMA EXTRACT; ALISMA ORIENTALIS EXTRACT; ANTIDIABETIC AGENT; CYCLOPHOSPHAMIDE; DIOSCOREA ALATA EXTRACT; DIOSCOREA BATATAS EXTRACT; FRUCTUS CORNI EXTRACT; GINKGO BILOBA EXTRACT; GLUCOCORTICOID; GLUCOSE; PAEONIA SUFFRUTICOSA EXTRACT; PLACEBO; PLANT EXTRACT; PORIA COCOS EXTRACT; PREDNISONE; REHMANNIA GLUTINOSA EXTRACT; REHMANNIA SIX FORMULA; UNCLASSIFIED DRUG;

ALISMA; ANTIINFLAMMATORY ACTIVITY; ANTIOXIDANT ACTIVITY; BODY FAT DISTRIBUTION; CHINESE MEDICINE; CONTACT DERMATITIS; CONTROLLED STUDY; DIABETES MELLITUS; DIABETIC NEPHROPATHY; DIET SUPPLEMENTATION; FOOT ULCER; FUNGUS; GLUCOSE BLOOD LEVEL; HEART INFARCTION; HUMAN; INFLAMMATION; KIDNEY DISEASE; LIVER PROTECTION; MEDICAL LITERATURE; NEUROPATHY; NONHUMAN; OXIDATIVE STRESS; PAEONIA SUFFRUTICOSA; PLANTAGO; PORIA COCOS; PRIORITY JOURNAL; RANDOMIZATION; REHMANNIA; REVIEW; SAMPLE SIZE; TABLET; TREATMENT DURATION; YAM;

EID: 80051809458     PISSN: 17530393     EISSN: 17530407     Source Type: Journal    
DOI: 10.1111/j.1753-0407.2011.00130.x     Document Type: Review

References (59)

1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: Estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27: 1047-53.
2. Oxford Centre for Evidence-based Medicine. Available from: (accessed 20 August 2010).
3. US Preventive Services Task Force Evidence Syntheses. Available from: (accessed 20 August 2010).
4. Fuchs SM, Heinemann C, Schliemann-Willers S, Härtl H, Fluhr JW, Elsner P. Assessment of anti-inflammatory activity of Poria cocos in sodium lauryl sulphate-induced irritant contact dermatitis. Skin Res Technol. 2006; 12: 223-7.
5. Hur GY, Park HJ, Kim HA, Ye YM, Park HS. Identification of Dioscorea batatas (sanyak) allergen as an inhalant and oral allergen. J Korean Med Sci. 2008; 23: 72-6.
6. Wang XX, Sun ZL, Yu JY. Effect of Liuwei Dihuang soft capsule and Ginkgo leaf tablet on serum regulated upon activation, normal T cell expressed and secreted in patients with diabetes mellitus Type 2. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2007; 27: 315-7 (in Chinese with an English abstract).
7. Song XY, Chen Q, Qi XY. Effect of liuwei dihuang pill on erythrocyte aldose reductase activity in early diabetic nephropathy patients. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004; 24: 1087-90 (in Chinese with an English abstract).
8. Hu SJ, Fang Q, Liu JS, Zhang L, Cao EZ. Clinical study on intervention of liuwei dihuang pill on hormonotherapy in treating nephrotic syndrome. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005; 25: 107-10 (in Chinese with an English abstract).
9. Zheng WC, Hu SJ, Fang Q. Intervention of liuwei dihuang pill on lupus nephropathy treated with cylophosphamide and glucocorticoids. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2005; 25: 983-5 (in Chinese with an English abstract).
10. Wang Y, Liu L, Hu C, Cheng Y. Effects of Salviae Mitiorrhizae and Cortex Moutan extract on the rat heart after myocardial infarction: A proteomic study. Biochem Pharmacol. 2007; 74: 415-24.
11. Xue YM, Luo R, Zhu B, Zhang Y, Pan YH, Li CZ. Effects of liuwei dihuang pills on expressions of apoptosis-related genes bcl-2 and Bax in pancreas of OLETF rats. Zhong Xi Yi Jie He Xue Bao. 2005; 3: 455-8 (in Chinese with an English abstract).
12. Qian Y, Xue YM, Li J. Effects of Liuweidihuang pills on plasma adiponectin level in OLETF rats. Nan Fang Yi Ke Da Xue Xue Bao. 2008; 28: 34-6 (in Chinese with an English abstract).
13. Wu YC, Hsu JH, Liu IM, Liou SS, Su HC, Cheng JT. Increase of insulin sensitivity in diabetic rats received die-huang-wan, a herbal mixture used in Chinese traditional medicine. Acta Pharmacol Sin. 2002; 23: 1181-7.
14. Liou SS, Liu IM, Hsu SF, Cheng JT. Corni fructus as the major herb of Die-Huang-Wan for lowering plasma glucose in Wistar rats. J Pharm Pharmacol. 2004; 56: 1443-7.
15. Hong X, Tang H, Wu L, Li L. Protective effects of the Alisma orientalis extract on the experimental nonalcoholic fatty liver disease. J Pharm Pharmacol. 2006; 58: 1391-8.
16. Zhang R, Zhou J, Jia Z, Zhang Y, Gu G. Hypoglycemic effect of Rehmannia glutinosa oligosaccharide in hyperglycemic and alloxan-induced diabetic rats and its mechanism. J Ethnopharmacol. 2004; 90: 39-43.
17. Lv XF, Meng QY, Guo XM. Effect of Rehmannia glutinosa water extraction on insulin resistance and gene expression of resistin in Type 2 diabetes mellitus rats. Zhongguo Zhong Yao Za Zhi. 2007; 32: 2182-4 (in Chinese with an English abstract).
18. Jeon JR, Lee JS, Lee CH, Kim JY, Kim SD, Nam DH. Effect of ethanol extract of dried Chinese yam (Dioscorea batatas) flour containing dioscin on gastrointestinal function in rat model. Arch Pharm Res. 2006; 29: 348-53.
19. Xue YM, Luo R, Zhu B, Zhang Y, Pan YH, Li CZ. Liuweidihuang pills reduces visceral fat deposition in Otsuka Long-Evans Tokushima Fatty rats. Nan Fang Yi Ke Da Xue Xue Bao. 2006; 26: 1446-8 (in Chinese with an English abstract).
20. Lau TW, Lam FF, Lau KM et al. Pharmacological investigation on the wound healing effects of Radix Rehmanniae in an animal model of diabetic foot ulcer. J Ethnopharmacol. 2009; 123: 155-62.
21. Lau TW, Sahota DS, Lau CH, Chan CM, Lam FC et al. An in vivo investigation on the wound-healing effect of two medicinal herbs using an animal model with foot ulcer. Eur Surg Res. 2008; 41: 15-23.
22. Shon YH, Nam KS. Protective effect of Moutan Cortex extract on acetaminophen-induced hepatotoxicity in mice. J Ethnopharmacol. 2004; 90: 415-9.
23. Lee SC, Tsai CC, Chen JC et al. Effects of "Chinese yam" on hepato-nephrotoxicity of acetaminophen in rats. Acta Pharmacol Sin. 2002; 23: 503-8.
24. Lee SC, Tsai CC, Chen JC, Lin CC, Hu ML, Lu S. The evaluation of reno- and hepatoprotective effects of huai-shan-yao (Rhizome Dioscoreae). Am J Chin Med. 2002; 30: 609-16.
25. Liou CJ, Tseng J. A Chinese herbal medicine, fu-ling, regulates interleukin-10 production by murine spleen cells. Am J Chin Med. 2002; 30: 551-60.
26. Waisundara VY, Huang M, Hsu A, Huang D, Tan BK. Characterization of the anti-diabetic and antioxidant effects of Rehmannia glutinosa in streptozotocin-induced diabetic Wistar rats. Am J Chin Med. 2008; 36: 1083-104.
27. Fang J, Zhang YX, Ru XB, Wei XL. Effect of liuwei dihuang decoction, on the cytokine expression in splenocytes in AA rats. Zhongguo Zhong Yao Za Zhi. 2001; 26: 128-31 (in Chinese with an English abstract).
28. Huang LM, Shi XQ, Liang H. Effects of Radix Astragali and Fructus Corni on urinary protein pattern in nephropathy mice by microfluidic chip. Zhongguo Zhong Yao Za Zhi. 2007; 32: 1324-8 (in Chinese with an English abstract).
29. Yokozawa T, Kim HY, Yamabe N. Amelioration of diabetic nephropathy by dried Rehmanniae Radix (Di Huang) extract. Am J Chin Med. 2004; 32: 829-39.
30. Kang DG, Sohn EJ, Moon MK, Lee YM, Lee HS. Rehmannia glutinose ameliorates renal function in the ischemia/reperfusion-induced acute renal failure rats. Biol Pharm Bull. 2005; 28: 1662-7.
31. Lee BC, Choi JB, Cho HJ, Kim YS. Rehmannia glutinosa ameliorates the progressive renal failure induced by 5/6 nephrectomy. J Ethnopharmacol. 2009; 122: 131-5.
32. Liu HR, Tang XY, Dai DZ, Dai Y. Ethanol extracts of Rehmannia complex (Di Huang) containing no Corni fructus improve early diabetic nephropathy by combining suppression on the ET-ROS axis with modulate hypoglycemic effect in rats. J Ethnopharmacol. 2008; 118: 466-72.
33. Lee KS, Lim BV, Chang HK et al. Liuweidihuang-tang improves spatial memory function and increases neurogenesis in the dentate gyrus in rats. Fitoterapia. 2005; 76: 514-9.
34. Yang S, Zhou W, Zhang Y, Yan C, Zhao Y. Effects of Liuwei Dihuang decoction on ion channels and synaptic transmission in cultured hippocampal neuron of rat. J Ethnopharmacol. 2006; 106: 166-72.
35. Chang SJ, Lee YC, Liu SY, Chang TW. Chinese yam (Dioscorea alata cv. Tainung No. 2) feeding exhibited antioxidative effects in hyperhomocysteinemia rats. J Agric Food Chem. 2004; 52: 1720-5.
36. Jung CH, Zhou S, Ding GX et al. Antihyperglycemic activity of herb extracts on streptozotocin-induced diabetic rats. Biosci Biotechnol Biochem. 2006; 70: 2556-9.
37. Gao X, Li B, Jiang H, Liu F, Xu D, Liu Z. Dioscorea opposita reverses dexamethasone induced insulin resistance. Fitoterapia. 2007; 78: 12-5.
38. Rau O, Wurglics M, Dingermann T, Abdel-Tawab M, Schubert-Zsilavecz M. Screening of herbal extracts for activation of the human peroxisome proliferator-activated receptor. Pharmazie. 2006; 61: 952-6.
39. Choi HJ, Kim NJ, Kim DH. Inhibitory effects of crude drugs on alpha-glucosidase. Arch Pharm Res. 2000; 23: 261-6.
40. Chen CC, Hsu CY, Chen CY, Liu HK. Fructus Corni suppresses hepatic gluconeogenesis related gene transcription, enhances glucose responsiveness of pancreatic beta-cells, and prevents toxin induced beta-cell death. J Ethnopharmacol. 2008; 117: 483-90.
41. Lau CH, Chan CM, Chan YW et al. In vitro antidiabetic activities of five medicinal herbs used in Chinese medicinal formulae. Phytother Res. 2008; 22: 1384-8.
42. Guo XN, Zhang RX, Jia ZP, Li MX, Wang J. Effects of Rehmannia glutinosa oligosaccharides on proliferation of 3T3-L1 adipocytes and insulin resistance. Zhongguo Zhong Yao Za Zhi. 2006; 31: 403-7 (in Chinese with an English abstract).
43. Meng QY, Lv XF, Jin XD. Effect of Rehmannia glutinosa Libosch water extraction on gene expression of proinsulin in Type 2 diabetes mellitus rats. Zhong Yao Cai. 2008; 31: 397-9 (in Chinese with an English abstract).
44. Jiang L, Zhang NX, Mo W et al. Rehmannia inhibits adipocyte differentiation and adipogenesis. Biochem Biophys Res Commun. 2008; 371: 185-90.
45. Shon YH, Nam KS. Protective effect of moutan cortex extract on acetaminophen-induced cytotoxicity in human Chang liver cells. Biol Pharm Bull. 2002; 25: 1427-31.
46. Shen JJ, Lin CJ, Huang JL, Hsieh KH, Kuo ML. The effect of liu-wei-di-huang wan on cytokine gene expression from human peripheral blood lymphocytes. Am J Chin Med. 2003; 31: 247-57.
47. Chun SC, Jee SY, Lee SG, Park SJ, Lee JR, Kim SC. Anti-inflammatory activity of the methanol extract of moutan cortex in LPS-activated Raw264.7 cells. Evid Based Complement Alternat Med. 2007; 4: 327-33.
48. Oh GS, Pae HO, Choi BM et al. Inhibitory effects of the root cortex of Paeonia suffruticosa on interleukin-8 and macrophage chemoattractant protein-1 secretions in U937 cells. J Ethnopharmacol. 2003; 84: 85-9.
49. Chung HS, Kang M, Cho C et al. Inhibition of nitric oxide and tumor necrosis factor-alpha by moutan cortex in activated mouse peritoneal macrophages. Biol Pharm Bull. 2007; 30: 912-6.
50. Szeto YT, Lei PC, Ngai KL et al. An in vitro study of the antioxidant activities and effect on human DNA of the Chinese herbal decoction "Liu Wei Di Huang". Int J Food Sci Nutr. 2009; 31: 1-6.
51. Rho S, Chung HS, Kang M et al. Inhibition of production of reactive oxygen species and gene expression profile by treatment of ethanol extract of Moutan Cortex Radicis in oxidative stressed PC12 cells. Biol Pharm Bull. 2005; 28: 661-6.
52. Liu F, Ng TB. Antioxidative and free radical scavenging activities of selected medicinal herbs. Life Sci. 2000; 66: 725-35.
53. Okubo T, Nagai F, Seto T, Satoh K, Ushiyama K, Kano I. The inhibition of phenylhydroquinone-induced oxidative DNA cleavage by constituents of Moutan Cortex and Paeoniae Radix. Biol Pharm Bull. 2000; 23: 199-203.
54. Sekiya N, Goto H, Shimada Y, Endo Y, Sakakibara I, Terasawa K. Inhibitory effects of triterpenes isolated from Hoelen on free radical-induced lysis of red blood cells. Phytother Res. 2003; 17: 160-2.
55. Wu SJ, Ng LT, Lin CC. Antioxidant activities of some common ingredients of traditional chinese medicine, Angelica sinensis, Lycium barbarum and Poria cocos. Phytother Res. 2004; 18: 1008-12.
56. Shin SW, Park CI, Yang CH, Park JW. Protective effect of Rehmannia glutinosa on the UV-induced apoptosis in U937 cells. Am J Chin Med. 2008; 36: 1159-70.
57. Yu HH, Kim YH, Jung SY et al. Rehmannia glutinosa activates intracellular antioxidant enzyme systems in mouse auditory cells. Am J Chin Med. 2006; 34: 1083-93.
58. Yu HH, Seo SJ, Kim YH et al. Protective effect of Rehmannia glutinosa on the cisplatin-induced damage of HEI-OC1 auditory cells through scavenging free radicals. J Ethnopharmacol. 2006; 107: 383-8.
59. Hou WC, Hsu FL, Lee MH. Yam (Dioscorea batatas) tuber mucilage exhibited antioxidant activities in vitro. Planta Med. 2002; 68: 1072-6.