The traditional uses, phytochemistry, pharmacology and toxicology of Dictamnus dasycarpus: a review.

OBJECTIVES: Dictamnus dasycarpus is a plant of the Rutaceae family, and its root bark is the main part used as a medicine, named 'Bai-Xian-Pi'. It is used to clear away heat, remove dampness, and dispel wind and also used for detoxification. The purpose of this review is to provide a systematic review about the botany, traditional uses, phytochemistry, pharmacology and toxicology of this plant. KEY FINDINGS: More than 200 compounds have been isolated and identified from the plant, including alkaloids and their glycosides, terpenoids and their derivatives and phenylpropanoids. Extensive pharmacological activities of the extracts or compounds of D. dasycarpus in vivo and in vitro were mainly confirmed, including anti-inflammatory activity, protecting cardiovascular activity, improving liver injury and anti-cancer activity. SUMMARY: In this paper, the botany, traditional uses, phytochemistry and pharmacology of D. dasycarpus were reviewed. In the future, D. dasycarpus needs further study, such as paying more attention to quality control and the utilization on agriculture. In addition, discussing the medicinal components of decoction as well as the toxicity will also contribute to the progress of clinical trial studies.

[Dictamni Cortex powder-induced liver injury based on integrated evidence chain].

A typical clinical case of taking Dictamni Cortex(Baixianpi) powder was analyzed to study liver damage caused by Dictamni Cortex. Liver damage was diagnosed according to the integrated evidence chain method recommended by the Guideline for Diagnosis and Treatment of Herb-Induced Liver Injury. By analyzing clinical history and biochemistry and imaging examinations, underlying diseases, such as viral hepatitis, autoimmune liver disease and alcoholic liver disease, were excluded. Through the investigation of medication history, we made it clear that the patient only took Dictamni Cortex powder during the period, and thus suspected that the liver injury was induced by Dictamni Cortex. Furthermore, the quality of the drug was tested, and the results showed it was consistent with the quality standard of Chinese Pharmacopoeia. DNA barcoding showed that the drug was 100% similar with Dictamnus dasycarpus. Moreover, exogenous harmful substances and chemical drug additions were tested, and the results showed that the content of heavy metal, pesticide residues and microbial toxin were consistent with the required standards, and no chemical drug additions were found in Agilent Fake TCM-Drugs database. In summary, we confirmed that the clinical case of drug-induced liver injury was induced by D. dasycarpus with the dose of 15 g•d⁻¹, which exceeded the prescribed amount of Chinese Pharmacopoeia. According to the Guideline for Diagnosis and Treatment of Herb-Induced Liver Injury, the case of drug-induced liver injury induced by D. dasycarpus was confirmed, which provided a direct and reliable evidence for the study of risk of liver injury induced by D. dasycarpus and its relevant preparations.

Four cases of toxic liver injury associated with Dictamnus dasycarpus / 대한간학회지

We report four cases of toxic hepatitis that occurred after taking a decoction made by boiling down the root of Dictamnus dasycarpus. The four patients had a median age of 60 years, common symptoms of jaundice and general weakness, and stated that they had not consumed alcohol for at least 5 years. The markers of hepatitis A, B, and C were all negative in the patients. Abdominal ultrasonography revealed common bile ducts with normal diameters. Two of the cases were a mother and daughter, and the other two were sporadic. All of them had consumed a decoction made by boiling down the root of Dictamnus dasycarpus five or six times daily until several days before admission. Dictamnus dasycarpus induced liver injury presenting with a benign course lasting less than 1 month after cessation of the causative agent. We suggest that this natural product can cause acute hepatitis in rural areas.