Chinese Journal of Integrative Medicine

, Volume 16, Issue 5, pp 472–479 | Cite as

The effect of Baihu Decoction (白虎汤) on blood glucose levels in treating systemic inflammatory response syndrome

  • Fang Yang (杨 昉)
  • Chen Hou (侯 沉)


In this paper we investigated the mechanisms of Baihu Decoction ((白虎汤, BH) and Baihu with Radix Ginseng (BHG) in treating systemic inflammatory response syndrome (SIRS) and sepsis in humans and animals. By reviewing published data on the effects of BH and BHG and the control of blood glucose in treating SIRS and sepsis, we found that (1) BH and BHG were beneficial in the treatment of SIRS and sepsis in humans and animals; (2) BH and BHG also had great effect in lowering blood glucose level; and (3) the tight control of blood glucose during critical illness substantially improved the outcome. Considering these data together, we hypothesize that one of the major mechanisms of BH and BHG in treating SIRS and sepsis is to lower the blood glucose level. The findings also suggest that the application of BH and BHG can extend to many acute illnesses and injuries, which commonly cause hyperglycemia.


Baihu Decoction mechanism hyperglycemia critical illness blood glucose control 


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  1. 1.
    Zhang Z. Treatise on febrile diseases caused by cold with 500 cases. 1st ed. Beijing: Chinese Bookstore Publishing House; 1993:65.Google Scholar
  2. 2.
    Li T, Li Y. Modern explanations of treatise on febrile diseases caused by cold. 1st ed. Xi’an: The Fourth Military Medicine University Publishing House; 2003:262–266.Google Scholar
  3. 3.
    Deng Z. Traditional Chinese medical formulae. 1st ed. Beijing: China Press of Traditional Chinese Medicine: 2003:93.Google Scholar
  4. 4.
    Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus WA, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101:1644–1655.CrossRefPubMedGoogle Scholar
  5. 5.
    Balk RA. Severe sepsis and septic shock. Definitions, epidemiology, and clinical manifestations. Crit Care Clin 2000;16:179–192.CrossRefPubMedGoogle Scholar
  6. 6.
    Levi M, Keller TT, van Gorp E, ten Cate H. Infection and inflammation and the coagulation system. Cardiovasc Res 2003;60:26–39.CrossRefPubMedGoogle Scholar
  7. 7.
    Trager K, DeBacker D, Radermacher P. Metabolic alterations in sepsis and vasoactive drug-related metabolic effects. Curr Opin Crit Care 2003;9:271–278.CrossRefPubMedGoogle Scholar
  8. 8.
    Cunneen J, Cartwright M. The puzzle of sepsis: fitting the pieces of the inflammatory response with treatment. AACN Clin Issues 2004;15:18–44.CrossRefPubMedGoogle Scholar
  9. 9.
    Balk RA. Pathogenesis and management of multiple organ dysfunction or failure in severe sepsis and septic shock. Crit Care Clin 2000;16:337–352.CrossRefPubMedGoogle Scholar
  10. 10.
    Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001;29:1303–1310.CrossRefPubMedGoogle Scholar
  11. 11.
    Angus DC, Wax RS. Epidemiology of sepsis: an update. Crit Care Med 2001;29(Suppl):S109–S116.CrossRefPubMedGoogle Scholar
  12. 12.
    An L. Clinical study of Baihu Decoction in treatment of 47 patients with hemorrhagic fever with renal syndrome. Hebei J Tradit Chin Med (Chin) 2003;25:599–600.Google Scholar
  13. 13.
    Jiang C. Clinical effects of traditional Chinese medicine syndrome differ classification treatment of systemic inflammatory response syndrome. Chin J Integr Tradit West Med Intens Crit Care (Chin) 2004;11:245–247.Google Scholar
  14. 14.
    Shu Y. Clinical study of Baihu Decoction in treatment of 78 patients with epidemic encephalitis B. J Hunan Coll Tradit Chin Med (Chin) 1993;13:34–35.Google Scholar
  15. 15.
    Sun S. The experimental study of Baihu Decoction in treating acute febrile disease’s qi-phase syndrome. Master Thesis (Fujian Traditional Chinese Medicien College, Fujian, China), 2004.Google Scholar
  16. 16.
    Zhao C, Li X, Zhang K, Jin R, Gou C, Hu Z, et al. Randomized control study of integrated traditional Chinese and Western medicine in treatment of 77 patients with SARS. Chin J Integr Tradit West Med Intens Crit Care (Chin) 2003;10:197–200.Google Scholar
  17. 17.
    Wen X, Mao P. Review of mechanism of Baihu Decoction in lowering body temperature. Shanghai J Tradit Chin Med (Chin) 1994;1:45–46.Google Scholar
  18. 18.
    van den Berghe G, Wouters P, Weekers F, C Verwaest, F Bruyninckx, M Schetz, et al. Intensive insulin therapy in critically ill patients. N Engl J Med 2001;345:1359–1367.CrossRefPubMedGoogle Scholar
  19. 19.
    van den Berghe G. How does blood glucose control with insulin save lives in intensive care? J Clin Invest 2004;114:1187–1195.PubMedGoogle Scholar
  20. 20.
    Wu Z. Epidemiology: Integrated Chinese traditional medicine and Western medicine. 1st ed. Beijing: Chinese Press of Traditional Chinese Medicine; 2001:50–57, 63–74.Google Scholar
  21. 21.
    Cui J. The applying of Baihu Decoction in hyperpyrexia acute disease. Hubei J Tradit Chin Med (Chin) 1998;22(2):44.Google Scholar
  22. 22.
    Chinese Medical Association and China Association of Traditional Chinese Medicine. Scheme of diagnosis and treatment of SARS. Chin J Clin Assemb 2003;83:1745–1746.Google Scholar
  23. 23.
    Liu F. Mechanisms of Chinese medicine herbs’ effect of clearing heat. Chin J Chin Materia Med (Chin) 1997;22:506–508.Google Scholar
  24. 24.
    Boord JB, Graber AL, Christman JW, Powers AC. Practical management of diabetes in critically ill patients. Am J Respir Crit Care Med 2001;164(Pt 1):1763–1767.PubMedGoogle Scholar
  25. 25.
    Douglas RG, Shaw JH. Metabolic response to sepsis and trauma. Br J Surg 1989;76:115–122.CrossRefPubMedGoogle Scholar
  26. 26.
    Robinson LE, van Soeren MH. Insulin resistance and hyperglycemia in critical illness: role of insulin in glycemic control. AACN Clin Issues 2004;15:45–62.CrossRefPubMedGoogle Scholar
  27. 27.
    Umpierrez GE, Isaacs SD, Bazargan N, You X, Thaler LM, Kitabchi AE. Hyperglycemia: an independent marker of inhospital mortality in patients with undiagnosed diabetes. J Clin Endocrinol Metab 2002;87:978–982.CrossRefPubMedGoogle Scholar
  28. 28.
    Andersen SK, Gjedsted J, Christiansen C, Tonnesen E. The roles of insulin and hyperglycemia in sepsis pathogenesis. J Leukoc Biol 2004;75:413–421.CrossRefPubMedGoogle Scholar
  29. 29.
    Sasaki K, Hashida K, Michigami T, Bannai S, Makino N. Restored vulnerability of cultured endothelial cells to high glucose by iron replenishment. Biochem Biophys Res Commun 2001;289:664–669.CrossRefPubMedGoogle Scholar
  30. 30.
    Maedler K, Sergeev P, Ris F. Glucose-induced beta cell production of IL-1beta contributes to glucotoxicity in human pancreatic islets. J Clin Invest 2002;110:851–860.PubMedGoogle Scholar
  31. 31.
    Baird TA, Parsons MW, Phanh T. Persistent poststroke hyperglycemia is independently associated with infarct expansion and worse clinical outcome. Stroke 2003;34:2208–2214.CrossRefPubMedGoogle Scholar
  32. 32.
    Bolk J, van der Ploeg T, Cornel JH, Arnold AE, Sepers J, Umans VA. Impaired glucose metabolism predicts mortality after a myocardial infarction. Int J Cardiol 2001;79:207–214.CrossRefPubMedGoogle Scholar
  33. 33.
    Capes SE, Hunt D, Malmerg K, Gerstein HC. Stress hyperglycemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet 2000;355:773–778.CrossRefPubMedGoogle Scholar
  34. 34.
    Gore DC, Chinkes D, Heggers J, Herndon DN, Wolfe SE, Desai M. Association of hyperglycemia with increased mortality after severe burn injury. J Trauma 2001;51:540–544.CrossRefPubMedGoogle Scholar
  35. 35.
    Kagansky N, Levy S, Knobler H. The role of hyperglycemia in acute stroke. Arch Neurol 2001;58:1209–1212.CrossRefPubMedGoogle Scholar
  36. 36.
    Krinsley JS. Association between hyperglycemia and increased hospital mortality in a heterogeneous population of critically ill patients. Mayo Clin Proc 2003;78:1471–1478.CrossRefPubMedGoogle Scholar
  37. 37.
    Ljungqvist O, Nygren J, Thorell A. Insulin resistance and elective surgery. Surgery 2000;128:757–760.CrossRefPubMedGoogle Scholar
  38. 38.
    McAlister FA, Man J, Bistritz L, Amad H, Tandon P. Diabetes and coronary artery bypass surgery: an examination of perioperative glycemic control and outcomes. Diabetes Care 2003;26:1518–1524.CrossRefPubMedGoogle Scholar
  39. 39.
    Ong TZ, Raymond AA. Risk factors for stroke and predictors of one-month mortality. Singapore Med J 2002;43:517–521.PubMedGoogle Scholar
  40. 40.
    Parsons MW, Barber PA, Desmond PM, Baird TA, Darby DG, Byrnes G. Acute hyperglycemia adversely affects stroke outcome: a magnetic resonance imaging and spectroscopy study. Ann Neurol 2002;52:20–28.CrossRefPubMedGoogle Scholar
  41. 41.
    Williams LS, Rotich J, Qi R, Fineberg N, Espay A, Bruno A. Effects on admission hyperglycaemia on mortality and costs in acute ischemic stroke. Neurology 2002;59:67–71.PubMedGoogle Scholar
  42. 42.
    McCowen KC, Malhotra A, Bistrian BR. Stress-induced hyperglycemia. Crit Care Clin 2001;17:107–124.CrossRefPubMedGoogle Scholar
  43. 43.
    Malhotra A. Intensive insulin in intensive care. N Engl J Med 2006;354:516–518.CrossRefPubMedGoogle Scholar
  44. 44.
    Finney SJ, Zekveld C, Elia A, Evans TW. Glucose control and mortality in critically ill patients. JAMA 2003;290:2041–2047.CrossRefPubMedGoogle Scholar
  45. 45.
    Van den Berghe G. Outcome benefit of intensive insulin therapy in the critically ill: insulin dose versus glycemic control. Crit Care Med 2003;31:359–366.CrossRefPubMedGoogle Scholar
  46. 46.
    He R. Synopsis of prescriptions of the gold chamber (collate and annotation). 1st ed. Beijing: People’s Medical Publishing House; 2003:23–24.Google Scholar
  47. 47.
    Chen J, Wan L, Dong X, Yang Q, Xiao W. Clinical observation of Bai-Hu-Ren-Shen Decoction to improve insulin resistance of type 2 diabetes mellitus. J Liaoning Coll Tradit Chin Med (Chin) 2005;2:138–139.Google Scholar
  48. 48.
    Chen W, Wang L. Clinical study of Bai-Hu-Ren-Shen Decoction in treatment of 30 patients with type II diabetes. Fujian J Tradit Chin Med (Chin) 2006; 37(4):40.Google Scholar
  49. 49.
    Xie C, Tan Y. Clinical study of Bai-Hu-Ren-Shen Decoction in treatment of 20 patients with type II diabetes. J Chengdu Univ Tradit Chin Med (Chin) 2002;25(4):23–24.Google Scholar
  50. 50.
    Wu C, Xin J. Clinical study of combination of Bai-Hu-Ren-Shen Decoction and conventional therapy in treatment of 51 patients with type II diabetes. Chin Commun Doctors 2006;3:37.Google Scholar
  51. 51.
    Wu S, Meng Q. Clinical study of modified Baihu Decoction in treatment of diabetes. J Tradit Chin Med Henan (Chin) 1994;14(5):266–268.Google Scholar
  52. 52.
    Dai J, Zheng J, Huang J, Jiang J, Xu S. Experimental study of Renshen Baihu Decoction on models of diabetic rats. J Fujian Coll Tradit Chin Med (Chin) 2001;11(3): 49–52.Google Scholar
  53. 53.
    Kimura I, Nakashima N, Sugihara Y, Chen F, Kimura M. The antihyperglycemic blend effect of traditional Chinese medicine Byakko-ka-ninjin-to on alloxan and diabetic KKCAy mice. Phytotherapy Res 1999;13:484–488.CrossRefGoogle Scholar
  54. 54.
    Okumura M, Suzuki K, Yamaura K, Uchiyama M, Nakayama S, Oguchi K. Antidiabetic effects of Kampo medicines in a non-insulin-dependent diabetes mellitus model using KK-Ay mice. J Tradit Med 2001;18(2): 81–88.Google Scholar
  55. 55.
    Yang L. Review of pharmacological actions of wind-weed Rhizome. Foreign Med Sci, Tradit Chin Med Sect (Chin) 2002;24:207–210.Google Scholar
  56. 56.
    Ni L, Qin M. Review of studies of pharmacology of wind-weed Rhizome. Chin Wild Plant Resources 2005;24(4):16–20.Google Scholar
  57. 57.
    Miura T, Ichiki H, Iwamoto N, Kato M, Kubo M, Sasaki H, et al. Antidiabetic activity of the rhizoma of Anemarrhena asphodeloides and active components, mangiferin and its glucoside. Biol Pharm Bull 2001;24:1009–1011.CrossRefPubMedGoogle Scholar
  58. 58.
    Shen Y. Pharmacology of traditional Chinese medicine. Beijing: People’s Medical Publishing House; 2000:281.Google Scholar
  59. 59.
    Fan Q. Experimental study of compatibility of medicines theory. J Nanjing Univ Tradit Chin Med (Chin) 1995;11(2):30–32.Google Scholar
  60. 60.
    Lewis KS, Kane-Giu SL, Blbek MB, Dasta JF. Intensive insulin therapy for critically ill patients. Ann Pharmacother 2004;38(7–8):1243–1251.PubMedGoogle Scholar
  61. 61.
    McGuinness O. Defective glucose homeostasis during infection. Ann Rev Nutr 2005;25:9–25.CrossRefGoogle Scholar
  62. 62.
    van den Berghe G, Wouters P, Weekers F, Mohan S, Baxter RC, Veldhuis J, et al. Reactivation of pituitary hormone release and metabolic improvement by infusion of growth hormone-releasing peptide and thyrotropin-releasing hormone in patients with protracted critical illness. J Clin Endocrinol Metab 1999;84:1311–1323.CrossRefPubMedGoogle Scholar
  63. 63.
    Chen X, Gao H, Cai X, Fan R, Pan S, Cai Y, et al. Application of modified Baihu Decoction in treatment of infective fever after renal transplantation. Chin J Integr Tradit West Med Intens Crit Care (Chin) 2004;11:173–175.Google Scholar
  64. 64.
    Black E, Vibe-Petersen J, Jorgensen L, Madsen S, Argen M, Holstein P. Decrease of collagen deposition in wound repair in type 1 diabetes independent of glycemic control. Arch Surg 2003;138:34–40.CrossRefPubMedGoogle Scholar
  65. 65.
    L’Ecuyer PB, Murphy D, Little J, Fraser V. The epidemiology of chest and leg wound infections following cardiothoracic surgery. Clin Infect Dis 1996;22:424–429.PubMedGoogle Scholar
  66. 66.
    Port D, Schwartz M. Diabetes complications: why is glucose potentially toxic? Science 1996;272:699–700.CrossRefGoogle Scholar
  67. 67.
    Zacharias A, Habib R. Factors predisposing to median sternotomy complications. Deep vs superficial infection. Chest 1996;110:1173–1178.CrossRefPubMedGoogle Scholar
  68. 68.
    Weekers F, Giulietti AP, Michalaki M, Coopmans W, van Herck E, Mathieu C, et al. Metabolic, endocrine, and immune effects of stress hyperglycemia in a rabbit model of prolonged critical illness. Endocrinology 2003;144:5329–5338.CrossRefPubMedGoogle Scholar

Copyright information

© Chinese Association of the Integration of Traditional and Western Medicine and Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.College of Basic Medical ScienceChengdu University of Traditional Chinese MedicineChengduChina
  2. 2.Department of Systems and Computational BiologyAlbert Einstein College of MedicineBronxUSA

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