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Pericarpium Trichosanthes

Also known as: Pericarpium Trichosanthes, Trichosanthes pericarp, Chinese cucumber peel, Tian Hua Fen, Trichosanthes kirilowii Maxim.

Overview

Pericarpium Trichosanthes is the dried outer peel (pericarp) of the fruit of *Trichosanthes kirilowii*, a plant widely utilized in Traditional Chinese Medicine (TCM). It is harvested from the mature fruit and processed into various forms, including extracts and powders. Traditionally, it has been employed for cardiovascular health, improving microcirculation, and addressing respiratory conditions. Modern research, including some randomized controlled trials and meta-analyses, focuses on its potential to improve cardiac function, particularly after acute myocardial infarction (AMI), and its role in lipid metabolism. The supplement contains bioactive compounds such as trichosanthin and other saponins, which are believed to contribute to its vascular and anti-inflammatory effects. While evidence is emerging, more rigorous, large-scale studies are needed to fully establish its efficacy and safety.

Benefits

Pericarpium Trichosanthes primarily offers cardiovascular benefits, particularly for patients recovering from acute myocardial infarction (AMI). A controlled clinical study demonstrated that its extract significantly improved coronary microcirculation and increased left ventricular ejection fraction (LVEF) from 56.6% to 62.1% (p < 0.001) in AMI patients post-primary PCI, alongside a reduction in major adverse cardiovascular events (MACEs) at 6 months. Another clinical study, combining Pericarpium Trichosanthis injection with nicorandil, showed significant improvements in lipid profiles, specifically reducing LDL (OR 0.30) and triglycerides (OR 0.57), and enhancing cardiac output (OR 1.83). These improvements suggest clinically meaningful cardiovascular benefits. Secondary effects include potential anti-inflammatory properties, indicated by a reduction in biomarkers like BNP, although CRP reduction was not statistically significant in one study. The benefits are most evident in AMI patients undergoing percutaneous coronary intervention, with effects observed within 6 months of treatment initiation. The strength of evidence is moderate, with several RCTs and meta-analyses supporting these findings.

How it works

The mechanism of action for Pericarpium Trichosanthes is believed to involve several pathways, primarily focusing on cardiovascular health. It is thought to improve coronary microcirculation, which is crucial for restoring blood flow to damaged heart tissue after events like acute myocardial infarction. The active compounds, including trichosanthin and various saponins, likely contribute to these effects by exerting vasodilatory, anti-inflammatory, and lipid-lowering actions. While specific molecular targets are not fully elucidated, these compounds interact with the cardiovascular system, particularly myocardial tissue and the vascular endothelium, to reduce ischemic injury and modulate lipid metabolism. Specific pharmacokinetic data regarding absorption and bioavailability are limited, but traditional preparations are often aqueous extracts.

Side effects

Pericarpium Trichosanthes appears to be generally well tolerated in clinical studies, with no major adverse events reported in the cited trials. Common side effects are not well documented, and traditional use suggests a low toxicity profile. Data regarding uncommon or rare side effects are insufficient to characterize. In terms of drug interactions, studies have investigated its use in combination with cardiovascular drugs like nicorandil, and no significant safety issues were reported in these combined therapies. Contraindications are not clearly defined, but caution is advised for patients with severe cardiac conditions, and its use should always be under medical supervision. There is limited data available concerning its safety in special populations such as pregnant women, children, or individuals with hepatic or renal impairment, warranting caution in these groups.

Dosage

The optimal dosage for Pericarpium Trichosanthes is not yet standardized and requires further research. Clinical studies have utilized extract doses in combination with standard care, but precise dosing details are often not fully disclosed. Currently, clinical trials employ formulations standardized to active components rather than specific raw herb quantities. A minimum effective dose and maximum safe dose have not been definitively established. In clinical settings, it has been administered post-PCI in AMI patients, with follow-up periods extending over 6 months. While extracts or injections are used in clinical trials, traditional use often involves decoctions. Information regarding absorption factors and bioavailability is currently lacking. It is frequently used as an adjunctive therapy, often combined with standard cardiovascular treatments, such as nicorandil.

FAQs

Is Pericarpium Trichosanthes safe for heart patients?

Clinical studies suggest it is safe and beneficial when used as an adjunct therapy post-acute myocardial infarction (AMI) under medical supervision, showing no major adverse events.

How soon can benefits be expected?

Improvements in cardiac function, such as increased left ventricular ejection fraction and better microcirculation, have been observed within 6 months of treatment initiation.

Can it be used alone?

Current evidence primarily supports its use as an adjunctive therapy alongside standard medical treatments, rather than as a standalone monotherapy.

Does it interact with other heart medications?

No significant adverse interactions have been reported when used in combination with drugs like nicorandil in clinical studies, suggesting compatibility with some cardiovascular medications.

Research Sources

  • https://pmc.ncbi.nlm.nih.gov/articles/PMC10794635/ – This randomized controlled trial investigated the effect of Trichosanthes pericarpium extract (TPE) in AMI patients post-PCI. It found that TPE significantly improved coronary microcirculation, increased left ventricular ejection fraction, and reduced major adverse cardiovascular events at 6 months, indicating its potential as an adjunctive therapy.
  • https://pmc.ncbi.nlm.nih.gov/articles/PMC10758601/ – This meta-analysis, utilizing logistic regression, examined the combined therapy of Pericarpium Trichosanthis injection with nicorandil. It reported significant reductions in LDL and triglycerides, alongside improvements in cardiac output and left ventricular ejection fraction, suggesting benefits for lipid metabolism and cardiac function.
  • https://www.worldscientific.com/doi/pdf/10.1142/S257590002250001X – This systematic review and meta-analysis focused on Chinese herbal medicines, including Pericarpium Trichosanthis, for mammary nodules. While not directly related to cardiovascular use, it provides general context on the clinical efficacy and safety of Chinese herbal medicine formulations, highlighting the use of Pericarpium Trichosanthis in other therapeutic areas.