**3. Method**

#### **3.1. Search in Chinese pharmacopeia**

Two review assessors carried out the word-by-word study in Chinese Pharmacopeia to identify the study medicines. First, they read all the recorded individual Chinese medicines and the formulae one by one and recorded in a list of the medicines remarked with application in pregnancy. Second, they checked the details of pharmaceutical effects and clinical functions and indications of these list-out medicines. If any adverse effects related to pregnancy were reported, the reference study would be traced and more details of the adverse outcomes were recorded, for further summaries and analyses. Third, they carried out the same rules to expand the search in different online databases, if the details of the adverse outcomes could not be accessed from the Chinese Pharmacopeia or the reference study. Finally, they extracted and summarized the specific safety information on three classifications of these Chinese medicines.

#### **3.2. Search in other databases**

To further supplement the pharmacological and toxicology data of the Chinese medicines, several online national and public resources on World Wide Web were also referred. It included Center for Food Safety and Applied Nutrition (CFSAN) from US Food and Drug Administration (FDA, (http://vm.cfsan.fda.gov/~dms/supplmnt.html), National Center for Complementary and Alternative Medicine (NCCAM) from US National Institute of Health (NIH, http://nccam.nih.gov), Agricultural Research Service (ARS) from US Department of Agriculture (USDA, http://www.ars-grin.gov/duke), Medical Dictionary for Regulatory Activities (MedDRA) from International Federation of Pharmaceutical Manufacturers and Associations (IFPMA, http://www.meddramsso.com), National Council Against Health Fraud (NCAHF) from a private health agency (http://www.ncahf. org), Quackwatch from an American non-profit organization (http://www.quackwatch. com), HerbMed from Alternative Medicine Foundation (http://www.herbmed.org) and ConsumerLab from an independent laboratory (http://www.consumerlab.com), accessibility verified until 1 September 2016.

#### *3.2.1. Search strategies for online databases*

Search by subject heading/keyword/abstract/full text with:


trials, most of the Chinese medicines were utilized for long history in culture which, however,

"Chinese Pharmacopeia", acknowledged by World Health Organization (WHO) as the official pharmacopeia for Chinese medicines, records 1146 different Chinese medicines [15]. It provides information on the herbs with their characteristics, identity, impurity, contents, extractum, analysis, property and channel, therapeutic action, pharmacological data, dose

Among all this valuable information, we will obtain the most specific safety information for pregnancy from the Chinese Pharmacopeia and provide to the doctors, scholars and patients

In this chapter, we will conduct a systematic review to summarize and characterize in details the Chinese medicines classified as contraindicated, not recommended and cautiously used for pregnancy in the most updated version of Chinese Pharmacopeia. Clinical reports including clinical trials, case series, case reports and animal studies including short-term and long-term toxicity, specific organ toxicity and different species of Chinese medicines will be

Two review assessors carried out the word-by-word study in Chinese Pharmacopeia to identify the study medicines. First, they read all the recorded individual Chinese medicines and the formulae one by one and recorded in a list of the medicines remarked with application in pregnancy. Second, they checked the details of pharmaceutical effects and clinical functions and indications of these list-out medicines. If any adverse effects related to pregnancy were reported, the reference study would be traced and more details of the adverse outcomes were recorded, for further summaries and analyses. Third, they carried out the same rules to expand the search in different online databases, if the details of the adverse outcomes could not be accessed from the Chinese Pharmacopeia or the reference study. Finally, they extracted and summarized the specific safety information on three classifications of these

To further supplement the pharmacological and toxicology data of the Chinese medicines, several online national and public resources on World Wide Web were also referred. It included Center for Food Safety and Applied Nutrition (CFSAN) from US Food and Drug Administration (FDA, (http://vm.cfsan.fda.gov/~dms/supplmnt.html), National Center

as scientific evidence on the safe application of Chinese medicines during pregnancy.

has very limited scientific data regarding the adverse pregnant outcomes.

30 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

and dosing, precautious, storage, authentication methods and so on.

**2. Objective**

studied.

**3. Method**

Chinese medicines.

**3.2. Search in other databases**

**3.1. Search in Chinese pharmacopeia**


Or could be included or replaced by similar words:


Only clinical trials, which assessed the adverse pregnant outcomes of the Chinese medicines, were further selected for meta-analysis.

#### **3.3. Study criteria**

#### *3.3.1. Types of studies*

All published studies (list in Chinese Pharmacopeia and reference and reference of reference) that evaluated the safety of Chinese medicines for pregnancy were included. Studies of Chinese medicines for other clinical applications and in animal, chemical and basic research were included. (Non)/Randomized control trials, case controlled studies, case series, case reports, commentary articles and non-systematic reviews were excluded. Studies with no evaluation or incomplete records of adverse pregnancy outcome were also included.

Language of the publications was restricted to English and Chinese. Literature with either English or Chinese abstract should be available for initial search. No translation was required for Chinese articles as all review assessors can read Chinese and understand Traditional Chinese Medicine and Chinese medicines thoroughly. Translations were only sought from the language facilities of the university for articles written in English and Chinese.

#### *3.3.2. Types of participants*

There was no strict for types of participants, as we collected all safety information then further extracted for the summary table (**Table 1**).

#### *3.3.3. Types of interventions*

Since Chinese medicines are crude drugs of plant, animal and mineral origins, not only those Chinese medicines originated from plants or herbs but also those from animals and minerals were included. All types of Chinese medicine in either standard or combined formulas used during pregnancy or on pregnancy model animals regardless of the dose or duration of administration.

#### *3.3.4. Types of outcome measures*

General and specific adverse effects of the study Chinese medicines were recorded. Adverse reproductive outcomes in both mothers and fetuses/infants (both human and animals) will be recorded. Maternal outcomes included (1) toxicity (e.g. renal failure, liver failure, neurological impairment and death); (2) side-effects (e.g. anaphylaxis, gastrointestinal disturbance, hypertension/hypotension, cardiac arrhythmia, gestational diabetes and so on); (3) pregnancy loss (e.g. late abortion, intrauterine death and still birth) and (4) pregnancy complications (e.g. preterm/postdate labor, placenta previa, placenta abruption and so on). Fetal outcomes included (5) perinatal mortality (including prenatal and postnatal death); (6) toxicity (e.g. fetal compromise, neurological consequences, hydrops fetalis and so on); (7) congenital malformations and (8) neonatal complications (e.g. jaundice, infection, hypoglycemia and so on). Both long- and short-term adverse outcomes were reported and summarized.

#### *3.3.5. Data collection and analysis*

For each reference study to be involved in this review, all review assessors first screened the titles, abstract sections and keywords of every record to exclude the duplicates and obvious false positive. Second, full text of eligible studies was assessed for further inclusion or exclusion. If there was sufficient information and it met the inclusion criteria, the study was included in the analyses and summaries. Two review assessors assessed the studies for inclusion independently; any disagreement was resolved by discussion among all the review authors. The study authors were contacted for clarification if there were doubts about the eligibility of the study and the disagreement could not be resolved. The review authors were not blinded to the journal of origin or institution.


Language of the publications was restricted to English and Chinese. Literature with either English or Chinese abstract should be available for initial search. No translation was required for Chinese articles as all review assessors can read Chinese and understand Traditional Chinese Medicine and Chinese medicines thoroughly. Translations were only sought from

There was no strict for types of participants, as we collected all safety information then further

Since Chinese medicines are crude drugs of plant, animal and mineral origins, not only those Chinese medicines originated from plants or herbs but also those from animals and minerals were included. All types of Chinese medicine in either standard or combined formulas used during pregnancy or on pregnancy model animals regardless of the dose or duration of

General and specific adverse effects of the study Chinese medicines were recorded. Adverse reproductive outcomes in both mothers and fetuses/infants (both human and animals) will be recorded. Maternal outcomes included (1) toxicity (e.g. renal failure, liver failure, neurological impairment and death); (2) side-effects (e.g. anaphylaxis, gastrointestinal disturbance, hypertension/hypotension, cardiac arrhythmia, gestational diabetes and so on); (3) pregnancy loss (e.g. late abortion, intrauterine death and still birth) and (4) pregnancy complications (e.g. preterm/postdate labor, placenta previa, placenta abruption and so on). Fetal outcomes included (5) perinatal mortality (including prenatal and postnatal death); (6) toxicity (e.g. fetal compromise, neurological consequences, hydrops fetalis and so on); (7) congenital malformations and (8) neonatal complications (e.g. jaundice, infection, hypoglycemia and so on). Both long- and short-term adverse outcomes were reported and

For each reference study to be involved in this review, all review assessors first screened the titles, abstract sections and keywords of every record to exclude the duplicates and obvious false positive. Second, full text of eligible studies was assessed for further inclusion or exclusion. If there was sufficient information and it met the inclusion criteria, the study was included in the analyses and summaries. Two review assessors assessed the studies for inclusion independently; any disagreement was resolved by discussion among all the review authors. The study authors were contacted for clarification if there were doubts about the eligibility of the study and the disagreement could not be resolved. The review authors were

the language facilities of the university for articles written in English and Chinese.

32 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

*3.3.2. Types of participants*

*3.3.3. Types of interventions*

*3.3.4. Types of outcome measures*

*3.3.5. Data collection and analysis*

not blinded to the journal of origin or institution.

administration.

summarized.

extracted for the summary table (**Table 1**).



**name)**

8

Crotonis

Croton tiglium L.

巴豆 (Ba Dou)

Proper dose

fructus

9

Crotonis semen

Croton tiglium L.

巴豆霜 (Ba

0.1–0.3

 Same as 8

Doushaung)

莪术 (E Zhu)

 6–9

Promotes qi flow and rids of blood stasis, amenorrhea due to blood

stasis; distension and pain due to stagnation of undigested food;

early stages of cancer in the cervix uteri (neck of uterus)

The flowers are being used in anesthesia, as sedative and for inducing

Contraindicated

34 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

Contraindicated

Contraindicated

Contraindicated

Contraindicated

sleep. The leaves are being used in rheumatoid arthritis. The seeds

are being used in promoting blood circulation and in ridding of pain

pulveratum

10

 Curcumae

Curcuma

phaeocaulis Val.

rhizoma

11 12

Erycibe

Erycibe obtusifolia

丁公藤 (Ding

3–6

Rheumatism

Gongteng)

schmidtii

13

Euphorbiae

Euphorbia

京大戟 (Jing Daji)

 1.5–3

For edema, ascites, retention of phlegm, tuberculosis of lymph

nodes. Can be taken internally or applied externally

pekinensis Rupr.

pekinensis

radix

14

Euphorbiae

Euphorbia lathyris

千金子 (Qian Jinzi)

 1–2

Dermatomycosis

semen

15

Euphorbiae

Euphorbia lathyris

千金子霜 (Qian

0.5–1

Dermatomycosis

Jinzishaung)

semen

L.

pulveratum

16

Eupolyphaga

Eupolyphaga

土鳖虫 (Tu

3–10

impact, sprain in loin area

For blood stasis, amenorrhea, injuries of bones and muscles from

Contraindicated

Contraindicated

Biechong)

阿魏 (A Wei)

 1–1.5

Being used in ridding of parasites, improving meat digesting,

treating purpura, epilepsy, enlarged liver

sinensis Walker

steleophaga

17

Ferulae resina

 Ferula sinkiangensis

K.M. Shen; Ferula

fukanensis K.M.

Shen

18

Genkwa flos

Daphne genkwa

芫花 (Yuan Hua)

 1.5–3

For edema, ascites. For worm parasite: vinegar processed yuan hua,

Contraindicated

xiong huang. Make into powder. Take internally. For head fungal or

ringworm: mix with lard and apply topically

Sieb. et Zucc.

L.

Benth.

Daturae flos

Datura metel L.

洋金花 (Yang

0.3–0.6

Jinhua)

**CHM (Biological** 

**CHM (Chinese)**

 **Dose**

**Actions and clinical indications**

As laxative for constipation, distention, abdominal fullness and

pain, caused by extreme coldness of bowels; for ascites; for clogged

phlegm; for topical uses for abscesses and ulcers, to speed up

ulceration of abscesses

**Classification** 

**in pregnancy**

Contraindicated

Contraindicated

Contraindicated


of pus, eczema, and leprosy


**name)**

30

radix

31

32

mollis flos

33

34

35

 Sparganii

rhizoma

36

37

Strychni semen

Strychnos nuxvomica L.

马钱子粉 (Ma Qianzifen)

0.3–0.7

 Same as 36

pulveratum

38

resina

39

 Gleditsiae sinensis fructus

berezovskii Flerov

Toxicodendri

Toxicodendron

干漆 (Gan Qi)

2–5

Elimination of parasite

vernicifluum

(Stokes) F.A. Barkl

Moschus

大皂角 (Da Zaojiao)

 1–1.5

1. Dispels phlegm or coughs with abundance of phlegm; 2. Opens

Not

recommended

the orifices after strokes or epilepsies or facial paralysis due to

excessive of phlegm; 3. Discharges puss when used externally for

boils. Zao jiao ci uses: early stages of boils, difficulty in discharging

of pus, eczema, and leprosy

Strychni semen

Strychnos nuxvomica L.

马钱子 (Ma Qianzi)

 0.3–0.6

 Scorpio

Karsch

Sparganium

三棱 (San Leng)

 5–10

stoloniferum Buch.


Buthus martensii

全蝎(Quan Xie)

 0.6–9

Epilepsy, stroke, paralysis, migraine, pain in arthritis, tetanus,

Contraindicated

Contraindicated

tuberculosis in lymph nodes, urticaria, and bunacles

Painful menses. Postpartum complication, amenorrhea cause by qi

stagnation and/or blood stasis. Cu san leng (prepared with vinegar)

is stronger in pain inhibition. Fu san leng (stir fried with flour) is

milder and is being used in promoting digestion

Rheumatoid arthritis, injuries, boils and swellings, sequelae from polio of children, impotence, for diseases of the gastrointestinal tract,

Contraindicated

organic and functional disorders of the heart and circulatory system,

glycine encephalopathy, nervous conditions, myasthenia gravis;

amyotrophic lateral sclerosis (als), cancer, depression, migraine,

menopausal syndromes, facial neuralgias, raynaud's syndromes

Contraindicated

Contraindicated

Scolopendra

Scolopendra

蜈蚣 (Wu Gong)

 3–5

Epilepsy, spasm, scrofula, sores, arthritis, hemorrhoid with pain,

snake poison, scalding, leukemia, stroke

subspinipes

mutilans L. Koch

Rhododendri

Rhododendron

闹羊花 (Nao

0.6–1.5

bones, fungal infection of the skin

Yanghua)

molle G. Don

 Realgar

 Realgar

雄黄 (Xiong Huang)

 0.05–0.1

Topical application for ridding of parasites: for scabies, ringworm,

damp rashes, abscesses, ulcerations, snake bites. Taking internally

for intestinal parasites, especially effective for roundworms. Dries

Alleviates pain. Being used in rheumatoid arthritis, pain in broken

Contraindicated

Contraindicated

36 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

dampness: expels phlegm

Roxb.

Phytolaccae

Phytolacca acinosa

商陆 (Shuang Lu)

 3–9

Promote diuresis

**CHM (Biological** 

**CHM (Chinese)**

 **Dose**

**Actions and clinical indications**

**Classification** 

**in pregnancy**

Contraindicated

Contraindicated

Overview of Contraindicated Chinese Medicines for Pregnancy http://dx.doi.org/10.5772/67066 37



**name)**

49

Arisaematis

Arisaeme

制天南星 (Zhi

3–9

 Same as 48

Tiannanxing)

erubescens (Wall.)

rhizoma

preparatum

50

 Aurantii

fructus

51

Aurantii

Citrus aurantium

枳实 (Zhi Shi)

 3–10

 Same as 50

fructus

L.

immaturus

52 53

 Borneolum

Borneol

syntheticum

54 55

Bovis calculus

Bos taurus

人工牛黄 (Ren

0.15–0.35

 Same as 54

Cautiously used

Cautiously used

Gongniuhuang)

体外培育牛黄 (Ti

0.15–0.35

 Same as 54

Waipeiyuniuhuang)

domesticus Gmelin

artifactus

56

sativus

Bovis calculus

Bos taurus

domesticus Gmelin

Bovis calculus

 Bos taurus domesticus Gmelin

Borneolum

Cinnamomum

天然冰片 (Tian

0.3–0.9

For fainting due to strokes or heat, bunacle, pain in joints, ulceration

Cautiously used

38 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

Cautiously used

of the cornea, sores in the mouth, eczema, taking internally: mainly

being used in pills; seldom in decoction. External application: for

washing or added in external medication

Ranbingpian) /

右旋龙脑 (You

Xuanlongnao)

冰片 (Bing Pian)/

0.15–0.3

Similar as 58

合成龙脑 (He

Chenglongnao)

牛黄 (Niu Huang)

 0.15–0.35

Anti-inflammatory, anti-fever, anti-bacterial, opens the orifices,

Cautiously used

awakens the spirit, rid of phlegm. For high fever with delirium and

convulsion due to hot diseases with hot phlegm, for chronic sore

throat, for abscesses that have ripen and ruptured. Clears the heart,

liver, relieves toxicity, rid of wind and tremors. For convulsions

with high fever due to liver heat

camphora (L.) Presl

L.

Schott

Citrus aurantium

枳壳 (Zhi Qiao)

 3–10

Indigestion due to low function; bloating in chest, abdomen and

Cautiously used

Cautiously used

solar plexus area; constipation; diarrhea but difficult to expel, focal

distention; fullness in the chest; cough with abundance of phlegm;

prolapse of stomach, uterus and rectum

**CHM (Biological** 

**CHM (Chinese)**

 **Dose**

**Actions and clinical indications**

**Classification** 

**in pregnancy**

Cautiously used



**name)**

\*\*\*\*60

Cinnamomi

Cinnamomum

肉桂 (Rui Gui)

1–5

cassia Presl

cortex

61

Cinnamomi

Cinnamomum

桂枝 (Gui Zhi)

 3–10

 Same as 60

Cautiously used

Cautiously used

40 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

cassia Presl

ramulus

62 63

64

 Cyathulae

Cyathula officinalis

川牛膝 (Chuan

5–10

Rheumatism, hematuria, amenorrhea, abdominal mass (fibroids of

the uterus, ovarian cysts, endometriosis, pelvic inflammation, blood

retention due to gynatresia, extra-uterine pregnancy, bleeding in the

uterus, and other pelvic masses)

Gonorrhea, edema, urinary tract inflammation, difficulty in

Cautiously used

Cautiously used

urination, irregular menses, amenorrhea, dystocia, carbucle

Niuxi)

radix

65

66

67

 Echinopsis

Echinops latifolius

禹州漏芦 (Yu

5–10

For boils, carbuncles, acute mastitis, unable to discharge milk

Cautiously used

Cautiously used

Cautiously used

Zhouloulu)

Tausch.; Echinops

grijisii Hance

radix

68

Euphorbiae

Euphorbia hirta L.

飞扬草 (Fei

6–9

Relieve itching, lactogenesis

Yangcao)

绿矾 (Lv Fan)

 0.8–1.6

Killing parasites

hirtae herba

69

Ferrous sulfate

 Melanterite

Dichroae radix

Lour.

Dichroa febrifuga

常山 (Chang Shan)

 5–9

Vomitting, malaria

Dianthi herba

L.

Dianthus superbus

瞿麦 (Qu Mai)

9–15

Kuan

Croci stigma

Crocus sativus L.

西红花 (Xi

1–3

Similar as 59

Cautiously used

Cautiously used

Honghua)

Coicis semen

Coix lacryma-jobi

薏苡仁 (Yi Yiren)

 9–30

For improving digestion, enhancing the lung function, ridding

of bacterial or fungal infection, arresting pain and itchiness. For

treatment of spastic muscles, arthritis pain in joints and muscular

rigidity. Beri-beri and edema, vagina yeast infection, stones in

the urinary tract, neualgia, difficulty in urination, lung abscess,

gonorrhea, restless leg syndrome. Use raw yi yi ren for infection.

Use stir fried yi yi ren for improving digestion

L. var.ma-yuen

(Roman.) Stapf

**CHM (Biological** 

**CHM (Chinese)**

 **Dose**

**Actions and clinical indications**

Tonic for stomach, rid of wind, to promote sweating, for headache,

anemia, cold limbs, to promote urination. To promote lung qi, in

chill and fever, cold phlegm, diarrhea, muscle spasm, headache,

back pain, sweating, to stop easily being annoyed, strengthening

muscles and bones, promote circulation. Use in impotence due

toshenyangxu (kidney yang deficient)

**Classification** 

**in pregnancy**

Cautiously used



**name)**

78 79

Momordicae

Momordica

木鳖子 (Mu Biezi)

 0.9–1.2

Similar as 36

Cautiously used

cochinchinensis

(Lour.) Spreng.

semen

80

81

Myrrha

Commiphora

没药 (Mo Yao)

 3–5

myrrha Engl.;

Commiphora

molmol Engl.

82 83

exsiccatus

84

Notoginseng

Radix Notoginseng

三七 (San Qi)

1–9

Raw san qi can stop bleeding and can transform blood stasis. It can

stop bleeding without causing blood clots. It is widely used in injury

medicine as in broken bones, swelling, impact injuries. Cooked san

qi can be used as tonic

radix et

rhizoma

85

Olibanum

Boswellia carterii

乳香 (Ru Xiang)

 3–5

Improves circulation, repairs muscle, as resolvent. Being used in:

Cautiously used

pain due to blood clots, spastic muscle, carbuncles, gum bleeding,

gingivitis, rheumatoid arthritis, cirrhosis of liver, amenorrhea,

physical injuries, ulcerated wounds not healing

Breaks up blood stasis for constipation due to dry intestines for

Cautiously used

early stage of liver cirrhosis inhibits epstein-barr virus anti-tumor

Birdw.; Boswellia

bhaw-dajiana

Birdw.

86

Persicae semen

Batsch

Prunus persica (L.)

桃仁 (Tao Ren)

 5–10

Natrii sulfas

Natrii Sulfas

玄明粉 (Xuan

3–9

Similar as 82

Mingfen)

Exsiccatus

Natrii sulfas

Mirabilitum

芒硝 (Mang Xiao)

 6–12

Moutan cortex

Paeonia

牡丹皮 (Mu Danpi)

 6–12

blood stasis

Clears heat and cools the blood, clears fire of yin deficiency, clear

Cautiously used

42 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

blood stasis and rid of clots, drain pus and reduces swelling due to

For pain due to injuries, bruises, rheumatoid arthritis, tumors in the

Cautiously used

uterus, hemorrhoid, cataract, amenorrhea, bone and muscle ache,

angina pectoris. External use on inflammation of the mouth cavity,

periodontitis, wounds from cut not healing, and pharyngitis

1. Constipation with dark urine, fullness and pain in abdomen; 2.

Cautiously used

Cautiously used

Cautiously used

Conjunctivitis; 3. Boils in mouth and tongue; 4. Swollen and painful

throat area; 5. Tumor of the breast; 6. Stopping lactation; 7. Worm

parasites of small children; 8. Red, swollen boils, before breakage

suffruticosa Andr.

Meliae cortex

Melia toosendan

苦楝皮 (Ku Lianpi)

 3–6

Sieb. et Zucc.;

Melia azedarach L.

**CHM (Biological** 

**CHM (Chinese)**

 **Dose**

**Actions and clinical indications**

Promote qi flow, rid of dampness-heat, clear liver fire, rid of pain,

promote urination, regulates qi, kills parasites. Also used externally

for fungus infections of scalp. Ku lian pi should be cooked longer

than other herbs in the formula, because the active ingredients are

more difficult to dissolve in water

**Classification** 

**in pregnancy**

Cautiously used



**name)**

94

Selaginellae

Selaginella

卷柏 (Juan Bai)

 5–10

Improves circulation

tamariscina

(Beauv.) Spring

herba

95 96

97

Tetrapanacis

Tetrapanax

papyrifer (Hook.)

K. Koch

medulla

98

Trichosanthis

trichosanthes

天花粉 (Tian

10–15

hydatidiform mole

Clears lung heat, dissolves phlegm, for cough with thick phlegm,

Cautiously used

44 Chinese Medical Therapies for Diabetes, Infertility, Silicosis and the Theoretical Basis

rid of toxicity, expels pus; for treatment of chlorion epithelioma,

kirilowii Maxim.;

Huafen)

trichosanthes

rosthornii Harms

99

Typhae pollen

L.

Typha angustifolia

蒲黄 (Pu Huang)

 5–10

Hei pu huang is pu huang that has been stir fried till dark color.

Cautiously used

It is being used in stopping bleeding. Raw pu huang possesses

double effects of stopping bleeding and promoting circulation.

For treatment of: angina: blood clot in the brain, high blood lipids,

inflammation of the intestine and difficulty in urination: pu huang

50 g, xiong huang 10 g, bing pian 3 g, fresh white part of green

onion 200 g,(wash the part of green onion and boil in water for

3 minutes. Smash all herb past it to the lower abdomen while

still warm. Bleeding and abdomen ache due to chronic colitis:

pu huang 3 g, wu ling zhi 3 g (wrap in cloth), baked ge gen 10

g, baked rou dou kou 3 g. Make into decoction and use as tea.

External injury of the head with swelling: use raw pu huang and

apply to the injury, 3 times a day. Bleeding in external injuries,

hemorrhoids, boils, inflammation of the rib cartilage (without pus),

Cautiously used

Cautiously used

rash in babies

100

 Typhonii

Typhonium

白附子 (Bai Fuzi)

 3–6

 Similar as 2

giganteum Engl.

vaccariae segetalis

王不留行 (Wang

5–10

Promote diuresis

Buliuxing)

(Neck.) Garcke

rhizoma

101

 Vaccariae

semen

radix

 Sulfur

 Surphur

硫黄 (Liu Huang)

通草 (Tong Cao)

 3–5

 1.5–3

Coprostasis, killing parasite

Being used in typhoid, paratyphoid with dark urine, pain in

gonorrhea, edema scanty urine, and lack of mother's milk

Sennae folium

Vahl

Cassia angustifolia

蕃泻叶 (Fan Xieye)

 2–6

 Coprostasis

**CHM (Biological** 

**CHM (Chinese)**

 **Dose**

**Actions and clinical indications**

**Classification** 

**in pregnancy**

Cautiously used

Cautiously used

Cautiously used

Cautiously used

Same: (1) The CHMs are origin from different parts of a same plant or animal. (2) The CHMs are origin from the same part of the same plant or animal, but prepared in a different way for clinical medications.

**Table 1.** Summary of 105 CHMs for pregnancy [15, 16].

#### *3.3.6. Data extraction, evaluation and management*

Extraction form was designed and used to extract data. For eligible studies, two review authors extracted the data, any discrepancy was resolved through discussion or the third person was consulted. For each selected literature, publication year, study population, participant numbers, maternal age, gestation age, symptoms and signs, clinical diagnosis, examination and laboratory results, disease course, study intervention, standard or modified Chinese medicine formulas, individual medicine, immediate and follow-up outcomes were recorded. But only the data related to the safety classification and adverse outcomes would be reported in this review.
