Gua Lou
StarTrichosanthes kirilowii Maxim.
Traditionally used for
- Cough & breathing
- Digestion
- Bowel health
- Pain & joints
- Heart & circulation
☯ TCM Properties
Clears Heat and Transforms Phlegm; Broadens the Chest and Dissipates Nodules; Moistens the Intestines and Unblocks the Bowels; Disperses Swelling and Dissipates Abscesses
Traditional Chinese Uses
Gua Lou (瓜蒌) is the fruit of Trichosanthes kirilowii Maxim. (Cucurbitaceae), Trichosanthis Fructus. It is sweet and bitter and cold, entering the Lung, Stomach and Large Intestine channels. It clears Heat and transforms Phlegm, broadens the chest and dissipates bound nodules, moistens the Intestines to unblock the bowels, and disperses swelling to resolve abscesses.
It suits Phlegm-Heat in the Lung — cough with thick yellow sputum that is difficult to raise, and a full, oppressed chest. Its most characteristic use is chest painful obstruction (胸痹), the constricting chest pain of Phlegm and Qi bound in the chest, where it is paired with Xie Bai and Ban Xia in Gua Lou Xie Bai Ban Xia Tang. It is a classical herb for breast abscess and for Lung and intestinal abscess, and its moistening seed relieves constipation from dry Intestines.
The three parts are prescribed separately. The whole fruit (Quan Gua Lou) does all of the above; the peel (Gua Lou Pi) is lighter and better at clearing the chest and moving Qi; the seed (Gua Lou Ren) is oily and moistening and is chosen for dry cough and constipation. All are cold and greasy and loosen the stool, so they are avoided in Spleen deficiency with loose stools, and they are classically held to antagonise Wu Tou (aconite).
Western Herbalism Properties
Relationships
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Botanical Description
Trichosanthes kirilowii (Gua Lou, Chinese snake gourd) is a perennial dioecious climbing vine in the Cucurbitaceae family, ascending several meters by means of bifid tendrils opposite the leaves. The stems are slender, ridged, and minutely hairy. The alternate, long-petioled leaves are broadly cordate-ovate in outline, 5 to 20 centimeters across, palmately 3- to 7-lobed with coarsely toothed margins. Flowers are unisexual: staminate flowers borne in axillary racemes, pistillate flowers solitary, each with a tubular calyx and five white petals deeply fringed at the margins into a delicate lace-like fringe characteristic of the genus, opening in the evening. The fruit is an orange to orange-red globose to ovoid pepo 7 to 11 centimeters long, ripening in autumn, containing a sweetish pulp and many flattened pale brown seeds. Three distinct medicinal materials are derived: Gua Lou (whole fruit), Gua Lou Pi (peel), Gua Lou Ren (seed), and Tian Hua Fen (root). Native to China, Korea, and Japan.
Active Constituents
Triterpenoid saponins
Triterpenoid saponinConcentration: Present in pericarp and whole fruit; variable
Contribute to the expectorant, anti-inflammatory and vasodilatory actions attributed to the fruit, supporting its use for phlegm-heat cough and chest obstruction (xiong bi).
Fatty oil (trichosanic/punicic acid and other fatty acids)
Seed lipid / fatty acidsConcentration: Abundant in the seed (Gua Lou Ren), up to ~25-40% of seed
The seed oil underlies the intestine-moistening, laxative action used for constipation; conjugated fatty acids also have studied lipid-modulating properties.
Sterols (e.g., stigmasterol, beta-sitosterol)
PhytosterolConcentration: Minor constituents of fruit and seed
Plant sterols with anti-inflammatory and cholesterol-modulating activity that add to the cardiovascular and lipid effects of the fruit.
Flavonoids
FlavonoidConcentration: Minor, concentrated in the pericarp (Gua Lou Pi)
Antioxidant flavonoids of the peel are linked in network-pharmacology and experimental studies to antithrombotic and endothelium-protective effects relevant to coronary heart disease.
Amino acids and organic acids (e.g., citrulline, oxalic/malic acids)
Nitrogenous compounds / organic acidsConcentration: Water-soluble fraction of the fruit
Water-soluble constituents that contribute to the fluid-generating and mild demulcent qualities of the fruit extract.
Trichosanthin (root protein - note on plant source)
Type-1 ribosome-inactivating proteinConcentration: Concentrated in the ROOT (Tian Hua Fen), not the ripe fruit
An abortifacient, immunomodulatory and antiviral protein isolated chiefly from the Trichosanthes root, not the fruit used as Gua Lou. It is noted here to distinguish the fruit drug from the root drug and to flag the plant's overall pregnancy-related toxicity concerns.
⚠ Drug Interactions
Aconite-containing herbs (Fu Zi, Chuan Wu, Cao Wu)
Trichosanthes fruit is one of the herbs traditionally listed in the 'Eighteen Incompatibilities' (shi ba fan) as antagonistic to aconite (wu tou), so classical practice avoids combining them.
Clinical note: By convention, do not combine Gua Lou with aconite-type herbs; modern toxicological evidence is limited but the traditional prohibition is widely observed.
Antiplatelet / anticoagulant agents
Pericarp constituents show antithrombotic and anti-platelet-aggregation activity in preclinical models, so additive effects with antiplatelet or anticoagulant drugs are conceivable.
Clinical note: Monitor for bruising or bleeding if combined with aspirin, clopidogrel or warfarin; clinical significance is unconfirmed.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 9–15 g | Daily | — | — | 中国药典 2020 【用法与用量】9～15g。 【注意】不宜与川乌、制川乌、草乌、制草乌、附子同用。 【性味与归经】甘、微苦，寒。归肺、胃、大肠经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Preparation Methods
Water decoction of whole fruit (Quan Gua Lou)
Parts: ripe fruit
Typically 9-15 g of the ripe fruit decocted; used to clear phlegm-heat, widen the chest and relieve chest bi (angina-type) and phlegm cough. It is cold and moistening and is avoided in Spleen deficiency with loose stools.
Pericarp (Gua Lou Pi) decoction
Parts: fruit peel/rind
The peel is favored for clearing heat, transforming phlegm and regulating qi in the chest; often paired with Xie Bai and Ban Xia in chest-painful (xiong bi) formulas.
Seed (Gua Lou Ren) preparation
Parts: seed
Crushed seeds, about 9-15 g, are used chiefly to moisten the intestines and move the stool for dry constipation, and to transform phlegm. Classically contraindicated in pregnancy and with aconite-type herbs.
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
Clears and transforms hot phlegm while drying phlegm and dispersing clumping, resolving phlegm-heat binding in the chest and epigastrium.
Minor chest bind: epigastric fullness painful on pressure, slippery pulse. Also paired in Gua Lou Xie Bai Ban Xia Tang.
Core pair of a classical formula — Xiao Xian Xiong Tang, Shang Han Lun (Zhang Zhongjing)
Moistens the lungs and clears heat while transforming phlegm and loosening the chest, for dry-phlegm cough with sputum that is hard to expectorate.
Core pair of a classical formula — Bei Mu Gua Lou San, Yi Xue Xin Wu (Cheng Guopeng, 1732)
Loosens the chest and transforms phlegm while unblocking yang qi, dispersing phlegm obstruction of chest yang.
Chest impediment (xiong bi) with chest pain radiating to the back and shortness of breath.
Core pair of a classical formula — Gua Lou Xie Bai Bai Jiu Tang, Jin Gui Yao Lue (Zhang Zhongjing)
Evidence Tier
Strong evidence · 1 studyRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
1
1 verified · 0 unverified
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
0
In vitro / animal
0
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
A systematic review of the effectiveness and safety of Chinese herbal medicine formula Gualou Xiebai Banxia (GLXBBX) decoction for the treatment of stable angina pectoris
Pooling 17 randomized controlled trials (1,676 patients), the Gua Lou-based GLXBBX decoction, alone or added to conventional therapy, appeared to improve angina symptoms and ECG findings versus conventional treatment alone. The authors caution that poor methodological quality and high risk of bias mean larger, double-blind trials are still needed.
⚠ Rule-Based Cautions
These entries come from the deterministic rule tables that gate Verscienta's formula tools — classical pair prohibitions, pregnancy and lactation contraindications, and dose ceilings.
Incompatibilities (十八反 / 十九畏)
- 十八反: Wu Tou × Gua Lou — avoid combining with Fu Zi / Aconite / Aconitum / Chuan Wu / Cao Wu / Wu Tou / Shu Fu / Hei Shun Pian / Fu Pian / Guan Bai Fu / Xue Shang Yi Zhi Hao / Aconitum brachypodum
Historical Texts
Jin Gui Yao Lue (Essentials from the Golden Cabinet), Zhang Zhongjing
Eastern Han, c. 220 CEBen Cao Gang Mu (Compendium of Materia Medica), Li Shizhen
Ming dynasty, 1578 CEReferences
- Chen M, Men L, Wu H, et al.. A systematic review of the effectiveness and safety of Chinese herbal medicine formula Gualou Xiebai Banxia (GLXBBX) decoction for the treatment of stable angina pectoris . Medicine (Baltimore) (2019) [DOI]
- Yu X, Tang L, Wu H, Zhang X, Luo H, Guo R, Xu M, Yang H, Fan J, Wang Z, et al.. Trichosanthis Fructus: botany, traditional uses, phytochemistry and pharmacology . Journal of Ethnopharmacology (2018) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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