Huang Lian
StarCoptis chinensis Franch.
Traditionally used for
- Eye health
- Ears & hearing
- Teeth & mouth
- Colds & fever
- Digestion
- Bowel health
- Urinary & fluids
- Sleep
- Mood & calm
- Skin
Cautions & contraindications
- Pregnancy
☯ TCM Properties
Clears Heat and dries Dampness; Drains Fire; Resolves Toxicity; Clears Heart Fire; Cools the Blood and Stops Bleeding; Clears Stomach Heat
Traditional Chinese Uses
Huang Lian (黄连) is the rhizome of Coptis chinensis Franch. and related species (Ranunculaceae), Rhizoma Coptidis. It is intensely bitter and cold, entering the Heart, Liver, Stomach, Large Intestine, Gallbladder and Spleen channels. It clears Heat and dries Dampness, drains Fire, resolves toxicity, clears Heart Fire, clears Stomach Heat, and cools the Blood to stop bleeding. It is among the coldest and most drying substances in the materia medica.
Its first use is Damp-Heat in the Stomach and Intestines: acute diarrhoea and dysenteric disorders with burning, foul stool and tenesmus. It drains Heart Fire for high fever with irritability, delirium, insomnia and mouth or tongue ulcers, and Stomach Fire for burning epigastric pain, acid reflux, foul breath, toothache and bleeding gums. It clears Heat toxin in carbuncles, boils and inflamed sores, and is applied topically for red, swollen eyes and for suppurating ear discharge.
Processing redirects it: wine-fried Huang Lian is turned upward to the head and eyes, ginger-fried moderates its cold for a queasy Stomach, and Wu Zhu Yu-fried tempers it for Liver-Stomach disharmony. Because it is so bitter and cold it readily injures Stomach Qi and Yin, and it is unsuitable in Spleen and Stomach deficiency Cold or for long courses without warming counterweights.
Western Herbalism Properties
Pharmacological Effects
- Antimicrobial: Rhizome and berberine strongly inhibit dysentery bacilli, S. aureus, pneumococci, streptococci and meningococci in vitro; berberine prevents cholera- and E. coli enterotoxin-induced secretion in animals; also antifungal (berberine sulphate vs 11 fungi; oral 350-700 mg/kg vs intestinal Candida in mice) and amoebicidal.
- CNS: Berberine sedated cats and mice, prolonged pentobarbital sleep, lowered temperature and was antipyretic; tetrahydroberberine produced sedation, analgesia and muscle relaxation in mice.
- Peripheral neurotransmitters: Berberine has biphasic cholinergic effects (potentiating at low, antagonizing at high dose), inhibits cholinesterase and attenuates curare antagonism.
- Cardiovascular: I.v. berberine caused transient hypotension in several species; antagonized chloroform- and aconitine-induced arrhythmias, raised ventricular fibrillation threshold and prolonged action potential and refractory period.
- Choleretic: Extracts and berberine increased bile and conjugated bilirubin excretion in animals.
- Enzyme inhibition: Berberine inhibited alcohol dehydrogenase, NADH oxidase (IC50 50 µM), cholinesterase, ATPase and RNA tumour virus reverse transcriptase.
- Antiinflammatory and other: Extract and berberine antiinflammatory comparable to butazolidin; berberine lowered serum cholesterol and blood glucose in normal and diabetic mice, inhibited platelet aggregation and activated macrophages against tumour cells.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 135.
Used In Formulas (58)
Relationships
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Botanical Description
Coptis chinensis is a low-growing herbaceous perennial in the Ranunculaceae, endemic to central and southern China, where it inhabits cool, moist, shaded broadleaved and mixed forests at elevations of 500-2,000 m. Plants reach 15-25 cm tall and arise from a creeping, knotty, bright golden-yellow rhizome that branches sympodially, leaving distinct nodal scars. The basal leaves are long-petiolate and ternately compound, the central leaflet ovate with deeply incised, sharply serrate lobes and the lateral leaflets asymmetrically two-lobed; all are leathery and dark green with sunken veins. In early spring slender flowering scapes bear loose cymes of three to eight small, greenish-white to pale yellow flowers, each with five to six narrow petaloid sepals and shorter, club-shaped true petals. The fruits are stalked clusters of green follicles that split to release a few small black seeds. The rhizomes are lifted in autumn after several years of cultivation.
Active Constituents
Berberine
Isoquinoline (protoberberine) alkaloidConcentration: approx. 5-8% (pharmacopoeial marker, >=5.5% for Coptis chinensis)
The dominant active and quality marker. Broadly antimicrobial and antiprotozoal, anti-inflammatory, antidiarrhoeal, glucose- and lipid-lowering (via AMPK activation and improved insulin sensitivity), and bitter/cooling, accounting for most of Huang Lian's Heat-clearing and Damp-drying actions.
Coptisine
Protoberberine alkaloidConcentration: approx. 0.8-2%
Antimicrobial, anti-inflammatory and lipid-lowering; contributes with berberine to the antibacterial and gastrointestinal actions and is a co-marker of Coptis.
Palmatine
Protoberberine alkaloidConcentration: approx. 0.5-1.5%
Antimicrobial, anti-inflammatory and sedative; broadens the antibacterial spectrum of the crude drug.
Jatrorrhizine
Protoberberine alkaloidConcentration: approx. 0.3-1%
Antimicrobial, antioxidant and hypolipidaemic; contributes to the herb's cholesterol-lowering and antifungal activity.
Epiberberine
Protoberberine alkaloidConcentration: qualitative (minor, a pharmacopoeial identity marker)
Antimicrobial and enzyme-inhibitory (e.g. urease inhibition relevant to gastric activity); used together with berberine, coptisine and palmatine for HPLC identification of Coptis.
Magnoflorine
Aporphine alkaloidConcentration: qualitative (minor)
Mild hypotensive and antioxidant activity, complementing the protoberberine alkaloids.
⚠ Drug Interactions
Cyclosporine A
In renal-transplant recipients, berberine raised cyclosporine trough concentrations by roughly 25-90%, most likely by inhibiting hepatic and intestinal CYP3A4 and P-glycoprotein and slowing gastrointestinal transit.
Clinical note: Avoid concurrent use or monitor cyclosporine levels closely; the interaction is clinically significant.
CYP3A4 / CYP2D6 / CYP2C9 substrates
Repeated berberine dosing inhibits CYP3A4, CYP2D6 and CYP2C9 in humans, so drugs metabolised by these enzymes (e.g. midazolam, dextromethorphan, many statins) may reach higher concentrations.
Clinical note: Use caution and consider monitoring when combined with narrow-therapeutic-index CYP substrates.
Antidiabetic agents (metformin, sulfonylureas, insulin)
Berberine independently lowers fasting and postprandial glucose and HbA1c; combined with hypoglycaemic drugs the effect can be additive.
Clinical note: Monitor blood glucose; antidiabetic doses may need adjustment.
Bilirubin-displacing context (neonates, G6PD deficiency)
Berberine displaces bilirubin from serum albumin and can raise free bilirubin, which is hazardous in neonates with jaundice and in G6PD-deficient individuals.
Clinical note: Contraindicated in neonates and during pregnancy near term; use caution in G6PD deficiency.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 2–5 g | Daily | — | — | 中国药典 2020 【用法与用量】2～5g。外用适量。 【性味与归经】苦，寒。归心、脾、胃、肝、胆、大肠经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Preparation Methods
Raw / unprocessed (sheng huang lian)
Parts: rhizome
The dried rhizome used unprocessed. The raw form most strongly drains Fire and clears Heart and Stomach Heat and resolves toxicity, used for high fever, irritability, mouth sores and damp-heat dysentery. Typical decoction dose is small because of intense bitterness and cold: 2-5 g (up to 9 g).
Wine-fried (jiu huang lian)
Parts: rhizome
Slices are stir-fried with rice wine. Wine processing moderates the extreme cold and directs the action upward, making it suitable for clearing Heat of the upper burner such as red, painful eyes and mouth/tongue sores.
Ginger-fried (jiang huang lian)
Parts: rhizome
Slices are fried with fresh ginger juice. Ginger tempers the coldness and enhances the ability to clear Stomach Heat and stop vomiting, used for damp-heat nausea and epigastric focal distention.
Evodia-processed (yu huang lian)
Parts: rhizome
Coptis is processed together with a decoction of Wu Zhu Yu (Evodia). This softens the cold nature and adds a warming, Liver-coursing quality for Liver-Stomach disharmony with acid reflux and flank pain (the Zuo Jin Wan pairing).
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
An acrid-opening, bitter-descending combination: one disperses phlegm and knotted qi while the other clears and drains heat, relieving epigastric focal distention from intermingled heat and phlegm.
Epigastric focal distention from mixed cold and heat. Ban Xia is used processed; the raw herb is toxic.
Core pair of a classical formula — Ban Xia Xie Xin Tang, Shang Han Lun (Zhang Zhongjing)
Together they drain fire and purge heat from the Heart and Stomach, relieving focal distention and bleeding caused by heat.
Core pair of a classical formula — Da Huang Huang Lian Xie Xin Tang, Shang Han Lun (Zhang Zhongjing)
Together they drain Heart fire and nourish yin and blood, calming the spirit when excess fire and deficient yin coexist.
Classic indication: irritability and insomnia from yin deficiency with blazing Heart fire.
Core pair of a classical formula — Huang Lian E Jiao Tang, Shang Han Lun (Zhang Zhongjing)
Acrid opening combined with bitter descending, which unblocks focal distention in the epigastrium from mixed heat and cold and harmonises the stomach.
Epigastric focal distention with nausea, vomiting and borborygmus from mixed cold and heat.
Core pair of a classical formula — Ban Xia Xie Xin Tang, Shang Han Lun (Zhang Zhongjing)
Venting and raising the clear yang combines with bitter cold drying, so damp-heat diarrhea with an unresolved exterior is treated from both sides.
Hot, foul diarrhea with fever.
Core pair of a classical formula — Ge Gen Qin Lian Tang, Shang Han Lun (Zhang Zhongjing)
Clears heat and dries dampness while moving qi, resolving damp-heat obstructing the middle burner.
Damp-heat sudden turmoil disorder with vomiting and diarrhea.
Core pair of a classical formula — Lian Po Yin, Huo Luan Lun (Wang Shixiong)
Together they strongly clear heat, drain fire and dry damp across the upper and middle burners, and resolve heat toxin.
Core pair of a classical formula — Ge Gen Huang Qin Huang Lian Tang, Shang Han Lun (Zhang Zhongjing)
Together they clear damp-heat from the intestines while moving qi to relieve abdominal pain and tenesmus.
Classic indication: damp-heat dysentery with abdominal pain and tenesmus; the pair forms Xiang Lian Wan.
Named pairing — Lu Jingshan, Shi Jinmo Dui Yao
Together they clear Heart fire and warm the Kidney, restoring communication between Heart and Kidney to calm the spirit.
Classic indication: insomnia and palpitations from Heart and Kidney failing to communicate.
Core pair of a classical formula — Jiao Tai Wan, Han Shi Yi Tong (Han Mao, 1522)
Bitter cold clearing is combined with upward venting, so stomach fire is drained while constrained fire is dispersed rather than trapped.
Stomach fire with toothache, gum swelling and bleeding.
Core pair of a classical formula — Qing Wei San, Pi Wei Lun (Li Dongyuan)
Together the bitter cold and the acrid warm drain Liver fire, direct rebellious Stomach qi downward and stop acid regurgitation and vomiting.
Classic indication: hypochondriac pain with acid reflux and bitter taste from Liver fire attacking the Stomach.
Core pair of a classical formula — Zuo Jin Wan, Dan Xi Xin Fa (Zhu Danxi)
Heavy settling of the Heart combined with bitter-cold draining of Heart fire, which calms the spirit when Heart fire is blazing.
Heart fire with irritability, insomnia and palpitations. Zhu Sha contains mercury; never heat it, avoid long-term use, contraindicated in pregnancy and in kidney or liver impairment.
Core pair of a classical formula — Zhu Sha An Shen Wan, Nei Wai Shang Bian Huo Lun (Li Dongyuan)
A small amount of acrid, fragrant herb with a bitter cold one harmonizes the stomach and stops vomiting from damp-heat.
Persistent nausea and vomiting from heat in the stomach, including in pregnancy.
Core pair of a classical formula — Su Ye Huang Lian Tang, Shi Re Bing Pian (Xue Shengbai)
Evidence Tier
Strong evidence · 2 studiesRecorded 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
2
2 verified · 0 unverified
Show 2 studies
- The effect of berberine on metabolic profiles in type 2 diabetic patients: a systematic review and meta-analysis of randomized controlled trials
- Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus
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
The effect of berberine on metabolic profiles in type 2 diabetic patients: a systematic review and meta-analysis of randomized controlled trials
Pooling RCTs of berberine (the chief Coptis alkaloid) in type 2 diabetes, the review found significant reductions in fasting and postprandial blood glucose, HbA1c, triglycerides and total cholesterol versus control, supporting a genuine antidiabetic and lipid-lowering effect while noting variable trial quality.
Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus
Across 33 RCTs (2,846 patients), Coptis chinensis-containing prescriptions added to metformin improved fasting blood glucose, 2-hour postprandial glucose, HbA1c and insulin-resistance markers compared with metformin alone, indicating an adjunctive benefit though the authors flag heterogeneity and trial-quality limitations.
⚠ Safety & Contraindications
- Pregnancy
Contraindications
- Best avoided in jaundiced neonates and pregnant women: berberine displaces bilirubin from serum protein binding, raising risk of brain damage from free bilirubin.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 135.
Side Effects
- Oral use may cause transient diarrhea, abdominal distention, borborygmus, polyuria, loss of appetite, vomiting, nausea and epigastric discomfort.
- One allergic reaction to i.v. berberine and one drug rash from powdered Huang Lian reported.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 135.
Historical Texts
Shennong Bencao Jing (Divine Husbandman's Classic of Materia Medica)
Han dynasty, c. 200 CEShanghan Lun (Treatise on Cold Damage), Zhang Zhongjing
Eastern Han, c. 200 CEBencao Gangmu (Compendium of Materia Medica), Li Shizhen
Ming dynasty, 1578 CEReferences
- Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica, 3rd edition . Eastland Press, Seattle (2004) [DOI]
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People's Republic of China, Volume I (Huanglian / Coptidis Rhizoma) . China Medical Science Press, Beijing (2020) [DOI]
- Guo J, Chen H, Zhang X, et al.. The effect of berberine on metabolic profiles in type 2 diabetic patients: a systematic review and meta-analysis of randomized controlled trials . Oxidative Medicine and Cellular Longevity (2021) [DOI]
- Ma H, et al.. Systematic review and meta-analysis of Coptis chinensis Franch.-containing traditional Chinese medicine as an adjunct therapy to metformin in the treatment of type 2 diabetes mellitus . Frontiers in Pharmacology (2022) [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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