Qi Cao

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Holotrichia diomphalia bates

Not yet clinically reviewed

Genus: Holotrichia Species: diomphalia Pinyin: Qi Cao
Scarab Beetle Larva蛴螬

Traditionally used for

  • Nose & throat
  • Cough & breathing
  • Skin

Cautions & contraindications

  • Bleeding disorders
  • Before surgery
  • Allergy risk
Moderate evidence · 4 studies

☯ TCM Properties

Category: regulating blood
Temperature: warm
Taste: salty
Meridians: liver
Functions:

Breaks Blood and Dispels Stasis; Disperses Swelling and Dissipates Nodules; Alleviates Pain; Resolves Toxicity; Promotes Lactation

Traditional Chinese Uses

Qi Cao (some traditions, thistle-related herb) is a cooling herb used in Chinese medicine to cool the Blood and stop bleeding, particularly from Heat patterns. It is applied for nosebleeds, coughing up blood, and hematuria from Blood Heat, as well as for external wounds. It has antiparasitic applications in historical texts and is used for its cooling, resolving properties in inflammatory conditions.

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Botanical Description

Qi Cao is the dried larva of the scarab beetle Holotrichia diomphalia Bates or related Holotrichia species (Scarabaeidae), large white grubs that live in soil feeding on plant roots and decaying organic matter across East Asia. The larvae are collected from cultivated fields in summer, killed in boiling water, and dried in the sun. The body contains proteins, amino acids, fatty acids, and chitinous material; modern analysis identifies fibrinolytic and antitumor peptides. In traditional Chinese medicine, Qi Cao (also called Qi Zao or Qi Cao Chong) is salty, slightly warm, and toxic, entering the liver channel; it invigorates the blood, dissipates blood stasis, brightens the eyes, and removes nebula (corneal opacity), used for traumatic injury, post-traumatic blood stasis, abdominal masses, and certain eye disorders involving stasis. Contraindicated in pregnancy.

Active Constituents

Heat-labile fibrin(ogen)olytic proteins

Proteins/proteases (mixed, not fully characterised)

Concentration: not quantified; the crude aqueous extract is reported to contain large numbers of proteins

The crude extract of H. diomphalia larvae cleaves the alpha- and beta-chains of fibrinogen preferentially, then the gamma-chains, and degrades fibrin directly rather than by activating plasminogen. The activity survives pH 3-10 and a range of metal ions and is only slightly affected by serine-, cysteine- and metallo-protease inhibitors, but it is destroyed completely at 75 C and 100 C, so a boiled decoction should not carry it.

Larval fatty oils (saturated and unsaturated fatty acids and esters)

Fatty acids and fatty acid esters

Concentration: 21 compounds accounting for 96.3% of the petroleum-ether extract by GC/MS; absolute yield from the dried larva not reported

The fat-soluble fraction is the antifungal fraction: ethanol and petroleum-ether extracts inhibited Pyricularia oryzae in vitro. No human antifungal data exist.

Holotricin 3 (antifungal hemolymph protein)

Glycine-rich inducible antimicrobial protein

Concentration: inducible; present in immunised larval hemolymph, not quantified in the dried drug

An antifungal protein purified and cDNA-cloned from the hemolymph of H. diomphalia larvae. It is an induced immune protein of the living insect, so its survival through drying, storage and decoction of the medicinal drug has not been demonstrated.

Holotricin 1 and holotricin 2

Inducible antibacterial proteins (holotricin 1 is a 43-residue cysteine-rich peptide; holotricin 2 is a coleoptericin-like 72-residue protein)

Concentration: inducible; not quantified in the dried drug

Holotricin 1 acts mainly on Gram-positive bacteria and holotricin 2 on Gram-negative bacteria. Like holotricin 3 these are immune effectors of the live larva rather than established constituents of the finished materia medica.

⚠ Drug Interactions

Warfarin, heparin, direct oral anticoagulants and antiplatelet drugs (aspirin, clopidogrel)

Moderate Evidence: Possible

Crude extract of H. diomphalia larvae inhibited blood coagulation and platelet aggregation dose-dependently in normal human plasma and platelet-rich plasma, prolonged bleeding time in transected mouse tails, degraded fibrinogen and fibrin directly, and was antithrombotic in a carrageenan-induced mouse tail thrombosis model. This is an animal and in vitro finding with the crude drug extract; there is no human interaction study.

Clinical note: Treat as additive with any anticoagulant or antiplatelet agent. The fibrin(ogen)olytic activity is destroyed at 75 C and above, so powders, pills and wine preparations of raw Qi Cao carry more of this risk than a boiled decoction. Withhold before surgery or dental extraction and avoid in active bleeding or thrombocytopenia.

Arthropod-allergen cross-reactivity (patients with shellfish, house dust mite or insect allergy)

Theoretical Evidence: Theoretical

Qi Cao is a whole dried insect larva, so it carries the full arthropod protein load including muscle and cuticular proteins. Cross-reactivity between crustacean, mite and insect proteins is well recognised in allergy practice, but no case of allergy to this specific drug has been published, so this remains a reasoned precaution and not a documented interaction.

Clinical note: Ask about shellfish, dust mite and insect sting allergy before prescribing, and start at a low dose in atopic patients.

Evidence Tier

Moderate evidence · 4 studies

Recorded 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.

Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description

Clinical Studies

Anticoagulant activity of crude extract of Holotrichia diomphalia larvae

Xu X, Liu W, Li W, Liu S (2016) Journal of Ethnopharmacology animal

The crude extract inhibited plasma recalcification and ADP-driven platelet aggregation dose-dependently, prolonged mouse tail bleeding time, cleaved fibrinogen alpha- and beta-chains before gamma-chains, degraded fibrin without activating plasminogen, and was active in a clot-lysis assay and a carrageenan-induced mouse tail thrombosis model. The activity was resistant to metal ions, to pH 3-10 and to standard protease inhibitors but was abolished at 75 C and 100 C.

Effect of Holotrichia diomphalia larvae on liver fibrosis and hepatotoxicity in rats

Oh WY, Pyo S, Lee KR, Lee BK, Shin DH, Cho SI, Lee SM (2003) Journal of Ethnopharmacology animal Verified: In vitro / animal

A single dose of the larval extract lowered serum ALT and AST in rats given carbon tetrachloride or beta-D-galactosamine. Four weeks of treatment after bile duct ligation and scission lowered ALT, AST, alkaline phosphatase and hepatic hydroxyproline and improved liver histology, supporting the Korean folk use of the larvae for cirrhosis. Rat data only.

Modulation of macrophage function activity by ethanolic extract of larvae of Holotrichia diomphalia

Kang NS, Park SY, Lee KR, Lee SM, Lee BG, Shin DH, Pyo S (2002) Journal of Ethnopharmacology animal Verified: In vitro / animal

An ethanolic larval extract modulated macrophage functional activity, providing a mechanistic reading of the drug's traditional use for swellings and sores. Preclinical only.

Antifungal activity of crude extracts and fat-soluble constituents of Holotrichia diomphalia larvae

Dong QF, Wang JL, Zhang SF, Wang Z, Zhang CX, Gao H, Zhang HM, Zhang L (2008) Bioresource Technology in vitro Verified: In vitro / animal

GC/MS of the larval fatty oils identified 21 compounds (96.3% of the profile) in the petroleum-ether extract and six compounds (99.53%) in the supercritical-fluid extract. Ethanol and petroleum-ether extracts inhibited the plant-pathogenic fungus Pyricularia oryzae. This is an agricultural antifungal screen, not a clinical antifungal result.

Historical Texts

Shen Nong Ben Cao Jing

Han dynasty
Lists Qi Cao (the larva) among the lower-grade drugs for malign blood, blood stasis and obstruction, and for films and opacities of the eye - the origin of the drug's later blood-breaking and swelling-dispersing indications.

Ben Cao Gang Mu

Ming dynasty
Retains the larva under the insect section, describing its use for stasis masses, breast swellings and blocked lactation, and for sores and traumatic injury.

References

  1. Deyrup ST, Stagnitti NC, Perpetua MJ, Wong-Deyrup SW. Drug Discovery Insights from Medicinal Beetles in Traditional Chinese Medicine . Biomolecules and Therapeutics (2021) [DOI]
  2. Lee SY, Moon HJ, Kurata S, Natori S, Lee BL. Purification and cDNA Cloning of an Antifungal Protein from the Hemolymph of Holotrichia diomphalia Larvae. . Biological and Pharmaceutical Bulletin (1995) [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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