She Zong Guan

She Zong Guan is a documented southern-Chinese folk synonym for Bai Hua She She Cao, listed alongside she she cao, she she huang, she zhen cao and others as an alias of the same plant, Hedyotis diffusa. The two are one drug, not two. Because Bai Hua She She Cao is commonly given at 15 to 60 g and higher in oncology practice, writing both names into a formula, or having one prescriber add She Zong Guan to a patient already taking Bai Hua She She Cao, doubles a dose that already sits above anything characterised toxicologically. Note also that the Latin name attached to this record, Herba Isodonis, belongs to a different drug entirely: Herba Isodonis is Xi Huang Cao, the aerial parts of Isodon species in the Lamiaceae, and it is not Hedyotis diffusa in the Rubiaceae. The recorded functions on this entry, which include strengthening the Stomach and invigorating the Spleen and the Blood, likewise do not match Hedyotis diffusa, whose actions are to clear heat, resolve fire toxin, reduce abscesses and promote urination.

In the one systematic in vitro screen of this herb against CYP3A4, ethanol and water-ethanol extracts of Oldenlandia diffusa, the older name for Hedyotis diffusa, inhibited CYP3A4 in human supersomes, with IC50 values across the four herbs tested falling between 17 and 83 microgram per millilitre. In the same study the herb also significantly induced PXR-mediated CYP3A4 reporter activity and raised CYP3A4 mRNA in LS180 cells at 250 microgram per millilitre. It was the only one of the four Chinese herbs tested to do both. The authors concluded that concomitant use could induce CYP3A4 and reduce the efficacy of narrow-therapeutic-index CYP3A4 substrates. Which of the two opposing effects dominates in a patient has never been tested; there is no human pharmacokinetic study.