Chinese Herbal Medicine Database

Fever with constipation, retention of feces and abdominal pain; dysentery; jaundice caused by damp-heat; haematemesis, epistaxis, inflammation of eyes and sore throat due to heat in blood; appendicitis with abdominal pain; boils, sores and abscess; amenorrhea due to blood stasis; traumatic injuries; hemorrhage from the upper gastrointestinal tract; external use for scalds and burns. Stir-baked with wine: Inflammation of the eye, swelling of the throat and painful swelling of the gums. Prepared: Boils, sores and abscess. Carbonized: Hemorrhage due to stagnation and heat in the blood

Research Findings

• A meta-analysis suggests that crude rhubarb as adjuvant treatment appears to have additional beneficial effects in patients with acute organophosphorus pesticide poisoning. [1]
• Combination of early enteral nutrition and rhubarb significantly improved the gastrointestinal function, inhibited systemic inflammation and disease severity and mitigated the disease-related damages of liver and kidney function in severe acute pancreatitis patients. [2]
• Rhubarb could serve as an effective prokinetic agent to promote the insertion of nasojejunal feeding tubes.[3]
• Rhubarb is an effective herb in alleviating symptoms of primary dysmenorrhoea.[4]
• Using rhubarb as the main drug can effectively eliminate paraquat, reduce absorption of the toxin, prevent the development of multiple organ dysfunction syndrome induced by the toxin, shorten the hospital stay days, and improve the prognosis of acute paraquat poisoning.[5]
• The rhubarb powder could significantly decrease the serum complement 3, complement 4, and hypersensitive C-reactive protein levels, and improve the curative effect in patients with hypertensive intracerebral hemorrhage after operation.[6]
• Rhubarb could prevent the digestive tract hemorrhage, reduce endotoxemia, inhibit inflammatory reactions, and improve the heart function through ameliorating the intestinal barrier function.[7]
• Several bioactive anthraquinones of rhubarb possess promising anti-cancer properties and could have a broad therapeutic potential.[8]
• Rhubarb can protect intestinal mucosal barrier in patients with severe burn. [9]
• Crude rhubarb possesss effects on septic patients of ameliorating intestinal permeability. [10]
• Rhubarb may obviously lower the incidence of multiple organ dysfunction syndrome and be used to prevent and treat systemic inflammatory response syndrome and multiple organ dysfunction syndrome after trauma.{11]
• Rhubarb can retard the introduction-period of hemodialysis and can also inhibit deterioration of the disease.[12]
• The rhubarb stalk fiber is effective in lowering serum cholesterol concentrations, especially low-density lipoprotein cholesterol, in hypercholesterolemic men.[13]
• Rhubarb and all kinds of its complex prescriptions have an assured effect on Chronic Renal Failure. [14]
• Rhubarb and enteral nutrition support have preventive effects on invasive fungal infection via gut mechanism.[15]
• Rhubarb could improve the prognosis of patients with systemic inflammation reaction syndrome. [16]
• Rhubarb significantly improves endothelial function mainly due to lipid-lowering effects in patients with atherosclerosis.[17]
• Rhubarb extract can significantly attenuate radiation induced lung toxicity and improved pulmonary function. [18]
• The prepared rhubarb could reduce the vascular endothelial cell's damage significantly and alter the immune balance, which is effective in treating the pregnancy induced hypertension.[19]
• Applying rhubarb on gastric cancer patients during perioperative period can effectively decrease the levels of C-reactive protein and interleukin-6 in peripheral blood, alleviate acute inflammatory reaction caused by operative trauma, promote the recovery of postoperative gastrointestinal motility and be beneficial for the supplement of enteral nutrition.[20]
• Rhubarb can positively modulate the acute inflammatory response, promote the recovery of postoperative gastrointestinal motility, and benefit enteral nutrition support in patients who have undergone major operations for gastric cancer.[21]
• Rhubarb was a markedly effective in cholagoging and abating of jaundice. [22]
• Raw rhubarb could ameliorate the intestinal permeability and reduce the shifting of intestinal bacteria, so as to ease the condition of disease in patients with sepsis.[23]
• Dahuang and its agents possess the action of anti-senility and can improve mentality. [24]

Use with caution in pregnancy

Chronic abuse of anthraquinone stimulant laxatives can lead to hepatitis [25]

Long-term laxative abuse may lead to electrolyte disturbances [26, 27, 28]

Secondary aldosteronism may occur due to renal tubular damage after aggravated use. Steatorrhoea and protein-losing gastroenteropathy with hypoalbuminaemia have also been reported in laxative abuse [29]

Long-term overdose exhibits nausea, vomiting, dizziness, etc. [30]

Reference

1. Wang L, Pan S. (2015). Adjuvant treatment with crude rhubarb for patients with acute organophosphorus pesticide poisoning: A meta-analysis of randomized controlled trials. Complement Ther Med. , 23(6):794-801. doi: 10.1016/j.ctim.2015.09.001. Epub 2015 Sep 9.
2. Wan B, Fu H, Yin J, Xu F. (2014). Efficacy of rhubarb combined with early enteral nutrition for the treatment of severe acute pancreatitis: a randomized controlled trial. Scand J Gastroenterol. , 49(11):1375-84. doi: 10.3109/00365521.2014.958523. Epub 2014 Sep 16.
3. Li J, Gu Y, Zhou R. (2016). Rhubarb to Facilitate Placement of Nasojejunal Feeding Tubes in Patients in the Intensive Care Unit. Nutr Clin Pract. , 31(1):105-10. doi: 10.1177/0884533615608363. Epub 2015 Oct 12.
4. Rehman H, Begum W, Anjum F, Tabasum H, Zahid S. (2015). Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial. J Complement Integr Med. , 12(1):61-9. doi: 10.1515/jcim-2014-0004.
5. Wang W, Li J, Ma G, Li N, Wang P, Xiao Q, Li B, Liu Y, Gao X, Li W. (2015). Effect of rhubarb as the main composition of sequential treatment in patients with acute paraquat poisoning: a prospective clinical research. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. , 27(4):254-8. doi: 10.3760/cma.j.issn.2095-4352.2015.04.006.
6. Yong-Jun F, Yi Z, Zun-Hua K, Zhen-Guo Z, Feng Z, Lu-Ning B. (2013). Effects of rhubarb powder on serum complement 3, complement 4, and hs-CRP in patients with intracerebral hemorrhage. Zhongguo Zhong Xi Yi Jie He Za Zhi , 33(2):168-71.
7. Mao XB, Wang SQ, Mao Y. (2012). Effects of rhubarb on the intestinal barrier function of patients with acute myocardial infarction-heart. Zhongguo Zhong Xi Yi Jie He Za Zhi. , 32(8):1046-50.
8. Huang Q, Lu G, Shen HM, Chung MC, Ong CN. (2007). Anti-cancer properties of anthraquinones from rhubarb. Med Res Rev. , 27(5):609-30.
9. Meng YB, Lei J, Hao ZM, Cao RL. (2011). Influence of rhubarb on gastrointestinal motility and intestinal mucosal barrier in patients with severe burn. Zhonghua Shao Shang Za Zhi. , 27(5):337-40.
10. Fang XL, Fang Q, Luo JJ, Zheng X. (2007). Effects of crude rhubarb on intestinal permeability in septic patients. Am J Chin Med. , 35(6):929-36.
11. Chen DC, Wang L. (2009). Mechanisms of therapeutic effects of rhubarb on gut origin sepsis. Chin J Traumatol. , 12(6):365-9.
12. Sanada H. (1996). Study on the clinical effect of rhubarb on nitrogen-metabolism abnormality due to chronic renal failure and its mechanism. Nihon Jinzo Gakkai Shi. , 38(8):379-87.
13. Goel V, Ooraikul B, Basu TK. (1997). Cholesterol lowering effects of rhubarb stalk fiber in hypercholesterolemic men. J Am Coll Nutr. , 16(6):600-604.
14. Xiao W, Deng HZ, Ma Y. (2002). Summarization of the clinical and laboratory study on the rhubarb in treating chronic renal failure. Zhongguo Zhong Yao Za Zhi. , 27(4):241-4, 262.
15. Chen DC, Yang XY, Zhao L, Lin ZF, Shan HW, Li WF, Guo CX. (2007). Effects of rhubarb and different routes of nutrition support on invasive fungal infection. Zhongguo Wei Zhong Bing Ji Jiu Yi Xue. , 19(3):150-2.
16. Peng SM, Wang SZ, Zhao JP. (2002). Effect of rhubarb on inflammatory cytokines and complements in patients with systemic inflammation reaction syndrome and its significance. Zhongguo Zhong Xi Yi Jie He Za Zhi. , 22(4):264-6.
17. Liu YF, Yu HM, Zhang C, Yan FF, Liu Y, Zhang Y, Zhang M, Zhao YX. (2007). Treatment with rhubarb improves brachial artery endothelial function in patients with atherosclerosis: a randomized, double-blind, placebo-controlled clinical trial. Am J Chin Med. , 35(4):583-95.
18. Yu HM, Liu YF, Cheng YF, Hu LK, Hou M. (2008). Effects of rhubarb extract on radiation induced lung toxicity via decreasing transforming growth factor-beta-1 and interleukin-6 in lung cancer patients treated with radiotherapy. Lung Cancer. , 59(2):219-26. Epub 2007 Sep 17.
19. Wang Z, Song H. (1999). Clinical observation on therapeutical effect of prepared rhubarb in treating pregnancy induced hypertension. Zhongguo Zhong Xi Yi Jie He Za Zhi. , 19(12):725-7.
20. Wang H, Guo LJ, Wu B. (2008). Effect of rhubarb combined with enteral nutrition on C-reactive protein and interleukin-6 in peripheral blood of patients with gastric cancer during perioperative period. Zhongguo Zhong Xi Yi Jie He Za Zhi. , 28(2):101-4.
21. Cai J, Xuan ZR, Wei YP, Yang HB, Wang H. (2005). Effects of perioperative administration of Rhubarb on acute inflammatory response in patients with gastric cancer. Zhong Xi Yi Jie He Xue Bao. , 3(3):195-8.
22. Huang ZH, Dong YS, Ye WY. (1997). Clinical observation on treatment of infantile cholestatic hepatitis syndrome by rhubarb. Zhongguo Zhong Xi Yi Jie He Za Zhi. , 17(8):459-61.
23. Fang XL, Fang Q, Luo JJ. (2006). Effects of raw rhubarb on plasma D-lactate and procalcitonin expressions in patients with sepsis. Zhongguo Zhong Xi Yi Jie He Za Zhi. , 26(2):128-30.
24. Tian J, Du H, Yang H, Liu X, Li Z. (1997). A clinical study on compound da huang (radix et Rhizoma rhei) preparations for improvement of senile persons' memory ability. J Tradit Chin Med. , 17(3):168-73.
25. Beuers U, Spengler U, Pape GR. Hepatitis after chronic abuse of senna. Lancet, 1991, 337:472.
26. American hospital formulary service. Bethesda, MD, American Society of Hospital Pharmacists, 1990.
27. Muller-Lissner SA. Adverse effects of laxatives: facts and fiction. Pharmacology, 1993, 47(Suppl. 1):138–145.
28. Godding EW. Therapeutics of laxative agents with special reference to the anthraquinones. Pharmacology, 1976, 14(Suppl. 1):78–101.
29. Heizer WD et al. Protein-losing gastroenteropathy and malabsorption associated with factitious diarrhoea. Annals of internal medicine, 1968, 68:839–852.
30. 徐忠雲 (2012)。<淺析大黃安全用藥>。中國醫藥指南，9。
31. 蕭惠來 (1998)。<德國限制使用含蒽類化合物的植物瀉藥>。中藥新藥與臨床藥理，3。