Yunnan Baiyao
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Yunnan Baiyao (or Yunnan Paiyao; ) is a proprietary
traditional Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of action ...
marketed and used as a
hemostatic An antihemorrhagic (antihæmorrhagic) agent is a substance that promotes hemostasis (stops bleeding). It may also be known as a hemostatic (also spelled haemostatic) agent. Antihemorrhagic agents used in medicine have various mechanisms of action: ...
product in both human and veterinary
alternative medicine Alternative medicine is any practice that aims to achieve the healing effects of medicine despite lacking biological plausibility, testability, repeatability, or evidence from clinical trials. Complementary medicine (CM), complementary and alt ...
. Although Yunnan Baiyao has long been recognized as a pharmaceutical preparation in China, the safety and efficacy of Yunnan Baiyao has not been assessed or established by the
FDA The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
, the
European Medicines Agency The European Medicines Agency (EMA) is an agency of the European Union (EU) in charge of the evaluation and supervision of medicinal products. Prior to 2004, it was known as the European Agency for the Evaluation of Medicinal Products or Euro ...
, or the Australian
Therapeutic Goods Administration The Therapeutic Goods Administration (TGA) is the medicine and therapeutic regulatory agency of the Australian Government. As part of the Department of Health and Aged Care, the TGA regulates the quality, supply and advertising of medicines, pa ...
. There is limited evidence regarding its effectiveness in preventing and treating
hemorrhagic Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vagi ...
and pathological conditions in both humans and animals via oral administration. In a limited number of human studies of small sample sizes, administration of Yunnan Baiyao has been shown to correlate with "reduced
perioperative The perioperative period is the time period of a patient's surgical procedure. It commonly includes ward admission, anesthesia, surgery, and recovery. Perioperative may refer to the three phases of surgery: preoperative, intraoperative, and posto ...
bleeding as well as bleeding in various ulcerative–hemorrhagic conditions". It has become popular particularly for animals with
hemangiosarcoma Hemangiosarcoma is a rapidly growing, highly invasive variety of cancer that occurs almost exclusively in dogs, and only rarely in cats, horses, mice, or humans (vinyl chloride toxicity). It is a sarcoma arising from the lining of blood vessels; ...
. There are multiple routes of drug administration. Yunnan Baiyao is sold in powder, tincture, plaster, paste, aerosol, or tablet form. The medicine, developed by Qu Huangzhang in 1902, is designated as one of two Class-1 protected
traditional Chinese medicine Traditional Chinese medicine (TCM) is an alternative medical practice drawn from traditional medicine in China. It has been described as "fraught with pseudoscience", with the majority of its treatments having no logical mechanism of action ...
s, which gives it 20 years of trade protection in China.CBW-Yunnan Baiyao, one of the most famous Chinese Companies in all Chinese Provinces of China, Yunnan Province
/ref> Yunnan Baiyao products are manufactured and distributed by a
state-owned enterprise A state-owned enterprise (SOE) is a Government, government entity which is established or nationalised by the ''national government'' or ''provincial government'' by an executive order or an act of legislation in order to earn Profit (econom ...
, Yunnan Baiyao Group () in
Yunnan Yunnan , () is a landlocked Provinces of China, province in Southwest China, the southwest of the People's Republic of China. The province spans approximately and has a population of 48.3 million (as of 2018). The capital of the province is ...
, China.


History

Yunnan Baiyao was developed by a Chinese man named Qu Huanzhang from
Jiangchuan County Jiangchuan District () is located in Yuxi, Yunnan Yunnan , () is a landlocked province in the southwest of the People's Republic of China. The province spans approximately and has a population of 48.3 million (as of 2018). The capital of ...
in
Yunnan Province Yunnan , () is a landlocked province in the southwest of the People's Republic of China. The province spans approximately and has a population of 48.3 million (as of 2018). The capital of the province is Kunming. The province borders the C ...
. He had set out to explore the entire region and taste its hundreds of
herb In general use, herbs are a widely distributed and widespread group of plants, excluding vegetables and other plants consumed for macronutrients, with savory or aromatic properties that are used for flavoring and garnishing food, for medicinal ...
s. In 1902, he formulated "Qu Huanzhang Panacea," which became Yunnan Baiyao ("White medicine from Yunnan")Dharmananda, Subhuti. (2007)
"Yunnan Baiyao Plaster"
Institute for Traditional Medicine. Retrieved March 1, 2018.
In the
Battle of Taierzhuang The Battle of Taierzhuang () was a battle of the Second Sino-Japanese War in 1938, which was fought between the armies of the Republic of China and the Empire of Japan. The battle was that war's first major Chinese victory. It humiliated the Jap ...
of 1938 (between Chinese and Japanese forces), Qu Huanzhang donated more than 30,000 bottles of Yunnan Baiyao to the Chinese
National Revolutionary Army The National Revolutionary Army (NRA; ), sometimes shortened to Revolutionary Army () before 1928, and as National Army () after 1928, was the military arm of the Kuomintang (KMT, or the Chinese Nationalist Party) from 1925 until 1947 in China ...
, supposedly saving the lives of many soldiers.
As an indication of its value, it is noted that during the 1940s, army commander Wu Xuexian was seriously injured in his right leg. The French hospital in
Kunming Kunming (; ), also known as Yunnan-Fu, is the capital and largest city of Yunnan province, China. It is the political, economic, communications and cultural centre of the province as well as the seat of the provincial government. The headquar ...
(capital of Yunnan) recommended amputation to save Wu's life. Wu turned to Qu for help, and to everyone's surprise, recovered without the need for an amputation. Yunnan Baiyao gained the reputation as a miracle remedy. After the death of Qu, his wife, Liao Lanying, donated the secret prescription to the government.
In 1935, pharmacist Qu Huanzhang registered a trademark using his own image. This was Yunnan Baiyao's first attempt at
intellectual property Intellectual property (IP) is a category of property that includes intangible creations of the human intellect. There are many types of intellectual property, and some countries recognize more than others. The best-known types are patents, cop ...
(IP) protection. Qu's wife Liao Lanying donated the Yunnan Baiyao recipe in 1956 to the Chinese government. Large-scale production of Yunnan Baiyao began. The Yunnan Baiyao Factory was established in 1971, but the company did not focus on IP protection until the late-1990s, when counterfeit products began affecting the company's business. During this period it registered a series of similar trademarks, including "Yunfeng" and "Yunnan Baiyao." In 2004, the brand was valued at 2.18 billion yuan (US$269 million), ranking 263rd in the
World Economic Forum The World Economic Forum (WEF) is an international non-governmental and lobbying organisation based in Cologny, canton of Geneva, Switzerland. It was founded on 24 January 1971 by German engineer and economist Klaus Schwab. The foundation, ...
and the World Brand Lab's list of the top 500 Chinese brands.


Patents

In the years prior to 2005, the company spent nearly 1 million yuan (US$123,300) on patent registration, industrialization of patent products, and technological innovation. The company applied for three invention patents in 2002. The number of patents reached 14 in 2004. As of October 2005, the company has applied for 36 invention patents and 40 design patents.


Formula

The formula of and production processes surrounding Yunnan Baiyao are
trade secret Trade secrets are a type of intellectual property that includes formulas, practices, processes, designs, instruments, patterns, or compilations of information that have inherent economic value because they are not generally known or readily asc ...
s. The company website says that the
steroid A steroid is a biologically active organic compound with four rings arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter membrane fluidity; and a ...
progesterone Progesterone (P4) is an endogenous steroid and progestogen sex hormone involved in the menstrual cycle, pregnancy, and embryogenesis of humans and other species. It belongs to a group of steroid hormones called the progestogens and is the m ...
is in the formula, in addition to several
saponin Saponins (Latin "sapon", soap + "-in", one of), also selectively referred to as triterpene glycosides, are bitter-tasting usually toxic plant-derived organic chemicals that have a foamy quality when agitated in water. They are widely distributed ...
s,
alkaloid Alkaloids are a class of basic, naturally occurring organic compounds that contain at least one nitrogen atom. This group also includes some related compounds with neutral and even weakly acidic properties. Some synthetic compounds of similar ...
s, and
calcium phosphate The term calcium phosphate refers to a family of materials and minerals containing calcium ions (Ca2+) together with inorganic phosphate anions. Some so-called calcium phosphates contain oxide and hydroxide as well. Calcium phosphates are white ...
– all components of
Chinese yam ''Dioscorea polystachya'' or Chinese yam ( zh, s=山药, t=山藥), also called cinnamon-vine, is a species of flowering plant in the yam family. It is sometimes called Chinese potato or by its Korean name ''ma''. It is a perennial climbing vin ...
.
Protopanaxadiol Protopanaxadiol (PPD) is an organic compound characterizing a group of ginsenosides. It is a dammarane-type tetracyclic terpene sapogenin found in ginseng (''Panax ginseng'') and in notoginseng (''Panax pseudoginseng''). Just what protopanaxadio ...
and
panaxatriol Panaxatriol is an organic compound characterizing a group of ginsenosides. It is a dammarane-type tetracyclic triterpene sapogenin found in ginseng (''Panax ginseng'') and in notoginseng (''Panax pseudoginseng''). It is formed by the dehydratio ...
,
sapogenin Sapogenins are the aglycones, or non-saccharide, portions of the family of natural products known as saponins. Sapogenins contain steroid or other triterpene frameworks as their key organic feature. For example, steroidal sapogenins such as tigge ...
s found in
ginseng Ginseng () is the root of plants in the genus ''Panax'', such as Korean ginseng ('' P. ginseng''), South China ginseng ('' P. notoginseng''), and American ginseng ('' P. quinquefolius''), typically characterized by the presence of ginsenosides an ...
(''Panax ginseng'') and
notoginseng ''Panax notoginseng'' is a species of the genus ''Panax'', and it is commonly referred to in English as Chinese ginseng * or notoginseng. In Chinese it is called ''tiánqī'' (), tienchi ginseng, ''sānqī'' () or ''sanchi'', three-seven root, a ...
(''Panax pseudoginseng''), have been detected in Yunnan Baiyao powder formulations through
capillary A capillary is a small blood vessel from 5 to 10 micrometres (μm) in diameter. Capillaries are composed of only the tunica intima, consisting of a thin wall of simple squamous endothelial cells. They are the smallest blood vessels in the body: ...
supercritical fluid A supercritical fluid (SCF) is any substance at a temperature and pressure above its critical point, where distinct liquid and gas phases do not exist, but below the pressure required to compress it into a solid. It can effuse through porous so ...
chromatography In chemical analysis, chromatography is a laboratory technique for the separation of a mixture into its components. The mixture is dissolved in a fluid solvent (gas or liquid) called the ''mobile phase'', which carries it through a system (a ...
. Yunnan Baiyao packaging indicates it should not be used with alcohol or when pregnant. Under the "Law on Guarding State Secrets", the formula as well as the production processes regarding Yunnan Baiyao are considered secret and possess the longest period of product proprietary secrecy protection of four levels of secrecy under Chinese trade law. As a result, Yunnan Baiyao's exact ingredients are not printed on its packaging in China, and its production process was not disclosed. Some of the Yunnan Baiyao's products are sold in the US as diet supplements. According to FDA regulations, all diet supplements sold in the US market must list their ingredients on the package and report them to relevant authorities. Officials from the Yunnan Baiyao Group, the exclusive producer of Yunnan Baiyao, denied to
Xinhua News Agency Xinhua News Agency (English pronunciation: )J. C. Wells: Longman Pronunciation Dictionary, 3rd ed., for both British and American English, or New China News Agency, is the official state news agency of the People's Republic of China. Xinhua ...
that there is a double standard in Yunnan Baiyao's secret-protection policy, and that ingredients are only reported to drug authorities. "Whoever disclosed the ingredients should be held legally liable," Huang Wushuang, an expert on intellectual property rights at
East China University of Political Science and Law East China University of Political Science and Law (ECUPL; ) is a public university in Shanghai, China, founded in 1952. It has two campuses, one in Songjiang University Town in Songjiang District, and the other in Changning District. History Th ...
, said.


Chinese disclosures

''
Paris Paris () is the capital and most populous city of France, with an estimated population of 2,165,423 residents in 2019 in an area of more than 105 km² (41 sq mi), making it the 30th most densely populated city in the world in 2020. S ...
'' is mentioned as a major ingredient of Yunnan Baiyao in a 2002 paper on biodiversity in Yunnan province. In 2014, Yunnan Baiyao amended the labeling of its Chinese products to add a warning regarding its use of ''
Aconitum ''Aconitum'' (), also known as aconite, monkshood, wolf's-bane, leopard's bane, mousebane, women's bane, devil's helmet, queen of poisons, or blue rocket, is a genus of over 250 species of flowering plants belonging to the family Ranunculaceae. ...
'' plant, which contains the
alkaloid Alkaloids are a class of basic, naturally occurring organic compounds that contain at least one nitrogen atom. This group also includes some related compounds with neutral and even weakly acidic properties. Some synthetic compounds of similar ...
toxin A toxin is a naturally occurring organic poison produced by metabolic activities of living cells or organisms. Toxins occur especially as a protein or conjugated protein. The term toxin was first used by organic chemist Ludwig Brieger (1849– ...
aconitine Aconitine is an alkaloid toxin produced by various plant species belonging to the genus '' Aconitum'' (family Ranunculaceae), known also commonly by the names wolfsbane and monkshood. Monkshood is notorious for its toxic properties. Aconitine is ...
. This substance has
analgesic An analgesic drug, also called simply an analgesic (American English), analgaesic (British English), pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain (that is, analgesia or pain management). It ...
properties, but is mainly known for being a highly potent poison.


Purported FDA ingredient list

In December 2010, purported lists of ingredients were published on the websites of
Amazon.com Amazon.com, Inc. ( ) is an American multinational technology company focusing on e-commerce, cloud computing, online advertising, digital streaming, and artificial intelligence. It has been referred to as "one of the most influential economi ...
and the
Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respon ...
(FDA). The list containing eight supposedly active ingredients of a liquid form of the drug were found in a 2002 document published on the FDA website that contains correspondence between the FDA and a distributor of the drug. Ingredient lists were also present in the product information sections for the powdered and capsule forms of the drug on Amazon.com. The corporation denies that the list is the secret formula. The 2010 FDA document listed
notoginseng ''Panax notoginseng'' is a species of the genus ''Panax'', and it is commonly referred to in English as Chinese ginseng * or notoginseng. In Chinese it is called ''tiánqī'' (), tienchi ginseng, ''sānqī'' () or ''sanchi'', three-seven root, a ...
(''Panax pseudoginseng'') root,
borneol Borneol is a bicyclic organic compound and a terpene derivative. The hydroxyl group in this compound is placed in an '' endo'' position. The exo diastereomer is called isoborneol. Being chiral, borneol exists as enantiomers, both of which are foun ...
crystal from ''
Dryobalanops aromatica ''Dryobalanops aromatica'', commonly known as Borneo camphor, camphor tree, Malay camphor, or Sumatran camphor, is a species of critically endangered plant in the family Dipterocarpaceae. The species name ''aromatica'' is derived from Latin (''ar ...
'', '' Boea clarkeana'' entire plant, ''
Inula ''Inula'' is a genus of about 80 species of flowering plants in the family Asteraceae, native to Europe, Asia and Africa. They may be annuals, herbaceous perennials or subshrubs that vary greatly in size, from small species a few centimeter ...
coppa'' root, Complanatum ('' Lycopodium complanatum'')
rhizome In botany and dendrology, a rhizome (; , ) is a modified subterranean plant stem that sends out roots and shoots from its nodes. Rhizomes are also called creeping rootstalks or just rootstalks. Rhizomes develop from axillary buds and grow hori ...
,
Chinese yam ''Dioscorea polystachya'' or Chinese yam ( zh, s=山药, t=山藥), also called cinnamon-vine, is a species of flowering plant in the yam family. It is sometimes called Chinese potato or by its Korean name ''ma''. It is a perennial climbing vin ...
(''Dioscorea opposita'') rhizome, galanga (''
Alpinia officinarum ''Alpinia officinarum'', known as lesser galangal, is a plant in the ginger family, cultivated in Southeast Asia. It originated in China, where its name ultimately derives. It can grow 1.5 to 2 m high, with long leaves and reddish-white flowers. ...
'') rhizome, cranebill (''
Erodium ''Erodium'' is a genus of flowering plants in the botanical family Geraniaceae. The genus includes about 60 species, native to North Africa, Indomalaya, the Middle East, and Australia. They are perennials, annuals, or subshrubs, with five-petall ...
stephanianum'') aerial parts,
camphor Camphor () is a waxy, colorless solid with a strong aroma. It is classified as a terpenoid and a cyclic ketone. It is found in the wood of the camphor laurel ('' Cinnamomum camphora''), a large evergreen tree found in East Asia; and in the k ...
crystal from ''
Cinnamomum camphora ''Camphora officinarum'' is a species of evergreen tree that is commonly known under the names camphor tree, camphorwood or camphor laurel. Description ''Camphora officinarum'' is native to China south of the Yangtze River, Taiwan, southern ...
'', and peppermint (''Menta haplocalyx'') leaves as active ingredients in Yunnan Baiyao products. A largely matching list of ingredients with proportions, allegedly from a bottle of ''Yunnan Baiyao'' powder bought in the USA, was published in science writer Fang Zhouzi's blog in 2009.


Taiwanese replica

In 1966, an ROC army hospital director by the name of Wu Junchang () "happened" on a key ingredient of Yunnan Baiyao when hunting near
Kaohsiung Kaohsiung City (Mandarin Chinese: ; Wade–Giles: ''Kao¹-hsiung²;'' Pinyin: ''Gāoxióng'') is a special municipality located in southern Taiwan. It ranges from the coastal urban center to the rural Yushan Range with an area of . Kaohsi ...
. He ended up successfully recreating the medication and selling it. Wu's formula contains 44% ''
Paris Paris () is the capital and most populous city of France, with an estimated population of 2,165,423 residents in 2019 in an area of more than 105 km² (41 sq mi), making it the 30th most densely populated city in the world in 2020. S ...
'' plant, 21% notoginseng root, 12%
Chinese yam ''Dioscorea polystachya'' or Chinese yam ( zh, s=山药, t=山藥), also called cinnamon-vine, is a species of flowering plant in the yam family. It is sometimes called Chinese potato or by its Korean name ''ma''. It is a perennial climbing vin ...
rhizome, 10% ''
Aconitum ''Aconitum'' (), also known as aconite, monkshood, wolf's-bane, leopard's bane, mousebane, women's bane, devil's helmet, queen of poisons, or blue rocket, is a genus of over 250 species of flowering plants belonging to the family Ranunculaceae. ...
'' root, 6% ''
Adenophora ''Adenophora'' is a genus of flowering plants in the family Campanulaceae, the bellflowers. Plants of this genus are known commonly as ladybells.Perry, LPerennial Plant Feature: Ladybells.Department of Plant and Soil Science, University of Vermo ...
stricta'' root, 1%
borneol Borneol is a bicyclic organic compound and a terpene derivative. The hydroxyl group in this compound is placed in an '' endo'' position. The exo diastereomer is called isoborneol. Being chiral, borneol exists as enantiomers, both of which are foun ...
, plus "a little"
musk Musk (Persian: مشک, ''Mushk'') is a class of aromatic substances commonly used as base notes in perfumery. They include glandular secretions from animals such as the musk deer, numerous plants emitting similar fragrances, and artificial sub ...
and dried ''
Veratrum ''Veratrum'' is a genus of flowering plants in the family Melanthiaceae. It occurs in damp habitats across much of temperate and subarctic Europe, Asia, and North America. ''Veratrum'' species are vigorous herbaceous perennials with highly poiso ...
taliense''.


Contamination and adulteration

In early 2013, officials in
Sichuan province Sichuan (; zh, c=, labels=no, ; zh, p=Sìchuān; alternatively romanized as Szechuan or Szechwan; formerly also referred to as "West China" or "Western China" by Protestant missions) is a province in Southwest China occupying most of the ...
banned the sale of Baiyao powders and pills over faulty and defective wrappers that led to
water contamination Water pollution (or aquatic pollution) is the contamination of water bodies, usually as a result of human activities, so that it negatively affects its uses. Water bodies include lakes, rivers, oceans, aquifers, reservoirs and groundwater. Water ...
in addition to finding products contaminated with mold. In February 2013, the Department of Health of Hong Kong found potentially toxic undeclared
aconitum ''Aconitum'' (), also known as aconite, monkshood, wolf's-bane, leopard's bane, mousebane, women's bane, devil's helmet, queen of poisons, or blue rocket, is a genus of over 250 species of flowering plants belonging to the family Ranunculaceae. ...
alkaloid Alkaloids are a class of basic, naturally occurring organic compounds that contain at least one nitrogen atom. This group also includes some related compounds with neutral and even weakly acidic properties. Some synthetic compounds of similar ...
s in samples of Yunnan Baiyao products, leading to a mandatory recall of products and a temporary ban on the sale of Yunnan Baiyao in the administrative regions of Hong Kong and
Macau Macau or Macao (; ; ; ), officially the Macao Special Administrative Region of the People's Republic of China (MSAR), is a city and special administrative region of China in the western Pearl River Delta by the South China Sea. With a pop ...
. In 2019, unauthorised Yunnan Baiyao toothpaste was recalled by
Health Canada Health Canada (HC; french: Santé Canada, SC)Health Canada is the applied title under the Federal Identity Program; the legal title is Department of Health (). is the Structure of the Canadian federal government#Departments, with subsidiary unit ...
due to the presence of
tranexamic acid Tranexamic acid (TXA) is a medication used to treat or prevent excessive blood loss from major trauma, postpartum bleeding, surgery, tooth removal, nosebleeds, and heavy menstruation. It is also used for hereditary angioedema. It is taken eith ...
, a prescription medication.


Cooperation

The Yunnan Baiyao Group has diversified and expanded into the global pharmaceutical industry. In 2001, the company revealed an adhesive band-aid product in a joint venture with German personal care products maker
Beiersdorf Beiersdorf AG is a German multinational company that manufactures and retails personal-care products and pressure-sensitive adhesives. Its brands include Elastoplast, Eucerin (makers of Aquaphor), Labello, La Prairie, Nivea, Tesa SE (Tesa t ...
AG. In 2003, 3M initiated contact with Yunnan Baiyao Group Co, Ltd. to discuss potential cooperation opportunities in the area of
transdermal Transdermal is a route of administration wherein active ingredients are delivered across the skin for systemic distribution. Examples include transdermal patches used for medicine delivery. The drug is administered in the form of a patch or ointme ...
pharmaceutical products.


Efficacy

Yunnan Baiyao products are classed as
dietary supplement A dietary supplement is a manufactured product intended to supplement one's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources or that are synthetic in order ...
s or new drugs by the FDA, and are not generally recognized as safe and effective for the prevention, mitigation, or treatment of wounds, pain, and hemorrhage among other conditions. The
European Medicines Agency The European Medicines Agency (EMA) is an agency of the European Union (EU) in charge of the evaluation and supervision of medicinal products. Prior to 2004, it was known as the European Agency for the Evaluation of Medicinal Products or Euro ...
has not assessed the safety or efficacy of the product as a
hemostatic An antihemorrhagic (antihæmorrhagic) agent is a substance that promotes hemostasis (stops bleeding). It may also be known as a hemostatic (also spelled haemostatic) agent. Antihemorrhagic agents used in medicine have various mechanisms of action: ...
. It is not listed on the Australian Register of Therapeutic Goods (ARTG) for approved sale in Australia, and the quality, safety, or efficacy of Yunnan Baiyao has not been established by the Australian
Therapeutic Goods Administration The Therapeutic Goods Administration (TGA) is the medicine and therapeutic regulatory agency of the Australian Government. As part of the Department of Health and Aged Care, the TGA regulates the quality, supply and advertising of medicines, pa ...
. Yunnan baiyao demonstrates hemostatic effects, stopping the flow of blood when applied topically on
open wound A wound is a rapid onset of injury that involves lacerated or punctured skin (an ''open'' wound), or a contusion (a ''closed'' wound) from blunt force trauma or compression. In pathology, a ''wound'' is an acute injury that damages the epiderm ...
s. Oral administration was shown to produce negligible results in laboratory tests. ''In vitro'' studies have suggested a theoretical benefit in the treatment of
rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and hands are involv ...
. Some studies have found heavy metal levels below oral tolerance levels, however the significance of this finding is not known. Multiple routes of drug administration results in varying degrees of efficacy. Topical administration has been shown to have a degree of efficacy possibly through ultrastructural changes in
platelet Platelets, also called thrombocytes (from Greek θρόμβος, "clot" and κύτος, "cell"), are a component of blood whose function (along with the coagulation factors) is to react to bleeding from blood vessel injury by clumping, thereby ini ...
s and platelet-constituent release. The effect of Yunnan Baiyao on the
coagulation Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It potentially results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The mechanism o ...
biochemical system has not been fully elucidated, but it has been suggested that the expression of
glycoprotein Glycoproteins are proteins which contain oligosaccharide chains covalently attached to amino acid side-chains. The carbohydrate is attached to the protein in a cotranslational or posttranslational modification. This process is known as glycos ...
s on platlets plays a role. One ''in vitro'' study found that Yunnan Baiyao causes dose- and time- dependent
hemangiosarcoma Hemangiosarcoma is a rapidly growing, highly invasive variety of cancer that occurs almost exclusively in dogs, and only rarely in cats, horses, mice, or humans (vinyl chloride toxicity). It is a sarcoma arising from the lining of blood vessels; ...
cell death through initiation of
caspase Caspases (cysteine-aspartic proteases, cysteine aspartases or cysteine-dependent aspartate-directed proteases) are a family of protease enzymes playing essential roles in programmed cell death. They are named caspases due to their specific cystei ...
-mediated cell apoptosis in a canine cell
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
line which supports future studies involving Yunnan Baiyao. It is reported to be well-tolerated in dogs. Another study found no significant difference from
placebo A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures. In general ...
regarding buccal
mucosal A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...
bleeding time,
prothrombin time The prothrombin time (PT) – along with its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) – is an assay for evaluating the ''extrinsic'' pathway and common pathway of coagulation. This blood test is als ...
, activated partial
thromboplastin Thromboplastin (TPL) is derived from cell membranes and is a mixture of both phospholipids and tissue factor, neither of which are enzymes. Thromboplastin acts on and accelerates the activity of Factor Xa, also known as thrombokinase, aiding bloo ...
time, and
clotting Coagulation, also known as clotting, is the process by which blood changes from a liquid to a gel, forming a blood clot. It potentially results in hemostasis, the cessation of blood loss from a damaged vessel, followed by repair. The mechanism o ...
parameters in canines. There was no high-quality evidence supporting the use of Yunnan Baiyao for either rheumatoid arthritis or hemangiosarcoma available in publicly reported scientific literature as of 2019. Two
randomized In common usage, randomness is the apparent or actual lack of pattern or predictability in events. A random sequence of events, symbols or steps often has no order and does not follow an intelligible pattern or combination. Individual rand ...
double-blind In a blind or blinded experiment, information which may influence the participants of the experiment is withheld until after the experiment is complete. Good blinding can reduce or eliminate experimental biases that arise from a participants' expec ...
studies showed the administration of yunnan baiyao produced effects on
intraoperative The perioperative period is the time period of a patient's surgical procedure. It commonly includes ward admission, anesthesia, surgery, and recovery. Perioperative may refer to the three phases of surgery: preoperative, intraoperative, and posto ...
blood loss Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...
, producing “a reduction in intraoperative blood loss in bimaxillary
orthognathic surgery Orthognathic surgery (), also known as corrective jaw surgery or simply jaw surgery, is surgery designed to correct conditions of the jaw and lower face related to structure, growth, airway issues including sleep apnea, TMJ disorders, malocclusion ...
“, and that it “reduced the amount of intraoperative bleeding of cervical open-door
laminoplasty Laminoplasty is an orthopaedic/neurosurgical surgical procedure for treating spinal stenosis by relieving pressure on the spinal cord. The main purpose of this procedure is to provide relief to patients who may have symptoms of numbness, pain, or ...
”. Another showed that
perioperative The perioperative period is the time period of a patient's surgical procedure. It commonly includes ward admission, anesthesia, surgery, and recovery. Perioperative may refer to the three phases of surgery: preoperative, intraoperative, and posto ...
oral administration “can effectively reduce the magnitude of facial swelling in bimaxillary orthognathic surgery”. Concerns include lack of
quality control Quality control (QC) is a process by which entities review the quality of all factors involved in production. ISO 9000 defines quality control as "a part of quality management focused on fulfilling quality requirements". This approach places ...
, manufacturing regulations, and standardization in China.


Market


Fields

Yunnan Baiyao is focused primarily on diversification of the higher-end market segment for pharmaceuticals. Following the success of its adhesive bandages, the Chinese firm added toothpaste to its product line-up. Sales revenue from the Yunnan Baiyao toothpaste grossed 500 million yuan in 2008, making it the fifth most popular toothpaste in China in terms of sales revenue.


Product research

Over the five years prior to 2016, the revenue of the Yunnan Baiyao Group doubled to $3.4 billion in 2016, while net profits increased by 140% to $440 million. Market capitalisation rose by over 250% since the end of 2011, to more than $13 billion. Starting around 2005, Yunnan Baiyao expanded further into consumer products including patches and shampoos. Adhesive bandages with Yunnan Baiyao powder are marketed under the slogan "It heals faster with Baiyao" ().Yunnan Baiyao: The picture of health September 19, 2017 at the forbesindia.www.forbesindia.com/article/cross-border/yunnan-baiyao-the-picture-of-health/48169/1


See also

*
Artemisinin Artemisinin () and its semisynthetic derivatives are a group of drugs used in the treatment of malaria due to ''Plasmodium falciparum''. It was discovered in 1972 by Tu Youyou, who shared the 2015 Nobel Prize in Physiology or Medicine for her dis ...
*
Artesunate Artesunate (AS) is a medication used to treat malaria. The intravenous form is preferred to quinine for severe malaria. Often it is used as part of Artemisinin-based combination therapy, combination therapy, such as artesunate plus mefloquine. I ...
*
Dihydroartemisinin Dihydroartemisinin (also known as dihydroqinghaosu, artenimol or DHA) is a drug used to treat malaria. Dihydroartemisinin is the active metabolite of all artemisinin compounds (artemisinin, artesunate, artemether, etc.) and is also available as ...
*
Project 523 Project 523 (or task number five hundred and twenty-three; ) is a code name for a 1967 secret military project of the People's Republic of China to find antimalarial medications. Named after the date the project launched, 23 May, it addressed mala ...
*
Tu Youyou Tu Youyou (; born 30 December 1930) is a Chinese pharmaceutical chemist and malariologist. She discovered artemisinin (also known as , ) and dihydroartemisinin, used to treat malaria, a breakthrough in twentieth-century tropical medicine, sav ...


References

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External links


Yunnan Baiyao Group Company Limited

Yunnan Baiyao for dogs
Plants used in traditional Chinese medicine