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Bupleurum (Chai Hu) in Chinese Medicine
Bupleurum (Chai Hu) is a root used in many Chinese formulas such as Xiao Chai Hu Tang; here is its traditional role, the low-quality trials, and the liver-safety questions reviews raise.
Content last updated . This page has not been medically reviewed.
Back to Traditional Chinese MedicineWhat it is
Bupleurum, called Chai Hu in Chinese and Radix Bupleuri in pharmacopoeias, is a root used for more than 2,000 years in China, Japan, Korea and other Asian countries, according to a review of its traditional uses. [1] It is a main ingredient in classical formulas such as Xiao Chai Hu Tang, Da Chai Hu Tang, Si Ni San and Chai Hu Shu Gan San. [2] See Xiao Chai Hu Tang (Minor Bupleurum Decoction) for the best-known formula.Traditional use
Reviews describe Bupleuri Radix as a herb used for "relieving liver depression" for thousands of years. [2] The phrase belongs to a traditional framework in which the "liver" is a functional system, not the organ studied in biomedicine; see Qi, Yin and Yang, Five Phases and Meridians as Traditional Concepts. Chai Hu is also traditionally prescribed to "harmonize Shaoyang disorders", a term from the Shanghan Lun tradition. [3] These are traditional explanations, not proven biology.What research shows
Trials nearly always test a whole formula, not Bupleurum alone, so they cannot show what Bupleurum itself does.Depression
Promising but limitedA meta-analysis of Bupleurum-based formulas, 30 trials against SSRI antidepressants and 25 as add-on to SSRIs, found lower depression scores. The authors judged the evidence low quality and at risk of bias, with very high heterogeneity. [4]
Epilepsy
Insufficient evidence (poor trial quality)A 2026 meta-analysis of 33 trials (2,464 patients) of Bupleurum formulas reported better seizure outcomes than anti-seizure monotherapy. Reporting quality was suboptimal; allocation concealment was described in only 6% and blinding was not mentioned. [3]
Liver disease
Preclinical and traditional useReviews describe the root and its formulas as used for hepatitis, fatty liver, cirrhosis and liver cancer, with effects shown through lab and animal mechanisms. [2]
Both reviews themselves flag weak trial reporting or high heterogeneity, so large pooled effects should be read with caution. Do not use these results to replace antidepressants, anti-seizure medicine or any prescribed treatment.
Quality and where it fits
The product may be a raw slice, a granule extract or one part of a mixed patent medicine, so the amount of Bupleurum is hard to know. See Chinese Herbal Products: Quality, Contamination and Medicine Interactions and the overview Chinese Herbal Medicine.Frequently asked questions
What is Chai Hu used for in Chinese medicine?
Traditionally it is used to "relieve liver depression" and to harmonize Shaoyang disorders, usually inside formulas. [2][3]
Is Bupleurum the same as Xiao Chai Hu Tang?
No. Bupleurum is one herb. Xiao Chai Hu Tang is a multi-herb formula that includes it; see Xiao Chai Hu Tang (Minor Bupleurum Decoction). [2]
Does Bupleurum treat depression?
Pooled trials of Bupleurum formulas showed lower depression scores, but the evidence was low quality and the studies varied widely. [4] It should not replace prescribed treatment.
Can Bupleurum harm the liver?
Reviews say it can at high doses and with long-term use, mainly from laboratory data. [1] Because reports often involve mixtures, it is hard to pin down. [5]
Is it safe in pregnancy?
The sources we read did not say. Ask a clinician and see Pregnancy and Breastfeeding.
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Safety and liver questions
A real-world note: one case report in Japan described acute hepatitis with jaundice after a Bupleurum-containing herbal medicine (Sairei-to). Testing in that report pointed to a different ingredient in the formula, Pinellia ternata, as the likely cause. [5] It shows how hard it is to tell which herb in a mixture is responsible. A review of that same formula, taken in China, Korea and Japan, reports rare unwanted effects, notably lung injury (pneumonitis). [6]
These sources did not give pregnancy, breastfeeding, child or interaction data for Chai Hu itself, so treat those as unknown and ask a clinician or pharmacist. See Pregnancy and Breastfeeding and Liver Injury From Chinese Herbal Products.
Who should ask first
References
- Radix Bupleuri: a review of traditional uses, botany, phytochemistry, pharmacology, and toxicology. Biomed Res Int 2017. PubMed 28593176. Read 2026-10-22.
- A comprehensive review of bupleuri radix and its bioactive components, with a major focus on treating chronic liver diseases. J Ethnopharmacol 2024. PubMed 38663781. Read 2026-10-22.
- Reporting quality and evidence support in randomized controlled trials of Bupleurum-based herbal medicine formulas for epilepsy. J Ethnopharmacol 2026. PubMed 42081955. Read 2026-10-22.
- Managing depression with Bupleurum chinense herbal formula: a systematic review and meta-analysis of randomized controlled trials. J Altern Complement Med 2020. PubMed 31328996. Read 2026-10-22.
- Liver injury induced by a Japanese herbal medicine, sairei-to (TJ-114). J Gastroenterol Hepatol 2007. PubMed 17444872. Read 2026-10-22.
- Efficacy and safety of the traditional herbal medication Chai-Ling-Tang, Siryung-tang or Sairei-To. J Ethnopharmacol 2024. PubMed 37683930. Read 2026-10-22.