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Herb library · Herb · Bupleurum chinense, B. falcatum

Bupleurum

A root from Chinese and Japanese (Kampo) medicine, almost always taken in formulas such as Sho-saiko-to. Formula studies for depression are low in quality, and Sho-saiko-to has rarely been linked to liver injury and lung inflammation.

Traditional use

Chinese books do not distinguish the species, which grow mainly in north China; the root-stock was considered to lower fever, relieve obstruction and ease gas. Bupleurum root is an ingredient of Sho-saiko-to (Xiao Chai Hu Tang), a mixture of at least seven herbs used since the Han Dynasty for fever and digestive complaints, and widely used in Japan for chronic hepatitis. Bupleurum formulas are also widely used in herbal practice for depression.

What studies show

  • Limited

    Depression: a 2020 review of 55 randomized trials found bupleurum formulas, alone or added to antidepressants, lowered depression scores more than antidepressants alone, with fewer side effects, but the evidence was low quality and at risk of bias.

  • Insufficient

    Liver disease: LiverTox says the clinical benefit of Sho-saiko-to in people has not been well demonstrated and rests mostly on small studies with uncertain end points.

  • Insufficient

    Bupleurum on its own: no study of the single herb in people was found; the results above are for formulas.

Be careful of

Cautions

  • ConditionSho-saiko-to and Dai-saiko-to have caused rare cases of acute liver injury, usually 3 to 8 weeks after starting and mostly in people who already had chronic hepatitis; it resolved on stopping and often came back on restarting. LiverTox suspects the Scutellaria (Chinese skullcap) in the mixture rather than bupleurum.
  • ConditionInterstitial pneumonitis, an inflammation of the lungs, is an uncommon reported side effect of Sho-saiko-to; a review of Japanese herbal medicine pneumonitis counted 19 cases linked to it.
  • NoteFormula products can vary in their herbs, and Chinese herbal products are sometimes mislabeled or contain undeclared drugs.
  • PregnancyNo safety information for pregnancy or breastfeeding was found in the sources used here. Talk with your clinician first.
  • Ask a clinicianTalk with a clinician or pharmacist before using this if you take prescription medicines, are pregnant or breastfeeding, or are giving it to a child.

From the old books

What herbals and dispensaries of the past printed. History, in their words.

“Young white shoots, which spring up in the spring and autumn, may be eaten. The old plant is used for fire-wood. The root-stock is the part used in medicine.”
G. A. Stuart, Chinese Materia Medica: Vegetable Kingdom (1911), p. 76. See the page of Chinese Materia Medica: Vegetable Kingdom, p. 76 (opens in a new tab) · Read the full passage from Chinese Materia Medica: Vegetable Kingdom, p. 76

Sources

  1. Sho Saiko To and Dai Saiko To - LiverTox (opens in a new tab) · NIH · read September 25, 2026
  2. Managing Depression with Bupleurum chinense Herbal Formula: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (opens in a new tab) · NIH · read September 25, 2026
  3. Chinese and other Asian Herbal Medicines - LiverTox (opens in a new tab) · NIH · read September 25, 2026

Reviewed September 25, 2026.