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Tripterygium wilfordii

Tripterygium wilfordii Hook F, TwHF, thunder god vine

Introduction

Tripterygium wilfordii is a vine that grows in East Asia. The root has been used to improve liver function and ease pain and swelling in the body. Tripterygium wilfordii can be taken as a pill. It can also be applied as a cream or gel.

Dosages

60 milligrams 2 to 3 times daily

What Research Shows

Likely Effective

  • Diabetic kidney disease —likely to improve kidney function when used with standard treatment C1- C4
  • Hives—likely to improve symptoms when used with standard treatment D1
  • Primary nephrotic syndrome —likely to improve total and complete remission rate G1
  • Rheumatoid arthritis—likely to ease soreness and pain when used with standard treatment I1- I8

May Be Effective

  • Crohn Disease —may help prolong remission B1-B3
  • IgA Nephropathy —may bring about remission E1

May Not Be Effective

  • Psoriasis —may not improve symptoms H1

Not Enough Data to Assess

  • Chronic kidney disease A1, A2
  • Inflammatory bowel disease F1

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Safety Notes

It may be safe to use Tripterygium wilfordii on the skin and to take it orally in small doses for a short time. It is unsafe to take during pregnancy. Not enough studies have been done to say whether it is safe to use for a long period. It is also not known whether it is safe to take by women who are breastfeeding.J1-J5

Interactions

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse.

 

References

A. Chronic Kidney Disease

A1. Zhu B, Wang Y, et al. Tripterygium preparations for the treatment of CKD: a systematic review and meta-analysis. Am J Kidney Dis. 2013;62(3):515-530.

A2. Wang D, Zhao XH, et al. Efficacy and safety of Tripterygium wilfordii Hook F for CKD in Mainland China: A systematic review and meta-analysis. Phytother Res. 2018 Mar;32(3):436-451.

B. Crohn Disease

B1. Ren J, Wu X, et al. Prevention of postoperative recurrence of Crohn's disease: Tripterygium wilfordii polyglycoside versus mesalazine. J Int Med Res. 2013 Feb;41(1):176-187.

B2. Zhu W, Li Y, et al. Tripterygium wilfordii Hook. f. versus azathioprine for prevention of postoperative recurrence in patients with Crohn's disease: a randomized clinical trial. Dig Liver Dis. 2015 Jan;47(1):14-9.

B3. Sun J, Shen X, et al. Tripterygium wilfordii Hook F as maintenance treatment for Crohn’s disease. Am J Med Sci. 2015;350(5):345-351.

C. Diabetic Kidney Disease

C1. Ge Y, Xie H, et al. Treatment of diabetic nephropathy with Tripterygium wilfordii Hook F extract: a prospective, randomized, controlled clinical trial. J Transl Med. 2013 May 31;11:134.

C2. Huang J, Zhang JQ, et al. [Systematic evaluation for the efficacy of tripterygium glycosides in treating diabetic nephropathy stave IV]. Zhongguo Zhong Yao Za Zhi. 2015;40(15):3100-3109.

C3. Yan W, Zhou B, et al. Antioxidant and antithrombotic therapies for diabetic kidney disease. Iran J Kidney Dis. 2015;9(6):413-420.

C4. Ren D, Zuo C, et al. Clinical efficacy and safety of Tripterygium wilfordii Hook in the treatment of diabetic kidney disease stage IV: A Meta-analysis of randomized controlled trials. Medicince (Baltimore). 2019;98(11):e14604.

D. Hives

D1. Liu L, Zhao H, et al. Efficacy and safety of Tripterygium wilfordii hook F for chronic urticaria: a systematic review and meta-analysis. BMC Complement Altern Med. 2018;18(1):243.

E. IgA Nephropathy

E1. Chen YZ, Gao Q, et al. Meta-analysis of Tripterygium wilfordii Hook F in the immunosuppressive treatment of IgA nephropathy. Intern Med. 2010;49(19):2049-2055.

F. Inflammatory Bowel Disease

F1. Ng SC, Lam YT, et al. Systematic review: the efficacy of herbal therapy in inflammatory bowel disease. Aliment Pharmacol Ther. 2013 Oct;38(8):854-863.

G. Primary Nephrotic Syndrome

G1. Wang XB, Dai EL, et al. A PRISMA-compliant systematic review and network meta-analysis on the efficacy between different regimens based on Tripterygium wilfordii Hook F in patients with primary nephrotic syndrome. Medicine (Baltimore). 2018 Jul;97(27):e11282.

H. Psoriasis

H1. Wu C, Jin HZ, et al. Efficacy and safety of Tripterygium wilfordii hook F versus acitretin in moderate to severe psoriasis vulgaris: a randomized clinical trial. Chin Med J (Engl). 2015 Feb 20;128(4):443-449.

I. Rheumatoid Arthritis

I1. Goldbach-Mansky R, Wilson M, et al. Comparison of Tripterygium wilfordii Hook F versus sulfasalazine in the treatment of rheumatoid arthritis: a randomized trial. Ann Intern Med. 2009 Aug 18;151(4):229-40, W49-51.

I2. Jiao J, Jiang Q. [External application of compound Tripterygium wilfordii decreased the activity of rheumatoid arthritis]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012;32(11):1470-1472.

I3. Jiang M, Zha Q, et al. Predicting and verifying outcome of Tripterygium wilfordii Hook F. based therapy in rheumatoid arthritis: from open to double-blinded randomized trial. Sci Rep. 2015;5:9700.

I4. Lv QW, Zhang W, et al. Comparison of Tripterygium wilfordii Hook F with methotrexate in the treatment of active rheumatoid arthritis (TRIFRA): a randomised, controlled clinical trial. Ann Rheum Dis. 2015 Jun;74(6):1078-1086.

I5. Jiao J, Tang XP, et al. [Effect of external applying compound tripterygium wilfordii Hook F. on joint pain of rheumatoid arthritis patients]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2016;36(1):29-34.

I6. Wang HL, Jiang Q, et al. Tripterygium wilfordii Hook F versus conventional synthetic disease-modifying anti-rheumatic drugs as monotherapy for rheumatoid arthritis: a systematic review and network meta-analysis. BMC Complement Altern Med. 2016;16:215.

I7. Wang X, Zu Y, et al. Treatment of rheumatoid arthritis with combination of methotrexate and Tripterygium wilfordii: A meta-analysis. Life Sci. 2017;171:45-50.

I8. Zhou YZ, Zhao LD, et al. Comparison of the impact of Tripterygium wilfordii Hook F and Methotrexate treatment on radiological progression in active rheumatoid arthritis: 2-year follow up of a randomized, non-blinded, controlled study. Arthritis Res Ther. 2018 Apr 10;20(1):70.

J. Safety

J1. Cameron M, Gagnier JJ, et al. Herbal therapy for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2011 Feb 16;(2):CD002948.

J2. Takei A, Nagashima G, et al. Meningoencephalocele associated with Tripterygium wilfordii treatment. Pediatr Neurosurg. 1997 Jul;27(1):45-48.

J3. Brown AC. Kidney toxicity related to herbs and dietary supplements: Online table of case reports. Part 3 of 5 series. Food Chem Toxicol. 2017 Sep;107(Pt A):502-519.

J4. Brown AC. Heart Toxicity Related to Herbs and Dietary Supplements: Online Table of Case Reports. Part 4 of 5. J Diet Suppl. 2018 Jul 4;15(4):516-555.

J5. Feng X, Fang SN, et al. Nephrotoxicity of Tripterygium wilfordii Hook. f Preparations: A Systematic Review and Meta-Analysis. J Altern Complement Med. 2019 Jan;25(1):16-31.

Last reviewed July 2019 by EBSCO NAT Review Board Eric Hurwitz, DC  Last Updated: 3/27/2020