Quick Summary

Bupleurum chinense is a traditional Chinese medicinal herb commonly used in multi-herb botanical formulations. Preliminary clinical evidence suggests it may have potential benefits in depressive disorders, immune modulation (notably in Graves’ disease), metabolic dysfunction-associated steatotic liver disease (MASLD), and as an adjunct therapy for conditions like hypertension and acute lung injury. Its main bioactive compounds include saikosaponins, which are thought to contribute to anti-inflammatory, immune-modulating, and metabolic regulatory effects. Evidence mostly comes from combination therapies, with clinical trials reporting generally favorable tolerability and safety and no serious adverse events.

What Is It?

Bupleurum is a genus of plants used in traditional Chinese medicine, with Bupleurum chinense being the most commonly studied species. It is frequently included in herbal formulas for its purported harmonizing and health-supporting properties, often as part of complex mixtures rather than used alone.

Traditional Uses

Traditionally, Bupleurum has been used to “soothe the liver,” regulate immune function, and support metabolic balance. It forms a key component of several traditional formulas aimed at treating mood disorders, autoimmune conditions, liver imbalances, hypertension, and inflammatory ailments.

Active Compounds

The primary active constituents of Bupleurum are saikosaponins, a class of triterpenoid saponins. These compounds are believed to possess anti-inflammatory, immunomodulatory, and metabolic regulatory activities contributing to the herb’s therapeutic effects.

Potential Benefits with Evidence Levels

  • Depressive disorders
    Preliminary human clinical evidence: Combination formulas including Bupleurum may produce earlier antidepressant effects compared to conventional SSRIs, with comparable or possibly better remission rates and fewer adverse reactions, according to 21 randomized controlled trials (RCTs) involving 2,766 participants. However, studies are limited by small sample sizes and short follow-up durations. [Han L, Liang Q., 2026]
  • Graves’ disease (thyroid autoimmune disorder)
    Systematic review and meta-analysis of RCTs: Chinese herbal formulas containing Bupleurum improved thyroid function and immune parameters and demonstrated lower adverse reaction rates versus conventional treatment in 44 trials. Further high-quality trials are needed. [Li SS et al., 2026]
  • Metabolic dysfunction-associated steatotic liver disease (MASLD)
    Preclinical and clinical evidence with limitations: Saikosaponins have shown potential in regulating lipid metabolism, insulin resistance, inflammation, and fibrosis. Clinical trials report favorable metabolic trends but are limited by heterogeneous designs and low evidence quality. [Xiong J et al., 2026]
  • Hypertension adjunct therapy
    Systematic review and meta-analysis of RCTs: The Longdan Xiegan formula, which includes Bupleurum, improved blood pressure and symptom scores across 9 RCTs involving 782 participants, though the overall quality of evidence is limited. [Lu S, Lv X, Zuo J., 2026]
  • Severe acute pancreatitis-related acute lung injury/ARDS
    Systematic review and meta-analysis: Combining Chinese herbal medicine containing Bupleurum with Western medicine improved clinical efficacy and lowered inflammation without increasing adverse reactions in 13 RCTs. [Han X et al., 2025]
  • Perimenopausal anxiety and depression
    Meta-analysis: Liver-soothing formulas including Bupleurum showed superior efficacy for anxiety and, when combined with other therapies, for depression relief in 12 RCTs with 1,798 participants, with comparable safety profiles. [Wang R et al., 2026]

Side Effects

Across clinical studies involving Bupleurum-containing formulas, no serious adverse events or hepatotoxicity have been reported. Mild side effects included gastrointestinal discomfort and sleep disturbances. In many cases, the frequency of adverse reactions was lower than in conventional medicine treatments. However, safety reporting was incomplete in some trials, and no direct safety data exist for Bupleurum used alone.

Drug Interactions

No clinically significant drug interactions have been systematically reported in studies involving Bupleurum-containing herbal formulas. However, comprehensive drug interaction data are lacking, especially regarding Bupleurum monotherapy. Caution is advised when combining with other medications.

Who Should Avoid It

There are no explicit contraindications identified in current clinical studies for Bupleurum-containing formulas. However, due to limited data on Bupleurum used as a single agent and incomplete safety reporting, cautious use is recommended until more evidence is available. Use during pregnancy and breastfeeding is not recommended due to lack of safety data.

Evidence Limitations

Most clinical evidence for Bupleurum chinense derives from multi-herb formulations rather than Bupleurum alone, limiting the ability to attribute benefits solely to this herb. Many studies have small sample sizes, short durations, potential biases, and lack long-term follow-up. Adverse event monitoring and pharmacokinetic data are incomplete. Rigorous large-scale randomized controlled trials with longer follow-up are needed to better validate efficacy, safety, and mechanisms.

References

  • Han L, Liang Q. Inflammation-neurotrophin synergy of Xiao-yao-san-type botanical drug formulations in depressive disorders: a qualitative synthesis of recent human studies with taxonomic and compositional characterisation. Front Pharmacol. 2026. PMID: 41929256
  • Li SS et al. Efficacy and safety evaluation of traditional Chinese medicine formulations in treating graves’ disease by improving immune function: A systematic review and meta-analysis. J Ethnopharmacol. 2026. PMID: 41956233
  • Xiong J et al. Therapeutic Potential of Saikosaponins in MASLD and Cross-Organ Protection: A Research Update. Food Sci Nutr. 2026. PMID: 41669557
  • Lu S, Lv X, Zuo J. Longdan Xiegan formula as adjuvant therapy for hypertension: A systematic review and meta-analysis. Medicine (Baltimore). 2026. PMID: 41731837
  • Han X et al. Assessment of the efficacy of Chinese herbal medicine combined with western medicine for treating severe acute pancreatitis-related acute lung injury/acute respiratory distress syndrome: a systematic review and meta-analysis based on randomized controlled trials. Front Pharmacol. 2025. PMID: 41244836
  • Wang R et al. Meta-analysis on the efficacy of liver-soothing formulas for perimenopausal anxiety and depression. World J Psychiatry. 2026. PMID: 41607452

Last Reviewed

June 2024

Disclaimer: This page is for informational purposes only and does not constitute medical advice. The effects of Bupleurum may vary and depend on individual circumstances. It should not replace consultation with a qualified healthcare professional. Always consult your healthcare provider before starting any new herbal product, especially if you are pregnant, breastfeeding, have existing health conditions, or are taking medications.