Effect and Mechanisms of Ermiao Formula Analogs and Their Active Components in Treating Dampness-heat Type Gouty Arthritis： A Review
10.13422/j.cnki.syfjx.20252243
- VernacularTitle:二妙类方及其有效成分干预湿热型痛风性关节炎的作用及机制研究进展
- Author:
Xueping ZHAO
1
;
Xinya ZHANG
1
;
Le YANG
2
;
Ye SUN
2
;
Xin SUN
1
;
Hui SUN
1
;
Qimeng ZHANG
1
;
Guangli YAN
1
;
Xijun WANG
1
Author Information
1. State Key Laboratory of Integration and Innovation for Classic Formula and Modern Chinese Medicine， National Chinmedomics Research Center， Heilongjiang University of Chinese Medicine， Harbin 150040， China
2. The Second Affiliated Hospital of Guangzhou University of Chinese Medicine， Guangdong Provincial Hospital of Traditional Chinese Medicine， State Key Laboratory of Dampness Syndrome of Chinese Medicine， Guangzhou 510120， China
- Publication Type:Review
- Keywords:
dampness-heat type gouty arthritis;
Ermiaosan;
Sanmiaowan;
Simiaowan;
active ingredients
- From:
Chinese Journal of Experimental Traditional Medical Formulae
2026;32(6):276-285
- CountryChina
- Language:Chinese
-
Abstract:
Gouty arthritis （GA） is caused by monosodium urate（MSU） deposition due to purine metabolism disorders. In traditional Chinese medicine （TCM）， it falls under the category of "dampness-heat Bi syndrome"， with core pathogenesis involving dampness-heat accumulation and dysfunction of the spleen and kidney. The dampness-heat syndrome is the most common and the primary syndrome type during acute attacks. In Western medicine， GA is associated with purine metabolism imbalance and inflammation triggered by MSU crystals， involving pathways such as NOD-like receptor protein 3 （NLRP3） inflammasome activation and Toll-like receptor 2/4 （TLR2/4） signaling. Clinically， colchicine and similar drugs are commonly used to treat GA， although long-term use carries potential side effects. Ermiao Formula analogs originate from ancient prescriptions， including Ermiao， Sanmiao， and Simiao compound formulas. All contain Atractylodis Rhizoma and Phellodendri Chinensis Cortex. Ermiaowan follow a 1∶1 formulation ratio. Sanmiaowan add Cyathulae Radix. Simiaowan further incorporate Coicis Semen. These formulas are rich in active ingredients， including alkaloids， terpenoids， flavonoids， and sterols， and treat GA through multi-component， multi-pathway， and multi-target mechanisms. Ermiaosan primarily exerts anti-inflammatory effects by inhibiting pathways such as TLR4/nuclear factor kappa-B （NF-κB） or regulating immune responses to reduce the release of inflammatory mediators， while also suppressing xanthine dehydrogenase （XDH） and xanthine oxidase （XO） activity to decrease uric acid production. Sanmiaowan enhance uric acid-lowering and anti-inflammatory effects through the guiding herb Cyathulae Radix， while also protecting cartilage from damage. Simiaowan utilizes Coicis Semen to regulate intestinal flora， alleviate dampness-heat symptoms， and exert multi-pathway anti-inflammatory and uric acid-lowering effects. The active ingredients contribute differently to uric acid metabolism regulation， anti-inflammation， antioxidant activity， and bone repair， resulting in varying therapeutic effects due to differences in formula composition. In summary， formulas derived from Ermiaosan demonstrate significant efficacy in treating dampness-heat type GA. This review summarizes their research progress and mechanisms， providing a reference for clinical application， new drug development， and further studies.
