Clinical Applications, Active Components and Mechanisms of Haemostatic Effects of Charred Chinese Medicines

Charred traditional Chinese medicines have been used to stop bleeding since ancient times. To date, they are often applied to treat purpura, metrorrhagia, upper gastrointestinal bleeding, postoperative hemorrhage of mixed hemorrhoids, and hemorrhoids bleeding. Conventional oral decoction is still a predominate application form. It is noteworthy that a new and original application form of charred herbs has occurred in the treatment of upper gastrointestinal bleeding. Different from the conventional oral decoction, the micron-sized rhei radix et rhizome carbonisatus was sprayed on the surface of the lesion through gastroscopy to stop upper gastrointestinal bleeding. Active tannins, calcium ions, flavonoids and anthraquinones play a role in a part of charred herbs to stop bleeding. The emergence or increase of active components may lead charred herbs to significantly better haemostatic effects than uncharred ones, especially the emergence of activated carbon and novel carbon dots. This underlines a big need to char herbs at first before their clinical use. It leads to a new issue how to char herbs properly for maximum active components, which is related to the quality control of charred herbs. Hence, the optimum charring methods should be explored in depth for different herbs in the future. Furthermore, modern research indicates the haemostatic mechanisms of charred herbs are related to their ability to activate coagulation pathways, enhance platelet systems and/or inhibit fibrinolysis systems.