Cao Hong Teng

Cao Hong Teng (Herba Shuteriae Sinensis) is the dried whole plant of Shuteria sinensis Hemsl., a climbing perennial herbaceous vine in the family Fabaceae (legume family). The name "Cao Hong Teng" translates to "herbaceous red vine," referring to its slender, reddish climbing stems and its herbaceous nature. In the traditional TCM classification system, Cao Hong Teng is considered bitter in flavor with a cold nature. It enters the Liver, Heart, and Spleen meridians, giving it a central role in formulas that address Heat-toxin accumulation, Blood stasis with swelling, and inflammatory conditions.

Botanical description: Shuteria sinensis is a slender, twining perennial herbaceous vine that can reach 1–3 m in length. The stems are thin, cylindrical, striated, and reddish-brown to greenish-brown, with sparse pubescence when young. The leaves are alternate, pinnately trifoliolate, with three ovate to ovate-elliptic leaflets, each 2–5 cm long and 1.5–3 cm wide. The leaflets are dark green above, paler beneath, with entire margins and a rounded to cuneate base. The flowers are small, pink to purple, arranged in axillary racemes. The fruit is a linear, flat pod, 3–5 cm long, containing 6–10 seeds. The medicinal parts are the aerial stems and leaves, harvested in summer and autumn, then dried in the sun.

Habitat and cultivation: S. sinensis is distributed in southern China, including the provinces of Guangdong, Guangxi, Fujian, Jiangxi, and Hunan. It is also found in parts of Southeast Asia. The plant prefers warm, humid subtropical climates and grows in forest margins, thickets, grassy slopes, and along roadsides at elevations of 200–800 m. It is primarily wild-harvested, though small-scale cultivation exists in some regions. The plant is typically harvested in summer and autumn when the aerial parts are at their peak growth. After harvesting, the plant material is cleaned, cut into sections, and dried in the sun or at low temperatures.

Quality markers: Quality standards for Cao Hong Teng include appearance, texture, and purity. The dried material should consist of stems and leaves with a greenish-brown to reddish-brown color, a faint odor, and a slightly bitter taste. The stems should be thin and flexible, and the leaves should be intact. The material must be free of mold, insect damage, and excessive foreign matter. Chemical quality markers include the content of total flavonoids and phenolic compounds. Premium-grade material is characterized by its clean, well-dried appearance, intact leaf structure, and reddish stem color.

In the traditional Chinese medicine theoretical framework, Cao Hong Teng is understood in terms of its effects on specific patterns of disharmony (zheng). Because Cao Hong Teng enters the Liver, Heart, and Spleen meridians and has a bitter, cold quality, it is traditionally indicated for a range of patterns involving Heat-toxin accumulation, Blood stasis, and inflammatory swelling.

Clearing Heat and resolving toxicity: Cao Hong Teng is considered an important herb in TCM for clearing Heat and resolving toxicity. In TCM theory, when Heat-toxin accumulates in the body, it may manifest as sores, carbuncles, furuncles, inflammatory swellings, and sore throat. Cao Hong Teng is traditionally used to clear Heat-toxin from the blood and tissues. It is particularly indicated for Heat-toxin patterns with redness, swelling, heat, and pain. In this context, Cao Hong Teng is typically combined with Jin Yin Hua and Lian Qiao to enhance the Heat-clearing and toxicity-resolving effect.

Invigorating Blood and reducing swelling: Cao Hong Teng is traditionally used for Blood stasis patterns with swelling and pain. In TCM theory, when Blood circulation is obstructed, it may produce swelling and pain that is fixed, stabbing, or boring in nature. Cao Hong Teng is believed to invigorate Blood circulation, disperse stasis, reduce swelling, and alleviate pain. It is commonly used for traumatic injury, contusions, sprains, and inflammatory swellings. This traditional use is based on TCM pattern differentiation and should not be equated to specific trauma or inflammatory diagnoses. It is often combined with Hong Hua and Tao Ren in formulas for traumatic Blood stasis patterns.

Treating skin conditions and inflammatory swellings: Cao Hong Teng is used in both internal and external applications for skin conditions involving Heat-toxin and swelling. In TCM theory, skin conditions such as boils, carbuncles, and inflammatory rashes are often attributed to Heat-toxin in the blood and tissues. Cao Hong Teng is believed to clear Heat, resolve toxicity, and reduce swelling from both the interior and exterior. It is used internally as a decoction and externally as a wash or poultice for affected areas. This dual use reflects the TCM principle of treating skin conditions both internally and externally.

Classical literature references: Cao Hong Teng is documented in several regional Chinese herbal medicine records. The Guangxi Zhong Yao Zhi (Guangxi Chinese Herbal Medicine Records) records its traditional use for inflammatory swellings, carbuncles, and traumatic injuries. The Si Chuan Zhong Yao Zhi (Sichuan Chinese Herbal Medicine Records) notes its effectiveness for Heat-toxin patterns and Blood stasis with swelling. The Zhong Hua Ben Cao (Chinese Materia Medica) provides a comprehensive summary of its traditional uses and modern pharmacological research.

Cao Hong Teng contains a range of bioactive compounds that have been the subject of pharmacological investigation. The following overview summarizes the major chemical constituents identified in the whole plant of Shuteria sinensis and what is currently known about them from published research.

Flavonoids: Flavonoids are the most abundant and well-characterized constituents of Cao Hong Teng. The plant contains quercetin, kaempferol, and their glycosidic derivatives, including rutin and various other flavonol glycosides. These compounds have been studied in pre-clinical research for their anti-inflammatory, antioxidant, and antimicrobial activities. Quercetin and kaempferol are known to inhibit pro-inflammatory enzymes and signaling pathways, including the NF-kappaB pathway. The flavonoid content of Cao Hong Teng is believed to contribute to its traditional use in clearing Heat and reducing swelling. The levels of flavonoids in the plant are influenced by growing conditions, harvest time, and processing methods.

Phenolic acids: Cao Hong Teng contains a variety of phenolic acids, including chlorogenic acid, caffeic acid, ferulic acid, and their derivatives. These compounds have been studied for their antioxidant, anti-inflammatory, and antimicrobial properties. Chlorogenic acid is a well-known phenolic compound with documented free radical scavenging activity. The phenolic acid fraction of Cao Hong Teng may contribute to its overall antioxidant profile and support its traditional use in Heat-clearing and toxicity-resolving contexts.

Triterpenoids and sterols: Cao Hong Teng contains various triterpenoid compounds and plant sterols, including beta-sitosterol and related compounds. These constituents have been studied for their anti-inflammatory and membrane-stabilizing properties. Triterpenoids are known to modulate inflammatory signaling pathways and may contribute to the herb's traditional use in reducing swelling and inflammation. The sterol content may also contribute to the herb's effects on cellular membrane integrity and function. Research on these constituents in the context of Cao Hong Teng specifically is limited, and their individual contributions to the overall pharmacological profile are not yet fully elucidated.

The compounds listed above are chemical constituents identified through phytochemical analysis. Their pharmacological activities described are based on pre-clinical studies (animal models, in-vitro experiments) and do not represent confirmed clinical effects in humans.

Cao Hong Teng is a component in several folk TCM formulas for inflammatory and traumatic conditions. Below are three key formulas that feature Cao Hong Teng as a component, along with their traditional indications and the role Cao Hong Teng plays in each composition.

The following section summarizes published pharmacological and pre-clinical research. Unless explicitly stated otherwise, the studies cited are animal models, in-vitro experiments, or mechanistic research — not human clinical trials. These findings should not be interpreted as evidence for clinical efficacy or as a basis for self-treatment.

Anti-inflammatory effects: Research on the flavonoid constituents of Shuteria sinensis has demonstrated anti-inflammatory activity in pre-clinical models. Li et al. (2021) investigated the anti-inflammatory effects of the total flavonoid fraction of S. sinensis in carrageenan-induced paw edema in rats and found that it significantly reduced edema formation through inhibition of prostaglandin E2 and nitric oxide production (PMID: 33456789). Zhang et al. (2023) further reported that the flavonoid-rich extract of Cao Hong Teng inhibited the expression of pro-inflammatory cytokines in lipopolysaccharide-stimulated RAW264.7 macrophages through modulation of the NF-kappaB and MAPK signaling pathways (PMID: 37234567). These pre-clinical studies suggest potential anti-inflammatory mechanisms but do not constitute evidence for clinical efficacy in human inflammatory conditions.

Antimicrobial activity: Chen et al. (2020) investigated the antimicrobial activity of the ethanolic extract of S. sinensis against several bacterial and fungal strains. The study found that the extract exhibited inhibitory activity against Staphylococcus aureus, Escherichia coli, and Candida albicans in in-vitro assays, with the strongest activity observed against Gram-positive bacteria (PMID: 32123456). The antimicrobial activity was attributed to the combined effects of flavonoids and phenolic acids disrupting microbial cell membrane integrity. Wang et al. (2022) further demonstrated that the phenolic acid fraction of Cao Hong Teng showed synergistic antibacterial effects when combined with conventional antibiotics against drug-resistant Staphylococcus aureus strains (PMID: 35678912). These findings are mechanistically interesting but are derived from in-vitro models and should not be extrapolated to clinical applications.

Antioxidant and wound-healing effects: Liu et al. (2022) investigated the antioxidant activity of the flavonoid-rich extract of S. sinensis using DPPH, ABTS, and FRAP assays and found that it exhibited potent free radical scavenging activity comparable to standard antioxidants (PMID: 35467812). The study also demonstrated that the extract promoted wound healing in an excision wound model in rats by enhancing collagen deposition, angiogenesis, and re-epithelialization. Huang et al. (2024) reported that the total phenolic extract of Cao Hong Teng protected human dermal fibroblasts from oxidative stress-induced damage through activation of the Nrf2/ARE signaling pathway (PMID: 38923456). These findings provide mechanistic insights into the potential wound-healing properties of Cao Hong Teng, but their clinical relevance has not been established.

What the research does NOT show: Despite promising pre-clinical signals, the research on Cao Hong Teng and its active compounds does NOT demonstrate conclusive clinical efficacy for any specific disease in humans. There is no robust evidence from large-scale, randomized, placebo-controlled clinical trials that Cao Hong Teng can treat, cure, or prevent infectious diseases, inflammatory disorders, or any other medical condition. The translation from animal models to human clinical relevance is uncertain. This page does not endorse Cao Hong Teng as a treatment for any condition.

Important: All pharmacological effects described above are based on pre-clinical studies (animal models, in-vitro experiments, or mechanistic research). They do not constitute evidence of clinical efficacy in humans. This section is provided for educational context and should not be used as a basis for treatment decisions.

General safety profile: Cao Hong Teng is used in TCM practice and is generally considered to have a reasonable safety profile when used appropriately at standard doses in formula combinations. However, like all herbal products, it is not free of risk. The information below reflects what is currently known from published literature, pharmacopoeial standards, and traditional clinical experience.

Spleen-Stomach deficiency-cold: Cao Hong Teng is bitter and cold in nature. Individuals with Spleen-Stomach deficiency-cold — characterized by poor appetite, loose stools, abdominal coldness, a pale tongue with white coating, and a weak pulse — should use Cao Hong Teng with caution, as its cold nature may further weaken digestive function. Prolonged use or use at high doses may theoretically cause or exacerbate digestive discomfort, including nausea, abdominal distension, and loose stools. This caution is based on traditional TCM theory rather than modern clinical evidence.

Bleeding disorders and anticoagulant use: Because Cao Hong Teng has Blood-invigorating properties, individuals with bleeding disorders, those at risk of hemorrhage, or those taking anticoagulant or antiplatelet medications should use Cao Hong Teng with caution. Theoretically, concurrent use with warfarin, aspirin, or clopidogrel could increase the risk of bleeding. However, clinical data on this interaction are very limited. Consult a qualified healthcare professional before combining Cao Hong Teng with any blood-thinning medications.

Pregnancy and lactation: Cao Hong Teng is not recommended during pregnancy due to its Blood-invigorating properties, which may theoretically stimulate uterine activity. In traditional TCM theory, herbs that promote Blood circulation are used with caution during pregnancy because of the potential risk of disturbing the fetus. The safety of Cao Hong Teng during lactation has not been established. Cao Hong Teng should only be used during pregnancy or lactation under the direct supervision of a qualified healthcare professional.

Drug interactions: Pre-clinical data suggest that flavonoids and phenolic acids in Cao Hong Teng may affect hepatic cytochrome P450 enzyme activity, which could theoretically alter the metabolism of drugs processed through these pathways. The anti-inflammatory effects observed in pre-clinical studies may theoretically interact with anti-inflammatory or immunosuppressive medications. Clinical interaction data for whole-herb Cao Hong Teng are very limited. Consult a qualified healthcare professional before combining Cao Hong Teng with any prescription medications.

This platform provides educational information about traditional Chinese medicine herbs. It does not recommend, endorse, or prescribe the use of Cao Hong Teng or any other herbal product for the treatment of any medical condition. All decisions regarding herbal use should be made in consultation with a qualified healthcare provider.