Ingredient Animal — whole (全虫 quán chóng)

Di Long

Earthworm · 地龙

Pheretima aspergillum (E. Perrier) · Pheretima

Also known as: Earth Dragon, Guǎng Dì Lóng (广地龙), Hù Dì Lóng (沪地龙),

Images shown are for educational purposes only

Di Long (earthworm) is a classic animal-derived medicine used in Chinese medicine to address conditions involving blocked circulation, high fevers with seizures, wheezing from lung heat, and swelling with reduced urination. It is best known for its ability to open the body's network vessels, making it a key ingredient in formulas for stroke recovery and joint pain. Despite its unusual origin, it has a long history of safe use spanning over two thousand years.

TCM Properties

Temperature

Cold

Taste

Salty (咸 xián)

Channels entered

Liver, Spleen, Urinary Bladder, Lungs

Parts used

Animal — whole (全虫 quán chóng)

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What This Ingredient Does

Every ingredient has a specific set of actions — here's what Di Long does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Di Long is primarily used to support these areas of health:

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Di Long performs to restore balance in the body:

How these actions work

'Clears Heat and arrests convulsions' means Di Long can bring down high fevers and stop seizures or spasms triggered by excessive Heat. Its cold, salty nature makes it especially suited for acute febrile illnesses where Heat has stirred up internal Wind, causing delirium, convulsions, or loss of consciousness. This is one of its most classical uses, recorded since the Shen Nong Ben Cao Jing.

'Extinguishes Wind and calms the Liver' refers to Di Long's ability to settle internal Wind patterns associated with the Liver, such as headaches, dizziness, or tremors caused by Liver Yang rising. Its salty taste softens and descends, helping to anchor rising Yang and settle agitated movement in the body.

'Unblocks the channels and collaterals' is Di Long's most widely used action in modern practice. As an animal substance, Di Long has a penetrating, burrowing nature that allows it to reach deep into the body's network vessels (collaterals). This makes it highly valued for conditions where blockage in the channels causes paralysis, numbness, joint pain, or restricted movement, such as post-stroke hemiplegia or chronic joint pain (Bi syndrome).

'Calms wheezing' means Di Long can relax the airways and ease breathing difficulty. This applies specifically to wheezing and asthma caused by Lung Heat. Its cold nature clears Heat from the Lungs while its channel-opening properties help relieve bronchial constriction. The active compound succinic acid is considered the main component responsible for this effect.

'Promotes urination' means Di Long can help the body expel excess fluid through the urinary system. This is used in cases of edema with scanty urine, particularly when Heat is involved. It enters the Urinary Bladder channel, directly supporting this function.

Patterns Addressed

In TCM, symptoms cluster into recognizable patterns of disharmony. Di Long is used to help correct these specific patterns.

Why Di Long addresses this pattern

Di Long's cold, salty nature and its strong affinity for the Liver channel make it well suited for Wind-Stroke affecting the channels and collaterals. In this pattern, Wind (often combined with Blood stasis or Qi deficiency) obstructs the network vessels, leading to hemiplegia, numbness, and impaired speech. Di Long's outstanding ability to penetrate and unblock the collaterals directly addresses this obstruction. Its burrowing, mobile nature (described classically as 'good at crawling through passages') enables it to guide other medicines through the entire body's network vessels, restoring circulation to paralyzed limbs. This is the action showcased in Bǔ Yáng Huán Wǔ Tāng.

A practitioner would look for one or more of these signs

Hemiplegia After Cerebrovascular Accident

One-sided paralysis after stroke

Numbness of the Limbs

Numbness or tingling in the extremities

Slurred Speech

Difficulty speaking clearly

Facial Paralysis

Deviation of mouth and eye

Commonly Used For

These are conditions where Di Long is frequently used — but only when they arise from the specific patterns it addresses, not in all cases

Arises from: Wind-Stroke (Channel and Collateral Level)

TCM Interpretation

TCM understands post-stroke hemiplegia as a condition where the body's Qi has become too weak to move Blood through the network vessels (collaterals), leading to Blood stasis and channel blockage. The paralyzed limbs, slurred speech, and facial deviation all reflect a failure of Qi and Blood to nourish the muscles, sinews, and tongue. This is the 'Qi deficiency with Blood stasis' mechanism described by the Qing dynasty physician Wang Qingren. The Liver and Spleen are the primary organs involved: the Liver governs the sinews and smooth flow of Qi, while the Spleen generates and controls Blood.

Why Di Long Helps

Di Long is one of the most important herbs for post-stroke recovery precisely because of its outstanding ability to penetrate and unblock the body's collateral vessels. As an animal substance with a mobile, burrowing nature, it reaches deep into the network vessels that static plant medicines may not access. In Bǔ Yáng Huán Wǔ Tāng, it serves as an Assistant herb that guides the formula's therapeutic effect throughout the entire body's channel network. While Huang Qi (Astragalus) provides the driving force by tonifying Qi, and Blood-moving herbs like Tao Ren and Hong Hua break up stasis, Di Long acts as the 'pathfinder' that opens the routes through which circulation can be restored to paralyzed areas. Its cold nature also helps prevent the formula from generating unwanted Heat.

Also commonly used for

Hypertension

High blood pressure, especially with Liver Yang rising

Convulsions

Febrile convulsions, especially in children

Epilepsy

Seizure disorders associated with Heat patterns

Deep Vein Thrombosis

Blood clot conditions, supported by fibrinolytic properties

Edema

Swelling with scanty urination due to Heat

Facial Paralysis

Bell's palsy and post-stroke facial deviation

Chronic Bronchitis

Chronic airway inflammation with wheezing

Ingredient Properties

Every ingredient has an inherent temperature, taste, and affinity for specific channels — these properties determine how it interacts with the body

Temperature

Cold

Taste

Salty (咸 xián)

Channels Entered

Liver Spleen Urinary Bladder Lungs

Parts Used

Animal — whole (全虫 quán chóng)

Dosage & Preparation

These are general dosage guidelines for Di Long — always follow your practitioner's recommendation, as dosages vary based on the formula and your individual condition

Standard dosage

5-15g

Maximum dosage

Up to 15-20g in decoction for severe conditions (acute stroke sequelae, severe asthma). When using fresh earthworms, up to 10-20g is used. As dry powder for oral ingestion, 1-2g per dose, up to 3-4g per dose in severe cases.

Dosage notes

Lower doses (5-10g) are used for general Heat-clearing, relieving wheezing, and promoting urination. Higher doses (10-15g) are used for unblocking collaterals in stroke sequelae and stubborn joint pain. When taken as dried powder (ground and swallowed rather than decocted), the dose is much smaller: 1-2g per dose. Fresh Di Long is used at roughly double the dried decoction dose. Wine-processed Di Long (酒制地龙) enhances the Blood-activating and collateral-unblocking action and reduces the strong fishy odor. Note that boiling or high-temperature processing destroys some of the fibrinolytic enzyme (lumbrokinase) activity, so powder form may preserve more of the thrombolytic effect.

Preparation

When using Di Long as powder (ground and swallowed), it does not require decoction. For decoction, no special handling is needed. Wine-processing (酒制) is commonly used to enhance Blood-moving and collateral-opening effects and to reduce the strong fishy smell. The raw (unprocessed) form is preferred for clearing Heat and settling convulsions.

Processing Methods

In TCM, the same ingredient can be prepared in different ways to change its effects — here's how processing alters what Di Long does

Processing method

The cleaned, cut segments of Di Long are mixed evenly with yellow rice wine (huang jiu), briefly moistened until the wine is absorbed, then stir-fried over low heat until the surface turns brown. The standard ratio is 12.5 kg of rice wine per 100 kg of Di Long.

How it changes properties

Wine processing moderates Di Long's intensely cold and salty nature, making it less likely to injure the Spleen and Stomach. It also removes the strong fishy smell, making the herb easier to take. Most importantly, wine enhances Di Long's channel-unblocking and Blood-moving actions, because wine itself has a warm, dispersing nature that directs herbs into the channels and collaterals. Research shows that wine-processed Di Long is superior to raw Di Long for reducing blood viscosity and dissolving blood clots.

When to use this form

Preferred for Wind-Damp Bi syndrome with joint pain and channel obstruction, and for post-stroke paralysis. Whenever the treatment priority is unblocking collaterals and moving Blood rather than clearing Heat, the wine-processed form is the better choice. Also preferred for patients with weaker digestion who cannot tolerate the raw form's strong fishy taste and cold nature.

Common Ingredient Pairs

These ingredients are traditionally combined with Di Long for enhanced therapeutic effect

Huang Qi
Huang Qi Huang Qi 30-120g : Di Long 3-10g (heavily weighted toward Huang Qi as in Bu Yang Huan Wu Tang)

Huang Qi strongly tonifies Qi to drive Blood circulation, while Di Long opens the collateral vessels so that the Qi-driven Blood can actually reach paralyzed or obstructed areas. Together they embody the principle of 'supplementing Qi to move Blood' combined with 'unblocking channels to restore function.' Neither herb alone achieves this as effectively: Huang Qi provides the motive force but lacks Di Long's penetrating reach into the network vessels.

When to use: Post-stroke hemiplegia with Qi deficiency and Blood stasis. The classic presentation is paralysis, numbness, and weakness with a pale tongue and weak pulse.

Zhi Chuan Wu
Zhi Chuan Wu 1:1 (equal parts, as in Xiao Huo Luo Dan)

Chuan Wu (prepared Aconite root) powerfully warms the channels, dispels Cold, and stops pain, while Di Long opens the collateral vessels and clears Heat. Together they address both the Cold obstruction in the channels (Chuan Wu) and the Phlegm-stasis blockage in the collaterals (Di Long). Di Long's cold nature also moderates Chuan Wu's intense heat, creating a more balanced therapeutic effect.

When to use: Chronic Wind-Cold-Damp Bi syndrome with joint pain, stiffness, numbness, and restricted movement, as seen in Xiao Huo Luo Dan.

Gou Teng
Gou Teng 1:1 (Di Long 10g : Gou Teng 10-15g)

Both herbs calm the Liver and extinguish Wind, but through complementary mechanisms. Gou Teng (Uncaria hook) clears Liver Heat and calms Liver Yang rising, while Di Long's salty, cold nature descends and settles internal Wind from the channel level. Together they provide stronger Wind-extinguishing and Liver-calming effects than either herb alone.

When to use: Liver Yang rising or Liver Wind stirring with headache, dizziness, tremors, or hypertension.

Ru Xiang
Ru Xiang Di Long 6-10g : Ru Xiang 3-6g

Ru Xiang (Frankincense) invigorates Blood and moves Qi to relieve pain, while Di Long opens the collateral vessels. Together they address both Qi-Blood stagnation (Ru Xiang) and collateral blockage (Di Long), creating a powerful channel-clearing, pain-relieving combination. This is one of the most historically common pairings in classical formulas containing Di Long.

When to use: Traumatic injury, chronic joint pain, or any Bi syndrome where Blood stasis and channel obstruction coexist.

Key Formulas

These well-known formulas feature Di Long in a prominent role

Bu Yang Huan Wu Tang 補陽還五湯 Assistant

This is the most clinically important formula featuring Di Long and the one practitioners most immediately associate with it. Created by Wang Qingren in the Qing dynasty, it treats post-stroke hemiplegia caused by Qi deficiency and Blood stasis. Di Long serves as Assistant, using its penetrating, collateral-unblocking nature to guide the formula's Qi-tonifying and Blood-moving effects throughout the entire body's network vessels. The formula perfectly showcases Di Long's signature action of opening blocked channels to restore movement to paralyzed limbs.

Xiao Huo Luo Dan 小活絡丹 Assistant

From the Song dynasty Tai Ping Hui Min He Ji Ju Fang, this formula treats Wind-Cold-Damp Bi syndrome with Phlegm and Blood stasis obstructing the channels. Di Long serves as Assistant alongside Ru Xiang and Mo Yao, contributing its collateral-opening action to complement the warming, Wind-dispelling properties of Chuan Wu and Cao Wu. This formula highlights Di Long's role in treating chronic joint pain and channel obstruction, its second most prominent clinical application.

Comparable Ingredients

These ingredients have overlapping uses — here's how to tell them apart

Tian Nan Xing
Di Long vs Tian Nan Xing

Both Dan Nan Xing (Arisaema with Bile) and Di Long clear Heat, stop convulsions, and address wheezing. However, Dan Nan Xing more strongly expels Wind and transforms Phlegm, making it better for spasmodic cough and wheezing caused by hot Phlegm blocking the Lungs (such as childhood pneumonia). Di Long more strongly calms the Liver, unblocks the collaterals, and is preferred when the focus is on paralysis, channel obstruction, or Heat-type asthma without prominent Phlegm.

Quan Xie
Di Long vs Quan Xie

Both are animal-derived medicines that extinguish Wind and stop convulsions. Quan Xie (Scorpion) is acrid, neutral to slightly toxic, and enters the Liver channel. It more strongly attacks and disperses, making it better for stubborn Wind patterns like chronic convulsions or intractable headaches. Di Long is salty and cold, so it is better suited when Heat is a significant component. Di Long also has additional actions (calming wheezing, promoting urination, unblocking collaterals for paralysis) that Quan Xie lacks.

Jiang Can
Di Long vs Jiang Can

Both extinguish Wind and stop spasms, and both are animal-derived. Jiang Can (Silkworm) is acrid, salty, and neutral, and it also disperses Wind-Heat, transforms Phlegm, and dissipates nodules. Di Long is colder and stronger at clearing Heat and calming febrile convulsions. Di Long's unique strength lies in unblocking the collaterals for post-stroke paralysis, an action Jiang Can does not share as prominently.

Common Substitutes & Adulterants

Related species and common adulterations to be aware of when sourcing Di Long

The Di Long market has significant adulteration problems. The main concern is substitution with non-pharmacopoeia earthworm species. DNA sequencing studies of commercially sold Di Long have found that many products contain species other than the four official Pharmacopoeia species, particularly the cosmopolitan species Amynthas corticis or various Eisenia species, which have different active compound profiles and lower therapeutic efficacy. Another issue is the inclusion of excessive internal soil or mud to increase weight. Imported earthworm products (particularly from Southeast Asia) may be of unverified species origin. Authentic Guang Di Long can be distinguished by its larger size, distinct purplish-grey dorsal color, and the characteristic "white collar" clitellum pattern with visible reproductive pore structures.

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any ingredient.

Toxicity Classification

Classical Chinese pharmacopoeia toxicity rating for Di Long

Non-toxic

Di Long is classified as non-toxic in the Ben Cao Gang Mu and modern Chinese Pharmacopoeia, though the original Shen Nong Ben Cao Jing listed it in the lower grade (implying caution). The earthworm body contains lumbrilysin (蚯蚓毒素), a hemolytic component, and lumbrofebin (蚯蚓解热碱), an antipyretic alkaloid. In processed dried form at standard dosages, these compounds do not cause significant toxicity. Overdosage may cause gastrointestinal discomfort (nausea, abdominal pain). Allergic reactions are the main safety concern: skin rash, itching, and in rare cases with injectable preparations, anaphylaxis-like symptoms (pallor, sweating, difficulty breathing, blood pressure drop). Raw, unprocessed earthworms may carry parasites or bacteria and should never be used internally without proper preparation.

Contraindications

Situations where Di Long should not be used or requires extra caution

Avoid

Pregnancy: Di Long has channel-unblocking and Blood-moving properties that may disturb the fetus and potentially stimulate uterine contractions. Classical sources list it as contraindicated (禁用) in pregnancy.

Caution

Spleen and Stomach deficiency-cold: Di Long is cold in nature and can injure Spleen and Stomach Yang. People with chronic loose stools, poor appetite, or cold abdomen should avoid it.

Caution

No true Heat pattern present: As a cold-natured substance, Di Long should not be used for convulsions, wheezing, or joint pain that are not caused by Heat or Heat-toxin.

Caution

Active bleeding or bleeding disorders: Due to its fibrinolytic and anticoagulant properties (via lumbrokinase), Di Long may increase bleeding risk in people with hemorrhagic conditions.

Avoid

Known allergy to earthworm proteins: Allergic reactions including skin rash, itching, and in rare cases anaphylaxis-like symptoms have been reported, particularly with injectable preparations.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Contraindicated in pregnancy. Di Long has strong channel-unblocking and collateral-penetrating properties. Classical sources (including the Chinese Pharmacopoeia notes) explicitly prohibit its use during pregnancy (孕妇禁服), citing the risk of disturbing the fetus (动胎). Research has also suggested potential teratogenic effects. There are no circumstances under which Di Long should be used during pregnancy without urgent medical justification.

Breastfeeding

There is limited specific data on Di Long during breastfeeding. Given its cold nature and bioactive protein content (including lumbrokinase and lumbrilysin), there is a theoretical risk of these components transferring through breast milk or of the cold nature affecting the nursing infant's digestion. Caution is advised, and it is generally not recommended during breastfeeding unless the clinical benefit clearly outweighs potential risks, under practitioner supervision.

Children

Di Long can be used in children for high fever with convulsions (acute childhood fright wind) at reduced, age-appropriate doses, typically one-third to one-half of the adult dose depending on the child's age and weight. It has a long history of pediatric use for febrile seizures. However, highly allergic children require extra caution. The strong fishy taste may cause nausea or vomiting in children, so powder form mixed with other herbs or encapsulated preparations may be better tolerated than decoction.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Di Long

Anticoagulant and antiplatelet drugs (warfarin, heparin, aspirin, clopidogrel, DOACs): Di Long contains lumbrokinase and other fibrinolytic proteins with demonstrated anticoagulant and thrombolytic activity. Concurrent use with pharmaceutical anticoagulants or antiplatelets may have an additive blood-thinning effect and increase bleeding risk. Regular monitoring of coagulation parameters (INR, PT) is advised if co-administration is necessary.

Thrombolytic agents (alteplase, tenecteplase): Theoretical additive fibrinolytic effect. Concurrent use should be avoided or closely monitored.

Antihypertensive drugs: Di Long has demonstrated hypotensive effects in animal studies and clinical use. Combined use with antihypertensive medications may potentiate blood pressure lowering, requiring dose adjustment and monitoring.

Dietary Advice

Foods and dietary considerations when taking Di Long

Because Di Long is cold in nature, it is best to avoid excessively cold or raw foods while taking it, especially for individuals with weaker digestion. Warm, easily digestible foods help counterbalance its cold property. Avoid alcohol in excess unless the practitioner specifically prescribes wine-processed Di Long. If taking Di Long for its blood-moving properties, reducing intake of greasy, fatty foods may support therapeutic outcomes.

Botanical Description

Physical characteristics and morphology of the Di Long source animal

Di Long is not a plant but an animal-derived medicinal substance. It is the dried body of earthworms from the family Megascolecidae (钜蚓科). The Chinese Pharmacopoeia (2020 edition) recognizes four species: Pheretima aspergillum (参环毛蚓, called "Guang Di Long"), Pheretima vulgaris (通俗环毛蚓), Pheretima guillelmi (威廉环毛蚓), and Pheretima pectinifera (栉盲环毛蚓). The latter three are collectively called "Hu Di Long" (沪地龙).

The largest species, P. aspergillum, reaches 11-38 cm in length and 5-12 mm in width, with a greyish-purple dorsal surface and paler ventral side. The body is long and cylindrical, tapering to a point at the front and blunter at the rear. It is composed of over 100 segments, each bearing a ring of bristle-like setae. Segments 14-16 form a distinctive smooth, lighter-colored band called the clitellum (生殖带), traditionally known as the "white collar" (白颈). Earthworms are nocturnal, living in moist, loose, organically rich soil at depths of 10-20 cm, and they are sensitive to light, salt, and vibration.

Sourcing & Harvesting

Where Di Long is sourced, when it's harvested or collected, and how to assess quality

Harvesting season

Guang Di Long: spring through autumn. Hu Di Long: summer.

Primary growing regions

Guang Di Long (广地龙, P. aspergillum) is considered the superior grade and is a recognized "Guang Yao" (广药, Guangdong medicinal). Its primary producing regions are Guangdong province (especially Boluo, Heshan, Nanhai, Panyu, Xinhui, Shunde, Jiangmen, Gaozhou, Huidong, Heyuan, and Xingning counties), Guangxi province (Rongxian, Hengxian, Lingshan, Beihai, Wuzhou, Beiliu), and Hainan and Fujian provinces. Hu Di Long (沪地龙, the other three species) is mainly produced in Shanghai, Zhejiang, Jiangsu, as well as Shandong, Henan, Anhui, and Fujian provinces. Guang Di Long from Guangdong and Guangxi is the most prized variety and is listed among Guangdong's "Ten Great Southern Medicines" (十大南药).

Quality indicators

Guang Di Long (the premium grade): Dried pieces should be long (15-20 cm), flat and strip-shaped with slightly curled edges, about 1-2 cm wide. The dorsal surface is brownish-brown to purplish-grey, the ventral surface light yellowish-brown. The clitellum ("white collar") at segments 14-16 should be clearly visible and slightly glossy. Good specimens are light in weight, slightly leathery in texture, and difficult to break. They should have a characteristic fishy smell and a slightly salty taste. Prefer pieces that are large, plump, intact (not broken), and free of internal soil or mud residue. Avoid specimens that are excessively dark, moldy, insect-damaged, or still containing visible soil.

Classical Texts

Key passages from the classical Chinese medical texts that describe Di Long and its therapeutic uses

Shen Nong Ben Cao Jing (《神农本草经》)

Original: 味咸,寒。主治蛇瘕,去三虫、伏尸、鬼疰、蛊毒,杀长虫,仍自化作水。

Translation: Salty in flavor, cold in nature. Treats snake-induced abdominal masses, eliminates the three worms, expels latent corpse toxin and ghost afflictions, overcomes gu-poison, and kills long worms. It can dissolve itself into water.

Ben Cao Gang Mu (《本草纲目》, Li Shizhen)

Original: 性寒而下行,性寒故能解诸热疾,下行故能利小便,治足疾而通经络。

Translation: Its nature is cold and downward-moving. Because it is cold, it can resolve all Heat diseases. Because it moves downward, it can promote urination, treat foot ailments, and unblock the channels and collaterals.

Ben Cao Jing Shu (《本草经疏》)

Original: 咸寒降泄,善走窜,能清热定惊,通利经络。

Translation: Salty and cold, with a descending and discharging nature. It excels at moving and penetrating, is able to clear Heat and settle fright, and opens and frees the channels and collaterals.

Historical Context

The history and evolution of Di Long's use in Chinese medicine over the centuries

The medicinal use of earthworms in China dates back over two thousand years. The substance was first recorded in the Shen Nong Ben Cao Jing (circa 200 BCE-200 CE) under the name "Qiu Yin" (蚯蚓), classified in the "lower grade" (下品), which indicated it had strong medicinal action and should be used cautiously. Its original applications were primarily for parasitic diseases, abdominal masses, and infectious conditions.

The name "Di Long" (地龙, literally "Earth Dragon") first appeared in the Song dynasty text Tu Jing Ben Cao (《图经本草》). This poetic renaming elevated the humble earthworm with the imagery of a dragon that moves through the earth, reflecting the creature's ability to penetrate, unblock, and move through passages, mirroring its therapeutic action of opening the channels and collaterals. By the Ming dynasty, Li Shizhen's Ben Cao Gang Mu greatly expanded the clinical indications to include febrile convulsions, urinary obstruction, wind-type joint pain, and many other conditions. Notably, although the Shen Nong Ben Cao Jing placed Di Long in the "toxic" lower category, later authorities including Li Shizhen reclassified it as non-toxic.

In modern TCM, Di Long became a key ingredient in famous formulas such as Bu Yang Huan Wu Tang (补阳还五汤) by Wang Qingren (Qing dynasty, Yi Lin Gai Cuo), where it is paired with large doses of Huang Qi and Blood-moving herbs to treat post-stroke hemiplegia. Master practitioners like Zhu Liangchun have used Di Long with Shui Zhi (leech) to treat cerebral infarction, reflecting the modern emphasis on its Blood-activating and collateral-unblocking properties.

Modern Research

3 published studies investigating the pharmacological effects or clinical outcomes of Di Long

1

Meta-analysis: Therapeutic Potential of Lumbrokinase in Acute Ischemic Stroke (2024)

Multiple authors, systematic review published in PMC, 2024. Based on RCTs searched through July 2024.

This systematic review and meta-analysis of randomized controlled trials found that lumbrokinase (the fibrinolytic enzyme from earthworms) combined with supportive care improved neurological function scores and reduced markers of thrombosis in acute ischemic stroke patients compared to standard care alone. No significant difference in adverse effects was found between groups. The authors concluded it may offer a safe, cost-effective adjunct in resource-limited settings, though evidence quality was moderate.

PubMed
2

Safety and Tolerability of Lumbrokinase DLBS1033 in Healthy Adults (Phase I, 2016)

Tjandrawinata R, Yunaidi D, Susanto L. Drug Research. 2016;66(06):293-299.

This clinical safety trial evaluated oral lumbrokinase (DLBS1033) in healthy volunteers and found it to be safe and well-tolerated. No serious adverse events were reported, supporting the feasibility of oral earthworm-derived fibrinolytic therapy.

Link
3

Comprehensive Review: Pharmacological Effects of Bioactive Agents in Earthworm Extract (2024)

Zhu et al. Animal Models and Experimental Medicine. 2024 (Wiley Online Library).

This review summarized the major bioactive compounds in earthworm extracts, including lumbrokinase (fibrinolytic), G-90 (anticoagulant), lysenin (hemolytic), antimicrobial peptides, and polyphenols. It detailed evidence for antithrombotic, anti-inflammatory, analgesic, antibacterial, antitumor, wound-healing, and blood sugar-regulating effects. The review highlighted that lumbrokinase's fibrin-specific action gives it an advantage over conventional thrombolytics by not causing hyperfibrinolysis-related bleeding.

Link

Research on individual TCM herbs is growing but still limited by Western clinical trial standards. These studies provide emerging evidence and should be considered alongside practitioner expertise.