Ci Ji Li (刺蒺藜) — Tribulus Fruit in TCM | Liver Yang, Eyes & Wind-Itch

At a Glance

• Herb: Ci Ji Li
• Chinese name: 刺蒺藜 (Cì Jí Lí)
• Latin name: Tribuli Fructus
• Nature: Warm
• Taste: Acrid / Bitter
• Meridian: Liver
• Category: Herbs that Calm the Liver and Extinguish Wind
• Introduction: Ci Ji Li (刺蒺藜, Tribulus terrestris fruit — puncturevine) is the spiny fruit of a low-growing ground-cover plant widespread across arid and sandy soils worldwide. Recorded in the Shennong Bencao Jing, its acrid, bitter, slightly warm character gives it an unusual dual profile among Liver herbs: it simultaneously calms Liver Yang, disperses Liver Qi stagnation, expels Wind to stop itching and clear the eyes, and mildly activates Blood — bridging the excess-calming and Qi-moving categories. In the West it gained popularity as an androgenic supplement (steroidal saponins — protodioscin), though clinical evidence for testosterone effects in humans remains debated. TCM uses center on Liver Yang headache, eye disorders, Wind-itch skin conditions, and Liver Qi constraint with hypochondriac pain.

Action

• Calms Liver Yang and extinguishes Wind — used for Liver Yang rising headache, dizziness, and tinnitus; also for Liver-Wind generating numbness and tremors.
• Disperses Liver Qi stagnation — addresses hypochondriac pain, breast distension and tenderness, and emotional irritability from Liver Qi constraint.
• Brightens the eyes — treats Wind-Heat red eyes, photophobia, and visual obstruction from Liver channel Wind-Heat.
• Expels Wind and stops itching — used for urticaria, eczema, prurigo, and skin itching from Wind-Heat or Wind-Damp.
• Activates Blood and disperses stagnation (mild) — combined with Blood-activating herbs for Liver Qi and Blood stasis patterns.

Clinical Application

• Liver Yang rising: headache, dizziness, and tinnitus — combined with Gou Teng, Ju Hua, and Bai Shao.
• Liver Qi stagnation: hypochondriac distension and pain, breast tenderness, premenstrual irritability — combined with Chai Hu and Xiang Fu.
• Wind-Heat eye disorders: red, painful, or tearing eyes — combined with Ju Hua and Man Jing Zi.
• Wind-itch skin: urticaria, generalized pruritus, and eczema — combined with Fang Feng and Ku Shen.
• Liver Wind numbness and tremors: extremity numbness and paresthesia from Liver Wind — combined with Gou Teng and Bai Ji Li.

Precautions

• Dose: 6–15 g.
• Contraindicated in pregnancy — Blood-activating and Liver-moving properties; traditional contraindication.
• Caution in Yin deficiency without Liver Yang rising or Wind — the dispersing action may consume Yin.
• Caution with 5-alpha reductase inhibitors or androgenic medications — steroidal saponin content may interact.
• The spiny fruit must be processed to remove spines before dispensing — raw unprocessed fruits can injure the mouth and GI tract.
• Stir-fried (炒刺蒺藜) is the standard processed form used clinically; reduces acridity and makes it safer.

Formula

• Combined with Gou Teng, Tian Ma, and Ju Hua for Liver Yang rising hypertension with headache and dizziness.
• Combined with Chai Hu, Bai Shao, and Xiang Fu (Xiao Yao San principle) for Liver Qi stagnation with hypochondriac pain and breast distension.
• Ci Ji Li San (刺蒺藜散): Ci Ji Li with Fang Feng and Chan Tui for Wind-itch skin conditions.
• Combined with Qing Xiang Zi and Mi Meng Hua for Wind-Heat eye disorders with photophobia and tearing.

Combinations

• Ci Ji Li (刺蒺藜) + Ju Hua (菊花) + Jue Ming Zi (决明子) + Qing Xiang Zi (青葙子) → clear Liver, brighten eyes; treat red painful eyes and corneal opacity
• Ci Ji Li (刺蒺藜) + Gou Teng (钩藤) + Zhen Zhu Mu (珍珠母) + Ju Hua (菊花) → calm Liver yang; treat hypertension with dizziness and headache
• Ci Ji Li (刺蒺藜) + Chai Hu (柴胡) + Xiang Fu (香附) + Yu Jin (郁金) → soothe Liver qi; treat rib-side distension and emotional depression
• Ci Ji Li (刺蒺藜) + Fang Feng (防风) + Jing Jie (荆芥) + Ku Shen (苦参) → dispel wind; treat urticaria and pruritus
• Ci Ji Li (刺蒺藜) + Bu Gu Zhi (补骨脂) + Sha Yuan Zi (沙苑子) → warm Kidney; treat vitiligo (白癜风); two varieties — important distinction: Ci Ji Li (Tribulus terrestris — thorny fruit, main medicinal) vs Sha Yuan Zi / Tong Ji Li (Astragalus complanatus — tonifies Kidney yin and yang, entirely different herb); dual Liver role: calms Liver yang (平肝) AND disperses Liver qi (疏肝) — unique among Liver herbs; topical use: Ci Ji Li decoction wash for itching skin conditions and vitiligo; sports nutrition: protodioscin converts to testosterone precursor — international supplement market

Pharmacological Effects

• Antihypertensive
  • protodioscin + saponins — inhibit ACE
  • relax vascular smooth muscle
  • Ca²⁺ channel blockade
  • reduce peripheral resistance
  • flavonoids — inhibit NADPH oxidase
  • improve endothelial NO bioavailability
  • clinical studies show reduction of 5-15 mmHg SBP in liver-yang hypertension
• Androgenic / testosterone modulation
  • protodioscin — stimulates LH release from pituitary
  • increases DHEA and testosterone synthesis
  • used in male infertility, erectile dysfunction, low libido
  • effect confirmed in animal models
  • human RCT evidence mixed but suggestive
• Anti-inflammatory
  • isorhamnetin — inhibit COX-2, 5-LOX, NF-κB
  • quercetin — inhibit TNF-α, IL-1β
  • reduce synovial inflammation
• Neuroprotective / antidepressant
  • β-carboline alkaloids — inhibit MAO-A/B
  • increase CNS monoamines
  • harmine — DYRK1A inhibitor, potential anti-Alzheimer
• Diuretic
  • saponins — increase GFR and natriuresis
  • support liver-calming effect via fluid reduction
• Hypoglycemic
  • quercetin, isorhamnetin — inhibit α-glucosidase
  • improve insulin sensitivity
• Hepatoprotective
  • flavonoids — reduce ALT/AST
• Antipruritic
  • topical — block histamine H1 receptors
  • reduce mast cell degranulation
• Anti-vitiligo
  • stimulate melanocyte function — used with 补骨脂 topically

Classic Description

• Shen Nong Ben Cao Jing: ‘Governs foul blood, breaks concretions, bindings, and accumulations; treats throat painful obstruction and difficult lactation. Long-term use grows muscles, brightens eyes, and lightens the body.’
• Ben Cao Gang Mu: ‘Ancient formulas for tonifying the Kidney and treating wind all used Ci Ji Li; later generations for tonifying the Kidney mostly used Sha Yuan Zi (Tong Ji Li) — some mistook them for the same herb, which is an error.’
• Ben Cao Hui Yan: ‘Ci Ji Li eliminates wind, descends qi, moves water, and transforms concretions — a herb with free-coursing and smooth nature that can move and disperse, coursing stagnant qi of the Liver and Spleen.’
• Ben Cao Zheng Yi: ‘Soothes Liver depression, calms Liver wind, purges Liver fire; treats red swelling, pterygium, and wind-heat of the eyes.’