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Ruyizhenbao Pill is a classic oral Tibetan herbal medicine composed of approximately 29–30 medicinal ingredients including pearl, cassia seed, bezoar, saffron (*Carthamus tinctorius*), amomum (*Amomum kravanh*), licorice (*Glycyrrhiza uralensis*), *Aquilaria sinensis*, *Eugenia caryophyllata*, *Myristica fragrans*, *Phyllanthus emblica*, *Santalum album*, and Lignum dalbergiae odoriferae[1][2][5]. It is traditionally used for the treatment of neurological and vascular conditions such as stroke (including limb numbness and paralysis), lumbar disc herniation (pain and dysfunction), acute spinal cord injury (SCI), neuropathic pain, gout, Baimai disease (“white channels” disease in Tibetan medicine), old fever/plague syndromes[1][3][4][5][6]. Mechanistically, its effects are attributed to multi-target actions including inhibition of the CXCL10-CXCR3 pathway in neuropathic pain models; modulation of immune response by reducing Treg cell proportion via the TUG1/miR-214/HSP27 signaling axis; regulation of estrogen receptor expression; inhibition of arrhythmias via SCN5A modulation; anti-inflammatory effects through PIK3CG/NOS2/NOS3/JUN/CASP3/F7/AKT1 pathways[1][4][5][6]. It has been approved for use in China since April 2020 for indications such as gout and is under clinical investigation for lumbar disc herniation. The main active components identified include agarotetrol (from Aquilariae Lignum Resinatum), piperine (from Piper longum L.), isoliquiritigenin (from Dalbergia odorifera T. Chen), ferulic acid (from licorice cream)[2].
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