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Zhichuanling is a multi-component traditional Chinese medicine (TCM) formulation widely used in China for the treatment of respiratory conditions such as bronchial asthma and acute exacerbation of chronic obstructive pulmonary disease (AECOPD). It is available in both injection and oral liquid forms. The oral liquid is primarily composed of extracts from Mahuang (Herba Ephedrae), Yangjinhua (flower of Datura metel L.), bitter almond (Semen Armeniacae Amarum), and Forsythia (Fructus Forsythiae). Its therapeutic effects are attributed to its ability to reduce airway inflammation, inhibit airway remodeling and mucus secretion, relieve cough, and relax bronchial smooth muscle spasm. Zhichuanling also exhibits antagonistic effects against cholinergic neurotransmitters like acetylcholine and inflammatory mediators such as histamine, thereby improving lung ventilation and overall lung function. Its complex mechanism of action involves modulating multiple signaling pathways, including NF-κB, PI3K/Akt, IL-17, Toll-like receptor, and TNF pathways, and it can restore Ca2+ homeostasis and suppress endoplasmic reticulum stress through inhibition of the STIM1/CHOP/JNK axis.
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