Traditional Chinese medicine

PerillaPerilla frutescens

Perilla leaf (zi su ye) is an aromatic leaf in Huo Xiang Zheng Qi; the formula beat placebo in a 212-person IBS-D trial (response gap 0.29); perilla alone is untested.

Botanical name

Perilla frutescens

Part used

leaf (zi su ye); stem and seed are separate drugs

Also called

pinyin Zi su ye (leaf), Zi su geng (stem), Zi su zi (seed) (紫苏叶 / 紫苏梗 / 紫苏子); Shiso, Beefsteak plant, Perillae folium, Soyeop (Korean), Soyo (Japanese)

Used in

Traditional Chinese medicine

Taken for

Nausea, Bloating, Indigestion

Sold as

decoction, granule extract, oral liquid, tea, capsules, dried leaf

What is meant by perilla

Perilla is an annual plant of the mint family that is grown for food and medicine across East Asia. A review in Molecules notes that it has been used for culinary and traditional purposes in China, Japan, Korea, Taiwan, Vietnam and India, and that its taxonomy is confused, with an unclear number of species. The Japanese kitchen herb shiso is the same species.

Chinese medicine treats three parts as separate drugs: the leaf (zi su ye), the stem (zi su geng) and the seed (zi su zi). The leaf is the part in the digestive formulas. It is in Huo Xiang Zheng Qi San and in Banxia Houpo Tang (the Kampo formula hangekobokuto). It is taken as a decoction, as a granule extract, in patent medicines, and as a tea. Perilla seed oil, a food oil, is a different product again.

In the traditions

Traditional Chinese medicine (about TCM)

Zi su ye is acrid and warm in the materia medica, entering the lung and spleen channels, with the actions of releasing the exterior and dispersing cold, moving qi, harmonizing the stomach and calming the fetus. The review of the plant lists its traditional uses as vomiting, abdominal pain, indigestion, constipation, coughs, colds and anxiety, among others. For the gut, the tradition uses the leaf where it sees an external cold with internal dampness: a stuffy chest, nausea, vomiting and loose stools after chill or a heavy meal, which is the picture Huo Xiang Zheng Qi San is written for. The seed, by contrast, is used for cough and for moistening the intestines in constipation. External cold and internal dampness are the texts’ pattern names and not physiological findings.

What the plant contains

The review reports that 271 molecules have been identified in perilla, including phenolic acids, flavonoids, essential oils (perillaldehyde), triterpenes, carotenoids and fatty acids. Rosmarinic acid, perillaldehyde, luteolin, apigenin, tormentic acid and isoegomaketone are the compounds that researchers have studied individually. In the laboratory, perilla and these compounds show antioxidant, antimicrobial, anti-allergic and anti-inflammatory activity. These are cell and animal findings, and the review says clinical studies are insufficient. A mouse model of postoperative ileus found hangekobokuto, which contains perilla leaf along with magnolia bark, pinellia and poria, reduced inflammation and restored delayed intestinal transit.

What has been tested in people

We could not find a controlled trial of perilla leaf on its own for a gut outcome. The review of the plant says that clinical studies are insufficient. The human data are formulas that contain it.

The larger trial is of Huo Xiang Zheng Qi oral liquid in diarrhea-predominant IBS. In a double-blind trial at 14 hospitals in China, 212 adults were randomized, 108 to the formula and 104 to placebo, with 20 ml twice a day for 4 weeks. The primary outcome was the proportion with adequate relief, and the formula beat placebo by 0.29 (95% CI 0.14 to 0.43), above the trial’s 10 percent margin; the fragility index was 13 at 4 weeks and 8 at 8 weeks, meaning that many patients changing outcome would remove significance. The IBS symptom severity score fell more on the formula (mean difference -10.92, 95% CI -18.93 to -2.90), and there were no serious adverse events. The product was supplied by its manufacturer, who had no role in the analysis.

In a second, exploratory multicenter trial of 60 patients having multiday cisplatin chemotherapy, the same formula was added to a 5-HT3 blocker and dexamethasone. Complete response against nausea and vomiting was 63.33 percent against 33.33 percent on placebo in the acute phase (p = 0.020), and 96.67 percent against 46.67 percent beyond the risk phase.

Not tested: perilla leaf alone for any digestive symptom, and the formula against active IBS drugs.

Doses used in trials and traditional preparations

In the 212-person IBS-D trial, Huo Xiang Zheng Qi oral liquid was given as 20 ml twice a day for 4 weeks; the chemotherapy trial added the formula to standard antiemetics and the abstract does not give its dose. The traditional preparation of the leaf is a short water decoction or tea made with the other herbs of the formula; the abstracts do not give gram weights. Granule extracts and patent medicines are sold ready-made, and perilla leaf alone is also sold as tea and capsules without a trial-based dose.

Safety

The review of the plant says clinical studies are insufficient to confirm either efficacy or safety, and that more study is needed. The IBS-D trial reported no serious adverse events, and the cisplatin trial described the formula as feasible and safe in combination with standard antiemetics. Pregnancy and breastfeeding data are absent from the sources we read, although the tradition uses the leaf to calm the fetus, which is a claim of the texts and not safety data. The same review notes that perilla’s taxonomy is confused, with an unclear number of species, which is one more reason a product label may not match the plant studied.

Drug interactions

No interaction between perilla leaf and a medicine is reported in the sources we read, and we found no study built to test for one. Huo Xiang Zheng Qi products contain several other herbs, including pinellia, magnolia bark and licorice, whose interaction notes apply to the finished product, and the ingredient list differs from one manufacturer to another.

Products in the catalog with perilla

These catalog entries list perilla or one of its preparations among their active ingredients. Each page shows the amount on the label, the trials behind it and what buyers report.

Related herbs

The questions that come up

Sources

• Guo X et al., "Huoxiang Zhengqi oral liquid for irritable bowel syndrome with diarrhea: a multicenter, double-blind, randomized controlled trial", Phytomedicine 2025;149:157567 pubmed.ncbi.nlm.nih.gov/41297321
• Wei H et al., "Huo Xiang Zheng Qi Oral Liquid Combined with 5-HT3 Receptor Antagonists and Dexamethasone Can Prevent Chemotherapy-Induced Nausea and Vomiting for Patients Receiving Multiday Cisplatin-Based Regimen: A Multicenter Trial", J Integr Complement Med 2023;29:501-9 pubmed.ncbi.nlm.nih.gov/36999940
• Endo M et al., "Hangekobokuto, a traditional Japanese herbal medicine, ameliorates postoperative ileus through its anti-inflammatory action", J Smooth Muscle Res 2022;58:78-88 pubmed.ncbi.nlm.nih.gov/36216552
• Ahmed HM, "Ethnomedicinal, Phytochemical and Pharmacological Investigations of Perilla frutescens (L.) Britt.", Molecules 2018;24:102 pubmed.ncbi.nlm.nih.gov/30597896
• Wu Y, Zhong P, "Clinical Progress on Management of Pneumonia Due to COVID-19 With Chinese Traditional Patent Medicines", Front Pharmacol 2021;12 (table of Huoxiang Zhengqi capsule and pill ingredients) pubmed.ncbi.nlm.nih.gov/34539389
• Bensky D, Clavey S, Stoger E, Chinese Herbal Medicine: Materia Medica, 3rd ed., Eastland Press, 2004 (nature, flavor, channels and actions as the tradition gives them) www.eastlandpress.com/products/chinese-herbal-medicine-materia-medica-portable-3rd-ed
• Bensky D, Barolet R, Ellis A, Scheid V, Chinese Herbal Medicine: Formulas and Strategies, 2nd ed., Eastland Press, 2009 (formula compositions: Huo Xiang Zheng Qi San, Banxia Houpo Tang) www.eastlandpress.com/products/chinese-herbal-medicine-formulas-strategies-portable-2nd-edition