Bujing Yishi tablets

What It Is

• Bujing Yishi tablets (补精益视片, “Bujing Yishi Pian”) are a traditional Chinese medicine (TCM) herbal formulation.
• The name roughly means something like “tonify essence and benefit vision,” reflecting its intended ophthalmic (eye) uses.
• The formulation comprises around ten herbal ingredients (depending on the version) — common herbs include Salvia miltiorrhiza (Danshen), Panax notoginseng (Sanqi), Semen cuscutae, Schisandra chinensis, Chaenomeles sinensis, Motherwort fruit, Lycium/medlar (goji), Plantago seed, and citrus pericarpium.
• It is used in China (and TCM practice) primarily for eye diseases, especially in contexts where conventional treatments have limited success or as adjunctive therapy.
• One of the key approved uses is for glaucoma with controlled intraocular pressure (GPCI) in Chinese hospitals.
• Beyond glaucoma, more recent experimental studies have explored its use in retinal degenerative diseases (e.g. retinitis pigmentosa) in animal models

How It Works

Because Bujing Yishi is a multi‐herb formula, its mechanisms are complex, multifactorial, and still under investigation. Below is what the current (preclinical and limited clinical) evidence suggests. Always note that many of these findings are from animal or in vitro (lab) studies, not large human trials.

Neuroprotection of retinal / optic nerve cells

• A major proposed function is protecting retinal ganglion cells (RGCs) and photoreceptors from degeneration or apoptosis (programmed cell death). For instance:
• In mouse models of glaucoma (induced by high intraocular pressure), Bujing Yishi reduced expression of pro-apoptotic proteins p53 and Bax, which implies a suppression of cell death pathways. Ingenta Connect
• It helps preserve retinal thickness and structure, and maintain the arrangement of retinal ganglion cells. Ingenta Connect

Modulation of signaling pathways / anti-inflammatory / anti-oxidative stress effects

• Some studies show that Bujing Yishi can activate the PI3K/Akt pathway (a cell survival / anti-apoptosis axis) in glaucoma models. BioMed Central
• In a rat model of retinitis pigmentosa, Bujing Yishi reduced microglial overactivation (immune cells in the retina) and lowered inflammation via the P2X7R / CX3CL1 / CX3CR1 axis. Pingming Health
• It may also reduce oxidative stress or secondary injury cascades, though explicit mechanistic reports in eye tissues are relatively sparse.

Mild intraocular pressure (IOP) effects

• Although Bujing Yishi is not primarily an IOP-lowering agent, some animal work suggests modest reduction in IOP in glaucoma models. Ingenta Connect
• In models where glaucoma is induced by injection of substances to raise IOP, animals treated with Bujing Yishi had less retinal damage and somewhat mitigated IOP increases. Ingenta Connect

Synergy / adjunctive effect with other agents

• In clinical / observational reports, Bujing Yishi has been used together with mecobalamin (a form of vitamin B12) in patients whose intraocular pressure is already controlled, aiming for improved visual function. J-GLOBAL+1
• The hypothesis is that while conventional therapies manage pressure, Bujing Yishi supports neural tissue health and slows degenerative changes.

Why It’s Important

Addressing unmet needs in glaucoma and retinal diseases

• In many patients with glaucoma, controlling intraocular pressure (IOP) alone is insufficient to prevent ongoing optic nerve damage and progressive vision loss. “Normal‐tension glaucoma” and cases where disease advances despite controlled IOP highlight the need for neuroprotective treatments. Bujing Yishi offers a potential complementary approach to preserve vision by protecting neural elements of the eye. BioMed Central

Traditional medicine heritage & accessibility in China

• Bujing Yishi is an established formula in TCM ophthalmology, used over decades in Chinese hospitals for “optic nerve hypofunction / retina / vision impairment” settings. BioMed Central
• Because it is an herbal formulation, it may be more accessible / culturally accepted in certain settings than novel pharmaceuticals.

Potential expansion to retinal degenerations

• The more recent animal work (e.g. in retinitis pigmentosa) suggests that Bujing Yishi may have broader utility beyond glaucoma. If further validated, it might be useful as adjunctive therapy in degenerative retinal disorders. Pingming Health

Low overt toxicity (so far)

• One of the attractions in TCM research is that well‐formulated herbal products, when manufactured under good practice (GMP) conditions, may have relatively favorable safety profiles compared to many synthetic neuroprotective drugs. Bujing Yishi is regulated in China (e.g. under Sichuan Food & Drug Administration standards) for safety and quality control (criterion SZBZ20070647–10). BioMed Central

Gap in high-quality clinical evidence

• Because Bujing Yishi targets a key gap in eye care (neuroprotection beyond pressure control), validating it with rigorous clinical trials could have meaningful implications for glaucoma and retinal disease management.

Considerations (Limitations, Warnings, Unknowns)

Limited high-quality clinical evidence

• To date, no large, well-powered randomized controlled trials (RCTs) have conclusively proven the efficacy and safety of Bujing Yishi in humans for glaucoma or retinal disease. BioMed Central
• The published “protocol” for a multicenter RCT (for glaucoma with controlled IOP) indicates that investigators intend to compare BJYSP vs mecobalamin over 6 months, measuring visual function, fields, IOP, etc. BioMed Central
• Observational and small studies (e.g. combining with mecobalamin) exist, but these are weaker forms of evidence. J-GLOBAL

Translation from animals to humans is uncertain

• Many mechanistic and efficacy findings come from rodent models (e.g. induced glaucoma, retinal degeneration in rats or mice) rather than human trials. Animal models may not entirely recapitulate human disease. Pingming Health
• Dose scaling, absorption, metabolism, herb–drug interactions (especially in human patients on multiple glaucoma/ophthalmic drugs) remain to be carefully characterized.

Quality, standardization, and batch variability

• Herbal products can suffer from variability in active ingredient content, adulteration, or contamination (heavy metals, pesticides, improper processing). Ensuring GMP manufacturing and consistent quality is crucial. BJYSP is purportedly regulated in China to certain standards. BioMed Central
• The identification and quantification of which phytochemical(s) mediate the neuroprotective effects is not yet clearly established; the formula is complex, and synergistic or antagonistic interactions among herbs may complicate consistency.

Safety, interactions, and side effects

• Although no major safety problems have been widely reported in the literature, the long-term safety profile in diverse patient populations is not well studied.
• Herbal medicines can interact with conventional drugs (e.g. anticoagulants, antihypertensives, immunosuppressants). Patients with glaucoma often take multiple eye drops or systemic medications, so risk of herb–drug interactions must be considered.
• In patients with systemic diseases (e.g. liver, kidney disease), herbal formulas may pose more risks (metabolism, clearance) and require caution.

Patient selection and syndrome differentiation (in TCM practice)

• In TCM theory, a formula like Bujing Yishi is often used in specific “syndrome” patterns (e.g. “liver–kidney deficiency, blood stasis, fluid retention”) rather than all glaucoma or retinal disease indiscriminately. Its efficacy may depend on matching the right patients (in TCM terms). BioMed Central
• Some patients may have comorbid conditions or ocular disease types for which Bujing Yishi is less relevant or even contraindicated (from a TCM viewpoint).

Regulatory and accessibility issues outside China

• In many countries, Bujing Yishi tablets may not be approved or regulated, making import or use legally complex.
• Physicians outside TCM practice may not be familiar with the formulation or comfortable prescribing/monitoring it.