After 28 days, the CT scan gave a rather clear result: the stone had disappeared in 44.6% of the people treated with an extract of Desmodium styracifoliumcompared to 33.8% of those who received a placebo. Just under eleven more expulsions for every hundred patients. The preparation comes from traditional Chinese medicine, but this time it went through a randomized phase 3 clinical trial published on JAMA Network Open.
Inside the study there were 606 adults between 18 and 70 years old, all enrolled in China, with ureteral stones measuring between 5 and 10 millimeters. They were distributed in a 3 to 1 ratio: 458 received Guang Jing Qian Cao capsules, containing total flavonoids extracted from Desmodium styracifoliumand 148 a placebo identical in appearance. Neither the patients nor the study leaders knew who was taking what.
The dose was anything but a generic herbal tea: 0.6 grams three times a day for four weeks, with a standardized preparation that is already authorized in China for some patients eligible for expulsive therapy. Furthermore, the trial was conducted between December 2017 and April 2020, although the results were only published on September 9, 2026.
After four weeks the lead was almost 11 percentage points
The number that is most interesting is that of the final CT scan. At 28 days, the stone was expelled in 204 of the 457 evaluable participants in the Desmodium group, versus 50 out of 148 in the placebo group: 44.6% versus 33.8%. The relative risk was 1.32, while the absolute difference was 10.9 percentage points. Said with numbers less inclined to congressional life, it means approximately one additional expulsion for every nine people treated.
It wasn’t happening as quickly. On the fourteenth day, 29.1% of the treated group and 22.3% of the placebo group had expelled the stone: a distance which, in this study, was not statistically significant. Even the distance the stone traveled along the ureter did not show any convincing differences between the two groups. The advantage is therefore seen above all when arriving at the end of the four weeks.
And there is another number to keep next to 44.6%, because it avoids transforming the Desmodium in yet another miraculous plant that appeared on the bedside table: 55.4% of the patients treated had not expelled the stone within 28 days. The result is interesting precisely because it is measurable, not because it guarantees that the pebble immediately packs up.
It’s not enough to buy a supplement that says “Desmodium”
The plant has long been used in traditional Chinese and Vietnamese medicine and its flavonoids have also been studied in animal models of stones. In the trial, however, the researchers did not administer leaves, infusions or a product chosen from the shelf of a herbalist’s shop: they used pharmaceutical capsules containing a defined quantity of total flavonoids. That’s a pretty big difference when you try to transfer the result out of the lab.
The study, however, does not yet clarify how the preparation favors the expulsion of a stone already present. There are hypotheses based on the observed effects of flavonoids on crystallization and inflammatory processes, but the trial was designed primarily to verify whether the stones came out or not. And on this he found a difference.
Even on the safety front, the two groups moved almost equally: adverse events were reported in 19.3% of treated patients and in 18.2% of those taking placebo. Events considered treatment-related were 5.5% and 5.4%. However, these numbers concern four weeks of therapy and a selected group of people.
Selected a lot. The trial did not include, among others, patients with severe hydronephrosis, significant kidney or liver problems, certain ureteral anomalies, pregnancy or breastfeeding. Furthermore, all participants analyzed were Asian. The result therefore tells what happened in that population and in those clinical conditions, it does not automatically assign the same percentage to anyone with a stone.
Then there is a detail to keep on the table: the study was sponsored by the Hubei Bio-Pharmaceutical Industrial Technological Institute, also involved in the design of the trial, in the monitoring of the centers and in the collection and analysis of the data according to the pre-established statistical plan. The authors have declared no conflicts of interest and, as reported in the article, the sponsor was not involved in the interpretation of the results or in the decision to publish them. However, independent confirmation would be particularly useful.
For calculations between 5 and 10 millimeters, other options already exist
The Desmodium it comes into a very concrete clinical question. Some ureteral stones can simply be observed waiting for spontaneous expulsion, provided the patient’s condition allows it. Others require intervention. In the case of infection with obstruction, for example, the priority changes completely and the guidelines of the European Association of Urology recommend urgent decompression of the urinary tract.
For patients suitable for conservative management, the same guidelines indicate alpha-blockers as a possible expulsive therapy, especially for distal stones between 5 and 10 millimetres, even though it is a off-label. The literature on these drugs is not perfectly uniform, but the benefit seems to be concentrated precisely in distal stones above 5 millimeters.
The new trial therefore adds an interesting possibility to a toolbox that already exists. For now it does so mainly in China, with a very specific preparation and in patients chosen with equally precise criteria.
After four weeks the Desmodium styracifolium it caused more stones to be expelled than the placebo. This is already much more solid news than “this plant dissolves stones”, a phrase that is much more convenient to print on the label and decidedly less faithful to what has been observed.
