anemarrhena asphodeloides

Anemarrhena asphodeloides: A Comprehensive Reference

1. Identity and Botanical Characterization

Taxonomy and Nomenclature

Anemarrhena asphodeloides Bunge is the only species in the genus Anemarrhena Bunge (family Asparagaceae), and is mainly distributed in China, Mongolia, and other eastern Asian countries. It is also historically classified within the family Liliaceae in older literature, and the rhizome, known as 'Zhi-mu' in TCM, is mainly distributed in China, Mongolia, Korea, Japan, and other eastern Asian countries.

The rhizomes of Anemarrhena asphodeloides, Anemarrhenae Rhizoma, are known as Zhimu (Chinese), Yanghuzi in vernacular name, Chimo in Japanese Sino-medicine, and Jimo in Korean medicine. The plant is first recorded in The Book of Songs Erya, and is also known as Dishen and Maozhimu in China.

Morphology

Anemarrhena asphodeloides is a perennial erect and herbaceous plant with horizontal and thickened rhizomes, which grows to approximately 1 m tall and 0.5–1.5 cm wide, covered by remained sheaths. The leaves are grasslike and all basal, up to 60 cm long and 2 cm wide, gradually narrowed into a filiform shape in the distal part. At the top of three-foot spikes, it has small, fragrant, white six-petaled flowers that bloom at night.

Pharmacopoeial Recognition

Anemarrhenae asphodeloides rhizoma is listed in the European Pharmacopoeia under monograph No. 2661E. In the Chinese Pharmacopoeia (2020 Edition), there are more than 40 Chinese medicine preparations containing Anemarrhena asphodeloides rhizome as an ingredient, the majority of which are used to treat pulmonary disease and emotional disease.

Medicinal Part and Common Preparations

The root, or rhizome, is used medicinally, and is often dried for use in decoctions. The plant typically grows in dry, sandy soil, and the rhizome is harvested in the autumn and then dried for medicinal purposes. Beyond traditional decoctions, the herb is available in diverse modern forms. It is also used as an ingredient of healthy food, wine, tea, and biological toothpaste.

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2. Traditional and Historical Use

History and Documentation

The rhizomes of Anemarrhena asphodeloides have been widely used in traditional Chinese medicine (TCM) for more than 2,000 years with remarkably therapeutic effects for the treatments of febrile diseases with high fever and thirst, heat in the lung with dry cough, consumptive fever, as well as diabetes due to internal heat and constipation. Its use in diabetes management was first documented in Shennong's Herbal Classic.

Anemarrhena asphodeloides has been commonly used in traditional medicine in China, Japan, and Korea for thousands of years. The traditional curative functions are to treat febrile diseases, fever, cough, and diabetes.

TCM Theoretical Framework

Traditional Chinese medicine classifies this herb as cold (or yin) and bitter. Anemarrhena is used to treat heat disorders, which are caused by excessive yang or insufficient yin functions. It exerted curative functions by clearing the evil-heat and purging body-fire, generating body-fluids, and moistening dryness in TCM. Traditional Chinese medicine uses bitter and cold herbs such as anemarrhena to clear the internal heat and provide moisture to the lungs and the kidneys.

In TCM theory, Zhi Mu has a bitter and sweet taste and is associated with the Lung, Stomach, and Kidney meridians.

Specific Traditional Indications

Anemarrhenae Rhizoma has a long history of use as a traditional medicine to treat various ailments, including cold-induced febrile disease with arthralgia, hematochezia, tidal fever and night sweats by Yin deficiency, bone-steaming, cough, and hemoptysis. Internally, it is used for a variety of disorders including congestive fever, high fever, chronic bronchitis, excessive sweating, dry throat, cough, dizziness, lumbago, and pneumonia. Externally, it is used as part of a mouthwash to treat oral ulcers.

Traditional Formulas

The classical Chinese medicine book Synopsis of the Golden Chamber, written by Zhang Zhongjing in the Han Dynasty, contains the formula Baihe Zhimu decoction (LBRAD), which is the first prescription of "Lily Disease" in that text. It is a special remedy for "Lily disease" after sweating. The classic recipe consists of two herbs — fresh lily bulbs and dried Rhizoma Anemarrhena slice — and has the effect of supplementing nutrition and clearing heat, nourishing Yin and moistening. After more than two thousand years of clinical practice, it has been currently widely used in clinical treatment of depression.

Anemarrhena asphodeloides, as one of the most important and frequently used traditional Chinese herbal medicines with an excellent safety record, has been effectively used for febrile diseases in oriental clinical practices. It has also been used in combinations with various other herbal ingredients for the purpose of prevention and management of acute lung infection, sterility, and climacteric syndrome.

Lee Mo Tang, a mixture of A. asphodeloides and Fritillaria cirrhosa, was reported to exhibit anti-asthmatic effects via the inhibition of ovalbumin-induced eosinophil accumulation and Th2-mediated bronchial hyperresponsiveness in a murine model of asthma. Zi Shen Pill, another formulation containing A. asphodeloides, exerted effects on benign prostatic hyperplasia via inhibition of vascular endothelial growth factor and basic fibroblast growth factor expression in rats.

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3. Key Chemical Constituents and Active Compounds

Overall Phytochemical Profile

Up to now, more than 108 compounds have been isolated from Anemarrhena asphodeloides, including steroidal saponins, flavonoids, phenylpropanoids, alkaloids, steroids, organic acids, anthraquinones, and others. The chemical constituents of Rhizoma Anemarrhenae are complex and diverse, mainly including steroidal saponins, flavonoids, phenylpropanoids, benzophenones, and alkaloids. Polysaccharides are among the most abundant components in AA, and have antioxidant, immunomodulatory, anti-inflammatory, hypoglycemic, anti-osteoporosis, and laxative effects.

Steroidal Saponins: Timosaponins

Steroidal saponins are important active components isolated from A. asphodeloides Bunge. Among these, Timosaponin AIII (Timo AIII) has attracted the most accumulated experimental study in recent decades. Timosaponin AIII has the molecular formula C₃₉H₆₄O₁₃ (PubChem CID: 71306914); Timosaponin BII has the molecular formula C₄₅H₇₆O₁₉ (PubChem CID: 44575945); sarsasapogenin has the molecular formula C₂₇H₄₄O₃ (PubChem CID: 92095).

Although Timo AIII and Timo BII are mainly metabolized to sarsasapogenin in vivo, the sugar chain plays important roles in their pharmacological activities. The sugar chain in Timo AIII is indispensable to its pharmacological activities, and conversion of Timo BII to Timo AIII enhanced its cytotoxicity. However, the hydrophobicity and low bioavailability of Timo AIII limit its efficacy in vivo, and many studies have focused on derivatization or drug delivery system design based on Timo AIII.

Sarsasapogenin

Sarsasapogenin is a major steroidal sapogenin isolated from the rhizome of Anemarrhena asphodeloides, which mostly contains timosaponin, with sarsasapogenin being its aglycone part. Overall, sarsasapogenin is a potent molecule with anti-inflammatory, anticancer, antidiabetic, anti-osteoclastogenic, and neuroprotective activities, and is also a potential molecule in the treatment for precocious puberty.

Mangiferin and Neomangiferin

Mangiferin is classified as a phenolic compound and a C-glycosylated xanthone (1,3,6,7-tetrahydroxyxanthone-C2-β-d glucoside). Its first origin was recorded from Anemarrhena asphodeloides Bunge, which was greatly used in traditional Chinese medicine to treat neuropathy caused by diabetes. In vivo animal researches and in vitro cell culture studies have shown that mangiferin has various potential health benefits, including anti-cancer, anti-inflammatory, antioxidant, antiviral, immunomodulatory, and neuroprotective activities.

Various studies show that mangiferin possesses antioxidant actions, a role in treating obesity, therapeutic potential for osteoarthritis, protection of the gastrointestinal tract, an antidiabetic role, in vitro repressing properties on type-II 5α-reductase, modulatory response in the immune system, as well as hepatoprotective and cardioprotective effects in various rodent disease models.

Biologically active components identified in Anemarrhenae rhizoma include timosaponin AIII (TAIII), timosaponin BII (TBII), sarsasapogenin (SSG), mangiferin (MGF), neomangiferin (NMGF), isomangiferin (IMGF), and baohuoside I (BHI).

Polysaccharides

AA contains bioactive ingredients, primarily polysaccharides, which exhibit diverse biological activities such as antioxidant and immunomodulatory effects. The polysaccharide fraction is considered quantitatively the most abundant class of compounds in the plant.

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4. Mechanisms of Action

Anti-Inflammatory Pathways

At non-cytotoxic concentrations of 10–100 µg/mL, ethanol extract of A. asphodeloides (EAA) significantly decreased the production of nitric oxide (NO) and interleukin-6 (IL-6) in lipopolysaccharide (LPS)-stimulated macrophages. EAA-mediated reduction of NO was due to reduced expression levels of inducible NO synthase (iNOS). Protein expression levels of LPS-induced cyclooxygenase-2 (COX-2) were also alleviated. This was due to inhibition of nuclear factor-κB (NF-κB) and activator protein 1 transcriptional activities, through the stabilization of inhibitor of κBα and inhibition of p38. These results indicate that EAA suppresses LPS-induced inflammatory responses by negatively regulating p38 and NF-κB.

Two saponin components isolated from A. asphodeloides — TBIII and t-HL — were shown to significantly suppress the production of NO and pro-inflammatory cytokines TNF-α and IL-6 by inhibiting the PI3K/Akt and NF-κB signaling pathways in LPS-stimulated N9 microglial cells. This indicates these compounds may contribute to the traditional therapeutic effects in neurodegenerative disease.

Anti-Diabetic Mechanisms

The glucosidase inhibitory effect of flavones, including mangiferin and isomangiferin, was found to be more effective than that of steroidal saponins including Timo AIII and Timo BII, revealing more potent anti-diabetic mellitus effects of the flavone fraction compared to the saponin fraction isolated from A. asphodeloides. Timo BII was found to prevent diabetic nephropathy by suppressing inflammation in alloxan-induced mice. These results revealed that the anti-diabetic mechanisms differ between steroidal saponins and flavone ingredients of A. asphodeloides, and the anti-diabetic mellitus activity of Timo AIII may be due to its anti-inflammatory property.

Mangiferin, an active component of Anemarrhenae Rhizoma, has been found to ameliorate insulin resistance and hyperglycemia in T2DM rats by modulating glycerophospholipids, sphingolipids, and arachidonic acid metabolism in erythrocyte membranes. Specific serum-absorbed AR components and their metabolites are hypothesized to regulate key metabolic pathways — particularly lipid metabolism — and inflammatory signaling via the NF-κB/PPAR axis in T2DM.

Neuroprotective Mechanisms

Timosaponin A-III was screened and identified as a potentially active component for anti-Alzheimer's disease activity, with BACE1 proven to be a potential high-affinity target. Timosaponin BII possesses neuronal protective and anti-inflammatory effects, possibly by suppressing the production of pro-inflammatory factors IL-1, IL-6, and TNF-α.

VEGFR, X-linked inhibitor of apoptosis protein (XIAP), B-cell-specific Moloney murine leukemia virus integration site 1 (BMI1), thromboxane A2 receptor, mTOR, NF-κB, COX-2, MMPs, and acetylcholinesterase (AChE) are identified as crucial pharmacological targets of Timo AIII.

The rhizome of Anemarrhena asphodeloides Bunge, used in Traditional Chinese Medicine as a brain function-improving herb, is a promising source of neuroprotective substances. One study evaluated the protective action of xanthones from A. asphodeloides rhizomes on the PC12 cell line exposed to the neurotoxic agent 3-nitropropionic acid (3-NP). Results showed a significant increase in the number of cells surviving after treatment with the xanthone fraction (XF) during exposure to neurotoxic 3-NP and decreased morphological changes in a dose- and time-dependent manner. The most effective protective action was observed when PC12 cells were pre-incubated with XF, an effect that may contribute to the traditional indications of this herb for neurological and cognitive complaints.

Mechanisms in Atopic Dermatitis / Skin Inflammation

In vivo and in vitro, A. asphodeloides treatment reduced AD-like skin symptoms, such as skin barrier dysfunction and pruritus, by modulating the expression of pro-inflammatory mediators through inhibition of STAT6/TSLP activation, NF-κB/MAPK-related pathways, and TWEAK/FN14 pathways.

Anti-Cancer Mechanisms

Timo AIII presents multiple pharmacological activities, including anti-cancer, anti-neuronal disorders, anti-inflammation, and anti-coagulant effects. Its anti-cancer effect in various cancers, especially hepatocellular cancer and breast cancer, is considered its most potent activity. The anti-inflammatory activity of Timo AIII is also beneficial to many diseases. Review of the anti-tumor activities of timosaponin AIII has focused on its ability to inhibit invasion and migration, induce apoptosis, regulate autophagy, and reverse multi-drug resistance.

Antidepressant Mechanisms

Sarsasapogenin, total saponins, and TBII from Anemarrhena asphodeloides possess antidepressant bioactivity. The bioassay showed that sarsasapogenin at 50 mg/kg could sharply increase noradrenaline and serotonin levels in the hypothalamus and hippocampus.

P-glycoprotein Interactions

The efficacy and pharmacokinetics of biologically active components in Anemarrhenae rhizoma would be affected by the interaction of P-glycoprotein (P-gp) and effective components in AR, although little was known about the interaction between them. Key components investigated for P-gp interactions include TAIII, TBII, SSG, MGF, NMGF, IMGF, and BHI.

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5. Scientific Evidence by Area of Use

5.1 Inflammation and Antipyretic Activity

Evidence level: Preclinical (in vitro and animal models); no controlled human clinical trials identified.

The medicine presents anti-inflammatory, antipyretic, sedative, and diuretic effects based on preclinical investigation. In vitro studies in macrophages demonstrate that EAA suppresses LPS-induced inflammatory responses by negatively regulating p38 and NF-κB. The study clarified the anti-inflammatory effects of EAA and its underlying mechanisms of action in murine macrophages, but further studies using experimental animal models of inflammation are required to provide further support for EAA as a candidate for severe inflammatory states. The anti-inflammatory evidence at this time remains limited to cell-based and animal model research; no published randomized controlled trials in humans examining standalone A. asphodeloides for inflammatory endpoints have been identified in the peer-reviewed literature.

5.2 Diabetes and Blood Glucose Regulation

Evidence level: Preclinical (animal and cell studies); human clinical evidence is largely embedded in multi-herb formulas.

Anemarrhenae Rhizoma is a widely used TCM with a long-standing history of hypoglycemic applications, with use in diabetes management first documented in Shennong's Herbal Classic. Modern pharmacological studies demonstrate that AR possesses multiple therapeutic effects, including anti-inflammatory, antioxidant, hypoglycemic, lipid-lowering, anti-aging, and neuroprotective properties.

Traditional Chinese medicines that contain mangiferin as the major bioactive have been used for disease treatment, including non-alcoholic fatty liver, hyperuricemia, and diabetes. The glucosidase inhibitory effect of flavones, including mangiferin and isomangiferin, was more potent than that of steroidal saponins in the anti-diabetic context. Robust, standalone human clinical trial data for Anemarrhena asphodeloides as a single-agent antidiabetic treatment remain absent from the current literature. There is a pressing need to investigate the current therapeutic agent information and the evidence of clinical studies on toxicity and adverse effects of Anemarrhena asphodeloides.

5.3 Neurodegenerative Diseases (Alzheimer's, Parkinson's, and Cognitive Impairment)

Evidence level: Preclinical (animal and cell studies); human evidence not established for the single herb.

Anemarrhenae Rhizoma is frequently used as a traditional Chinese medicine to treat Alzheimer's disease (AD) and other memory deficits associated with aging. AR and its components have been demonstrated to possess excellent biological and pharmacological activity, including immunomodulatory, anti-inflammatory, anti-diabetes, anti-tumor, anti-depression, and anticoagulation effects.

Sarsasapogenin, a natural bioactive steroidal saponin derived from Anemarrhena asphodeloides, has demonstrated significant neuroprotective effects in preclinical models of Alzheimer's disease. However, its specific mechanism of action, particularly in modulating receptor-interacting protein kinase 1 (RIPK1)-mediated necroptosis and pyroptosis, remains underexplored.

The rhizome of Anemarrhena asphodeloides Bunge, used in Traditional Chinese Medicine as a brain function-improving herb, is a promising source of neuroprotective substances. Anemarrhenae rhizoma has been mentioned along with a few other TCM herbs as a promising treatment and prevention option for senile dementia.

Based on phytochemical and pharmacological studies since the 1930s, Anemarrhena asphodeloides has been explored for potential in treating Alzheimer's disease, Parkinson's disease, and schizophrenia, among others. All such evidence to date originates from preclinical research. There is a pressing need to investigate the current therapeutic agent information and the evidence of clinical studies on toxicity and adverse effect of Anemarrhena asphodeloides.

5.4 Depression and Mood Disorders

Evidence level: Preclinical (animal models) and limited traditional/formula-level clinical reports.

The classical Chinese medicine formula Baihe Zhimu decoction is described in the Han Dynasty text Synopsis of the Golden Chamber and is recognized as the first prescription for "Lily Disease," which has clinical features similar to depression as understood in modern medicine. Sarsasapogenin, total saponins, and TBII from A. asphodeloides possess antidepressant bioactivity in animal assays, with sarsasapogenin at 50 mg/kg shown to sharply increase noradrenaline and serotonin levels in the hypothalamus and hippocampus in rodents. Human clinical trial data are not currently available for the single herb.

5.5 Osteoporosis and Bone Health

Evidence level: Preclinical (animal and network pharmacology studies); no human clinical trial data identified.

Osteoporosis is a systemic bone disease characterized by reduced bone density and quality. Anemarrhena asphodeloides shows therapeutic potential, but its mechanisms remain unclear. One study aimed to elucidate the potential mechanisms using a combination of bioinformatics and experimental approaches. Anemarrhena asphodeloides treatment significantly downregulated the expression of AKR1C1, AKR1C2, and ABCC1 and upregulated the expression of AKT1 and SMO in femoral tissue, suggesting these may be potential therapeutic targets for the treatment of osteoporosis.

Sarsasapogenin from Anemarrhena asphodeloides could prevent retinoic acid from inducing osteoporosis, and the possible mechanism was that sarsasapogenin improved the level of estrogenic hormone and inhibited high bone turnover.

5.6 Anti-Cancer Activity

Evidence level: Preclinical (in vitro and animal models) only; no human clinical trial data identified.

Studies have shown that the extracts and compounds from Anemarrhena asphodeloides have extensive pharmacological activities, such as nervous system activity, antitumor, anti-inflammatory, antidiabetic, antiosteoporotic, antiallergic, antiplatelet aggregation, antimicrobial, antiviral, anti-aging, hair growth promoting, and preventing cell damage.

Timosaponin AIII had potent cytotoxicity in preclinical research, which was considered potentially developable as an anticancer agent; however, the molecular mechanism underlying the anticancer activity has not been fully elucidated. Newly isolated glycosides from A. asphodeloides, including aneglycoside A–C and timosaponin U, were evaluated for cytotoxicity against HepG2, HeLa, and SGC7901 human cancer cell lines, with compounds 1, 2, and 4 showing weak antiproliferative activities. All such data are from in vitro cell line work and do not constitute clinical evidence.

5.7 Atopic Dermatitis / Skin Inflammation

Evidence level: In vitro and animal models; no independent human RCTs identified for this indication alone.

A 2024 study demonstrated that A. asphodeloides treatment is a potential alternative for managing atopic dermatitis due to its anti-inflammatory effects and ability to improve the skin barrier function. In vivo and in vitro, AA treatment reduced AD-like skin symptoms by modulating the expression of pro-inflammatory mediators through inhibition of STAT6/TSLP activation, NF-κB/MAPK-related pathways, and TWEAK/FN14 pathways.

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6. Body Systems and Health Areas

Modern research has confirmed that A. asphodeloides has a long history of medicinal use mainly for allergic diseases, diabetes, fever, thirst, and respiratory tract inflammation, and has been proven to possess biological activities including nervous system activity, antitumor activity, anti-inflammatory activity, antidiabetic activity, and immunomodulatory activity. The following body systems are most prominently associated with its research profile:

• Central Nervous System: Anemarrhena asphodeloides is one of the most frequently used herbs with neuroprotective activities on the central nervous system.
• Endocrine/Metabolic: Traditional curative functions include treating febrile diseases, fever, cough, and diabetes; modern pharmacological effects include anti-diabetic properties.
• Immune System: AA is used clinically for inflammation, diabetes, osteoporosis, and tumors; its polysaccharides have antioxidant and immunomodulatory effects.
• Musculoskeletal System: Traditional use included treatment of arthralgia and bone-steaming; preclinical work supports anti-osteoporotic potential via sarsasapogenin.
• Respiratory System: Therapeutic application includes heat in the lung with dry cough.
• Integumentary System: Modern research supports its potential for managing representative skin inflammation (atopic dermatitis).
• Hepatic / Gastrointestinal: TCMs containing mangiferin as the major bioactive have been used for non-alcoholic fatty liver, hyperuricemia, and diabetes.

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7. Dosage Forms and Reported Dosages

Traditional Decoction

According to the classical text Summary of the Golden Chamber, 9 g of Anemarrhena asphodeloides rhizome was boiled with 2 L (400 mL) of spring water to produce 1 L (200 mL) of decoction.

Modern Preparations and Forms

Zhi Mu is often used in the form of concentrated granules, which are extracts derived from the herb. Concentrated granules are typically dissolved in warm water and consumed as a tea. Other forms in which it is commercially available include dried slices, powders, tinctures, and capsules.

Dosages Referenced in Studies

• In a rat hepatotoxicity study, timosaponin A3 (TA3) was administered to male SD rats at 100 mg/kg/day orally for 14 days to investigate its hepatotoxic mechanisms.
• In antidepressant bioassays, sarsasapogenin at 50 mg/kg sharply increased noradrenaline and serotonin levels in the hypothalamus and hippocampus of animals.
• TBII at 100 and 150 mg/kg could effectively shorten the immobility time in the tail suspension test (TST) and forced swimming test (FST) in animal models.
• In the in vitro macrophage anti-inflammatory study, the effective non-cytotoxic concentrations of ethanol extract (EAA) were 10–100 µg/mL.
• In the neuroprotection study, the xanthone-enriched fraction (XF) of the ethanolic extract was examined at concentrations from 5 to 100 µg/mL.

No standardized human clinical dosing regimen for Anemarrhena asphodeloides as a single-agent supplement has been established and validated in controlled trials. All dosage data above derive from preclinical or traditional-use sources.

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8. Safety Considerations and Interactions

Hepatotoxicity of Timosaponin AIII

The hepatotoxicity of Timo AIII is the most concerning safety issue, and the pharmacokinetics and toxicity of Timo AIII need further studies in diverse animal models.

Inconsistent with the suggested safe use of Anemarrhena asphodeloides at the whole-herb level, it was found that after a 14-day treatment of isolated TA3 in rats, the levels of total bile acids and ALT in serum increased significantly. TA3 treatment induced ROS generation in cultured rat hepatocytes and upregulated HO-1 gene expression, associated with the oxidative stress pathway. The excess production of ROS can oxidize proteins, DNA, lipids, and other macromolecules, leading to the disruption of cell processes and hepatocyte injury. N-acetylcysteine (NAC) reduced ROS production and restored ATP levels and mitochondrial membrane potential in TA3-treated hepatocytes, confirming the role of oxidative stress in TA3-induced hepatotoxicity.

These findings pertain to an isolated, concentrated compound (TAIII) administered to animals at high doses. Whether the whole rhizome at traditional dosages produces equivalent hepatotoxic risk in humans has not been established in published clinical literature.

Cytotoxicity at High Concentrations

A significant cytotoxicity was observed at higher xanthone-fraction concentrations (over 10 µg/mL) and longer incubation times (48 h), which requires caution in future research and thorough investigation into potential adverse effects.

Need for Further Toxicity Studies

Evaluating the quality and toxicity of Anemarrhena asphodeloides is essential to confirm its safe use in humans. The plant is widely used in traditional medicine and has diverse chemical constituents with obvious biological activities; nevertheless, more studies should be carried out in animals and humans to evaluate the cellular and molecular mechanisms involved in its biological activity and confirm its safe use.

P-glycoprotein-Based Drug Interactions

The efficacy and pharmacokinetics of biologically active components in Anemarrhenae rhizoma would be affected by the interaction of P-glycoprotein (P-gp) and effective components in AR. The potential for pharmacokinetic herb-drug interactions via P-gp modulation — which could affect the absorption or elimination of co-administered pharmaceuticals — warrants further investigation, particularly for drugs that are known P-gp substrates.

TCM-Defined Contraindications

From a TCM theoretical perspective, the cold and bitter properties of Anemarrhena asphodeloides have historically led to its avoidance in patients with specific constitution types. It is a medicinal plant that has long been used as a tonic agent in various ethnomedicinal systems in East Asia, especially in China, and has been used for treating arthralgia, hematochezia, tidal fever, night sweats, cough, dry mouth and tongue, and hemoptysis. TCM tradition cautions against its use in conditions characterized by Cold or Yang deficiency.

Overall Evidence Gap on Safety

Current studies on the chemical constituents and pharmacological mechanisms of Anemarrhena asphodeloides lack depth, and more studies on phytochemistry and the mechanisms of the main active ingredients (TBII, TAIII, and mangiferin) are needed. Clinical studies of main therapeutic aspects such as diabetes, Alzheimer's disease, and Parkinson's disease, as well as toxicity and adverse effects of Anemarrhena asphodeloides, will undoubtedly be the focus of future investigation.

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References

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