Bai Shao
StarPaeonia lactiflora Pall.
Traditionally used for
- Headaches
- Dizziness
- Menstrual & women's health
- Mood & calm
☯ TCM Properties
Nourishes Blood and regulates menstruation; Astringes Yin and stops sweating; Softens the Liver and alleviates pain; Calms the Liver and Subdues Yang
Traditional Chinese Uses
Bai Shao (white peony root) is a cool, Blood-nourishing herb central to Chinese medicine's approach to regulating Liver function and treating Blood deficiency patterns. It nourishes Liver Blood to address amenorrhea, menstrual irregularities, and gynecological conditions from Blood deficiency. Its sour, astringent quality calms Liver Yang rising to relieve headache, dizziness, and irritability, and it softens and harmonizes the Liver to relieve flank pain and cramping. When combined with prepared licorice, it relieves acute muscle spasm.
Used In Formulas (27)
Relationships
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Botanical Description
Paeonia lactiflora is a herbaceous perennial in the Paeoniaceae, native to central and eastern Asia, including Siberia, Mongolia, northern China, Korea, and parts of Japan. It grows from a stout, fleshy rootstock to 50-70 cm tall, forming clumps of erect, hairless stems. The compound, biternate leaves are dark green above and paler beneath, with elliptic to lanceolate leaflets that often have reddish petioles. Solitary or few-clustered terminal flowers appear in late spring to early summer, 8-16 cm across, typically white to pale pink in the wild type with a boss of yellow stamens, though many cultivated forms are double and intensely coloured. The fruit is a group of leathery follicles containing several black, glossy seeds. It favours well-drained loamy soils on grassy slopes, open woodland and meadows, and is widely cultivated as an ornamental and as the source of the medicinal root known in Chinese medicine.
Active Constituents
Paeoniflorin
Monoterpene glucoside (pinane type)Concentration: 1.6-7.0% of dried root; Chinese Pharmacopoeia requires not less than 1.6%
The principal bioactive and quality-control marker of white peony root. Exhibits anti-inflammatory, immunomodulatory, analgesic, antispasmodic and neuroprotective actions, and is the main active of the standardized extract 'total glucosides of paeony' (TGP) used clinically for rheumatoid arthritis and other autoimmune conditions.
Albiflorin
Monoterpene glucosideConcentration: Approximately 0.2-1.0% of dried root
A structural isomer-related constituent that co-occurs with paeoniflorin. Shows antidepressant-like, anxiolytic and neuroprotective activity in preclinical models and contributes to the antispasmodic and analgesic profile of the root.
Oxypaeoniflorin
Monoterpene glucosideConcentration: Trace to ~0.5% of dried root
An oxidized paeoniflorin analogue with antioxidant and radical-scavenging activity that adds to the overall anti-inflammatory potential of the herb.
Benzoylpaeoniflorin
Monoterpene glucoside (benzoyl ester)Concentration: Trace, typically <0.2%
A benzoylated derivative of paeoniflorin reported to have antiplatelet and vasorelaxant properties, contributing to peony's traditional blood-regulating actions.
Gallotannins / gallic acid
Hydrolysable tannins / phenolic acidConcentration: Tannins several percent of the root
Astringent polyphenols responsible for the herb's ability to 'astringe yin and stop sweating'. They provide antioxidant activity and contribute to antimicrobial and haemostatic effects.
Paeonol
Phenolic (acetophenone)Concentration: Minor in the root (more abundant in bark/moutan)
An anti-inflammatory and analgesic phenol that inhibits prostaglandin synthesis and platelet aggregation, supporting the pain-relieving use of peony.
Beta-sitosterol
PhytosterolConcentration: Trace
A common plant sterol with anti-inflammatory and lipid-modulating activity that contributes minor supportive pharmacology.
⚠ Drug Interactions
Methotrexate
Total glucosides of paeony (paeoniflorin-rich) exert immunomodulatory and hepatoprotective effects. In rheumatoid arthritis, adding TGP to methotrexate improves clinical response and reduces methotrexate-associated liver enzyme elevation rather than causing harm.
Clinical note: Multiple RCTs and meta-analyses report improved efficacy and fewer hepatic adverse events when TGP is combined with methotrexate; considered a favorable adjunct rather than a contraindicated interaction.
Anticoagulant / antiplatelet drugs (e.g., warfarin, aspirin)
Paeoniflorin and benzoylpaeoniflorin show antiplatelet activity in vitro, which could theoretically add to the effect of anticoagulant or antiplatelet medication.
Clinical note: No clinically significant bleeding events documented at usual doses; monitor if used with warfarin or high-dose antiplatelet therapy.
Veratrum (Li Lu)
Traditional 'eighteen incompatibilities' (shi ba fan) doctrine lists peony (Shao Yao) as antagonistic to Veratrum (Li Lu); the combination is avoided in classical prescribing.
Clinical note: Classical prohibition rather than a documented pharmacokinetic interaction; the two are not combined in traditional formulas.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 6–15 g | Daily | — | — | 中国药典 2020 【用法与用量】6～15g。 【注意】不宜与藜芦同用。 【性味与归经】苦、酸，微寒。归肝、脾经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Preparation Methods
Raw white peony root (Bai Shao) decoction
Parts: dried root (cortex removed, boiled and peeled)
Clean dried root sliced and decocted, typically 6-15 g per day (up to 30 g in some formulas). Emphasizes nourishing blood, softening the liver, calming ascendant liver yang and relieving pain; classic in Shao Yao Gan Cao Tang for muscle spasm and cramping.
Dry stir-fried white peony (Chao Bai Shao)
Parts: dried root slices
Root slices dry-fried until faintly yellow. Frying moderates the cool nature, making it gentler on the spleen and stomach and better suited to regulating menstruation and harmonizing the liver and spleen.
Wine-fried white peony (Jiu Bai Shao)
Parts: dried root slices, rice wine
Slices stir-fried with rice wine to enhance blood-moving and menstruation-regulating action and reduce the cold, cloying quality; used for pain and gynecological complaints.
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
The spleen is strengthened while the liver is softened, harmonising liver overacting on spleen.
Painful diarrhea with borborygmus from liver-spleen disharmony.
Core pair of a classical formula — Tong Xie Yao Fang, Dan Xi Xin Fa (Zhu Danxi; also cited in Jing Yue Quan Shu from Liu Caochuang)
Liver qi is dredged while liver blood is nourished and the liver softened, so dispersal does not injure yin.
Core of Si Ni San and Xiao Yao San.
Named pairing — Lü Jingshan, Shi Jinmo Dui Yao
Together one invigorates and cools the blood while the other nourishes blood and softens the Liver, so they both tonify and move blood and relieve pain.
Named pairing — Lu Jingshan, Shi Jinmo Dui Yao
Liver blood is nourished and the liver softened while blood is harmonised, treating blood deficiency with abdominal pain and menstrual disorders.
Named pairing — Bensky et al., Chinese Herbal Medicine: Materia Medica (3rd ed.)
Sour and sweet combine to generate yin and relax spasm, relieving cramping pain of the limbs and abdomen.
Core pair of a classical formula — Shao Yao Gan Cao Tang, Shang Han Lun (Zhang Zhongjing)
Releasing the exterior is balanced with preserving yin, harmonising the nutritive and protective levels.
Core pair of a classical formula — Gui Zhi Tang, Shang Han Lun (Zhang Zhongjing)
Together they clear heat from the intestines while softening the Liver and relieving spasm, treating heat diarrhea or dysentery with abdominal pain.
Core pair of a classical formula — Huang Qin Tang, Shang Han Lun (Zhang Zhongjing)
The middle is warmed and tonified while spasm is relaxed, relieving abdominal pain from deficiency cold.
Core pair of a classical formula — Xiao Jian Zhong Tang, Shang Han Lun (Zhang Zhongjing)
Evidence Tier
Strong evidence · 2 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
1
1 verified · 0 unverified
Randomized controlled trial
1
0 verified · 1 unverified
Other clinical trial
0
Observational / case report
0
In vitro / animal
0
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Total glucosides of paeony for rheumatoid arthritis: A systematic review of randomized controlled trials
Systematic review of randomized controlled trials of total glucosides of paeony (the paeoniflorin-rich extract of Paeonia lactiflora) in rheumatoid arthritis. TGP, used alone or with conventional DMARDs, improved clinical outcomes (ESR, CRP, swollen and tender joint counts) and was associated with a favorable safety profile, particularly fewer hepatic adverse events.
Efficacy and safety of total glucosides of paeony in the treatment of recurrent aphthous ulcers: a single-center, double-blind, randomized, placebo-controlled clinical trial
A single-center double-blind RCT found that total glucosides of paeony reduced the frequency and severity of recurrent aphthous ulcers compared with placebo, with good tolerability, supporting the immunomodulatory use of Paeonia lactiflora extract.
⚠ Rule-Based Cautions
These entries come from the deterministic rule tables that gate Verscienta's formula tools — classical pair prohibitions, pregnancy and lactation contraindications, and dose ceilings.
Incompatibilities (十八反 / 十九畏)
- 十八反: Li Lu × Shao Yao — avoid combining with Li Lu / Veratrum
Historical Texts
Shen Nong Ben Cao Jing (Divine Husbandman's Classic of the Materia Medica)
Han dynasty (c. 200 CE)Shang Han Lun (Treatise on Cold Damage) by Zhang Zhongjing
Eastern Han dynasty (c. 200 CE)Ben Cao Gang Mu (Compendium of Materia Medica) by Li Shizhen
Ming dynasty (1578)References
- Luo J, Song W, Yang G, Xu H, Chen K. Total glucosides of paeony for rheumatoid arthritis: A systematic review of randomized controlled trials . Complementary Therapies in Medicine (2017) [DOI]
- Chinese Pharmacopoeia Commission. Paeoniae Radix Alba (Bai Shao) monograph . Pharmacopoeia of the People's Republic of China, 2020 Edition, Vol. I (2020) [DOI]
- Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica, 3rd Edition (Bai Shao entry) . Eastland Press, Seattle (2004) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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