Bai Zhu
StarAtractylodes macrocephala Koidz.
Traditionally used for
- Digestion
- Bowel health
- Urinary & fluids
- Energy & fatigue
☯ TCM Properties
Tonifies Qi and Strengthens the Spleen; Dries Dampness; Promotes Urination and Reduces Edema; Astringes to Stop Sweating; Calms the Fetus
Traditional Chinese Uses
Bai Zhu (white atractylodes rhizome) is a warm, sweet-bitter herb and one of the most important Spleen-tonifying herbs in Chinese medicine. It strengthens Spleen Qi and dries Dampness to relieve chronic diarrhea, bloating, poor appetite, and fatigue from Spleen Qi deficiency with Dampness. It is also used to calm the fetus in threatened miscarriage from Spleen deficiency, and it consolidates Wei Qi to reduce spontaneous sweating. Together with codonopsis root, it forms the core of Spleen-Qi tonifying formulas.
Western Herbalism Properties
Pharmacological Effects
- Tonic / immunologic: Oral decoction for one month increased body weight and swimming endurance in mice, potentiated reticuloendothelial activity; raised leukocytes in leukopenic patients, lymphocyte transformation and serum IgG.
- Diuretic: Decoction/extract produced marked prolonged diuresis with sodium excretion in rats, rabbits and dogs (dogs i.v.: urine ×9.2, sodium ×39.3); some contradictory reports.
- Antiulcer: 50% methanol extract (50-200 mg/kg) and acetone extract (500 mg/kg) reduced stress and HCl-ethanol lesions; TDEYA reduced indomethacin and ischemia-reperfusion lesions in rats, partly via xanthine oxidase inhibition.
- Hypoglycemic: Water extract s.c. lowered rabbit blood sugar to 40% of baseline; oral extract lowered it in rats.
- Anticoagulant: Oral decoction prolonged prothrombin time in rats; 5% decoction prolonged prothrombin and coagulation time in healthy people.
- Hepatoprotective: Decoction protected mice against CCl4; atractylon inhibited CCl4 cytotoxicity and lipid peroxidation in rat hepatocytes/microsomes by radical scavenging.
- Other (cardiovascular, antitumor): Herb inhibited heart and lowered blood pressure; essential oil inhibited esophageal carcinoma cells in vitro and Ehrlich ascites in vivo; atractylon (from A. japonica) inhibited TPA tumor promotion in mouse skin.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 564.
Used In Formulas (94)
Relationships
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Botanical Description
Atractylodes macrocephala is a herbaceous perennial in the Asteraceae, native to eastern China and cultivated extensively in Zhejiang, Anhui, Jiangxi and Hunan provinces. Plants grow 30-80 cm tall from a thick, knotty, aromatic rhizome that branches irregularly and is yellowish-brown outside with cream-coloured flesh. The erect, often reddish stems bear alternate, deeply pinnately divided to lobed leaves with sharply serrate, spiny-toothed margins and conspicuous reticulate venation. From late summer into autumn the plant produces solitary, terminal capitula 2-3 cm across, with purplish to white tubular florets enclosed in overlapping, pectinate, bristly involucral bracts. The fruit is a small achene topped with a feathery pappus. It favours well-drained, sunny mountain slopes and forest margins between 600 and 2,500 m elevation and is propagated commercially from seedlings, the rhizomes being lifted in autumn of the second year.
Active Constituents
Atractylenolide I
Sesquiterpene lactone (eudesmanolide)Concentration: Minor volatile-oil constituent, typically ~0.01-0.3% of dried rhizome
Principal bioactive sesquiterpene lactone of Bai Zhu. Exerts anti-inflammatory activity by suppressing the TLR4/NF-κB and PI3K/Akt signaling pathways, mitigates cancer-associated cachexia and muscle wasting, and shows immunomodulatory and antitumor effects (in part via JAK2/STAT3 inhibition). Considered a key marker for pharmacological activity of the rhizome.
Atractylenolide II
Sesquiterpene lactone (eudesmanolide)Concentration: Trace to minor component of the volatile oil
Structurally related to atractylenolide I with more limited anti-inflammatory potency. Promotes apoptosis in tumor cells through the PI3K/Akt and Ras/ERK pathways and contributes to gastroprotective and lipid-regulating effects of the rhizome.
Atractylenolide III
Sesquiterpene lactone (eudesmanolide)Concentration: Trace to minor component of the volatile oil
Hydroxylated atractylenolide with antioxidant, anti-inflammatory and neuroprotective activity. Attenuates oxidative stress and inflammatory cytokine release and shows multi-organ (cardiac, renal, hepatic, pulmonary, gastrointestinal) protective effects in preclinical models.
Atractylone
Sesquiterpene (volatile oil)Concentration: A principal component of the rhizome essential oil
Major volatile-oil sesquiterpene contributing to the aromatic character of Bai Zhu. Displays anti-inflammatory and gastrointestinal regulatory activity and modulates gastric motility, consistent with the herb's traditional spleen-strengthening and dampness-drying actions.
Biatractylolide
Dimeric sesquiterpenoid lactoneConcentration: Minor constituent
Dimeric sesquiterpene lactone unique to Atractylodes with notable neuroprotective activity; protects neurons against oxidative and excitotoxic injury in vitro, of interest for neurodegenerative applications.
Atractylodes macrocephala polysaccharides (AMP)
PolysaccharideConcentration: Major water-soluble fraction of the rhizome (several percent of dry weight)
Water-soluble glucans and heteropolysaccharides that underlie much of the tonic activity. Immunomodulatory (activating macrophages, T/B lymphocytes and cytokine secretion), gastroprotective, prebiotic and hematopoietic; also implicated in intestinal-barrier protection and anti-fatigue effects.
β-Eudesmol
Sesquiterpene alcohol (volatile oil)Concentration: Constituent of the essential oil
Volatile sesquiterpenoid with reported anti-inflammatory, gastro-regulatory and antiangiogenic activity; contributes, with atractylone, to the pharmacological profile of the rhizome's essential oil.
⚠ Drug Interactions
Warfarin and other anticoagulant/antiplatelet drugs
Atractylenolides and volatile-oil components exhibit antiplatelet activity in preclinical studies, which could theoretically add to the effect of anticoagulant or antiplatelet drugs. No human case reports have been documented.
Clinical note: Clinically significant interaction is unproven; monitor for bleeding only with high, sustained doses of concentrated extracts.
Antidiabetic agents (insulin, sulfonylureas)
Atractylodes polysaccharides show hypoglycemic and insulin-sensitizing effects in animal models, which could be additive with glucose-lowering medication.
Clinical note: Theoretical only; routine blood-glucose monitoring is sufficient in diabetic patients using tonic doses.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 6–12 g | Daily | — | — | 中国药典 2020 【用法与用量】6～12g。 【性味与归经】苦、甘，温。归脾、胃经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Preparation Methods
Raw / unprocessed (sheng Bai Zhu) decoction
Parts: rhizome
Dried rhizome sliced and decocted, typically 6-12 g per day. The raw herb more strongly dries dampness and promotes urination; used for dampness, edema and profuse sweating.
Bran-fried / dry-fried (chao or fu-chao Bai Zhu)
Parts: rhizome
Rhizome slices stir-fried, often with wheat bran, until yellow and aromatic. This processing enhances the spleen-strengthening and Qi-tonifying action and reduces the herb's drying/greasy quality; preferred for Spleen-Qi deficiency with poor appetite and loose stools.
Charred (jiao Bai Zhu)
Parts: rhizome
Stir-fried until scorched brown. Used to strengthen the astringent, diarrhea-arresting action for chronic Spleen-deficiency diarrhea.
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)
One dries and disperses dampness while the other tonifies the spleen, together both removing dampness and preventing its return.
Spleen deficiency with pronounced dampness.
Named pairing — Lü Jingshan, Shi Jinmo Dui Yao
Spleen qi is strengthened while dampness is leached out, treating edema, loose stools and phlegm-fluids from spleen deficiency.
Named pairing — Bensky et al., Chinese Herbal Medicine: Materia Medica (3rd ed.)
Together they clear heat and strengthen the Spleen to calm a restless fetus.
Traditionally attributed to Zhu Danxi as a key pairing for calming the fetus when heat and Spleen deficiency are present.
Named pairing — Zhong Yao Xue, national textbook (pei wu section for Huang Qin)
Tonifies the spleen while reducing accumulated food, so digestion is strengthened rather than only cleared.
Spleen deficiency with poor appetite and chronic diarrhea.
Core pair of a classical formula — Yi Pi Bing, Yi Xue Zhong Zhong Can Xi Lu (Zhang Xichun)
Spleen qi is tonified while dampness is dried, strengthening transformation and transport.
Core pair of a classical formula — Si Jun Zi Tang, Tai Ping Hui Min He Ji Ju Fang
Drains water downward while strengthening the spleen to transform dampness, resolving thin mucus that clouds the head.
Thin mucus below the heart with severe dizziness.
Core pair of a classical formula — Ze Xie Tang, Jin Gui Yao Lue (Zhang Zhongjing)
Warming yang and dispelling cold-damp combined with strengthening the Spleen and drying dampness, which relieves cold-damp aching of the body and joints.
Wind-cold-damp painful obstruction with heavy aching body. Aconite is toxic; processed root only.
Core pair of a classical formula — Bai Zhu Fu Zi Tang, Jin Gui Yao Lue (Zhang Zhongjing)
The spleen is strengthened while qi stagnation is broken up, so tonification and dispersal proceed together without cloying or depletion.
Epigastric focal distension and poor digestion from spleen deficiency with stagnation.
Core pair of a classical formula — Zhi Zhu Wan, Nei Wai Shang Bian Huo Lun (attributed to Zhang Yuansu)
Evidence Tier
Limited 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
0
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
0
In vitro / animal
0
Other / unclassified
2
2 verified · 0 unverified
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
The traditional uses, phytochemistry, and pharmacology of Atractylodes macrocephala Koidz.: A review
Comprehensive review of the botany, traditional uses, phytochemistry, pharmacology, pharmacokinetics and toxicology of Bai Zhu. Attributes the herb's activity chiefly to sesquiterpenoids, polysaccharides and polyacetylenes, and documents gastrointestinal-regulating, immunomodulatory, anti-inflammatory, anti-cancer and neuroprotective effects.
Chemical Constitution, Pharmacological Effects and the Underlying Mechanism of Atractylenolides: A Review
Focused review of atractylenolides I-III, summarizing anti-inflammatory (TLR4/NF-κB, PI3K/Akt), anti-cancer (JAK2/STAT3), multi-organ protective, and metabolic (glucose/lipid, antiplatelet, blood-pressure) actions and their molecular mechanisms.
⚠ Safety & Contraindications
Side Effects
- Oral decoction 0.5 g/kg for 1-2 months in rats caused no obvious toxicity but reduced leukocytes and slight anemia.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 564.
Historical Texts
Shennong Bencao Jing (Divine Farmer's Materia Medica)
Eastern Han dynasty, c. 200 CEMing Yi Bie Lu (Miscellaneous Records of Famous Physicians), attrib. Tao Hongjing
Southern dynasties, c. 500 CEBencao Gangmu (Compendium of Materia Medica), Li Shizhen
Ming dynasty, 1596References
- Zhu B, Zhang QL, Hua JW, Cheng WL, Qin LP. The traditional uses, phytochemistry, and pharmacology of Atractylodes macrocephala Koidz.: A review . Journal of Ethnopharmacology 226:143-167 (2018) [DOI]
- Xie Z, Lin M, He X, Dong Y, Chen Y, Li B, Chen S, Lv G. Chemical Constitution, Pharmacological Effects and the Underlying Mechanism of Atractylenolides: A Review . Molecules 28(10):3987 (2023) [DOI]
- Chinese Pharmacopoeia Commission. Baizhu (Atractylodis Macrocephalae Rhizoma), Pharmacopoeia of the People's Republic of China, Vol. I . China Medical Science Press (2020) [DOI]
- Bensky D, Clavey S, Stoger E. Chinese Herbal Medicine: Materia Medica, 3rd ed. . 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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