Cang Zhu
StarAtractylodes lancea (Thunb.) DC.
Traditionally used for
- Eye health
- Colds & fever
- Digestion
- Pain & joints
- Energy & fatigue
☯ TCM Properties
Dries Dampness and strengthens the Spleen; Dispels Wind-Dampness; Releases the Exterior and Disperses Wind-Cold; Brightens the Eyes; Dispels Turbidity and Filth
Traditional Chinese Uses
Cang Zhu (black atractylodes rhizome) is a warm, pungent-bitter herb with an intense Damp-drying and Spleen-strengthening action. It is the primary herb for treating Dampness obstructing the Middle Burner — conditions presenting with bloating, fatigue, heavy limbs, poor appetite, loose stools, and a thick, greasy tongue coating. It also expels Wind-Cold-Damp from the channels for joint pain and bodily heaviness from external dampness invasion. Burned as a fumigant, it was historically used to purify spaces during epidemic illness.
Western Herbalism Properties
Used In Formulas (2)
Relationships
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Botanical Description
Atractylodes lancea (Thunb.) DC. (Asteraceae) is a perennial herb 30-100 cm tall native to East Asia, with erect simple or sparingly branched stems, sessile leathery lanceolate to elliptic leaves with spiny-toothed margins (the lower often three-lobed), and terminal solitary thistle-like capitula of tubular white to purplish florets surrounded by pinnatifid spiny bracts. The knotty cylindrical to irregular rhizome, 3-10 cm long, exudes aromatic oil and shows red-brown oil glands ('zhusha dian', cinnabar spots) on the cut surface that turn into white needle-like crystals on standing. Rhizomes are dug in autumn or spring, sun-dried, and traditionally bran-fried. In TCM, Cang Zhu is acrid and bitter in flavor and warm in nature, entering the Spleen, Stomach, and Liver channels; it strongly dries dampness, strengthens the Spleen, and dispels wind-cold-damp.
Active Constituents
Atractylodin
Polyacetylene (polyyne)Concentration: Sole quantitative assay marker for Atractylodis Rhizoma in the Chinese Pharmacopoeia, which requires not less than 0.30% of the dried rhizome
The pharmacopoeial marker of the drug and the compound tracked in human pharmacokinetic work: after a single 1,000 mg dose of standardised Atractylodes lancea extract in healthy volunteers it is absorbed rapidly but reaches only low plasma concentrations (Cmax roughly 7-153 ng/mL) and is cleared within about 4 hours, with no accumulation over 21 days of dosing. In rodents it activates AMPK and reduces hepatic steatosis, and it is cytotoxic to cholangiocarcinoma cell lines in vitro.
beta-Eudesmol
Eudesmane sesquiterpene alcoholConcentration: Dominant volatile constituent of the Hubei chemotype of A. lancea; a minor component of the geo-authentic Maoshan chemotype
Accelerates gastric emptying and small-intestinal transit in mice, which is the experimental correlate of the drug's traditional use for epigastric fullness. It is metabolised in human liver microsomes chiefly by CYP2C19 with a secondary contribution from CYP3A4, and in isolated mouse diaphragm it potentiated depolarising neuromuscular blockade.
Hinesol
Spirovetivane sesquiterpene alcoholConcentration: Paired with beta-eudesmol as the chemical signature of the Hubei chemotype; the beta-eudesmol/hinesol ratio is largely genetically determined and is used to assign chemotype
One of the two sesquiterpene alcohols used to type A. lancea material by geographic origin. It contributes to the anti-ulcer and gastric acid-suppressing activity attributed to the volatile oil in animal models; human data specific to hinesol are lacking.
Atractylon
Eudesmane-type furanosesquiterpeneConcentration: Together with atractylodin characterises the geo-authentic Maoshan (Mao Cang Zhu) chemotype; scarce in the Hubei chemotype
A chemically unstable furanosesquiterpene that degrades on storage and processing, which is part of why traditional processing and storage conditions alter the drug's profile. It carries anti-inflammatory and antitumour activity in cell-based assays.
Atractylodes lancea rhizome polysaccharide
PolysaccharideConcentration: Not standardised in the Chinese Pharmacopoeia; content varies with extraction method
The water-soluble, non-volatile fraction of the rhizome. In cyclophosphamide-immunosuppressed mice it restored immune parameters and reduced intestinal mucosal injury, an activity distinct from the volatile oil that dominates the drug's traditional reputation.
⚠ Drug Interactions
CYP2C19 substrates (e.g. clopidogrel, omeprazole, diazepam, voriconazole)
Reaction phenotyping in human liver microsomes and recombinant enzymes showed that beta-eudesmol, a major volatile constituent of A. lancea rhizome, is metabolised predominantly by CYP2C19 with a smaller contribution from CYP3A4 (Muhamad and Na-Bangchang 2023, in vitro). A shared metabolic route raises the possibility of competition at the enzyme, but no human interaction study has been performed and the systemic exposure achieved by the marker compound atractylodin after a 1,000 mg standardised-extract dose is low.
Clinical note: No dose change is indicated for decoctions at customary doses. If a patient is taking a narrow-therapeutic-index CYP2C19 substrate and is using concentrated or extract-based A. lancea products, monitor for altered drug effect rather than assume none.
CYP3A4 substrates (e.g. tacrolimus, ciclosporin, midazolam, statins)
The same in vitro reaction-phenotyping study identified CYP3A4 as a secondary route for beta-eudesmol metabolism. No induction or inhibition study of A. lancea against CYP3A4 probe substrates in humans has been published, so this is an inference from a shared pathway rather than a demonstrated interaction.
Clinical note: Flag rather than avoid. For transplant patients or others on narrow-therapeutic-index CYP3A4 substrates, prefer to keep herbal regimens stable and monitor drug levels through any change.
Depolarising neuromuscular blocking agents (succinylcholine)
beta-Eudesmol isolated from A. lancea potentiated depolarising neuromuscular blockade in isolated diaphragm muscle from normal and diabetic mice (Muroi et al. 1989, ex vivo). The concentrations used are far above anything plausibly reached from an oral decoction, and no clinical case has been reported.
Clinical note: Not a reason to withhold the herb, but include Cang Zhu in the pre-anaesthetic herbal history; the conventional advice to stop herbal medicines about a week before elective surgery applies.
Bai Zhu (Atractylodes macrocephala rhizome) substituted for Cang Zhu
Cang Zhu (sojutsu) and Bai Zhu (byakujutsu, A. macrocephala) are distinct drugs from the same genus that are routinely confused in trade and in translation, and the older bencao literature did not separate them at all. Direct in vitro comparison of the two crude drugs found different anti-inflammatory and immunostimulative profiles (Shimato et al. 2017), and they differ chemically: Cang Zhu is defined by atractylodin, beta-eudesmol, hinesol and atractylon, while Bai Zhu is defined by atractylenolides. The Chinese Pharmacopoeia accepts A. lancea and A. chinensis (DC.) Koidz. as Cang Zhu; A. macrocephala is a separate monograph.
Clinical note: Confirm the botanical source on the certificate of analysis. Cang Zhu is the drying, dampness-transforming drug; Bai Zhu is the tonifying one, and substituting it changes the prescription's intent. Chloroplast trnK sequencing and HPLC marker profiles both distinguish the two reliably.
Antidiabetic agents (insulin, sulfonylureas, metformin)
A. lancea extract and atractylodin activate AMPK and improve hepatic lipid and glucose handling in rodent models of metabolic dysfunction-associated steatotic liver disease (Song et al. 2024, animal). No human glycaemic endpoint has been measured; the phase I trial in healthy volunteers reported no clinically significant laboratory changes.
Clinical note: No action required at customary doses. If a diabetic patient adds a concentrated extract, ask them to keep their usual glucose monitoring routine for the first few weeks.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 3–9 g | Daily | — | — | 中国药典 2020 【用法与用量】3～9g。 【性味与归经】辛、苦，温。归脾、胃、肝经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
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
Dries dampness and moves qi together, relieving the fullness and distention of dampness encumbering the spleen and stomach.
Epigastric and abdominal distention, no appetite, thick greasy tongue coating.
Core pair of a classical formula — Ping Wei San, Taiping Huimin Hejiju Fang
Together they clear heat and dry damp in the lower burner, treating damp-heat descending to the legs.
Classic indication: hot, swollen, painful legs and knees, or damp-heat leukorrhea.
Core pair of a classical formula — Er Miao San, Dan Xi Xin Fa (Zhu Danxi)
The moistening, yin-nourishing herb restrains the drying herb while the drying herb strengthens the spleen, a balanced pair Shi Jinmo used for wasting-thirst.
Named pairing — Lü Jingshan, Shi Jinmo Dui Yao
Evidence Tier
Strong evidence · 7 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
3
1 verified · 2 unverified
Show 3 studies
- Phase I clinical trial to evaluate the safety and pharmacokinetics of capsule formulation of the standardized extract of Atractylodes lancea
- A randomized placebo-controlled phase I clinical trial to evaluate the immunomodulatory activities of Atractylodes lancea (Thunb) DC. in healthy Thai subjects
- Exploratory Phase II Study of Atractylodes lancea (Thunb.) DC. in Advanced-Stage Intrahepatic Cholangiocarcinoma
Other clinical trial
0
Observational / case report
0
In vitro / animal
4
2 verified · 2 unverified
Show 4 studies
- The roles of CYP2C19 and CYP3A4 in the in vitro metabolism of beta-eudesmol in human liver: Reaction phenotyping and enzyme kinetics
- Effects of an Atractylodes lancea rhizome extract and a volatile component beta-eudesmol on gastrointestinal motility in mice
- Comparison of byakujutsu (Atractylodes rhizome) and sojutsu (Atractylodes lancea rhizome) on anti-inflammatory and immunostimulative effects in vitro
- Atractylodes Lancea and Its Constituent, Atractylodin, Ameliorates Metabolic Dysfunction-Associated Steatotic Liver Disease via AMPK Activation
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
Phase I clinical trial to evaluate the safety and pharmacokinetics of capsule formulation of the standardized extract of Atractylodes lancea
Forty-eight healthy Thai volunteers received a single 1,000 mg oral dose, or 1,000 mg daily for 21 days, of a standardised ethanolic extract of A. lancea rhizome (about 48 mg atractylodin per dose) or placebo. The extract was well tolerated with no clinically significant adverse events or laboratory abnormalities. Atractylodin was absorbed rapidly but with low systemic exposure and short residence time, and repeated dosing produced no accumulation and no dose dependency, supporting 1,000 mg/day as a starting dose for cholangiocarcinoma trials.
A randomized placebo-controlled phase I clinical trial to evaluate the immunomodulatory activities of Atractylodes lancea (Thunb) DC. in healthy Thai subjects
A randomised, double-blind, placebo-controlled phase I trial in 48 healthy Thai subjects given a single or 21-day repeated 1,000 mg oral dose of standardised A. lancea extract. Single dosing significantly increased NK, CD4+ and CD8+ lymphocyte counts and lowered IFN-gamma and IL-10; repeated dosing significantly suppressed IL-17A and again raised CD4+ and CD8+ cells. In parallel in vitro work the extract, beta-eudesmol and atractylodin inhibited TNF-alpha and IL-6 expression in stimulated PBMCs. The endpoints are immunological markers, not clinical outcomes.
Exploratory Phase II Study of Atractylodes lancea (Thunb.) DC. in Advanced-Stage Intrahepatic Cholangiocarcinoma
Forty-eight patients with advanced intrahepatic cholangiocarcinoma were randomised to 1,000 mg/day of the A. lancea capsule plus palliative care, an escalating 1,000-2,000 mg/day regimen plus palliative care, or palliative care alone, for three months with four months of follow-up. Both regimens were well tolerated; the higher-dose arm showed improved clinical response and quality-of-life scores, with reported gains in overall survival rate, disease control rate and progression-free survival versus supportive care alone. It is an exploratory study in 48 patients and is not a definitive efficacy trial.
The roles of CYP2C19 and CYP3A4 in the in vitro metabolism of beta-eudesmol in human liver: Reaction phenotyping and enzyme kinetics
Human liver microsome and recombinant-enzyme phenotyping identified CYP2C19 as the principal enzyme metabolising beta-eudesmol, with CYP3A4 contributing secondarily. This is the main published basis for predicting pharmacokinetic drug interactions with Cang Zhu preparations; it is an in vitro study and has not been confirmed in humans.
Effects of an Atractylodes lancea rhizome extract and a volatile component beta-eudesmol on gastrointestinal motility in mice
Oral A. lancea rhizome extract and isolated beta-eudesmol accelerated gastric emptying and small-intestinal transit in mice, and countered delayed transit induced by pharmacological blockade. This gives a mechanistic correlate for the traditional use of the rhizome in epigastric distension and poor appetite; it is a rodent study, not a clinical one.
Comparison of byakujutsu (Atractylodes rhizome) and sojutsu (Atractylodes lancea rhizome) on anti-inflammatory and immunostimulative effects in vitro
A head-to-head comparison of the two Atractylodes crude drugs that are routinely conflated. Sojutsu (A. lancea rhizome, Cang Zhu) and byakujutsu (Bai Zhu) produced different anti-inflammatory and immunostimulative profiles in cell-based assays, supporting the position that they are not interchangeable despite the shared genus.
Atractylodes Lancea and Its Constituent, Atractylodin, Ameliorates Metabolic Dysfunction-Associated Steatotic Liver Disease via AMPK Activation
A. lancea extract and purified atractylodin reduced hepatic steatosis in a rodent model of metabolic dysfunction-associated steatotic liver disease, with AMPK activation identified as the mechanism. Preclinical only; no human metabolic endpoint has been tested.
Historical Texts
Shen Nong Ben Cao Jing (Divine Farmer's Classic of Materia Medica)
Han dynasty, compiled c. 200 CEBen Cao Jing Ji Zhu (Collected Commentaries on the Classic of Materia Medica), Tao Hongjing
Southern dynasties, c. 500 CEBen Cao Gang Mu (Compendium of Materia Medica), Li Shizhen
Ming dynasty, 1596Pharmacopoeia of the People's Republic of China, Atractylodis Rhizoma (Cang Zhu) monograph
Modern standard, 2020 editionReferences
- Zhang WJ; Zhao ZY; Chang LK; Cao Y; Wang S; Kang CZ; Wang HY; Zhou L; Huang LQ; Guo LP. Atractylodis Rhizoma: A review of its traditional uses, phytochemistry, pharmacology, toxicology and quality control . Journal of Ethnopharmacology (2021) [DOI]
- Sun J; Qiao J; Tang J; Cheng N; Gao M; Yang J; Kou B. Herbal Textual Research, Phytochemistry, Pharmacology and Toxicity of Atractylodis Rhizoma: A Comprehensive Review . Molecules (2026) [DOI]
- Xie J; Peng F; Yu L; Peng C. Pharmacological effects of medicinal components of Atractylodes lancea (Thunb.) DC. . Chinese Medicine (2018) [DOI]
- Saeheng T; Karbwang J; Na-Bangchang K. Population-pharmacokinetic/pharmacodynamic model of atractylodes lancea (Thunb.) DC. administration in patients with advanced-stage intrahepatic cholangiocarcinoma: a dosage prediction . BMC Complementary Medicine and Therapies (2024) [DOI]
- Mizukami H; Okabe Y; Kohda H; Hiraoka N. Identification of the Crude Drug Atractylodes Rhizome (Byaku-jutsu) and Atractylodes Lancea Rhizome (So-jutsu) Using Chloroplast TrnK Sequence as a Molecular Marker. . Biological and Pharmaceutical Bulletin (2000) [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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