Liang Mian Zhen
StarZanthoxylum nitidum (Roxb.) DC.
Traditionally used for
- Teeth & mouth
- Pain & joints
Cautions & contraindications
- Pregnancy
- Heart conditions
- Liver conditions
- Kidney conditions
☯ TCM Properties
Invigorates Blood and Dispels Stasis; Moves Qi and Alleviates Pain; Dispels Wind-Dampness and Unblocks the Collaterals; Resolves Toxicity and Reduces Swelling
Traditional Chinese Uses
Liang Mian Zhen (zanthoxylum nitidum, shiny-leaved prickly ash) is a warm herb used in Chinese medicine for its pain-relieving, Blood-moving, and toxin-clearing properties. It is used for joint pain and stiffness from Wind-Cold-Damp obstruction, traumatic injury pain, and toothache. Its warming, circulating action makes it applicable to cold-type pain from Blood and Qi obstruction in the channels. Its mild toxicity requires that it not be taken in excess.
Western Herbalism Properties
Relationships
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Botanical Description
Zanthoxylum nitidum (Roxb.) DC. (Rutaceae), the shiny-leaf prickly ash, is a scrambling evergreen shrub or woody climber to 3-5 m, with stems and branches densely armed with stout, recurved, broad-based prickles. The alternate, imparipinnate leaves bear three to nine glossy, leathery, ovate to elliptic leaflets 4-10 cm long, with crenate margins and prominent translucent oil dots; the rachis and midribs are also prickly. Small, four-merous, pale yellow-green flowers in axillary panicles give rise to reddish-brown, glandular-dotted follicles releasing shiny black seeds. Native to southern China, Taiwan, Indochina, the Indian subcontinent, and the Pacific islands, the pungent, aromatic root (Liang Mian Zhen) is used in TCM and southern Chinese folk medicine to invigorate blood, dispel wind-damp, and relieve pain.
Active Constituents
Nitidine chloride
Benzophenanthridine alkaloidConcentration: 0.19-3.47 mg/g in wild roots and 0.27-2.48 mg/g in cultivated roots across sampled material; it is the assay marker used for the drug in the Chinese Pharmacopoeia
The characteristic and most-studied alkaloid of the root, and simultaneously its main toxic principle. It targets DNA topoisomerases I and IIA, and shows anti-tumour, anti-inflammatory, anti-malarial and analgesic activity in preclinical models. It is also a substrate of CYP3A4 and of the organic cation transporters OCT1 and OCT3, it causes dose-dependent hepatocellular toxicity, and in zebrafish embryos it produces dose-dependent slowing of the heart rate, cardiac arrest and bleeding around the heart. It accumulates in rat heart tissue and is toxic to cardiomyocytes and cardiac fibroblasts.
Chelerythrine
Benzophenanthridine alkaloidConcentration: up to about 5.58 mg/g, highest in cultivated roots
A protein kinase C inhibitor and cytotoxin, and the second major benzophenanthridine of the drug. In cardiomyocyte work it, like nitidine, significantly affects ion channel activity, so it contributes to the cardiac toxicity of the crude root rather than only to its anti-inflammatory action. It is the same alkaloid found in Chelidonium and Macleaya, so exposure can be additive across a prescription.
Magnoflorine
Quaternary aporphine alkaloidConcentration: up to about 6.05 mg/g, highest in wild material
Often the most abundant alkaloid by weight in wild roots. One of the four compounds shown to act on prostaglandin-endoperoxide synthase 2 (PTGS2) and to influence cardiomyocyte ion channels.
Hesperidin
Flavanone glycosideThe main non-alkaloidal marker among the four principal compounds of the root, contributing anti-inflammatory activity through PTGS2 without the alkaloids' toxicity.
Sesamin
Furofuran lignanConcentration: mean 0.36-0.48 mg/g
A lignan used together with the alkaloids as a quality marker, and one of the constituents that helps distinguish root from stem material.
⚠ Drug Interactions
CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin, ritonavir, grapefruit juice)
Nitidine chloride is a CYP3A4 substrate, and its hepatocellular toxicity is dose-dependent and relieved by CYP3A4-mediated metabolism. Blocking that route therefore raises exposure to the parent alkaloid in a herb that is already classified as slightly toxic. Conversely, CYP3A4 inducers would be expected to lower efficacy. This rests on transporter and enzyme identification plus animal toxicity data; there is no human pharmacokinetic study.
Clinical note: Do not prescribe internal Liang Mian Zhen alongside azole antifungals, macrolides or protease inhibitors, and avoid it entirely in patients with existing liver disease.
Drugs that prolong the QT interval or depress cardiac conduction, and cardiac glycosides
Nitidine and chelerythrine both significantly influence ion channels in cardiomyocytes. In zebrafish embryos nitidine chloride caused dose-dependent reduction in heart rate, cardiac arrest and bleeding in the heart area at higher concentrations, and in rats it accumulates in cardiac tissue with toxicity to cardiomyocytes and fibroblasts. This is the clearest safety signal for the herb and it is not softened by the fact that the evidence is preclinical.
Clinical note: Keep internal use within the 5-10 g decoction range, do not exceed it, and avoid internal use altogether in patients with known arrhythmia, heart failure or on antiarrhythmic therapy. External application in liniments and washes carries far less of this risk than internal dosing.
OCT1 and OCT3 substrates and inhibitors (metformin, cimetidine)
Nitidine chloride is a substrate of the organic cation transporters OCT1 and OCT3, which are also the uptake route for metformin into hepatocytes. Competition at these transporters can change the distribution of either partner, and OCT1-mediated hepatic uptake is the step that delivers nitidine to the hepatocyte where its toxicity is expressed.
Clinical note: Use caution when combining with metformin, particularly in patients with reduced renal function.
Other hepatotoxic drugs (methotrexate, isoniazid, high-dose paracetamol, statins)
Nitidine chloride shows dose-dependent hepatocellular toxicity in its own right, so any co-prescription that loads the liver adds to that burden. Zanthoxyli Radix is formally a slightly toxic drug in the Chinese Pharmacopoeia rather than a bland one.
Clinical note: Check liver function before and during any course lasting more than a few weeks, and stop the herb if transaminases rise.
Toddalia asiatica (Fei Long Zhang Xue) and other Zanthoxylum species sold as Liang Mian Zhen
Z. nitidum is regularly confused with Toddalia asiatica and with Zanthoxylum armatum, and near-infrared discriminant methods have had to be developed precisely because Z. nitidum must be separated from Z. avicennae, Z. scandens and T. asiatica in the trade. Authentic root has a bright yellow inner bark, a strongly acrid tongue-numbing taste and concentric rings on the cut surface; T. asiatica root lacks the bright yellow section. Stem material is also passed off as root, which changes the marker profile. Since the whole safety margin of this drug rests on its alkaloid content, misidentification cuts both ways: an inert substitute fails the patient, and an alkaloid-richer one poisons them.
Clinical note: Insist on identified root material with a marker assay, and reject batches sold only by pinyin name.
Other benzophenanthridine-containing herbs and products (Macleaya cordata, Chelidonium majus, sanguinarine-containing preparations)
Chelerythrine is a shared constituent of Z. nitidum, Chelidonium majus and Macleaya cordata, and sanguinarine is its close congener. Because the toxic effects of these alkaloids are dose-related, combining sources within one prescription raises the total load even though each individual herb may be within its own dose limit.
Clinical note: Do not stack benzophenanthridine herbs in a single formula, and count topical as well as internal sources.
Anticoagulants and antiplatelet drugs
The herb is prescribed to invigorate Blood and dispel stasis, and it is traditionally avoided in pregnancy for the same reason. There is no direct platelet or coagulation study on Z. nitidum, so this is an inference from indication rather than from measured pharmacology; the cardiac and hepatic signals above are the more important safety concerns.
Clinical note: Avoid in pregnancy. Where anticoagulants are already in use, weigh this herb against safer alternatives given its toxicity profile.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction, or powder/pills | 5–10 g | Daily | — | — | 中国药典 2020 【用法与用量】5～10g。外用适量，研末调敷或煎水洗患处。 【注意】不能过量服用；忌与酸味食物同服。 【性味与归经】苦、辛，平；有小毒。归肝、胃经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
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
2
0 verified · 2 unverified
Show 2 studies
- Analgesic Effect of Zanthoxylum nitidum Extract in Inflammatory Pain Models Through Targeting of ERK and NF-κB Signaling
- The Therapeutic Potential of Four Main Compounds of Zanthoxylum nitidum (Roxb.) DC: A Comprehensive Study on Biological Processes, Anti-Inflammatory Effects, and Myocardial Toxicity
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
Analgesic Effect of Zanthoxylum nitidum Extract in Inflammatory Pain Models Through Targeting of ERK and NF-κB Signaling
Chronic inflammatory pain was induced in C57BL/6J mice by intraplantar complete Freund's adjuvant, and the mice were then treated with Zanthoxylum nitidum extract. The extract reduced hyperalgesia, and peripheral and central mechanism work implicated ERK and NF-kappaB signalling. This is the most direct preclinical support for the traditional use of the root in pain and rheumatic complaints.
The Therapeutic Potential of Four Main Compounds of Zanthoxylum nitidum (Roxb.) DC: A Comprehensive Study on Biological Processes, Anti-Inflammatory Effects, and Myocardial Toxicity
Nitidine chloride, chelerythrine chloride, magnoflorine chloride and hesperidin, the four highest-concentration bioactive compounds of the root, were examined by proteomics in myocardium and by electrophysiology in cardiomyocytes. All four produced anti-inflammatory effects through interaction with PTGS2, but all four also significantly influenced cardiomyocyte ion channels. The paper frames the cardiac toxicity of this herb as an open and unresolved question rather than a settled one.
Historical Texts
Ben Cao Qiu Yuan
Qing dynastyReferences
- Qiang Lu, Runfang Ma, Yang Yang, Zhimi Mo, Xudong Pu, Cailan Li. Zanthoxylum nitidum (Roxb.) DC: Traditional uses, phytochemistry, pharmacological activities and toxicology . Journal of Ethnopharmacology (2020) [DOI]
- Fu-Hui Luo, Zi-Hao Chen, Fen-Fen Zeng, Xia Yang, Jin-Jin Li, Feng-Xiang Zhang, Wei Shi. Botany, phytochemistry, pharmacologic activities, traditional applications, pharmacokinetics, quality control and toxicity of Zanthoxyli Radix: An updated review . Journal of Ethnopharmacology (2025) [DOI]
- Qiang Lu, Shuang Luo, Zhongfeng Shi, Mingzhen Yu, Weifeng Guo, Cailan Li. Nitidine chloride, a benzophenanthridine alkaloid from Zanthoxylum nitidum (Roxb.) DC., exerts multiple beneficial properties, especially in tumors and inflammation-related diseases . Frontiers in Pharmacology (2022) [DOI]
- Xinhong Wang, Qingwen Wu, Lulu Li, Peng Wang, Yue Wang, Weifeng Wei, Xiaojun Ma, Jing Shu, Kai Zhang, Dongming Ma. Determination of quality markers for quality control of Zanthoxylum nitidum using ultra-performance liquid chromatography coupled with near infrared spectroscopy . PLOS ONE (2022) [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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