Lu Xian Cao
StarPyrola calliantha H. Andres; Pyrola decorata H. Andres
Traditionally used for
- Cough & breathing
- Menstrual & women's health
- Pain & joints
Cautions & contraindications
- Bleeding disorders
☯ TCM Properties
Dispels Wind-Dampness; Nourishes Liver and Kidney Yin; Strengthens the Sinews and Bones; Stops Bleeding; Stops Cough
Traditional Chinese Uses
Lu Xian Cao (pyrola herb, shinleaf) is a warm, bitter-sweet herb used in Chinese medicine to expel Wind-Damp, tonify Kidney and strengthen the bones and sinew, and stop certain types of bleeding. It is used for joint pain and lower back weakness from Wind-Cold-Damp bi obstruction on a background of Liver-Kidney deficiency — particularly in the elderly. Its secondary hemostatic action addresses chronic cough with blood and uterine bleeding from cold deficiency. It addresses both the obstruction and the underlying weakness simultaneously.
Relationships
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Botanical Description
Pyrola calliantha (and the closely related P. decorata) is a small evergreen perennial herb in the Ericaceae (subfamily Monotropoideae), growing in coniferous and mixed mountain forests across central, southern, and western China. From a slender creeping rhizome arises a basal rosette of long-petiolate, broadly elliptic to nearly round, thick, leathery leaves 3-6 cm long, dark glossy green above and often purplish beneath, with entire to minutely crenulate margins. A single erect leafless scape 15-25 cm tall bears a loose raceme of 5-15 nodding, broadly cup-shaped, fragrant flowers with five greenish-white to pale pink petals, a long curved style protruding from the centre, and a slightly fleshy calyx. Fruits are small five-valved capsules with very fine dust-like seeds. The whole dried plant is the medicinal Lu Xian Cao.
Active Constituents
Chimaphilin (2,7-dimethyl-1,4-naphthoquinone)
NaphthoquinoneConcentration: Characteristic quinone of the drug; not quantified in the comparative species survey and not a pharmacopoeial assay limit
The signature quinone of Pyrola and the constituent most often treated as the drug's chemical marker. It has documented anti-inflammatory and antibacterial activity, and it induced apoptosis in MCF-7 breast cancer cells through a reactive-oxygen-species-mediated mitochondrial pathway in vitro. Related quinones 7-hydroxychimaphilin and renifolin occur alongside it.
Hyperoside (quercetin 3-O-galactoside)
Flavonol glycosideConcentration: 0.46 to 1.93 mg per gram dry weight in Pyrola calliantha and 0.34 to 0.96 mg per gram dry weight in Pyrola decorata across sampled populations
The main flavonoid of the drug and the compound most used in HPLC fingerprinting to compare batches and species. It carries antioxidant activity and is part of the basis for the cardiovascular and anti-inflammatory pharmacology attributed to the total flavonoid fraction. Note that Pyrola calliantha runs roughly twice as high as Pyrola decorata, so the two official source species are not interchangeable batch for batch.
Quercetin
Flavonol aglyconeConcentration: 0.084 to 0.147 mg per gram dry weight in Pyrola calliantha and 0.062 to 0.080 mg per gram dry weight in Pyrola decorata
Free aglycone accompanying the glycosides, contributing antioxidant activity. It is also the compound most likely to matter for enzyme-mediated drug interactions, though at these levels the exposure from a normal dose is small.
Arbutin, homoarbutin, isohomoarbutin and renifolin
Hydroquinone and phenolic glycosidesConcentration: Reported qualitatively from Pyrola decorata and the genus; not quantified in the drug and not subject to a pharmacopoeial limit
Arbutin-type glycosides are hydrolysed in the gut and the urinary tract to hydroquinone, which is the basis for the urinary antiseptic use of arbutin-containing herbs generally and also the reason such herbs are conventionally restricted to short courses. No hydroquinone exposure study has been done on Pyrolae herba specifically, so the amount involved is unknown.
Condensed and hydrolysable tannins, with gallic acid and protocatechuic acid
Tannins and phenolic acidsConcentration: Total tannin 20.34 to 34.75 mg per gram dry weight in Pyrola calliantha against 9.77 to 16.48 mg per gram dry weight in Pyrola decorata
The astringent fraction, consistent with the traditional haemostatic and antidiarrhoeal uses. The roughly twofold difference in tannin between the two official species is the largest single chemical difference between them and is the practical reason a batch's source species should be recorded.
Ursolic acid and oleanolic acid
Pentacyclic triterpenoidsConcentration: Among the seven major triterpenoids quantifiable in Pyrola decorata by LC-MS
Anti-inflammatory triterpenes credited alongside chimaphilin and hyperoside with the drug's activity in joint and connective tissue complaints. Widely distributed and of no diagnostic value.
Total flavonoid fraction of Herba Pyrolae
Mixed flavonoidsConcentration: 16.66 to 19.30 mg per gram dry weight in Pyrola calliantha and 16.22 to 37.82 mg per gram dry weight in Pyrola decorata
The fraction on which most of the drug's cardiovascular pharmacology has been done, including protection against isoproterenol-induced myocardial ischaemic injury in rats. Preclinical work on a concentrated fraction rather than a decoction.
⚠ Drug Interactions
Other Pyrola species and Chimaphila japonica sold as Lu Xian Cao
The Chinese Pharmacopoeia recognises only Pyrola calliantha and Pyrola decorata as sources of Pyrolae herba, but other members of the genus circulate under the same name, and comparative HPLC fingerprinting of three Pyrola species including Pyrola renifolia found distinct profiles and materially different levels of hyperoside, quercetin, tannins and total flavonoids. Chimaphila japonica, a closely related Ericaceae herb with an overlapping name and a similar habit, is likewise a documented near neighbour in trade. Pyrola calliantha carried the highest overall phytochemical content and antioxidant activity of the species compared, so a substitution is a potency change rather than an inert swap.
Clinical note: Require the supplier to state which of the two official species was shipped and treat the two as separate materials for dose-finding, particularly where the astringent action is what is wanted. A batch of markedly lower tannin content is likely to be Pyrola decorata or an unofficial species.
Oral iron supplements and other divalent mineral supplements
The drug carries 10 to 35 milligrams of tannin per gram of dried herb depending on species, and tannins chelate non-haem iron and other divalent cations in the gut lumen, an effect well established for tannin-rich plant materials as a class. It has not been measured for Pyrolae herba specifically, so the size of the effect at a normal decoction dose is inferred rather than known.
Clinical note: Separate the herb from an oral iron dose by two hours or more. This matters most in a patient being treated for iron deficiency anaemia, which is not an unusual co-diagnosis in someone taking the herb for bleeding.
Anticoagulants and antiplatelet drugs (warfarin, direct oral anticoagulants, aspirin, clopidogrel)
Stopping bleeding is one of the drug's traditional functions, so the theoretical concern here runs the other way from the usual herbal bleeding worry: an astringent haemostatic could in principle blunt a deliberately anticoagulated state. No coagulation assay, no pharmacokinetic study and no case report exists for this herb. The entry records the absence of data, not an observed effect.
Clinical note: There is nothing to act on beyond noting the co-prescription. Do not stop an anticoagulant on the strength of this, and if the herb is used for weeks alongside warfarin, keep the usual INR monitoring rather than adding extra tests.
Hepatotoxic drugs and prolonged high-dose use, in relation to hydroquinone exposure
The drug contains arbutin and homoarbutin, and arbutin-type glycosides release hydroquinone on hydrolysis. Arbutin-containing herbs are conventionally limited to short courses on that basis, though the restriction rests on the chemistry of the class rather than on toxicity data for Pyrolae herba, which has none. Whether a normal dose of this herb produces meaningful hydroquinone exposure has not been measured.
Clinical note: Prefer intermittent to continuous long-term use pending data, and do not treat the absence of a toxicity study as a clean safety record. There is no basis for a specific monitoring regimen.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 9–15 g | Daily | — | — | 中国药典 2020 【用法与用量】9～15g。 【性味与归经】甘、苦，温。归肝、肾经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Evidence Tier
Moderate evidence · 4 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
4
0 verified · 4 unverified
Show 4 studies
- Phytochemical Composition, Antioxidant Activity and HPLC Fingerprinting Profiles of Three Pyrola Species from Different Regions
- Chimaphilin induces apoptosis in human breast cancer MCF-7 cells through a ROS-mediated mitochondrial pathway
- Antioxidant and Cytoprotective effects of Pyrola decorata H. Andres and its five phenolic components
- Pyrolae herba alleviates cognitive impairment via hippocampal TREM2 signaling modulating neuroinflammation and neurogenesis in lipopolysaccharide-treated mice
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
Phytochemical Composition, Antioxidant Activity and HPLC Fingerprinting Profiles of Three Pyrola Species from Different Regions
Compared thirteen samples across Pyrola decorata, Pyrola calliantha and Pyrola renifolia and quantified tannin, hyperoside, quercetin and total flavonoids in each. Pyrola calliantha ran roughly twice as high in tannin as Pyrola decorata (20.34 to 34.75 against 9.77 to 16.48 milligrams per gram) and higher in hyperoside and quercetin, and had the highest overall phytochemical content and antioxidant activity. This is the quantitative basis for treating the two official source species as distinct materials rather than interchangeable ones.
Chimaphilin induces apoptosis in human breast cancer MCF-7 cells through a ROS-mediated mitochondrial pathway
The characteristic naphthoquinone of the drug induced apoptosis in MCF-7 breast cancer cells by way of reactive oxygen species and the mitochondrial pathway. Isolated-compound cell work at concentrations unrelated to what a decoction delivers; it is relevant to the chemistry of the marker constituent, not evidence for a clinical anticancer use.
Antioxidant and Cytoprotective effects of Pyrola decorata H. Andres and its five phenolic components
Tested a Pyrola decorata extract and five of its isolated phenolics for radical scavenging and for protection of cells against oxidative damage, attributing the activity to the phenolic fraction. Cell and chemical assay work on one of the two official species; it does not speak to Pyrola calliantha, whose phenolic levels differ.
Pyrolae herba alleviates cognitive impairment via hippocampal TREM2 signaling modulating neuroinflammation and neurogenesis in lipopolysaccharide-treated mice
Pyrolae herba reduced lipopolysaccharide-induced cognitive impairment in mice, with hippocampal TREM2 signalling, neuroinflammation and neurogenesis proposed as the mechanism. A whole-drug extract in a rodent model, and an indication well outside the traditional wind-damp and haemostatic uses; it should not be read as support for a clinical cognitive use.
Historical Texts
Dian Nan Ben Cao
Ming dynasty, c. 1436Ben Cao Gang Mu
Ming dynasty, 1596Zhi Wu Ming Shi Tu Kao
Qing dynasty, 1848Pharmacopoeia of the People's Republic of China, 2020 edition
Modern, 2020References
- He C, Liu J, Ke T, Luo Y, Zhang S, Mao T, Li Z, Qin X, Jin S. Pyrolae herba: A review on its botany, traditional uses, phytochemistry, pharmacology and quality control . Journal of Ethnopharmacology (2022) [DOI]
- Yang X, She J, Liu J, Yang T, An G, Chen Q, Fan C, Li S, Liu Q, Qian C. A Comprehensive Review of the Genus Pyrola Herbs in Traditional Uses, Phytochemistry and Pharmacological Activities . Current Topics in Medicinal Chemistry (2020) [DOI]
- Liu L, Li AL, Zhao MB, Tu PF. Tetralones and Flavonoids from Pyrola calliantha . Chemistry and Biodiversity (2007) [DOI]
- Chen YL, Tan CH, Tan JJ, Qu SJ, Wang HB, Zhang Q, Jiang SH, Zhu DY. Phenolic and Triterpenoid Glycosides from Pyrola calliantha . Helvetica Chimica Acta (2007) [DOI]
- Zhang YY, Zhang C, Ren R, Liu R. Simultaneous determination of seven major triterpenoids in Pyrola decorata H. Andres by LC-MS method . Die Pharmazie (2012) [DOI]
- Deng Q, Peng Z, Liu N, Peng J. Exploring the mechanisms of Pyrola calliantha in the treatment of rheumatoid arthritis based on weighted-gene co-expression and pharmacology network analyses . Asian Journal of Surgery (2025) [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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