Niu Xi

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Achyranthes bidentata Blume

Genus: Achyranthes Species: bidentata Pinyin: Niu Xi
Ox Knee Root牛膝

☯ TCM Properties

Category: regulating blood
Temperature: neutral
Taste: bitter, sour, sweet
Meridians: liver, kidney
Functions:

Invigorates Blood and Dispels Stasis; Guides Herbs and Blood Downward; Supplements the Liver and Kidneys; Strengthens the Sinews and Bones; Promotes Urination and Relieves Stranguria

Traditional Chinese Uses

Niu Xi (ox-knee root, achyranthes root) is a bitter, sour herb with a strong downward-directing action. It promotes Blood circulation, eliminates stasis, and tonifies the Liver and Kidney — making it valuable for knee and lower back pain, joint stiffness, and muscle weakness from Liver-Kidney deficiency. Its descending nature makes it useful for drawing Fire downward to relieve tooth pain, nosebleeds, and headaches from rising Liver Fire. It also promotes urination and expels Blood stasis from the lower body.

Western Herbalism Properties

Actions:
tonicstimulantdiuretic

Used In Formulas (3)

Botanical Description

Achyranthes bidentata (Niu Xi, two-toothed amaranth, ox-knee) is a perennial herb in the Amaranthaceae family, growing 70 to 120 centimeters tall, with quadrangular, conspicuously swollen, knee-like nodes (giving rise to both the Chinese common name Niu Xi, ox-knee, and English ox-knee). Stems are erect, sparsely branched, and finely pubescent. Leaves are opposite, elliptic to elliptic-lanceolate, 4 to 12 centimeters long, with entire margins, acuminate tips, and short petioles. The inflorescence is a slender terminal spike 3 to 5 centimeters long that elongates in fruit to 10 to 15 centimeters, bearing numerous small greenish flowers that reflex downward against the rachis as they mature; each flower is subtended by a persistent bract and two stiff bracteoles tipped with sharp barbed spines that cling to clothing and animal fur, aiding dispersal. The medicinal root is long, cylindrical, slightly twisted, 30 to 90 centimeters long and 0.4 to 1 centimeter thick, externally grayish-yellow, internally pale yellowish-brown. Native to East Asia, India, and adjacent regions.

Active Constituents

β-Ecdysterone (20-hydroxyecdysone)

Phytoecdysteroid

Concentration: Principal marker; ~0.03-0.1% of dried root, used for pharmacopoeial quality control

The principal quality-control marker of Achyranthis Bidentatae Radix. Exhibits anabolic, protein-synthesis-promoting, osteogenic and neurotrophic activity, and is regarded as a key contributor to the herb's actions on bone, joint and connective tissue.

Inokosterone

Phytoecdysteroid

Concentration: Minor ecdysteroid component alongside β-ecdysterone

A co-occurring ecdysteroid contributing to anti-inflammatory, hypotensive and anabolic effects reported for the root.

Oleanolic acid

Pentacyclic triterpenoid (saponin aglycone)

Concentration: Released as the aglycone on hydrolysis of the herb's triterpenoid saponins

Aglycone of the herb's triterpenoid saponins; associated with hepatoprotective, anti-inflammatory and lipid-lowering activity.

Achyranthes bidentata triterpenoid saponins (e.g. ginsenoside Ro / bidentatosides)

Oleanane-type triterpenoid saponins

Concentration: Major saponin fraction of the root

Oleanolic-acid glycosides that account for much of the herb's anti-inflammatory, blood-invigorating and uterine-stimulant activity.

Achyranthes bidentata polysaccharides (ABPS)

Polysaccharide

Concentration: Abundant water-soluble fraction of the decoction

Immunomodulatory and chondroprotective. Enhance macrophage phagocytosis, NK-cell activity and antibody formation, and have been studied for protection of chondrocyte extracellular matrix in osteoarthritis.

Rubrosterone

Ketosteroid / ecdysteroid derivative

Concentration: Trace steroidal constituent

A minor steroidal constituent reported to have protein-anabolic activity.

Free amino acids and trace elements (e.g. glycine; copper, iron)

Amino acids / minerals

Concentration: Multiple amino acids plus trace metals

Contribute to nutritive tonic effects and are part of the crude drug's overall composition.

⚠ Drug Interactions

Warfarin and other anticoagulant / antiplatelet agents

Moderate Evidence: Theoretical

Niu Xi is a blood-invigorating (huo xue) herb with documented effects on blood circulation and platelet/coagulation parameters; combined use could in theory add to the effect of anticoagulant or antiplatelet drugs.

Clinical note: Monitor for bruising or bleeding when combined with warfarin, heparin, aspirin or clopidogrel; no well-documented clinical case reports exist.

Antidiabetic agents (insulin, sulfonylureas)

Minor Evidence: Theoretical

Experimental studies report blood-glucose-lowering activity for the crude drug, which could theoretically add to the effect of hypoglycemic medication.

Clinical note: Monitor blood glucose if used alongside antidiabetic therapy.

Dosage

FormAmount Frequency Duration Population Notes
decoction 6-15g Daily

Preparation Methods

Decoction

Parts: Root

Typically 5-15 g of dried root simmered in water. Raw (unprepared) Niu Xi is favored to invigorate blood, guide fire and blood downward, and relieve stranguria.

Wine-processed (jiu zhi) decoction

Parts: Root

Root stir-processed with rice wine before decocting to strengthen the tonifying action on the Liver and Kidneys and the effect on sinews and bones.

Clinical Studies

Compatibility of Achyranthes bidentata components in reducing inflammatory response through Arachidonic acid pathway for treatment of Osteoarthritis

Li Z, Ma D, Peng L, Li Y, Liao Z, Yu T (2022) Bioengineered In vitro / network pharmacology study

Identified optimal ratios of Achyranthes bidentata-derived components that suppressed the arachidonic-acid inflammatory pathway, supporting the herb's traditional use in osteoarthritis of the knee.

A Systematic Pharmacology and In Vitro Study to Identify the Role of the Active Compounds of Achyranthes bidentata in the Treatment of Osteoarthritis

Chen Z, Wu G, Zheng R (2020) Medical Science Monitor Network pharmacology and in vitro study

Used systematic (network) pharmacology plus in vitro experiments to map active compounds of A. bidentata to osteoarthritis-related targets and inflammatory pathways.

Historical Texts

Shen Nong Ben Cao Jing (Divine Farmer's Materia Medica)

Eastern Han dynasty (c. 200 CE)
Lists Niu Xi among the superior-grade herbs, indicated for cold-damp painful obstruction of the limbs and for strengthening the sinews and bones.

Ben Cao Gang Mu (Compendium of Materia Medica), Li Shizhen

Ming dynasty (1578)
Distinguishes Huai Niu Xi (from Huaiqing) for tonifying the Liver and Kidneys from Chuan Niu Xi for invigorating blood, and describes guiding blood and fire downward.

References

  1. Chen YR, Niu YS, Zhou HL. Achyranthes bidentata Blume (Amaranthaceae): a review of its botany, traditional uses, phytochemistry, pharmacology, and toxicology . Journal of Pharmacy and Pharmacology (2024) [DOI]
  2. Li Z, Ma D, Peng L, Li Y, Liao Z, Yu T. Compatibility of Achyranthes bidentata components in reducing inflammatory response through Arachidonic acid pathway for treatment of Osteoarthritis . Bioengineered (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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