☯ TCM Properties

Category: tonifying

Temperature: warm

Taste: sweet, salty

Meridians: kidney, large intestine

Functions:

Tonifies Kidney Yang; Nourishes Essence and Blood; Moistens the Intestines and Unblocks the Bowels; Relaxes Sinews and Strengthens Bones

Traditional Chinese Uses

Rou Cong Rong (cistanche, broomrape) is a warm, sweet herb considered one of the most important Kidney Yang tonics in Chinese medicine. It supplements Kidney Yang and essence for impotence, infertility, lower back weakness, and urinary incontinence, and its oily, moistening nature simultaneously lubricates the Intestines to relieve constipation from cold dryness. This combination of Yang-tonifying and moistening properties makes it uniquely suitable for elderly patients with Kidney Yang deficiency and dry constipation. It is known as "desert ginseng" in Inner Mongolian tradition.

Western Herbalism Properties

Actions:

tonicdemulcent

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Botanical Description

Cistanche deserticola (Orobanchaceae), known as Rou Cong Rong or desert ginseng, is a holoparasitic flowering plant lacking chlorophyll that grows attached to the roots of the desert shrub Haloxylon ammodendron. The visible portion is a fleshy, scaly, club-shaped flowering stem 40-160 cm tall, 3-10 cm thick, covered in spirally arranged yellow-brown to purplish scale-leaves. Dense terminal spikes bear tubular, two-lipped, pale yellow to lavender flowers in spring. Native to arid sandy soils of Inner Mongolia, Gansu, Ningxia, and Xinjiang in China and adjacent Mongolia. The succulent stem is harvested in spring before flowering, salted, and dried for medicinal use. CITES-listed due to overharvest. (Sources: POWO; Wikipedia)

Active Constituents

Echinacoside

Phenylethanoid glycoside

The principal phenylethanoid glycoside of the drug and, with acteoside, the basis of pharmacopoeial assay for Cistanches Herba. It carries most of the reported antioxidant, neuroprotective and anti-fatigue activity in preclinical models. Note for anyone reading supplement labels: Cistanche tubulosa contains substantially more echinacoside than C. deserticola, so high-echinacoside products are usually the other species.

Acteoside (verbascoside)

Phenylethanoid glycoside

The second pharmacopoeial marker compound, co-assayed with echinacoside. Anti-inflammatory and antioxidant in vitro; also the compound to which several of the drug's reported hepatoprotective effects are attributed in animal models.

Cistanosides A, B, C, F and H, isoacteoside and 2-acetylacteoside

Phenylethanoid glycosides

More than twenty phenylethanoid glycosides have been isolated from the species; these are the ones most often used as secondary quality markers. Individually characterised only in vitro, and their absorption is poor enough across Caco-2 monolayers that systemic exposure after oral dosing is likely to be low.

Iridoid glycosides (geniposidic acid, 8-epiloganic acid, bartsioside, ajugol)

Iridoid glycosides

Around 27 iridoids have been described from the species. They are chemically distinct from the phenylethanoids and are among the compounds identified as candidate quality markers for Cistanches Herba by combined mass spectrometry and network pharmacology.

Cistanche polysaccharides

Heteropolysaccharides

Composed of glucose, galactose, rhamnose, arabinose and fructose. Reported immunomodulatory activity in animal models. As with the polysaccharide fractions of most tonic herbs, the human relevance of the preclinical work is unestablished.

Lignans (liriodendrin, (+)-syringaresinol-O-beta-D-glucopyranoside, (+)-pinoresinol-O-beta-D-glucopyranoside)

Lignan glycosides

Concentration: described as relatively low in the review literature

Minor constituents relative to the phenylethanoids and iridoids. Included for completeness of the chemical profile rather than for any established activity in this drug.

⚠ Drug Interactions

CYP2C19 substrates (e.g. clopidogrel, omeprazole, voriconazole) and other CYP1A2, CYP2E1 and CYP3A4 substrates

Theoretical Evidence: Possible

Echinacoside inhibited human liver microsomal CYP2C19, CYP2E1, CYP1A2 and CYP3A4 with IC50 values of 8.70, 19.15, 21.23 and 55.42 micromolar respectively. The CYP2C19 inhibition is the most potent and the CYP3A4 inhibition was time-dependent, which usually signals mechanism-based inactivation and would matter more if the exposure were achievable. It probably is not: oral phenylethanoid glycosides are poorly absorbed, and no in vivo or clinical confirmation of any of this exists. Recorded as a signal to watch rather than a known interaction.

Clinical note: No routine restriction is justified on this evidence. If a patient on clopidogrel, voriconazole or another narrow-margin CYP2C19 substrate is taking high-dose standardised cistanche extract rather than a decoction dose of the crude drug, treat the combination as unstudied and monitor clinically.

Cistanche tubulosa and Cistanche salsa material traded or sold as Rou Cong Rong

Moderate Evidence: Established

Cistanches Herba on the market is not one species. Analytical work quantifying seven phenylethanoid glycosides handles Cistanche deserticola and Cistanche tubulosa side by side because both circulate commercially, and their glycoside profiles differ; C. tubulosa carries markedly more echinacoside, which is why most Western supplements standardised on echinacoside are that species. This is not a taxonomic footnote but a supply consequence of conservation status. Cistanche deserticola is listed on CITES Appendix II, is a second-grade nationally protected plant in China, and appears on the IUCN Red List; a national harvest ban was introduced in 2000 and wild populations are described in the literature as gradually exhausted. It is a holoparasite with no chlorophyll of its own, depending on the roots of desert saxaul (Haloxylon ammodendron and relatives), and collecting the wild plant damages or destroys the host, whose numbers are separately falling because herders cut it for firewood. Legitimate supply therefore means cultivated material, and legitimate international trade in wild material means CITES documentation.

Clinical note: Buy cultivated material with the binomial stated, and require CITES paperwork for any imported wild-collected stock. Do not substitute a C. tubulosa extract for a C. deserticola decoction dose without recalculating: the glycoside content differs several-fold. If a product does not name the species, assume it is not C. deserticola.

Laxatives (senna, bisacodyl, macrogol, lactulose)

Minor Evidence: Theoretical

One of the drug's two principal classical uses is to moisten the intestines and unblock the bowels, and this is the action for which it is most often prescribed to elderly and debilitated patients. Additive effect with a pharmaceutical laxative is expected on that basis. No trial has measured it, and no mechanism has been established for the laxative action itself.

Clinical note: When adding Rou Cong Rong to a patient already on a regular laxative, reduce the laxative first rather than running both at full dose, particularly in older patients where diarrhoea risks dehydration.

Dosage

Form	Amount	Frequency	Duration	Population	Notes
decoction	6–10 g	Daily	—	—	中国药典 2020 【用法与用量】6～10g。【性味与归经】甘、咸，温。归肾、大肠经。 — 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.

with Dang Gui 当归

Kidney yang and essence are warmed while blood is nourished and the intestines moistened, moving the stool without purging.

Constipation from kidney deficiency in the elderly.

Core pair of a classical formula — Ji Chuan Jian, Jing Yue Quan Shu (Zhang Jingyue)

Evidence Tier

Moderate evidence · 2 studies

Recorded 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

2

1 verified · 1 unverified

Show 2 studies

Effects of Cistanche deserticola Y.C. Ma Supplementation on Muscle Strength and Recovery: A Randomized Controlled Trial
A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study

Other clinical trial

0

Observational / case report

0

In vitro / animal

0

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

Effects of Cistanche deserticola Y.C. Ma Supplementation on Muscle Strength and Recovery: A Randomized Controlled Trial

Tao Biaoxu; Lian Weihao; Min Rongrong; Zhang Xiaoyu; Chen Liqi; Hao Sun; Li Ze; Ma Chengzhe; Zhang Haojie; Liu Chang (2025) Nutrients RCT Verified: Randomized controlled trial

Randomised, double-blind, placebo-controlled trial in 48 men, half resistance-trained and half untrained, all following the same eight-week training programme, with 5 g of Cistanche deserticola extract twice daily or matched placebo. In untrained subjects the extract group gained significantly more in bench press and squat one-repetition maximum, maximal voluntary isometric contraction and repetitions to failure; in trained subjects squat 1RM and MVIC improved significantly. Serum testosterone rose, cortisol fell, and CRP and creatine kinase fell in both strata. The single best piece of human evidence on this species, but small, male-only, industry-relevant to sports nutrition, and at a dose (10 g extract daily) far above a normal decoction.

DOI: 10.3390/nu17182965 Link

A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study

Kan Juntao; Cheng Junrui; Hu Chun; Chen Liang; Liu Siyu; Venzon Dawna; Murray Mary; Li Shuguang; Du Jun (2021) Frontiers in Nutrition RCT

Randomised, double-blind, placebo-controlled trial of a two-herb product in adults with chronic fatigue syndrome, reporting improvement in fatigue symptoms. Two caveats matter for this record: the cistanche component was a water extract of Cistanche tubulosa root standardised to at least 28% echinacoside, not Cistanche deserticola, and the product also contained Ginkgo, so no effect can be attributed to cistanche alone.

DOI: 10.3389/fnut.2021.658630 Link

Historical Texts

Shen Nong Ben Cao Jing

Han dynasty

Listed as Rou Song Rong. Credited with treating the five exhaustions and seven injuries, warming cold and painful conditions of the genitals, nourishing the five zang, strengthening yin and augmenting essence and qi, and with restoring fertility. The reproductive and yang-tonifying emphasis of the Han entry is still the drug's primary indication.

Ben Cao Gang Mu

Ming dynasty (1596)

Li Shizhen gathers the earlier records and brings out the second use that modern texts keep, weakness of the lower back and knees, and constipation in the elderly and depleted, which is rendered today as moistening the intestines and unblocking the bowels. He also describes the plant as growing from the roots of other desert plants, an early notice of the parasitism that is now the drug's central conservation problem.

References

Liu Xiaofeng; Yang Zichao; Han Minjun; Zhang Yao; Muhammad Hussain; Zhong Hao; Guan Rongfa. Bioactive Components, Pharmacological Properties, and Applications of Cistanche deserticola Y. C. Ma: A Comprehensive Review . Nutrients (2025) [DOI]
Zhang Shengai; Ma Yiwei; Chen Jia; Yu Mingli; Zhao Qinghua; Jing Bo; Yang Na; Ma Xinyu; Wang Yuyan. Chemical composition, pharmacological effects, and parasitic mechanisms of Cistanche deserticola: An update . Phytomedicine (2024) [DOI]
Jiang Linlin; Zhou Baochang; Wang Xiaoqin; Bi Yaqiong; Guo Wenfang; Wang Jianhua; Yao Ruyu; Li Minhui. The Quality Monitoring of Cistanches Herba (Cistanche deserticola Ma): A Value Chain Perspective . Frontiers in Pharmacology (2021) [DOI]
Bai Dingyong; Zhang Huihua. A parasitic model between Haloxylon ammodendron and Cistanche deserticola under harvesting pressure . Chaos, Solitons and Fractals (2025) [DOI]
Wu Yujie; Qiao Aiqing; Lin Shu; Chen Lijia. In vitro evaluation of the inhibition potential of echinacoside on human cytochrome P450 isozymes . BMC Complementary Medicine and Therapies (2022) [DOI]
Dong Yanhong; Guo Qi; Liu Jingjing; Ma Xueqin. Simultaneous determination of seven phenylethanoid glycosides in Cistanches Herba by a single marker using a new calculation of relative correction factor . Journal of Separation Science (2018) [DOI]
Liu Xiaofeng; Han Minjun; Yang Zichao; Chen Zherui; Zhang Yao; Guan Rongfa. Phenylethanoid Glycosides from Cistanche deserticola Y. C. Ma: Synergistic Effects, Multi-target Mechanisms and Translational Applications . Nutrients (2026) [DOI]

Rou Cong Rong

Traditionally used for