Xian Mao
StarCurculigo orchioides Gaertn.
Traditionally used for
- Fertility & vitality
- Pain & joints
- Energy & fatigue
Cautions & contraindications
- Pregnancy
- Heart conditions
- Liver conditions
- Kidney conditions
- Toxic — professional use only
☯ TCM Properties
Tonifies Kidney Yang; Strengthens the Sinews and Bones; Dispels Cold-Dampness; Warms the Ming Men Fire
Traditional Chinese Uses
Xian Mao (curculigo rhizome) is a hot, pungent herb used to powerfully warm and tonify Kidney Yang, expel cold and damp, and strengthen the sinew and bones. It is indicated for impotence, infertility, cold extremities, lower back pain from Kidney Yang deficiency, and joint pain in cold, damp conditions. Its intense heating nature means it must be used cautiously, especially in patients with Yin deficiency or internal heat.
Western Herbalism Properties
Used In Formulas (1)
Relationships
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Botanical Description
Curculigo orchioides is a small perennial herb in the Hypoxidaceae family, native to tropical and subtropical Asia including India, southern China, and Southeast Asia. It grows from a stout, cylindrical, dark brown to nearly black rhizome that descends vertically into the soil and bears slender, fibrous roots. The leaves arise in a basal tuft, are linear-lanceolate, plicate, 15-45 cm long and 1-2 cm wide, with conspicuous parallel veins and a softly hairy surface, resembling a small palm seedling. The bright yellow, star-shaped flowers, 1-2 cm across with six tepals, are borne singly or in small clusters at ground level, often partly hidden by the leaf bases. In TCM the rhizome is Xian Mao; in Ayurveda it is Kali Musli, used as a rejuvenative tonic.
Active Constituents
Curculigoside
Phenolic glucosideConcentration: the Chinese Pharmacopoeia quality marker, requiring not less than 0.1% of the rhizome by HPLC; measured samples typically run 0.11-0.35%, averaging around 0.2%
The principal marker and one of the main active constituents. It carries much of the anti-osteoporotic and antioxidant activity attributed to the herb in laboratory models and is the compound used to judge crude drug quality.
Orcinol glucoside
Phenolic glucosideA major phenolic glucoside of the rhizome, studied for antidepressant and antioxidant activity. It showed no hepatotoxicity against the human hepatic cell line HL-7702 in vitro.
Curculigines A-Q
Chlorinated phenolic glucosidesA distinctive series of chlorophenolic glucosides characteristic of the genus. Phenolics are the main bioactive class in Curculigo, and this series contributes to the antioxidant and neuroprotective activity reported for rhizome extracts.
Cycloartane triterpene saponins
Triterpene saponinsPresent alongside the phenolics. Not uniformly benign: at least one cycloartane triterpene isolated from the rhizome showed hepatotoxicity against the human hepatic cell line HL-7702 in vitro, which is relevant to the traditional caution against long-term use.
Norlignans
Norlignans (phenylpropanoid-derived)A recognised constituent class of the genus Curculigo, reported alongside the phenolic glycosides, polysaccharides and alkaloids in phytochemical reviews.
Polysaccharides (e.g. COP90-1, COP70-3)
PolysaccharidesIsolated rhizome polysaccharide fractions studied for immunomodulatory and antioxidant activity. They are among the constituents behind the herb's traditional use as a tonic.
⚠ Drug Interactions
CYP3A4 substrates (e.g. midazolam, ciclosporin, statins)
In normal rats, Curculigo orchioides inhibited hepatic CYP3A enzymatic activity and reduced CYP3A4 protein expression. The picture is state-dependent: in the Kidney-Yang Deficiency model, where baseline CYP3A activity and CYP3A4 expression were already lower than in normal animals, treatment restored them. Evidence is animal only; no human probe-drug study has been done.
Clinical note: Be alert for raised exposure when Xian Mao is added to a stable regimen containing a narrow-index CYP3A4 substrate, particularly ciclosporin, tacrolimus or simvastatin. Monitor levels rather than pre-emptively adjusting dose.
Hepatotoxic drugs and prolonged high-dose use
Xian Mao is a Pharmacopoeia-graded toxic herb (slightly toxic, xiao du). Toxicological testing found that Curculigo orchioides at 120 g/kg administered to rats for 180 days may cause injury of the liver and kidney, and one isolated cycloartane triterpene from the rhizome was hepatotoxic to HL-7702 human hepatocytes in vitro. Traditional prescribing independently states that it should not be used long-term and that toxic reactions can occur.
Clinical note: Keep to 3-10 g decocted, cycle treatment with rest periods rather than prescribing continuously, and monitor liver function if it is combined with other hepatically stressful drugs. Contraindicated in pregnancy, in Yin deficiency with heat signs, and in excess heat patterns.
Antihypertensive therapy
Standard Chinese herbal prescribing guidance lists hypertension as a contraindication for this hot, Kidney-Yang-warming herb. No pharmacological mechanism has been demonstrated and no interaction study exists; this is a traditional caution rather than an evidenced pharmacodynamic effect, and is recorded here because it is the prevailing prescribing convention.
Clinical note: Treat as a relative contraindication in poorly controlled hypertension; monitor blood pressure if used.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 3–10 g | Daily | — | — | 中国药典 2020 【用法与用量】3～10g。 【性味与归经】辛，热；有毒。归肾、肝、脾经。 — 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.
Kidney yang is warmed and the Chong and Ren regulated, strengthening yang more strongly than either alone.
Joint chief herbs of Er Xian Tang, a modern formula (Zhang Bona, 1950s) for menopausal syndrome.
Named pairing — Chen and Chen, Chinese Medical Herbology and Pharmacology
Evidence Tier
Strong 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
1
1 verified · 0 unverified
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
0
In vitro / animal
1
1 verified · 0 unverified
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
Curculigo orchioides (Xian Mao) modifies the activity and protein expression of CYP3A in normal and Kidney-Yang Deficiency model rats
Hepatic CYP3A enzymatic activity and CYP3A4 protein expression were inhibited by Xian Mao in normal rats. In the Kidney-Yang Deficiency model, baseline CYP3A activity and CYP3A4 expression were lower than in normal rats and were restored by treatment, linking the herb's traditional indication to a measurable change in drug-metabolising capacity.
Treatment of Menopausal Symptoms with Er-xian Decoction: A Systematic Review
Five studies with 677 participants met inclusion criteria out of 154 retrieved. Meta-analysis found Er-xian decoction significantly relieved at least one menopausal symptom versus control (p < 0.01), performed better than non-hormonal comparators and showed no significant difference from menopausal hormone therapy. Note that this tests the six-herb formula (Rhizoma Curculiginis, Herba Epimedii, Radix Morindae Officinalis, Radix Angelicae Sinensis, Cortex Phellodendri, Rhizoma Anemarrhenae), not Xian Mao alone, and the authors judged the included study quality low.
⚠ Safety & Contraindications
- Pregnancy
- Heart conditions
- Liver conditions
- Kidney conditions
- Toxic — professional use only
Contraindications
Contraindicated in yin deficiency with heat, and in pregnancy.
Safety Warnings
- Not for prolonged use; the toxicity is cumulative.
- Liver function should be monitored on an extended course.
⚠ Toxicity Information
Dry mouth, nausea and — on prolonged use — reported hepatic injury. Overdose has produced tongue swelling and numbness.
Historical Texts
Ben Cao Gang Mu
Ming dynastyReferences
- Wang Y, Li J, Li N. Phytochemistry and Pharmacological Activity of Plants of Genus Curculigo: An Updated Review Since 2013 . Molecules (2021) [DOI]
- Nie Y, Dong X, He Y, Yuan T, Han T, Rahman K, Qin L, Zhang Q. Medicinal plants of genus Curculigo: Traditional uses and a phytochemical and ethnopharmacological review . Journal of Ethnopharmacology (2013) [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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