Xu Chang Qing
StarCynanchum paniculatum (Bge.) Kitag.
Traditionally used for
- Teeth & mouth
- Menstrual & women's health
- Pain & joints
- Skin
☯ TCM Properties
Dispels Wind and Stops Pain; Drains Dampness; Relieves Itching; Invigorates Blood and resolves toxins; Warms the Channels and Disperses Cold; Reduces Swelling
Traditional Chinese Uses
Xu Chang Qing (cynanchum paniculatum root, swallowwort root) is a warm herb with broad pain-relieving, Wind-expelling, and toxin-clearing properties. It is used for joint and muscle pain from Wind-Cold-Damp bi, toothache, lower back pain, dysmenorrhea from Blood stasis, and the pain of traumatic injuries. It also addresses allergic skin conditions including eczema, urticaria, and contact dermatitis. Its versatile analgesic and anti-inflammatory profile makes it clinically applicable to multiple pain and skin conditions.
Relationships
Full-screen graph →Click a node for details · double-click to expand it · Ctrl/⌘ + scroll or two fingers to zoom and pan.
Botanical Description
Cynanchum paniculatum is a slender perennial herb of the family Apocynaceae (formerly Asclepiadaceae), native to dry, sunny grassy slopes, open woodland margins, and rocky meadows across China, Korea, Japan, and the Russian Far East. It grows 50 to 80 cm tall from a short, knotty rhizome bearing many slender, fibrous roots; the rhizome and root system together emit a distinctive aromatic odor when crushed. The stems are erect, mostly unbranched, and nearly glabrous, bearing opposite, narrowly linear-lanceolate leaves 5 to 13 cm long with entire margins. Loose terminal and axillary cymose panicles of small, pale yellow-green to brownish star-shaped flowers appear in summer, followed by paired, narrow follicles releasing comose seeds. The rhizome with attached roots is harvested in autumn for use.
Active Constituents
Paeonol
Acetophenone (phenolic ketone); 2-hydroxy-4-methoxyacetophenone, CAS 552-41-0Concentration: Around 1 percent of the entire dry drug; it is the principal marker compound of Xu Chang Qing and is also the compound this species shares with the unrelated Moutan Cortex and Paeonia species
The main active constituent and the analytical marker. It inhibits NF-kappaB p65 signalling and downstream cyclooxygenase-2 and interleukin-1 beta, and acts on TLR4/NF-kappaB and MAPK pathways. It is volatile, which means the volatile and aqueous extracts of the root differ substantially in paeonol content and in anti-inflammatory potency. Note that paeonol is not diagnostic of this species: an assay showing paeonol does not confirm that the material is Cynanchum paniculatum.
Antofine
Phenanthroindolizidine alkaloid; CAS 32671-82-2Concentration: Identified in the roots; isolated as early as the 1980s to 1990s. No standardised content limit is published
A phenanthroindolizidine alkaloid with reported inhibitory effects on tumour cell growth in vitro. Phenanthroindolizidines as a class are potent protein synthesis inhibitors and cytotoxins, so the presence of this alkaloid is a reason to treat high-dose or prolonged use of the root as uncharacterised rather than benign. No human toxicity data specific to antofine in this drug exist.
Cynanversicoside A
C21 steroidal glycoside; CAS 138875-31-7Concentration: Identified in the roots in the 1980s to 1990s
One of the C21 steroidal glycosides characteristic of the genus Cynanchum. These glycosides, not paeonol, are what chemically place this drug in the Asclepiadaceae, and they are the constituents by which it is distinguished from paeonol-containing drugs of other families.
Cynanversicoside C
C21 steroidal glycoside; CAS 934701-03-8Concentration: Identified in the roots in the 1980s to 1990s
A further C21 steroidal glycoside of the root, flagged in the review literature as warranting study but with no biological characterisation of its own.
Cynapanosides A, B and C
C21 steroidal glycosidesConcentration: Three glycosides isolated from the Chinese drug xu-chang-qing and structurally characterised in 1988
Named directly for the drug and among the earliest structurally defined constituents of it. Biological activity remains largely uncharacterised.
Paniculatumoside G and neocynapanogenin C
C21 steroidal glycosidesConcentration: Identified in 2017; further members paniculatumoside H and paniculatumoside I were identified in 2019
Recent additions to the C21 steroidal glycoside series of this species. The 2020 review notes explicitly that biological assessment of these newly identified compounds remains preliminary and at in vitro level only.
3-Hydroxy-4-methoxyacetophenone
Acetophenone (phenolic ketone); CAS 6100-74-9Concentration: Identified in the roots in the 1980s to 1990s
An acetophenone isomer accompanying paeonol in the volatile fraction of the root. Its presence is part of the reason volatile and aqueous extracts of this drug behave differently in inflammation models.
⚠ Drug Interactions
Asarum heterotropoides F. Schmidt (Xi Xin) as a look-alike substitute
Asarum heterotropoides and Cynanchum paniculatum look alike as dried root material and are confused frequently enough that a dedicated multi-instrument discrimination method has been developed for them. That study identified 91 compounds in Asarum heterotropoides and 90 in Cynanchum paniculatum; both share nitrogenous compounds, volatile oils, organic acids and lignans, but Asarum heterotropoides uniquely contained coumarins and flavonoids and, critically, the toxic components aristolactam I, aristolochic acid D and safrole, while Cynanchum paniculatum uniquely contained steroidal compounds and saccharides. Substituting Asarum heterotropoides therefore converts a drug with no aristolochic acid content into one carrying an aristolactam and an aristolochic acid, both from a class that IARC classifies as carcinogenic to humans, plus safrole. Because both drugs are aromatic roots, ordinary organoleptic identification by smell and taste does not separate them.
Clinical note: Do not authenticate this drug by smell or taste alone. Where Xu Chang Qing is supplied as a cut root, require an analytical or documented identity check. This is also why the species matters more than the pinyin: Xu Chang Qing carries no aristolochic acid, but material misidentified as Xu Chang Qing may.
Other Cynanchum drugs (Bai Wei, Cynanchum atratum; Bai Shou Wu, Cynanchum auriculatum; Cynanchum wilfordii)
The genus Cynanchum supplies several distinct Chinese drugs whose roots are superficially similar and whose C21 steroidal glycoside chemistry overlaps, so genus-level identification is not sufficient. Cynanchum paniculatum is Xu Chang Qing; Cynanchum atratum is Bai Wei; Cynanchum auriculatum and Cynanchum wilfordii are the Bai Shou Wu drugs and have their own separate regulatory histories in East Asia. Pharmacological findings, dosages and restrictions attached to one Cynanchum species must not be carried across to another.
Clinical note: Record the binomial on the prescription, not just the pinyin. Do not transfer safety data between Cynanchum species in either direction.
Paeonia suffruticosa root bark (Mu Dan Pi) and Paeonia lactiflora
Paeonol is the shared major constituent of Cynanchum paniculatum, Paeonia suffruticosa and Paeonia lactiflora, and Moutan Cortex is the commercial source from which paeonol is usually extracted. Prescribing Xu Chang Qing with Mu Dan Pi therefore stacks the same compound from two sources. The practical consequence is not a recognised toxicity but a loss of dose control, and it also means that detecting paeonol in a formula tells you nothing about which herb supplied it.
Clinical note: Account for paeonol from both herbs when they appear in the same formula, and do not treat a paeonol assay as proof that Xu Chang Qing is present.
Central nervous system depressants and antipsychotics
Paeonol from this species altered sensorimotor gating and behaviour in MK-801-treated mice through PI3K-Akt-GSK3-beta and NF-kappaB signalling, and the drug is described in the older Chinese and Korean literature as sedative and analgesic. That is an animal pharmacodynamic signal in a pathway relevant to antipsychotic and sedative drugs; no human pharmacokinetic or pharmacodynamic interaction study exists.
Clinical note: Watch for additive sedation if a patient on this herb is also taking a sedating psychotropic, and record that the interaction is inferred from an animal model rather than measured in humans.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction (added late) | 3–12 g | Daily | — | — | 中国药典 2020 【用法与用量】3～12g，后下。 【性味与归经】辛，温。归肝、胃经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Evidence Tier
Moderate evidence · 6 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
5
3 verified · 2 unverified
Show 5 studies
- Discrimination of poisonous and medicinal plants with similar appearance (Asarum heterotropoides vs. Cynanchum paniculatum) via a fusion method of E-nose, E-tongue, LC-HR-Q-TOF-MS/MS, and electrochemical fingerprint spectra
- The anti-inflammatory effects of paeonol from Cynanchum paniculatum extracts on LPS-induced macrophage RAW 264.7 cells and Helicobacter pylori-infected gastrointestinal mucosal damaged zebrafish
- Paeonol, the active component of Cynanchum paniculatum, ameliorated schizophrenia-like behaviors by regulating the PI3K-Akt-GSK3β-NF-κB signalling pathway in MK-801-treated mice
- Cynanchum paniculatum (Bunge) Kitag. ex H.Hara inhibits pancreatic cancer progression by inducing caspase-dependent apoptosis and suppressing TGF-β-mediated epithelial-mesenchymal transition
- Network Pharmacological Study on the Mechanism of Cynanchum paniculatum (Xuchangqing) in the Treatment of Bungarus multicinctus Bites
Other / unclassified
1
1 verified · 0 unverified
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Cynanchum paniculatum and Its Major Active Constituents for Inflammatory-Related Diseases: A Review of Traditional Use, Multiple Pathway Modulations, and Clinical Applications
The most complete review of this species. It records paeonol at around 1 percent of the dry drug, alongside antofine, cynanversicosides A and C, cynapanosides, neocynapanogenins and paniculatumosides, and traces the mechanism through NF-kappaB, TLR4 and MAPK signalling. It reports the conventional dose as 15 to 30 g per administration in decoction, with 15 g per adult per day used for allergic and mucosal symptoms and 30 g per day for chronic joint pain and recurrent tissue oedema. It notes that Xu Chang Qing appears in the 2015 Chinese Pharmacopoeia within Yangzheng Xiaoji capsules and Yunxiang Qufeng analgesic spray. The authors state plainly that the clinical studies available are mostly preliminary and observational and lack randomised control, and that further randomised double-blind trials are needed; the human data cited, such as a 79-patient series in atrophic gastritis treated with a multi-herb decoction, are uncontrolled.
Discrimination of poisonous and medicinal plants with similar appearance (Asarum heterotropoides vs. Cynanchum paniculatum) via a fusion method of E-nose, E-tongue, LC-HR-Q-TOF-MS/MS, and electrochemical fingerprint spectra
Analytical study addressing the frequent confusion between these two similar-looking roots. Ninety-one compounds were identified in Asarum heterotropoides and 90 in Cynanchum paniculatum. Asarum heterotropoides uniquely contained coumarins, flavonoids and the toxic constituents aristolactam I, aristolochic acid D and safrole; Cynanchum paniculatum uniquely contained steroidal compounds and saccharides. The combined electronic nose, electronic tongue, LC-HR-Q-TOF-MS/MS and Belousov-Zhabotinsky electrochemical fingerprint approach separated the two with 100 percent accuracy. The clinically important result is negative and reassuring for this species: the aristolochic acid analogues belong to the adulterant, not to Xu Chang Qing.
The anti-inflammatory effects of paeonol from Cynanchum paniculatum extracts on LPS-induced macrophage RAW 264.7 cells and Helicobacter pylori-infected gastrointestinal mucosal damaged zebrafish
Compared the volatile extract, the aqueous extract and their combination, with paeonol quantified by HPLC in each. The comparison matters clinically because it shows that the preparation method determines paeonol content and therefore the anti-inflammatory effect, so a volatile-preserving preparation and a long decoction of the same herb are not equivalent. Macrophage and zebrafish models only.
Paeonol, the active component of Cynanchum paniculatum, ameliorated schizophrenia-like behaviors by regulating the PI3K-Akt-GSK3β-NF-κB signalling pathway in MK-801-treated mice
Cynanchum paniculatum extract and its constituent paeonol improved MK-801-induced disruption of sensorimotor gating in mice via PI3K-Akt-GSK3-beta-NF-kappaB signalling. A single rodent model addressing a traditional indication recorded in some Chinese and Korean sources for psychotic symptoms; it is a long way from clinical evidence, and it is the basis for flagging a theoretical additive interaction with sedating psychotropics.
Cynanchum paniculatum (Bunge) Kitag. ex H.Hara inhibits pancreatic cancer progression by inducing caspase-dependent apoptosis and suppressing TGF-β-mediated epithelial-mesenchymal transition
Aqueous extract of the root induced caspase-dependent apoptosis and suppressed TGF-beta-mediated epithelial-mesenchymal transition in pancreatic cancer cell lines. Preclinical only; it does not support any clinical anticancer claim for the herb.
Network Pharmacological Study on the Mechanism of Cynanchum paniculatum (Xuchangqing) in the Treatment of Bungarus multicinctus Bites
A purely computational network pharmacology and docking analysis of the traditional use of this herb for many-banded krait envenomation, screening candidate compounds and predicted targets. It contains no experimental or clinical work and provides no support for using this herb in snakebite, which is a medical emergency requiring antivenom.
Historical Texts
Shen Nong Ben Cao Jing
Han dynasty, about 100 CEReferences
- Chen Wang, Wangxiang Huang, Qianzi Chen, Chenying Yang, Haiting Zhu, Xiya Chen, Qiyi He, Xiaodong Yu. Exploring the mechanism of Cynanchum paniculatum (Bunge) Kitag's therapeutic strategy for rheumatoid arthritis: integrating network pharmacology, molecular docking and in vivo experiments . Journal of Biomolecular Structure and Dynamics (2025) [DOI]
- Shu-Yu Yang, Jen Ying Li, Guan-Jhong Huang, Badrinathan Sridharan, Jen-Shu Wang, Kai-Ming Chang, Meng-Jen Lee. Effects of Water Extract of Cynanchum paniculatum (Bge.) Kitag. on Different Breast Cancer Cell Lines . Evidence-Based Complementary and Alternative Medicine (2021) [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.
📝 Notes
Public notes from the community and your own private notes on Xu Chang Qing.
No notes yet.