Zhu Ma Gen

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Boehmeria nivea (L.) Gaud.

Not yet clinically reviewed

Genus: Boehmeria Species: nivea Pinyin: Zhu Ma Gen
Ramie root苎麻根

Traditionally used for

  • Nose & throat
  • Urinary & fluids
  • Menstrual & women's health
Moderate evidence · 3 studies

☯ TCM Properties

Category: regulating blood
Temperature: cold
Taste: sweet
Meridians: heart, liver
Functions:

Cools the Blood and Stops Bleeding; Calms the Fetus; Clears Heat and Resolves Toxicity; Promotes Urination; Invigorates Blood and Dispels Stasis

Traditional Chinese Uses

Zhu Ma Gen (ramie root, china grass root) is a cool herb used in Chinese medicine to clear Heat toxin, cool the Blood, and calm the fetus. It is used for bleeding conditions from Blood Heat including uterine bleeding, nosebleeds, and blood in the urine, as well as for threatened miscarriage and fetal heat patterns. Its fetus-calming property makes it specifically important in obstetric applications for women with Heat or Fire disturbing the fetal environment. Topically it is used for burns and carbuncles.

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Botanical Description

Boehmeria nivea, ramie or China grass, is a perennial herbaceous subshrub of the Urticaceae family growing 1 to 2.5 m tall from a stout woody rootstock and spreading by underground rhizomes to form colonies. Unlike most relatives in the nettle family it lacks stinging hairs. Stems are erect, unbranched or sparingly branched, ribbed, and clothed in fine appressed pubescence. Leaves are alternate, broadly ovate to nearly orbicular, 7 to 18 cm long, coarsely serrate, dark green and roughened above, and conspicuously white-tomentose on the lower surface (giving the epithet nivea, snowy). The plant is monoecious; tiny greenish unisexual flowers are borne in slender axillary panicles, the staminate clusters below and pistillate above. The fruit is a minute hairy achene. Long cultivated across East and Southeast Asia for its strong stem bast fibers.

Active Constituents

Emodin

Anthraquinone

Concentration: isolated from the root; the isolation report gives no quantitative figure

One of eight compounds isolated from Radix Boehmeriae by Shao and Wang (2010). Emodin is a widely distributed anthraquinone with laxative, anti-inflammatory and hepatic effects in other drugs; no study has attributed any action of the ramie root specifically to its emodin content, so its presence here is a compositional fact rather than an established mechanism.

Emodin-8-O-beta-glucopyranoside

Anthraquinone glycoside

Concentration: isolated from the root; no quantitative figure reported

The glucoside of emodin, reported from Radix Boehmeriae in the same isolation study. Anthraquinone glycosides are generally poorly absorbed intact and are hydrolysed by gut flora to the aglycone.

Physcion

Anthraquinone

Concentration: isolated from the root; no quantitative figure reported

Reported from Radix Boehmeriae for the first time by Shao and Wang (2010). Its pharmacological contribution to the drug has not been studied.

Polydatin (piceid, resveratrol-3-O-beta-glucoside)

Stilbene glucoside

Concentration: isolated from the root; no quantitative figure reported

A stilbene glucoside better known from Polygonum cuspidatum, reported from ramie root for the first time in the 2010 isolation study.

Catechin and epicatechin

Flavan-3-ol

Concentration: present in the root, but total flavonoids in root tissue are among the lowest of the plant, roughly 637 mg catechin equivalents per 100 g dry weight against 2755 in phloem

Flavan-3-ols isolated from the root and quantified across plant parts by Wang and colleagues (2019), who found root and petiole to be the poorest tissues of the six examined. Their comparative work attributes the strong antioxidant and antiproliferative activity of ramie mainly to xylem and bud, not to the root that is the medicinal drug.

Chlorogenic acid

Hydroxycinnamic acid ester (phenylpropanoid)

Concentration: a dominant phenolic of the plant, but total phenolics in the root are the lowest of six vegetative parts measured, roughly 443 mg gallic acid equivalents per 100 g dry weight against 4585 in bud

Chlorogenic acid is routinely cited as the leading active of Boehmeria nivea, but the quantitative comparison of vegetative parts shows the claim rests on leaf, bud and xylem rather than on the root. Practitioners should not assume that chlorogenic-acid pharmacology from ramie leaf carries over to the root decoction.

Potassium nitrate

Inorganic nitrate salt

Concentration: isolated from the root as a discrete constituent; no quantitative figure reported

Reported among the eight compounds isolated from Radix Boehmeriae. Its presence is a reminder that an appreciable part of the water-soluble matter of a ramie root decoction is inorganic salt rather than secondary metabolite; it is also the likeliest chemical basis of the diuretic action traditionally ascribed to the drug, though this has not been tested.

beta-Sitosterol

Phytosterol

Concentration: isolated from the root; no quantitative figure reported

A ubiquitous plant sterol, isolated from Radix Boehmeriae. It is not a marker of identity or quality for this drug.

⚠ Drug Interactions

Nucleos(t)ide analogue antivirals for hepatitis B (entecavir, tenofovir, lamivudine)

Theoretical Evidence: Possible

Boehmeria nivea root extract suppresses hepatitis B virus replication in HepG2 2.2.15 cells (over 99% reduction of particle-associated HBV DNA at 100 mg/L) and lowers serum HBV DNA and HBsAg in HBV-viremia SCID mice. There is, however, no human trial. In the SCID mouse study the authors also observed reduced natural killer cell activity after high-dose extract, correlating with the fall in serum HBV DNA, which raises the possibility that part of the apparent antiviral effect is immunosuppressive rather than antiviral. No pharmacokinetic interaction with nucleos(t)ide analogues has been studied.

Clinical note: Do not present ramie root as an alternative to established anti-HBV therapy, and do not stop or delay antiviral treatment on the strength of these preclinical results. If a patient with chronic hepatitis B wishes to take it alongside treatment, monitor HBV DNA and liver enzymes as usual.

Warfarin, direct oral anticoagulants and antiplatelet drugs

Theoretical Evidence: Theoretical

The drug is used specifically to stop bleeding, so a pharmacodynamic opposition to anticoagulants is the obvious concern. It must be labelled as theoretical: no study of Radix Boehmeriae on prothrombin time, activated partial thromboplastin time, platelet function or any other coagulation endpoint has been published, and none of the eight compounds isolated from the root is a recognised procoagulant.

Clinical note: There is no evidence either way. If an anticoagulated patient takes ramie root, monitor INR or the relevant anticoagulation marker as you would for any new herbal addition rather than assuming an effect exists.

Evidence Tier

Moderate evidence · 3 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

0

Other clinical trial

0

Observational / case report

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

Inhibition of hepatitis B virus production by Boehmeria nivea root extract in HepG2 2.2.15 cells

Huang KL, Lin CC, Lai YK, Chang JM (2006) World Journal of Gastroenterology in vitro

An ethanol extract of dried Boehmeria nivea root was tested at 0.1 to 100 mg/L in HBV-producing HepG2 2.2.15 cells. At 100 mg/L, HBeAg secretion fell by about 60% and particle-associated HBV DNA in the supernatant by more than 99%, both p < 0.01, while HBsAg was not inhibited. The reported 50% effective concentration for suppression of secreted HBV DNA was 0.0462 mg/L. This is the source study for the anti-hepatitis-B claim made for this drug, and it is a cell-culture study on the root specifically.

The Anti-Hepatitis B Virus Activity of Boehmeria nivea Extract in HBV-Viremia SCID Mice

Chang JM, Huang KL, Yuan TT, Lai YK, Hung LM (2010) Evidence-Based Complementary and Alternative Medicine animal

A HBV-viremia model was built by inoculating HepG2 2.2.15 cells subcutaneously into SCID mice, giving serum HBV DNA of 10 to the 5th to 10 to the 6th copies per mL. Both oral and intraperitoneal Boehmeria nivea extract inhibited production of HBsAg and HBV DNA without affecting tumour growth, intraperitoneal dosing being the more effective route at equal dose. The authors also report reduced natural killer cell activity at high dose, correlating with the fall in serum HBV DNA, which they note explicitly.

Involvement of GRP78 in inhibition of HBV secretion by Boehmeria nivea extract in human HepG2 2.2.15 cells

Huang KL, Lai YK, Lin CC, Chang JM (2009) Journal of Viral Hepatitis in vitro

Follow-up mechanistic work in the same HepG2 2.2.15 system implicating the endoplasmic reticulum chaperone GRP78 in the block on hepatitis B virus secretion produced by Boehmeria nivea extract. The finding is at the level of virion secretion rather than viral polymerase inhibition, which is consistent with the earlier observation that HBsAg was unaffected while particle-associated DNA fell sharply.

Historical Texts

Ming Yi Bie Lu

compiled by Tao Hongjing, Liang dynasty, about 500 CE
Earliest medicinal entry, under the name zhu gen (ramie root): it governs red erysipelas in children, the steeped ramie juice treats thirst, it calms the fetus, and it is effective applied to hot erysipelas-type swellings. Both the fetus-calming indication and the heat-clearing, toxin-resolving indications of the modern drug descend directly from this line.

Ben Cao Jing Ji Zhu

Liang dynasty
Tao Hongjing identifies the drug plant as the cultivated ramie of his day and adds that a mountain ramie which closely resembles it may also be used medicinally. The species latitude in this drug is therefore ancient, not a modern adulteration problem.

Ben Cao Gang Mu

Ming dynasty
Li Shizhen separates the cultivated ramie from the wild or mountain ramie, and further distinguishes a purple-leaved form from a white-backed green-leaved form, all with white leaf undersides. He does not assign different actions to them.

Ben Cao Gang Mu Shi Yi

Qing dynasty
Zhao Xuemin records the wild ramie growing on hillsides and beside water channels, and summarises the root's actions as resolving toxins, invigorating the blood, stopping bleeding, dispersing outward, relieving thirst and calming the fetus. This is the first source to state the invigorate-blood and stop-bleeding pair that the modern category placement rests on.

References

  1. Shao LJ, Wang JN. [Studies on the chemical constituents of radix Boehmeriae] . Zhong Yao Cai (Journal of Chinese Medicinal Materials), PubMed identifier 21137364 (2010)
  2. Wang H, Qiu C, Chen L, Abbasi AM, Guo X, Liu RH. Comparative Study of Phenolic Profiles, Antioxidant and Antiproliferative Activities in Different Vegetative Parts of Ramie (Boehmeria nivea L.) . Molecules (2019) [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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