Herbs & Botanicals · Chinese digestive rhizome herb

Atractylodes

Q: What is atractylodes?

Atractylodes usually means bai zhu, the dried underground stem (rhizome) of Atractylodes macrocephala, used in Chinese medicine for weak digestion, bloating and loose stools. Cang zhu is a different species.

Q: What is the difference between bai zhu and cang zhu?

Bai zhu is Atractylodes macrocephala. Cang zhu is Atractylodes lancea, a separate species with different traditional uses and different main compounds. Evidence for one should not be assumed for the other.

Q: Has atractylodes itself been proven to help digestion?

No trial of bai zhu on its own was found. Trials of combination formulas, such as Xiangsha Liujunzi for indigestion, are positive but used several herbs.

Q: What is Si Jun Zi Tang?

Si Jun Zi Tang (Sijunzi decoction, four gentlemen decoction) is a classic Chinese formula that includes bai zhu among other herbs. A pooled analysis of 13 trials found more helper T-cells after digestive cancer surgery, rated low to very low certainty. The results belong to the combination, not to bai zhu.

Q: What is Yu Ping Feng San?

Yupingfeng powder (jade windscreen) combines astragalus, bai zhu and saposhnikovia. Pooled trials report better results as an add-on in asthma and in children's repeated infections, but it is a combination and the studies are modest in quality.

Q: Does it help with cancer treatment?

Pooled trials of formulas containing bai zhu with chemotherapy for advanced stomach cancer report better response and fewer side effects. Two small old trials of purified atractylenolide I found better appetite in cancer cachexia. The evidence is low or very low certainty and does not show bai zhu works alone. Tell the cancer team about any herb.

Q: Is it safe in pregnancy or breastfeeding?

Not known. Traditional Chinese texts use it to protect pregnancy, but no human safety trial exists, lab results on uterine muscle are mixed, and RxList advises avoiding it in pregnancy and breastfeeding. Ask a doctor first.

Q: Can it affect the liver?

No case reports of liver injury were found, but LiverTox was not checked. Purified atractylenolide I and II damaged the liver of zebrafish embryos in a lab study; that is not human evidence.

Q: Does it interact with blood thinners?

No human interaction was found. In the lab, two atractylenolides reduced platelet clumping and lengthened bleeding time in mice, so a precaution is reasonable. Ask a pharmacist.

Q: Does it affect blood sugar or blood pressure medicines?

No human interaction was found. Lab work suggests blood-sugar-lowering effects, and one formula trial reported lowering blood pressure. These are theoretical reasons for caution. Ask your prescriber.

Atractylodes macrocephala (bai zhu); A. lancea (cang zhu) is a different species · also called Bai zhu, baizhu, white atractylodes, largehead atractylodes, Atractylodis macrocephalae rhizoma

Atractylodes is a root-like underground stem used in Chinese medicine, mostly bai zhu, for weak digestion, bloating and loose stools. Most studies test formulas that mix it with other herbs, or one purified compound, so what the plain herb does is unproven. Pregnancy safety is unknown, and lab work suggests caution with blood thinners.

General information, not medical advice. Last substantive update October 25, 2026 · Not medically reviewed. A named clinician has not signed off on this page. How this page is made

About Atractylodes

Atractylodes (bai zhu) is a rhizome used in Chinese medicine, mostly for digestion. Almost all research is on combination formulas or a purified compound, not the plain herb, and certainty is low. Pregnancy safety is unknown, and interactions are theoretical.

What it is

Bai zhu is the dried rhizome of Atractylodes macrocephala, a plant in the daisy family. Cang zhu is Atractylodes lancea, a different species with different traditional uses. The accepted names were checked in GBIF.

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Traditional and current uses

In Chinese medicine bai zhu strengthens the spleen and eases bloating, diarrhoea and swelling, and is used for threatened miscarriage. Si Jun Zi Tang and Yu Ping Feng San are combinations that contain it. Modern trials test these formulas, not bai zhu alone.

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What is in it and how it works

Its main compounds include the atractylenolides (I, II and III) and atractylon, plus polysaccharides. Findings on gut movement, platelets and the liver come from lab and animal work. Purified atractylenolide I is not the same as the whole herb.

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What the research shows

Pooled trials of formulas report benefit in indigestion, asthma and children's infections, and with chemotherapy for stomach cancer, at low or very low certainty. Two small old trials of purified atractylenolide I found better appetite in cancer cachexia. No trial of bai zhu alone was found, including for constipation.

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At a glance

Traditional uses history, not proof

Weak digestion, bloating, diarrhoea, swelling and sweating in Chinese medicine (2021 review)
Traditionally used to stop slight bleeding in pregnancy and prevent miscarriage (2021 review; no human safety trial)
Ingredient in Si Jun Zi Tang and Yu Ping Feng San (combinations)

Studied for research

Stomach cancer chemotherapy support (formulas), low certainty
Indigestion: Xiangsha Liujunzi formula, low certainty
Asthma and children's infections: Yupingfeng, low certainty
Cancer cachexia appetite (purified atractylenolide I), very low certainty
Plain bai zhu for any use: no trial found

Main compounds

Atractylenolide I (PubChem 5321018)
Atractylenolide II (14448070)
Atractylenolide III (155948)
Atractylon (3080635)

Common forms

Dried sliced rhizome, raw or stir-fried, steamed or soil-fried
Decoction, granules or capsules
Multi-herb formulas such as Si Jun Zi Tang and Yu Ping Feng San (combinations)
Purified atractylenolide extracts are a separate product

Research links: PubMed: bai zhu comprehensive review (2021) · PubMed: bai zhu formulas with chemotherapy in gastric cancer (2024) · RxList: Atractylodes · Research Library · Genes & Biomarkers Library

The plant and its history

Accepted scientific name: Atractylodes macrocephala
Naming authority: Koidz.
Common names: Bai zhu (zh); White atractylodes (en); Largehead atractylodes (en)
Botanical family: Asteraceae (daisy family)
Classification: Plantae > Not read > Not read > Not read > Asteraceae > Atractylodes > Atractylodes macrocephala
Native range: Not verified in the sources read. The 2021 review lists Chinese growing provinces.
Habitat: Not read.
What the plant looks like: Roots: The dried rhizome is the medicinal part (review).; Stems: Not read.; Leaves: Not read.; Flowers: Not read.; Fruit: Not read.
Cultivation: Not read.
Harvest and processing: The review describes stir-fried, steamed and soil-fried processing; details not re-opened.
Look-alikes and adulterants: Name: Atractylodes lancea (cang zhu); Note: Accepted separate species (GBIF 3122433; NCBI taxid 41486). Different traditional uses and main compounds (atractylodin, beta-eudesmol). Bai zhu vs cang zhu: do not mix their evidence.; Name: Other Atractylodes (A. chinensis, A. japonica); Note: Named in reviews; not examined.
Sustainability and conservation: Not verified; no conservation record read.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Traditional Chinese medicine (listed in Shen Nong's Herbal Classic, Han dynasty, per the 2021 review)	Strengthen the spleen, replenish qi, dry dampness, ease bloating, diarrhoea, oedema and sweating; also used for threatened miscarriage.	Yang et al. 2021 (PMID 34803677)
Classic formulas	Bai zhu is an ingredient in combinations such as Si Jun Zi Tang (four gentlemen) and Yu Ping Feng San (jade windscreen). These are combinations; their results belong to the whole formula.	PMID 34803677; PMID 40103588; PMID 42147341

Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.

What is inside, and how it may work

What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.

Main compounds

Compound	Family	Where it is concentrated	Activity studied	Level of evidence
Atractylenolide I PubChem 5321018	Sesquiterpene lactone	rhizome	Studied in cachexia pilots (purified); lab anti-inflammatory and anti-cancer; toxic to zebrafish liver at lab doses. ^{8 3 6}	Human data
Atractylenolide II PubChem 14448070	Sesquiterpene lactone	rhizome	Lab: reduced platelet clumping; lab anti-cancer. ^{2 3}	Laboratory research
Atractylenolide III PubChem 155948	Sesquiterpene lactone	rhizome	Lab: reduced platelet clumping, anti-inflammatory; not toxic to zebrafish in one study. ^{2 6}	Laboratory research
Atractylon PubChem 3080635	Sesquiterpene (volatile oil)	rhizome	Named in the brief as a bai zhu volatile compound; no source on atractylon was read for this build. ²³	Laboratory research
Polysaccharides, polyacetylenes and other sesquiterpenoids	Mixed	rhizome	The review names sesquiterpenoids, polysaccharides and polyacetylenes as the main components. ¹⁶	Laboratory research

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
Gut movement, gut bacteria and short-chain fatty acids	5-HT4 receptor	A 2025 Chinese review proposes bai zhu acts on gut bacteria, short-chain fatty acids and 5-HT4 signalling to help constipation. Lab and animal findings. ⁴	Animal research
Platelet activation (Akt and p38 signalling)	Akt, p38 MAPK	Atractylenolide II and III reduced platelet clumping and lengthened bleeding time in mice. ²	Animal research
Drug-metabolising enzymes	CYP3A4, CYP2C19	Cang zhu compounds weakly inhibit human CYP enzymes in the lab; atractylenolides also inhibit metabolic enzymes (review). ^{13 3}	Laboratory research
Cancer cachexia inflammation signals and PIF	TNF-alpha, IL-1, PIF	In two small trials atractylenolide I lowered inflammatory messengers and PIF versus a fish-oil supplement. ^{8 7}	Human data

Absorption, metabolism and elimination

Absorption: Atractylenolides are rapidly absorbed but slowly metabolised in animals (review). Human absorption data for whole bai zhu were not read.
Distribution: The 2021 review reports rapid tissue distribution in mice after injection.
Metabolism: Atractylenolides inhibit metabolic enzymes (review). Beta-eudesmol from cang zhu is processed by CYP2C19 and CYP3A4 in lab studies.
Elimination: The 2021 review reports a long elimination half-life in mice; not read in detail.
Bioavailability: Low bioavailability is named as a challenge for Atractylodis Rhizoma compounds (2026 review).

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Isolated compounds versus whole extracts

The only human trials of a bai zhu component used purified atractylenolide I (small, old, no placebo). Most other human trials test multi-herb formulas. Atractylenolide I and II were toxic to zebrafish embryos while III was not, so compounds differ from each other and from the whole herb.

Nutritional composition

No vitamin or mineral role for bai zhu was found. It is used for its sesquiterpenes and polysaccharides.

11benefits and uses looked at

24studies and sources checked

Low certaintybest evidence rating found

6lab markers tracked in trials

4 low certainty3 very low certainty4 not enough evidence

What is Atractylodes good for?

The main proposed uses and how strong the human evidence is for each. "Low" means small or inconsistent studies, and "insufficient" means there is not enough to judge. Most rows describe formulas or a purified compound, not the plain herb.

Advanced stomach cancer: bai zhu formulas with chemotherapyLow certaintyPooled trials of multi-herb formulas containing bai zhu, given with chemotherapy, report better tumour response and fewer side effects. Bai zhu's own part cannot be separated and the authors want better trials. Cancer cachexia: purified atractylenolide IVery low certaintyTwo small trials of a purified compound found better appetite than a fish-oil supplement. It is not the whole herb and there was no placebo. Chemotherapy digestive side effects: Jianpi Yiwei granulesNot enough evidenceA 136-person placebo-controlled trial of a formula with bai zhu exists, but its abstract gave no results. Immune cells after digestive cancer surgery: Sijunzi decoctionVery low certaintyPooled trials of Sijunzi decoction, a combination, report more helper T-cells. These are blood tests, rated low to very low certainty. Functional dyspepsia: Xiangsha Liujunzi formulaLow certaintyA 216-person placebo-controlled trial and a pooled analysis found symptom improvement with this combination formula. Bai zhu alone was not tested. Constipation, loose stools and bloating (traditional use)Not enough evidenceUsed traditionally for both. No trial of bai zhu alone was found; the proposed gut effects come from lab and animal work. Adult asthma: Yupingfeng powder as an add-onLow certaintyPooled trials report a better response and lung function when this three-herb combination is added to usual treatment. Repeated infections in children: Yupingfeng granulesLow certaintyPooled trials report better response and higher antibody levels, with very uneven results between trials. Hay fever: Yupingfeng with acupunctureVery low certaintyHigher effective rate, but acupuncture was part of the treatment, so the powder's own effect is unknown. Blood pressure: a bai zhu formula (one small trial)Not enough evidenceA single 88-person trial of a formula is known only through a review summary. Liver, blood sugar and platelets (lab and animal only)Not enough evidenceMany lab and animal findings; no human trials.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Advanced stomach cancer: bai zhu formulas added to chemotherapy

Low certainty

Pooled Chinese trials of herbal formulas containing bai zhu, given with chemotherapy, reported better tumour response and fewer side effects than chemotherapy alone. The formulas contain several herbs, so bai zhu's own part is unknown.

2 studiesSeveral different multi-herb formulas, given by mouth; recipes and am…

Studies, doses and limits

What the trials found

A 2024 meta-analysis of trials of bai zhu-containing formulas with neoadjuvant chemotherapy in advanced gastric cancer found higher response and disease-control rates, better quality-of-life scores, higher T-cell counts and fewer adverse reactions than chemotherapy alone. The authors say more high-quality randomised trials are needed.

Results

Higher tumour response, disease control, quality of life and T-cell markers; fewer adverse reactions.

Effect sizes as reported

Response RR 1.41 (95% CI 1.27 to 1.57); disease control RR 1.20 (1.13 to 1.27); quality of life RR 1.43 (1.30 to 1.57), MD 8.47 (7.16 to 9.77).

Why this rating

Pooled trials show benefit, but the formulas differ, bai zhu cannot be separated, the abstract gives no GRADE ratings or trial count, and the authors ask for better trials.

Form and dose studied

Several different multi-herb formulas, given by mouth; recipes and amounts not given in the abstract.

Who was studied

Adults with advanced gastric cancer having chemotherapy; trials in China

Limits

Not bai zhu alone. Study quality unclear. Results may not apply outside China or to other chemotherapy plans. No survival data in the abstract.

Why researchers looked

Bai zhu is a standard ingredient in formulas used in China to support the stomach and strength of people having cancer treatment.

Traditional use

Bai zhu is traditionally used to strengthen the spleen and stomach in Chinese medicine (review).

Proposed mechanism Preliminary mechanism

Not established. Lab work suggests immune and anti-tumour effects, but this does not show benefit in people.

A proposed mechanism does not show that the effect happens in people.

Talk to the cancer team before taking any herb during chemotherapy; herbs can interact with cancer drugs (theory; see Safety).

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Cancer cachexia (loss of appetite and muscle): purified atractylenolide I

Very low certainty

Two small trials from one group in China gave purified atractylenolide I, a compound from bai zhu, to people with cancer cachexia. Appetite improved more than with a fish-oil supplement. This is a purified compound, not the herb you would buy.

3 studiesAtractylenolide I extract; the pilot used 1.32 g per day for 7 weeks …

Studies, doses and limits

What the trials found

A 2008 randomised pilot (22 people, not blinded) compared atractylenolide I 1.32 g a day with a fish-oil nutritional supplement for 7 weeks. Both improved arm muscle size and weight; atractylenolide I did better for appetite and performance status. A 2005 Chinese trial of 64 patients reported better appetite and arm muscle with lactone I, lower IL-1 and TNF-alpha and lower urine PIF, with no difference in weight or IL-6.

Results

Better appetite, performance status and arm muscle than the comparison supplement; no difference in body weight in the larger trial.

Effect sizes as reported

Pilot: significant for appetite, Karnofsky status and PIF-positive rate (P < 0.05); no CI in the abstract. 2005 trial: no effect sizes in the abstract.

Why this rating

Small, partly unblinded trials from one group, 2005 and 2008; the comparator was a different supplement, not placebo; purified compound; effect sizes not reported in the abstracts.

Form and dose studied

Atractylenolide I extract; the pilot used 1.32 g per day for 7 weeks (dose in the trial, not advice).

Who was studied

People with gastric or other cancers with cachexia, China

Limits

Not the whole herb. No placebo. Old, small trials. The two papers may overlap in patients (not stated).

Why researchers looked

Cachexia is loss of appetite, weight and muscle in advanced cancer. Atractylenolide I lowered inflammation signals and a muscle-breakdown factor in lab work.

Traditional use

Not a traditional use as such; bai zhu is traditionally used to improve appetite and strengthen digestion (review).

Proposed mechanism Preliminary mechanism

Lab work links atractylenolide I to lower inflammatory messengers and a muscle-breakdown factor. The trials measured these markers.

A proposed mechanism does not show that the effect happens in people.

Slight nausea (3 of 11) and dry mouth (1 of 11) in the pilot.

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Chemotherapy nausea, poor appetite and bloating: Jianpi Yiwei granules

Not enough evidence

A 136-person placebo-controlled trial tested a formula containing bai zhu and codonopsis for stomach side effects of lung-cancer chemotherapy. The abstract reports its design but no results, so the result is not known from what was read.

1 studiesMulti-herb granules; amounts not given in the abstract.

Studies, doses and limits

What the trials found

A 2026 randomised double-blind placebo-controlled trial of Jianpi Yiwei granules plus standard anti-sickness drugs in 136 people with lung cancer. The abstract states aims and design and says preliminary observations confirmed safety; no outcome numbers are given.

Results

Not reported in the abstract.

Effect sizes as reported

Not available.

Why this rating

Result numbers were not in the abstract, so no judgement is possible. Formula, not bai zhu alone.

Form and dose studied

Multi-herb granules; amounts not given in the abstract.

Who was studied

Adults with non-small cell lung cancer having carboplatin chemotherapy

Limits

Only the abstract was read. The trial's stated aim is to show the formula helps.

Why researchers looked

Nausea, poor appetite and bloating are common with carboplatin-based chemotherapy.

Traditional use

Bai zhu is traditionally used to support the spleen and stomach (review).

Proposed mechanism Preliminary mechanism

The authors propose anti-inflammatory and gut-movement effects, which is theory.

A proposed mechanism does not show that the effect happens in people.

Safety was described as confirmed in preliminary observations; no figures given.

Immune cells after stomach or bowel cancer surgery: Sijunzi decoction

Very low certainty

Pooled Chinese trials of Sijunzi decoction, a classic formula that includes bai zhu, reported more helper T-cells in people after surgery for digestive cancers. These are blood-test changes, and the authors rate the evidence low to very low.

2 studiesSijunzi decoction, a multi-herb combination; amounts varied.

Studies, doses and limits

What the trials found

A 2025 meta-analysis of 13 randomised trials (1,010 people) found that adding Sijunzi decoction to conventional therapy raised CD3+ and CD4+ T-cells and the CD4+/CD8+ ratio and lowered CD8+ cells.

Results

Higher CD3+ and CD4+ T-cells, higher CD4+/CD8+ ratio, lower CD8+ cells.

Effect sizes as reported

CD3+ MD 5.73 (2.07 to 9.39); CD4+ MD 5.86 (3.90 to 7.82); CD4+/CD8+ MD 0.29 (0.15 to 0.43); CD8+ MD -2.44 (-4.03 to -0.85).

Why this rating

The authors graded CD4+, CD8+ and the ratio as low quality and the rest as very low, with likely publication bias. Blood markers, not infections or survival.

Form and dose studied

Sijunzi decoction, a multi-herb combination; amounts varied.

Who was studied

Adults after surgery for gastrointestinal cancer

Limits

Formula, not bai zhu alone. A lab-marker change is not a proven health benefit.

Why researchers looked

Surgery for digestive cancers can lower immune cell counts.

Traditional use

Sijunzi decoction (four gentlemen decoction) is a classic Chinese formula to strengthen digestion and energy.

Proposed mechanism Pharmacological theory

The authors used network pharmacology (computer prediction) to suggest immune pathways; this is theory.

A proposed mechanism does not show that the effect happens in people.

No safety figures in the abstract.

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Functional dyspepsia (indigestion, fullness after meals): Xiangsha Liujunzi formula

Low certainty

A 216-person placebo-controlled trial and a pooled analysis of 23 studies found a bai zhu-based formula helped indigestion symptoms. It is a multi-herb formula and the pooled studies were low quality.

3 studiesXiangsha Liujunzi granules or decoction, a combination formula.

Studies, doses and limits

What the trials found

A 2017 three-centre randomised double-blind placebo-controlled trial (216 adults, 4 weeks) found improvement in postprandial discomfort, global impression, anxiety/depression score, symptom score, quality of life and stomach emptying versus placebo. A 2024 meta-analysis of 23 studies (2,101 people) found a higher effectiveness rate than controls; the authors called the studies low quality.

Results

Better symptom scores and stomach emptying than placebo; higher effectiveness rate than control treatments.

Effect sizes as reported

Meta-analysis effectiveness RR 1.27 (95% CI 1.21 to 1.33); adverse events RR 0.67 (0.16 to 2.76). Trial effect sizes not given in the abstract.

Why this rating

One good-looking placebo-controlled trial plus pooled low-quality studies; formula, not bai zhu alone; short follow-up.

Form and dose studied

Xiangsha Liujunzi granules or decoction, a combination formula.

Who was studied

Adults with functional dyspepsia, China

Limits

The abstract does not list the ingredients; the 2021 review says bai zhu is the dominant herb. Bai zhu alone has not been tested for dyspepsia.

Why researchers looked

Bai zhu is the main herb in Xiangsha Liujunzi decoction, used in China for fullness, poor appetite and indigestion (review).

Traditional use

Traditionally used to strengthen the spleen and ease bloating (review).

Proposed mechanism Preliminary mechanism

Lab work suggests effects on gut movement; this does not show benefit in people.

A proposed mechanism does not show that the effect happens in people.

No clear difference in adverse events versus controls in the pooled analysis.

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Constipation, loose stools and bloating (traditional use)

Not enough evidence

Bai zhu is traditionally used both for loose stools and for constipation. A 2025 Chinese review proposes how it might work, but it describes lab and animal work, and no human trial of bai zhu alone was found.

3 studiesDecoctions of sliced rhizome or formulas in tradition; no tested amou…

Studies, doses and limits

What the trials found

No randomised trial of bai zhu alone for constipation or diarrhoea was found. A 2021 review lists small clinical reports for constipation, functional dyspepsia and ulcerative colitis but details are limited. The consumer reference RxList rates the evidence for indigestion, stomachache, bloating and diarrhoea as insufficient.

Results

No reliable result.

Effect sizes as reported

None.

Why this rating

Only traditional use, lab and animal work, and small unclear clinical reports.

Form and dose studied

Decoctions of sliced rhizome or formulas in tradition; no tested amounts.

Who was studied

None specific

Limits

Evidence is mostly lab and animal.

Why researchers looked

Bai zhu is called a core herb for strengthening the spleen and regulating the bowel (review in Chinese).

Traditional use

Traditional texts use bai zhu for diarrhoea, bloating and, in decoctions, constipation (review).

Proposed mechanism Preliminary mechanism

Proposed effects on gut bacteria, short-chain fatty acids, gut-muscle movement and water content, from lab and animal studies.

A proposed mechanism does not show that the effect happens in people.

See Safety.

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Adult asthma: Yupingfeng powder added to usual treatment

Low certainty

Pooled trials of Yupingfeng powder (astragalus, bai zhu and saposhnikovia) added to usual asthma treatment reported better response and lung-function scores. It is a three-herb combination and was tested as an add-on, not alone.

2 studiesYupingfeng powder (combination), amounts varied.

Studies, doses and limits

What the trials found

A 2026 meta-analysis of 20 randomised trials (1,896 adults) found that adding Yupingfeng to conventional asthma treatment gave a higher response rate and better lung function and asthma control scores. Only two studies reported adverse events, which were mild.

Results

Higher response rate and better lung function when added to usual care.

Effect sizes as reported

Response RR 1.20 (95% CI 1.16 to 1.25), 86.8% vs 72.3%; FEV1 SMD 1.32 (as reported).

Why this rating

Moderate trial quality per the authors, trials from China, open-label designs, little adverse-event data.

Form and dose studied

Yupingfeng powder (combination), amounts varied.

Who was studied

Adults with bronchial asthma

Limits

Not bai zhu alone. Add-on to medicines; not a replacement. Asthma needs medical care.

Why researchers looked

Yupingfeng powder (Jade Windscreen) is a classic formula for people who catch colds easily or have wheeze.

Traditional use

Traditional formula for weak defences against colds (the review lists it for colds, chronic bronchitis and allergy).

Proposed mechanism Preliminary mechanism

Not established.

A proposed mechanism does not show that the effect happens in people.

Mild stomach discomfort and dry mouth reported in two studies.

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Recurrent chest and throat infections in children: Yupingfeng granules

Low certainty

A pooled analysis of 17 trials found children given Yupingfeng granules alongside usual care had better clinical response and higher antibody levels. Results varied greatly between trials, and the product is a combination.

1 studiesYupingfeng granules (combination), amounts varied.

Studies, doses and limits

What the trials found

A 2022 meta-analysis of 17 randomised trials in children with recurrent respiratory tract infections found a higher clinical response rate and higher IgA, IgM and IgG with the add-on, and lower TNF-alpha. Heterogeneity was high (I-squared 84 to 95 percent) for the blood markers. The authors say effectiveness and safety remain to be verified.

Results

Higher response rate; higher antibody levels; lower TNF-alpha.

Effect sizes as reported

Response RR 1.18 (1.12 to 1.24); IgA SMD 1.23 (0.68 to 1.78); IgM SMD 0.85 (0.35 to 1.35); IgG SMD 1.06 (0.65 to 1.47); TNF-alpha SMD -1.03 (-1.55 to -0.51).

Why this rating

High heterogeneity, open trials from China, blood markers; combination product.

Form and dose studied

Yupingfeng granules (combination), amounts varied.

Who was studied

Children with recurrent respiratory tract infections, China

Limits

Not bai zhu alone. Number of children not read. Not a reason to give an herb to a child without a doctor.

Why researchers looked

Yupingfeng is used in China to try to reduce repeat infections.

Traditional use

Traditional formula for people prone to colds.

Proposed mechanism Preliminary mechanism

Not established.

A proposed mechanism does not show that the effect happens in people.

Safety not confirmed by the authors.

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Allergic rhinitis (hay fever): Yupingfeng powder with acupuncture

Very low certainty

Nine studies tested Yupingfeng powder together with acupuncture and found a higher effective rate. Because acupuncture was part of the treatment, the powder's own effect cannot be separated.

1 studiesYupingfeng powder (combination) plus acupuncture

Studies, doses and limits

What the trials found

A 2025 meta-analysis of 9 studies (686 people) found a higher effective rate with Yupingfeng plus acupuncture than other treatments, and a higher follow-up effective rate. The abstract says recurrence was lower.

Results

Higher effective rate than other treatments.

Effect sizes as reported

Effective rate RR 2.52 (1.80 to 3.54); follow-up RR 2.03 (1.32 to 3.13).

Why this rating

Powder plus acupuncture together; control treatments varied; only the abstract was read.

Form and dose studied

Yupingfeng powder (combination) plus acupuncture

Who was studied

People with allergic rhinitis, China

Limits

Cannot attribute any effect to bai zhu.

Why researchers looked

Yupingfeng is used in China for allergy-prone people.

Traditional use

Traditional formula for weak defences.

Proposed mechanism Preliminary mechanism

Not established.

A proposed mechanism does not show that the effect happens in people.

Not described in the abstract.

⁵

Blood pressure: a bai zhu-based formula (single small trial)

Not enough evidence

One 88-person Chinese trial cited by a 2021 review compared a bai zhu-based formula with the blood pressure drug captopril. That trial was not read, so it cannot be judged here.

1 studiesBanxia Baizhu Tianma decoction (combination)

Studies, doses and limits

What the trials found

The 2021 review reports that in 88 people the formula group had lower angiotensin II, renin and aldosterone and a better blood pressure effect than captopril. This is a summary of a primary paper (Miao 2017) that was not opened.

Results

Reported as better than captopril in the review summary.

Effect sizes as reported

Not available.

Why this rating

Single small trial known only from a review summary; a multi-herb formula; compared with a drug, not placebo.

Form and dose studied

Banxia Baizhu Tianma decoction (combination)

Who was studied

Adults with high blood pressure, China

Limits

The original paper was not read (summary-only).

Why researchers looked

Banxia Baizhu Tianma decoction is used in China for dizziness and high blood pressure (review).

Traditional use

Traditional use for dizziness (review).

Proposed mechanism Preliminary mechanism

Not established.

A proposed mechanism does not show that the effect happens in people.

If taking blood pressure medicine, do not add herbs without asking a doctor.

¹⁶

Liver, blood sugar, platelets and other findings (lab and animal only)

Not enough evidence

Cell and animal work reports many effects of bai zhu and atractylenolides on the liver, blood sugar, platelets, fat metabolism and inflammation. None of this shows benefit in people.

3 studiesNot applicable.

Studies, doses and limits

What the trials found

No human trial was found for these effects. A 2026 liver review states clinical evidence remains limited.

Results

No human result.

Effect sizes as reported

None.

Why this rating

Laboratory and animal evidence only.

Form and dose studied

Not applicable.

Who was studied

Not applicable.

Limits

Lab effects often do not carry over to people.

Why researchers looked

These findings generate ideas for research.

Traditional use

Not applicable.

Proposed mechanism Animal research

Lab and animal results, for example on SIRT1/AMPK, NF-kB and platelet signalling.

A proposed mechanism does not show that the effect happens in people.

Some lab findings point to possible risks; see Safety.

^{11 3 16}

Connections to the rest of health

How Atractylodes connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

A. Wellness goals

Connected to	Kind of connection	Evidence status	Context	Studies
Immune Support	Demonstrated clinical effect	Low certainty	Advanced stomach cancer: bai zhu formulas added to chemotherapy: Pooled Chinese trials of herbal formulas containing bai zhu, given with chemotherapy, reported better tumour response and fewer side effects than chemotherapy alone. The formulas contain several herbs, so bai zhu's own part is unknown. Adult asthma: Yupingfeng powder added to usual treatment: Pooled trials of Yupingfeng powder (astragalus, bai zhu and saposhnikovia) added to usual asthma treatment reported better response and lung-function scores. It is a three-herb combination and was tested as an add-on, not alone.	^{10 16 19 18}
Digestive Support	Potential benefit	Very low certainty	Cancer cachexia (loss of appetite and muscle): purified atractylenolide I: Two small trials from one group in China gave purified atractylenolide I, a compound from bai zhu, to people with cancer cachexia. Appetite improved more than with a fish-oil supplement. This is a purified compound, not the herb you would buy.	^{8 7 24}
Digestive Support	Traditional use	Not enough evidence	Chemotherapy nausea, poor appetite and bloating: Jianpi Yiwei granules: A 136-person placebo-controlled trial tested a formula containing bai zhu and codonopsis for stomach side effects of lung-cancer chemotherapy. The abstract reports its design but no results, so the result is not known from what was read. Constipation, loose stools and bloating (traditional use): Bai zhu is traditionally used both for loose stools and for constipation. A 2025 Chinese review proposes how it might work, but it describes lab and animal work, and no human trial of bai zhu alone was found.	^{1 4 16 24}
Immune Support	Potential benefit	Very low certainty	Immune cells after stomach or bowel cancer surgery: Sijunzi decoction: Pooled Chinese trials of Sijunzi decoction, a classic formula that includes bai zhu, reported more helper T-cells in people after surgery for digestive cancers. These are blood-test changes, and the authors rate the evidence low to very low. Allergic rhinitis (hay fever): Yupingfeng powder with acupuncture: Nine studies tested Yupingfeng powder together with acupuncture and found a higher effective rate. Because acupuncture was part of the treatment, the powder's own effect cannot be separated.	^{15 17 5}
Digestive Support	Demonstrated clinical effect	Low certainty	Functional dyspepsia (indigestion, fullness after meals): Xiangsha Liujunzi formula: A 216-person placebo-controlled trial and a pooled analysis of 23 studies found a bai zhu-based formula helped indigestion symptoms. It is a multi-herb formula and the pooled studies were low quality.	^{9 14 16}
Gut Health	Traditional use	Not enough evidence	Constipation, loose stools and bloating (traditional use): Bai zhu is traditionally used both for loose stools and for constipation. A 2025 Chinese review proposes how it might work, but it describes lab and animal work, and no human trial of bai zhu alone was found.	^{4 16 24}
Blood Pressure Support	Traditional use	Not enough evidence	Blood pressure: a bai zhu-based formula (single small trial): One 88-person Chinese trial cited by a 2021 review compared a bai zhu-based formula with the blood pressure drug captopril. That trial was not read, so it cannot be judged here.	¹⁶
Liver Support	Preliminary mechanism	Not enough evidence	Liver, blood sugar, platelets and other findings (lab and animal only): Cell and animal work reports many effects of bai zhu and atractylenolides on the liver, blood sugar, platelets, fat metabolism and inflammation. None of this shows benefit in people.	^{11 3 16}
Blood Sugar Balance	Preliminary mechanism	Not enough evidence	Liver, blood sugar, platelets and other findings (lab and animal only): Cell and animal work reports many effects of bai zhu and atractylenolides on the liver, blood sugar, platelets, fat metabolism and inflammation. None of this shows benefit in people.	^{11 3 16}

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Digestive System	Biological association	Low certainty	Studied for: Advanced stomach cancer: bai zhu formulas added to chemotherapy Studied for: Cancer cachexia (loss of appetite and muscle): purified atractylenolide I	^{10 16 8 7 24 1 15 17 9 14 4}
Immune System	Biological association	Low certainty	Studied for: Advanced stomach cancer: bai zhu formulas added to chemotherapy Studied for: Immune cells after stomach or bowel cancer surgery: Sijunzi decoction	^{10 16 15 17 18 5}
Metabolism Weight	Biological association	Very low certainty	Studied for: Cancer cachexia (loss of appetite and muscle): purified atractylenolide I	^{8 7 24}
Respiratory System	Biological association	Low certainty	Studied for: Adult asthma: Yupingfeng powder added to usual treatment Studied for: Recurrent chest and throat infections in children: Yupingfeng granules	^{19 16 18 5}
Cardiovascular System	Biological association	Not enough evidence	Studied for: Blood pressure: a bai zhu-based formula (single small trial)	¹⁶
Hepatic System	Biological association	Not enough evidence	Studied for: Liver, blood sugar, platelets and other findings (lab and animal only)	^{11 3 16}
Endocrine System	Biological association	Not enough evidence	Studied for: Liver, blood sugar, platelets and other findings (lab and animal only)	^{11 3 16}

E. Health conditions

Connected to	Kind of connection	Evidence status	Context	Studies
Pregnancy	Contraindication	Not enough evidence	Traditional anti-miscarriage use versus guidance to avoid; no human safety trial. Traditional protective use versus guidance to avoid; no human safety trial. Preparation or compound: Bai zhu rhizome	^{16 24}
Functional dyspepsia	Demonstrated clinical effect	Low certainty	A bai zhu-based combination formula beat placebo in one trial. Preparation or compound: Xiangsha Liujunzi formula	^{9 14}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
CD4+ T-cells (helper immune cells)	Biological association	Very low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	^{15 10}
Proteolysis-inducing factor (PIF), a muscle-breakdown signal	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{8 7}
TNF-alpha and IL-1 (inflammation signals)	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{7 8}
Stomach emptying rate	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	⁹
FEV1 (lung function)	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	¹⁹
Antibodies IgA, IgM and IgG	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	¹⁸

J. Genes, receptors and enzymes

Connected to	Kind of connection	Evidence status	Context	Studies
CYP3A4	Biological association	Very low certainty	Weak inhibition in the lab; lower liver enzyme expression in mice after 14+ days. Preparation or compound: Cang zhu compounds atractylodin and beta-eudesmol	¹³
CYP3A4	Preliminary mechanism	In vitro	Weakly inhibited by cang zhu compounds in the lab; atractylenolides inhibit metabolic enzymes.	^{13 3}

K. Biological pathways

Connected to	Kind of connection	Evidence status	Context	Studies
AMPK/SIRT1 signalling	Preliminary mechanism	Animal	Proposed in lab liver models; not tested in people.	¹¹

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Atractylenolide I	Biological association	Human	Studied in cachexia pilots (purified); lab anti-inflammatory and anti-cancer; toxic to zebrafish liver at lab doses. Preparation or compound: rhizome	^{8 3 6}
Atractylenolide II	Biological association	In vitro	Lab: reduced platelet clumping; lab anti-cancer. Preparation or compound: rhizome	^{2 3}
Atractylenolide III	Biological association	In vitro	Lab: reduced platelet clumping, anti-inflammatory; not toxic to zebrafish in one study. Preparation or compound: rhizome	^{2 6}
Atractylon	Biological association	In vitro	Named in the brief as a bai zhu volatile compound; no source on atractylon was read for this build. Preparation or compound: rhizome	²³
Polysaccharides, polyacetylenes and other sesquiterpenoids	Biological association	In vitro	The review names sesquiterpenoids, polysaccharides and polyacetylenes as the main components. Preparation or compound: rhizome	¹⁶

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).

Evidence at a glance: what changed in 6 lab markers

Tap a number to show only those markers. Counts are markers, not people.

Inflammatory1 Other14

The evidence

The research centre for Atractylodes. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Advanced stomach cancer: bai zhu formulas added to chemotherapy 2 studies Low certainty Cancer cachexia (loss of appetite and muscle): purified atractylenolide I 3 studies · 86 people in trials Very low certainty Chemotherapy nausea, poor appetite and bloating: Jianpi Yiwei granules 1 studies · 136 people in trials Not enough evidence Immune cells after stomach or bowel cancer surgery: Sijunzi decoction 2 studies Very low certainty Functional dyspepsia (indigestion, fullness after meals): Xiangsha Liujunzi formula 3 studies · 216 people in trials Low certainty Constipation, loose stools and bloating (traditional use) 3 studies Not enough evidence Adult asthma: Yupingfeng powder added to usual treatment 2 studies Low certainty Recurrent chest and throat infections in children: Yupingfeng granules 1 studies Low certainty Allergic rhinitis (hay fever): Yupingfeng powder with acupuncture 1 studies Very low certainty Blood pressure: a bai zhu-based formula (single small trial) 1 studies Not enough evidence Liver, blood sugar, platelets and other findings (lab and animal only) 3 studies Not enough evidence

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We built from our existing atractylodes summary and re-read PubMed abstracts for the studies cited, checked plant names in GBIF and NCBI, compounds in PubChem, and read RxList. An EMA monograph and an NCCIH page were not found; LiverTox and LactMed were not checked.

Study library: every study we checked 24

Design Research type Plant part Year from Search

Study	Design	People	Product, dose, length	Result
Cai 2026 Jianpi Yiwei Granules for Chemotherapy-Induced Gastrointestinal Reactions: A Randomized Double-Blind Placebo-Controlled Trial Anticancer Agents Med Chem · PMID 41114481 · DOI	Controlled trial	136 People with non-small cell lung cancer having carboplatin-based chemotherapy	Jianpi Yiwei granules (a multi-herb formula that contains Codonopsis pilosula and Atractylodes macrocephala) plus standard anti-sickness drugs not stated not given in abstract not given in abstract · vs Placebo plus standard anti-sickness drugs	The abstract describes the aims and says preliminary observations confirmed safety, but it reports no outcome numbers or between-group results. No results given in the abstract (not given) Methods, limits and funding Outcomes: Nausea and vomiting control, appetite, bloating, constipation, quality of life, fatigue Limitations: Only the abstract was read and it contains no results. Formula, not bai zhu alone. Funding and conflicts: Not stated in the abstract. Read: abstract
Chen 2017 Atractylodes lactone compounds inhibit platelet activation Platelets · PMID 27560602 · DOI	Laboratory research animal	Human platelets in the lab and mice	Atractylenolide I, II and III (purified) rhizome compounds not applicable not applicable · vs Aspirin used as a comparison in the lab	Atractylenolide II and III, but not I, reduced platelet clumping in the lab, similar to aspirin in response to agonists. They delayed artery blockage and lengthened bleeding time in mice. Lab and mouse findings only (not applicable) Methods, limits and funding Outcomes: Platelet aggregation, clot retraction, artery clotting and bleeding time in mice Limitations: No human data. Purified compounds, not the herb. Funding and conflicts: No conflict stated. Read: abstract
Deng 2021 Atractylenolides (I, II, and III): a review of their pharmacology and pharmacokinetics Arch Pharm Res · PMID 34269984 · DOI	Narrative review in-vitro	Review of the three atractylenolides from bai zhu	Atractylenolides I, II, III (purified) rhizome compounds not applicable not applicable · vs not applicable	Lab findings: anti-cancer, anti-inflammatory, anti-platelet, nerve-protecting, blood-sugar and blood-fat effects. Atractylenolides are rapidly absorbed but slowly metabolised, and inhibit metabolic enzymes, so the authors advise attention to side effects when combined with other drugs. Clinical research is recommended. Not applicable (not applicable) Methods, limits and funding Outcomes: Pharmacology and pharmacokinetics Limitations: Mostly lab and animal evidence; no human trial pooling. Funding and conflicts: No conflict stated. Read: abstract
Li 2025 Research progress on mechanism of Atractylodis Macrocephalae Rhizoma and its combinations in treating constipation Zhongguo Zhong Yao Za Zhi · PMID 41508168 · DOI	Narrative review animal	Review (in Chinese) of bai zhu for constipation	Bai zhu and combinations rhizome not applicable not applicable · vs not applicable	Describes proposed effects on gut bacteria, short-chain fatty acids, gut movement through 5-HT4 signalling, mucus and water content. The abstract describes mechanisms from lab and animal work and gives no human trial results. Not applicable (not applicable) Methods, limits and funding Outcomes: Proposed mechanisms in constipation Limitations: Chinese-language mechanism review; only the English-language abstract text was read; no human trial data given. Funding and conflicts: No conflict stated. Read: abstract (Chinese review)
Li 2025 Analysis of the efficacy of Yupingfeng powder combined with acupuncture on allergic rhinitis: systematic review and meta analysis Allergol Immunopathol (Madr) · PMID 41229058 · DOI	Meta-analysis	686 People with allergic rhinitis (9 studies, China)	Yupingfeng powder plus acupuncture not stated varied varied · vs Other treatments	Yupingfeng plus acupuncture was more effective than other treatments, with a higher follow-up effective rate and lower recurrence. The combination with acupuncture means the powder's own effect cannot be isolated. Effective rate RR 2.52; follow-up RR 2.03 (Effective 1.80 to 3.54; follow-up 1.32 to 3.13) Methods, limits and funding Outcomes: Effective rate, follow-up effective rate, recurrence Limitations: Powder plus acupuncture versus other treatments; cannot show the powder works alone. Only the abstract was read. Funding and conflicts: No conflict declared. Read: abstract
Li 2026 Differential toxic phenotypes and liver injury induced by Atractylenolides (I, II, and III): Insights from zebrafish (Danio rerio) models and network toxicology Comp Biochem Physiol C Toxicol Pharmacol · PMID 40997982 · DOI	Animal research animal	Zebrafish embryos	Atractylenolides I, II, III (purified) rhizome compounds LC50 81.64, 138.40 and 151.90 micromolar embryo exposure · vs Unexposed embryos	Atractylenolide I and II caused developmental abnormalities and liver damage signs (smaller liver, higher AST and ALT); atractylenolide III did not. Silybin partly reversed the liver injury. Lab values only (not applicable) Methods, limits and funding Outcomes: Developmental toxicity, liver size and enzymes, drug-metabolising genes Limitations: Zebrafish embryos, purified compounds; not evidence of liver injury in people. Funding and conflicts: No conflict stated. Read: abstract
Liu 2005 Effects of lactone I from Atractylodes macrocephala Koidz on cytokines and proteolysis-inducing factors in cachectic cancer patients Di Yi Jun Yi Da Xue Xue Bao · PMID 16234118	Controlled trial	64 People with cancer cachexia (China)	Lactone I (atractylenolide I) from bai zhu rhizome extract compound not given in abstract 3 and 7 weeks · vs Fish-oil-enriched nutritional supplement	Appetite and arm muscle size were better with the lactone. Serum IL-1 and TNF-alpha and urine PIF were lower than with the supplement. Body weight and IL-6 did not differ. Better appetite and arm muscle; lower IL-1, TNF-alpha, urine PIF; no difference in weight or IL-6 (not given) Methods, limits and funding Outcomes: Appetite, weight, mid-arm muscle circumference, Karnofsky score, IL-1, IL-6, TNF-alpha, proteolysis-inducing factor Limitations: Chinese-language paper; only the English abstract was read. Purified compound. Dose and blinding not stated; may overlap with the same group's 2008 pilot. Funding and conflicts: Not stated. Read: abstract (Chinese paper, English abstract)
Liu 2008 A randomized pilot study of atractylenolide I on gastric cancer cachexia patients Evid Based Complement Alternat Med · PMID 18830451 · DOI	Controlled trial	22 People with gastric cancer cachexia (China)	Atractylenolide I extracted from bai zhu (a purified compound) rhizome extract compound 1.32 g per day 7 weeks · vs Fish-oil-enriched nutritional supplement 3.6 g per day	Both groups improved arm muscle size and body weight. Atractylenolide I did better than the supplement for appetite and Karnofsky status and lowered the proportion positive for proteolysis-inducing factor. Slight nausea (3 of 11) and dry mouth (1 of 11) occurred in the atractylenolide group. Appetite, Karnofsky status and PIF-positive rate better with atractylenolide I (P < 0.05) (not given in abstract) Methods, limits and funding Outcomes: Appetite, body weight, mid-arm muscle circumference, Karnofsky status, TNF-alpha, IL-1, IL-6, proteolysis-inducing factor Limitations: Pilot, 11 per group, not blinded, 7 weeks. A purified compound, not the whole herb. Authors say a proper randomised design is needed. Funding and conflicts: Not stated in the abstract. Read: abstract
Lv 2017 Efficacy and safety of Xiangsha Liujunzi granules for functional dyspepsia: A multi-center randomized double-blind placebo-controlled clinical study World J Gastroenterol · PMID 28852318 · DOI	Controlled trial	216 Adults with functional dyspepsia (Rome III) with a spleen-deficiency and qi-stagnation pattern, three centres in China	Xiangsha Liujunzi granules (a multi-herb formula; bai zhu is its main herb according to a 2021 review, but the abstract does not list ingredients) not stated 130 mL dissolved granules three times a day 4 weeks · vs Placebo (2:1 randomisation)	The formula improved the postprandial discomfort score, global impression, anxiety/depression score, symptom score, quality of life and stomach emptying compared with placebo. Significant improvement over placebo (P < 0.05 or < 0.01); effect sizes not given in abstract (not given in abstract) Methods, limits and funding Outcomes: Postprandial discomfort score, global impression, anxiety and depression score, symptom score, quality of life, gastric emptying Limitations: A formula, not bai zhu alone. Only 4 weeks. Abstract gives no effect sizes or adverse-event numbers. Funding and conflicts: Authors declare no competing interests; neither funder nor outside body had a role in design or manuscript. Read: abstract
Niu 2024 Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis Front Oncol · PMID 39479020 · DOI	Meta-analysis	Adults with advanced gastric cancer having neoadjuvant chemotherapy (trials in China)	Multi-herb TCM formulas that contain bai zhu, given with chemotherapy rhizome (as part of formulas) varied between trials (not given in abstract) subgroups of 8 weeks or longer, and under 8 weeks · vs Chemotherapy alone	Formulas containing bai zhu plus chemotherapy had higher response and disease control, better quality-of-life scores, higher T-cell subsets and fewer adverse reactions than chemotherapy alone. Authors call for more high-quality randomised trials. Response rate RR 1.41; disease control RR 1.20; quality of life RR 1.43 (MD 8.47) (ORR 1.27 to 1.57; DCR 1.13 to 1.27; QOL RR 1.30 to 1.57, MD 7.16 to 9.77) Methods, limits and funding Outcomes: Objective response rate, disease control rate, quality of life, adverse reactions, T-cell counts Limitations: The formulas contain other herbs, so bai zhu's own part cannot be separated. The abstract says GRADE was used but gives no ratings or number of trials. Authors say more high-quality trials are needed. Funding and conflicts: No conflict declared. Registered PROSPERO CRD42023461079. Read: abstract
Sun 2026 Pharmacological Effects and Proposed Mechanisms of Atractylodes Medicinal Plants in Liver Diseases: A Narrative Review Life (Basel) · PMID 42795341 · DOI	Narrative review animal	Review of lab models of liver disease	Atractylodes species (A. lancea, A. chinensis, A. macrocephala) and compounds rhizome not applicable not applicable · vs not applicable	Summarises lab and animal findings (fat metabolism, oxidative stress, inflammation, fibrosis) and states that clinical evidence remains limited and efficacy is not established. Not applicable (not applicable) Methods, limits and funding Outcomes: Liver-related lab findings Limitations: Preclinical; says clinical efficacy remains to be established. Says nothing in the abstract about liver injury cases. Funding and conflicts: No conflict declared. Read: abstract
Sun 2026 Herbal Textual Research, Phytochemistry, Pharmacology and Toxicity of Atractylodis Rhizoma: A Comprehensive Review Molecules · PMID 41900114 · DOI	Narrative review	Review of Atractylodis Rhizoma (the abstract does not name the species)	Atractylodis Rhizoma rhizome not applicable not applicable · vs not applicable	Reports 327 compounds and mostly lab activities (antimicrobial, anti-inflammatory, antioxidant, liver-protecting, nerve-protecting). Says the herb is used for gastrointestinal disorders and influenza and that low bioavailability is a challenge. The abstract does not describe toxicity findings. Not applicable (not applicable) Methods, limits and funding Outcomes: History, chemistry, pharmacology, toxicity Limitations: Abstract does not name the species or give toxicity details; it is not clear it covers bai zhu. Funding and conflicts: No conflict declared. Read: abstract
Thiengsusuk 2023 Modulatory Effects of Atractylodin and Beta-Eudesmol on Human Cytochrome P450 Enzymes: Potential Drug-Drug Interactions Molecules · PMID 37049902 · DOI	Laboratory research animal	Lab enzymes and mice	Atractylodin and beta-eudesmol (main compounds of A. lancea, cang zhu) rhizome compounds 100 mg/kg per day in mice 1 to 21 days (mice) · vs Untreated	Inhibition of the human enzymes was weak. In mice, 1 to 7 days raised liver enzyme messenger RNA, but 14 days or longer lowered it and reduced enzyme activity. The authors flag a risk of drug interactions with long-term dosing of these compounds. IC50 167 to over 686 micromolar (weak) (not applicable) Methods, limits and funding Outcomes: Inhibition of human CYP1A2, 2C9, 2C19, 2D6, 3A4 enzymes; mouse liver enzyme expression Limitations: Lab and mouse work on cang zhu compounds, not bai zhu and not people. Funding and conflicts: No conflict declared. Read: abstract
Wang 2024 Efficacy and safety of Xiangsha liujunzi decoction for functional dyspepsia: a systematic review and meta-analysis Front Pharmacol · PMID 38933675 · DOI	Meta-analysis	2101 Adults with functional dyspepsia (23 studies, China)	Xiangsha liujunzi decoction (multi-herb formula) not stated varied varied · vs Control treatments (usually conventional drugs)	Higher clinical effectiveness rate, better gastric emptying and symptom scores than controls. No clear difference in adverse events. Authors say the included studies were of low quality. Effectiveness rate RR 1.27; adverse events RR 0.67 (Effectiveness 1.21 to 1.33; adverse events 0.16 to 2.76) Methods, limits and funding Outcomes: Clinical effectiveness rate, gastric emptying, symptom score, safety Limitations: Low study quality per the authors; formula, not bai zhu alone. Funding and conflicts: No conflict declared (one author on a journal editorial board, stated to have no impact). Read: abstract
Wu 2025 The efficacy of Sijunzi on immune function in patients with gastrointestinal cancers after surgery: Integrating systematic review and network pharmacology Medicine (Baltimore) · PMID 39928794 · DOI	Meta-analysis	1010 People with gastrointestinal cancers after surgery (13 RCTs, China)	Sijunzi decoction (a classic multi-herb formula) plus conventional care not stated varied varied · vs Conventional therapy alone	The formula group had higher CD3+ and CD4+ cells, a higher CD4+/CD8+ ratio and lower CD8+ cells. Authors graded the evidence low for CD4+, CD8+ and CD4+/CD8+, and very low for the other markers, and saw likely publication bias. CD3+ MD 5.73; CD4+ MD 5.86; CD4+/CD8+ MD 0.29; CD8+ MD -2.44 (CD3+ 2.07 to 9.39; CD4+ 3.90 to 7.82; ratio 0.15 to 0.43; CD8+ -4.03 to -0.85) Methods, limits and funding Outcomes: T-lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) Limitations: Blood-marker outcomes only; no survival or infection outcomes in the abstract. Formula, not bai zhu alone. Funding and conflicts: No conflict declared. Registered INPLASY 202440001. Read: abstract
Yang 2021 A Review of the Ethnopharmacology, Phytochemistry, Pharmacology, Application, Quality Control, Processing, Toxicology, and Pharmacokinetics of the Dried Rhizome of Atractylodes macrocephala Front Pharmacol · PMID 34803677 · DOI	Narrative review	Review of literature on bai zhu (A. macrocephala dried rhizome)	Bai zhu, many forms rhizome not applicable not applicable · vs not applicable	Lists traditional uses (weak spleen function, bloating, diarrhoea, oedema, and to stop minimal vaginal bleeding in pregnancy). Most pharmacology is lab or animal work. The text says there is a lack of clinical studies that directly support safety in humans, though no serious adverse events were described. Animal acute and 3-month volatile-oil studies found low toxicity. Lab work on uterine muscle is mixed. Not a trial; no pooled effect (not applicable) Methods, limits and funding Outcomes: Traditional uses, chemistry, lab and animal findings, small clinical reports, toxicology, pharmacokinetics Limitations: Narrative review of mostly lab, animal and small Chinese clinical reports; no GRADE rating. Review text beyond the abstract was read on PMC (toxicity, pregnancy and application sections). Funding and conflicts: No conflict declared. Read: full-text (selected sections)
Yang 2025 The potential of Sijunzi decoction in the fight against gastrointestinal disorders: a review Front Pharmacol · PMID 40103588 · DOI	Narrative review	Review of Sijunzi decoction for digestive disorders	Sijunzi decoction (multi-herb formula) not stated not applicable not applicable · vs not applicable	Says clinical studies support the formula for functional dyspepsia, chronic gastritis, gastric and colorectal cancer, irritable bowel syndrome and ulcerative colitis, and describes proposed mechanisms. The abstract gives no numbers. Not applicable (not applicable) Methods, limits and funding Outcomes: Clinical uses and proposed mechanisms (gut bacteria, inflammation, immune response, mucosal repair) Limitations: Narrative review; the abstract's claim of proven efficacy is not backed by pooled numbers in the abstract. Funding and conflicts: No conflict declared. Read: abstract
Zhang 2022 Adjuvant treatment with yupingfeng granules for recurrent respiratory tract infections in children: A systematic review and meta-analysis Front Pediatr · PMID 36619520 · DOI	Meta-analysis	Children with recurrent respiratory tract infections (17 RCTs, China)	Yupingfeng granules (multi-herb formula) added to usual treatment not stated varied varied · vs Usual treatment alone	Higher clinical response rate, higher immunoglobulins and lower TNF-alpha with the add-on. Heterogeneity between trials was high for the immunoglobulin and TNF-alpha results (I-squared 84 to 95 percent). Authors say effectiveness and safety remain to be verified. Response RR 1.18; IgA SMD 1.23; IgG SMD 1.06; TNF-alpha SMD -1.03 (Response 1.12 to 1.24; IgA 0.68 to 1.78; IgG 0.65 to 1.47) Methods, limits and funding Outcomes: Clinical response rate, IgA/IgM/IgG, TNF-alpha Limitations: High heterogeneity; blood markers; combination product, not bai zhu alone. Number of children not read. Funding and conflicts: No conflict declared. Registered INPLASY202230150. Read: abstract
Zhang 2026 Efficacy of Yupingfeng powder in the treatment of bronchial asthma in adults: a systematic review and meta-analysis Front Pharmacol · PMID 42147341 · DOI	Meta-analysis	1896 Adults with bronchial asthma (20 RCTs, China)	Yupingfeng powder (astragalus, bai zhu and saposhnikovia) added to conventional treatment not stated varied varied · vs Conventional treatment alone	Add-on Yupingfeng had a higher response rate, better lung function and asthma control scores. No difference in the CD4+/CD8+ ratio. Only two studies reported adverse events; these were mild (stomach discomfort, dry mouth) with no serious events. Response RR 1.20; response 86.8% vs 72.3%; FEV1 SMD 1.32 (Response 1.16 to 1.25) Methods, limits and funding Outcomes: Overall response rate, lung function (FEV1, FVC, PEF), asthma control test, CD4+/CD8+ ratio, adverse events Limitations: Authors cite moderate quality, trials from one country, open-label designs and little adverse-event data. A three-herb combination, not bai zhu alone. Funding and conflicts: Registered PROSPERO CRD420251172600. Funding not read. Read: abstract
s-ema-hmpc-atractylodes EMA / HMPC: no Atractylodes monograph found · Source	Regulator page not found in-vitro			Methods, limits and funding Read: not found
s-gbif-atractylodes GBIF Backbone Taxonomy: Atractylodes macrocephala Koidz. (3122454) and Atractylodes lancea (Thunb.) DC. (3122433) · Source	Database record in-vitro			Methods, limits and funding Read: api
s-nccih-atractylodes NCCIH: no Atractylodes page · Source	Regulator page not found in-vitro			Methods, limits and funding Read: http status
s-pubchem-atractylodes PubChem name lookups: atractylenolide I (CID 5321018), II (14448070), III (155948), atractylon (3080635) · Source	Database record in-vitro			Methods, limits and funding Read: api
s-rxlist-atractylodes RxList: Atractylodes (consumer supplement reference, undated) · Source	Consumer reference			Methods, limits and funding Read: web page text

What we do not know yet

What the evidence supports: combination formulas show low-certainty benefit in indigestion, asthma and with cancer treatment; plain bai zhu is untested.
No trial of bai zhu alone, including for constipation, was found.
Human safety in pregnancy and breastfeeding is not known.
No human study of drug interactions was found; LiverTox and LactMed were not checked.

How new research is added

New studies are found by a saved PubMed search and are placed in a review queue. A person reads each one before it changes any evidence rating or safety wording. New publications never change ratings automatically.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Inflammatory 1

↕

TNF-alpha and IL-1 (inflammation signals)

Mixed results in trials

Blood proteins that rise with inflammation.

Very low certainty

Results and what it means

Why it was measured

Raised in cancer cachexia.

Statistical vs. clinical meaning

The two papers disagree in detail and the 2008 abstract wording is unclear, so no direction is stated beyond what is quoted.

Safety implication

None identified.

Study	Result	People	Product
⁷	Serum IL-1 and TNF-alpha lower than with the fish-oil supplement; IL-6 no different	64 people with cancer cachexia	Lactone I from bai zhu
⁸	Within-group changes in TNF-alpha and IL-1 were significant in both groups (abstract wording: TNF-alpha increase, IL-1 decrease)	22 people, gastric cancer cachexia	Atractylenolide I vs fish-oil supplement

^{7 8}

Other 5

▲

CD4+ T-cells (helper immune cells)

Raised in trials

A blood count of a type of immune cell.

Very low certainty

Results and what it means

Why it was measured

A common marker of immune strength after cancer surgery.

Statistical vs. clinical meaning

Statistically higher in pooled trials but graded low to very low; a lab change, not proof of fewer infections or longer survival.

Safety implication

Immune changes in cancer patients should be read by the cancer team.

Study	Result	People	Product
¹⁵	CD4+ MD 5.86 (95% CI 3.90 to 7.82); CD4+/CD8+ MD 0.29 (0.15 to 0.43)	After surgery for digestive cancers, 13 trials	Sijunzi decoction (formula)
¹⁰	CD4+ T-cell subsets increased (abstract gives no numbers)	Advanced gastric cancer with chemotherapy	Bai zhu-containing formulas

^{15 10}

▼

Proteolysis-inducing factor (PIF), a muscle-breakdown signal

Lowered in trials

A protein linked to muscle wasting in cancer.

Very low certainty

Results and what it means

Why it was measured

Measured in the cachexia trials as a possible way atractylenolide I works.

Statistical vs. clinical meaning

A lab marker in small unblinded trials; not proof of less muscle loss.

Safety implication

None identified.

Study	Result	People	Product
⁸	PIF-positive rate lowered more than with fish-oil supplement (P < 0.05)	11 vs 11 people, gastric cancer cachexia	Atractylenolide I 1.32 g per day, 7 weeks
⁷	Urine PIF lower than with fish-oil supplement (abstract: significantly lower)	64 people with cancer cachexia	Lactone I from bai zhu

^{8 7}

▲

Stomach emptying rate

Raised in trials

How quickly food leaves the stomach.

Low certainty

Results and what it means

Why it was measured

Slow emptying is one cause of fullness after meals.

Statistical vs. clinical meaning

A lab test change in a placebo-controlled trial; formula, not bai zhu alone.

Safety implication

None identified.

Study	Result	People	Product
⁹	Emptying rates of the proximal and distal stomach improved versus placebo (P < 0.05 or 0.01); numbers not in abstract	216 adults with functional dyspepsia	Xiangsha Liujunzi granules

⁹

▲

FEV1 (lung function)

Raised in trials

The amount of air blown out in one second.

Low certainty

Results and what it means

Why it was measured

Standard measure of airflow in asthma.

Statistical vs. clinical meaning

Pooled trials of moderate quality; combination formula; add-on only.

Safety implication

None identified.

Study	Result	People	Product
¹⁹	FEV1 SMD 1.32 (as reported; confidence interval not in the abstract) in favour of Yupingfeng plus usual treatment	Adults with asthma, 20 trials	Yupingfeng powder as add-on

¹⁹

▲

Antibodies IgA, IgM and IgG

Raised in trials

Blood antibodies that fight infection.

Low certainty

Results and what it means

Why it was measured

Used as a proxy for immune function in children with repeated infections.

Statistical vs. clinical meaning

High heterogeneity; a blood marker, not fewer infections.

Safety implication

None identified.

Study	Result	People	Product
¹⁸	IgA SMD 1.23 (0.68 to 1.78); IgM SMD 0.85 (0.35 to 1.35); IgG SMD 1.06 (0.65 to 1.47); heterogeneity 91 to 95 percent	Children with recurrent respiratory infections, 17 trials	Yupingfeng granules as add-on

¹⁸

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 4

Pregnancy and breastfeeding: traditional use to protect pregnancy, but no human safety data. Chinese texts use bai zhu to stop slight bleeding in pregnancy and prevent miscarriage. Modern lab work on uterine muscle is mixed: one study found it excited late-pregnancy uterine muscle cells, another found high concentrations calmed contractions. No human trial tested safety in pregnancy, and the consumer reference RxList advises avoiding it in pregnancy and breastfeeding because too little is known. Use only on a doctor's advice. Authoritative guidance ^{16 24}
Drug interactions are mostly theory: no human interaction study was found. Lab work shows atractylenolides and cang zhu compounds affect liver drug-processing enzymes and platelets, and bai zhu is reported to lower blood sugar in lab studies. No human study of these interactions was found. As a precaution, ask a pharmacist before combining with blood-thinning, diabetes, blood-pressure or narrow-range drugs. Pharmacological theory ^{3 2 13 16}
The Latin name matters: bai zhu and cang zhu are different species. Bai zhu is Atractylodes macrocephala. Cang zhu is a different species, Atractylodes lancea, with different traditional uses and different main compounds. Safety findings for one species or for a purified compound should not be assumed for the other. Other ^{21 11}
Daisy-family allergy. Bai zhu belongs to the daisy family (Asteraceae). RxList warns that people sensitive to ragweed, chrysanthemums, marigolds or daisies may react. Authoritative guidance ²⁴

Side effects 4

Effect	How often	Severity and recovery	Evidence
Nausea, dry mouth and a bad taste Purified atractylenolide I 1.32 g per day for 7 weeks; RxList lists the same three effects. No frequency exists for the whole herb.	In the 11-person atractylenolide I pilot: slight nausea 3 of 11, dry mouth 1 of 11	mild Did not interrupt treatment in the pilot	Controlled trial ^{8 24}
Stomach discomfort and dry mouth This was for Yupingfeng powder, a three-herb combination.	Reported in 2 studies in the asthma meta-analysis, no difference from controls	mild not stated	Meta-analysis ¹⁹
Allergic reaction in people sensitive to the daisy family A warning from a consumer reference; no case reports were read.	Not established	not stated not stated	Authoritative guidance ²⁴
No formal safety data for the whole herb in people The 2021 review says clinical studies directly supporting safety in humans are lacking, though no serious adverse events were described.	Not established	not stated not stated	Narrative review ¹⁶

Liver

No case report of liver injury from bai zhu was found, but no liver registry such as NIH LiverTox was read, so the absence is not confirmed. In animals, 3 months of bai zhu volatile oil in rats was reported safe. In zebrafish embryos, purified atractylenolide I and II (not III) caused liver damage signs, including raised AST and ALT, and reduced drug-metabolising genes; this is lab evidence only. The 2026 liver review says clinical evidence remains limited. ^{6 16 11}

How often. No frequency can be given.

Monitoring. No monitoring protocol exists. People with liver disease or on liver-affecting drugs should ask a doctor.

This is a safety connection. It is not evidence that Atractylodes supports liver health.

Medicines and supplements 5

With	Why it matters	Importance	Evidence	What to do
Blood thinners and antiplatelet drugs (such as warfarin, aspirin, clopidogrel) pharmacodynamic (theory)	In the lab, atractylenolide II and III reduced platelet clumping like aspirin and lengthened bleeding time in mice. The 2021 review also lists an anticoagulant effect from lab work.	No human interaction or bleeding case was found. This is a theoretical additive effect only.	Laboratory research Very low certainty ^{2 16}	Ask a doctor or pharmacist before combining, and before surgery.
Diabetes medicines (insulin, metformin, sulfonylureas) pharmacodynamic (theory)	Lab and animal work reports blood-sugar-lowering effects of bai zhu and atractylenolides.	No human trial or case showed low blood sugar with bai zhu. Theoretical additive effect only.	Animal research Very low certainty ^{3 16}	If you use diabetes medicines, check with your prescriber.
Blood pressure medicines pharmacodynamic (theory)	A bai zhu-based formula was reported in a single small trial (known only from the 2021 review) to lower blood pressure more than captopril. Whether bai zhu itself adds to drug effects is unknown.	No interaction report was found. Theory based on one formula trial.	Controlled trial Very low certainty ¹⁶	Check blood pressure and ask your prescriber if you add a formula.
Medicines cleared by liver enzymes (CYP3A4 and others) pharmacokinetic (lab)	The atractylenolide review notes atractylenolides inhibit metabolic enzymes. For cang zhu compounds (atractylodin, beta-eudesmol) inhibition of human enzymes was weak, but 14 days or more of daily dosing lowered liver enzyme expression in mice.	Unknown in people. Lab and mouse data only; compounds studied were purified.	Laboratory research Very low certainty ^{3 13}	Tell your pharmacist you use it if you take narrow-range drugs such as transplant medicines.
Chemotherapy and other cancer drugs unknown	Bai zhu formulas are used alongside chemotherapy in China trials with reported fewer side effects, but herb-drug interactions with cancer drugs were not studied in the abstracts read.	Not assessed.	Meta-analysis Not enough evidence ¹⁰	Tell the cancer team before using any herbal formula.

Who should check first 5

Situation	Advice	Evidence
Pregnancy	Ask a doctor first. Traditional use is to protect pregnancy, but there is no human safety trial; RxList advises avoiding it. Sources disagree.	Authoritative guidance ^{16 24}
Breastfeeding	RxList advises avoiding because not enough is known. LactMed was not checked.	Authoritative guidance ²⁴
Allergy to ragweed, chrysanthemum, marigold or daisy	Possible cross-reaction; check before use.	Authoritative guidance ²⁴
Bleeding disorders, surgery coming up, or taking blood thinners	Precaution based on lab platelet findings; no human reports.	Laboratory research ²
Children	Yupingfeng granules have been tested in children, as a combination with usual treatment, but safety is not confirmed by the authors. No data on bai zhu alone.	Meta-analysis ¹⁸

Overdose, product quality and regulators

Summary. The 2021 review reports low acute toxicity in animals, safe 3-month volatile oil dosing in rats, and no genetic toxicity of the water extract. Purified atractylenolide I and II were toxic to zebrafish embryos at 82 to 138 micromolar (LC50), atractylenolide III less so. None of this is human data.

Animal. Rat and zebrafish only; see above.

Human doses studied. Atractylenolide I 1.32 g a day for 7 weeks in a small pilot; formulas in trials of up to several weeks. No safe amount for the plain herb is established.

High dose or long term signals. Not established in people. Mouse data on cang zhu compounds showed enzyme suppression after 14 or more days.

Overdose response. No overdose data in the sources read.

Genotoxicity. The review reports no genetic toxicity for the water extract (animal data).

Toxic plant parts. The rhizome is the part used. Other parts not covered in the sources read.

Bai zhu and cang zhu are easily confused, and Atractylodes products and formulas may contain other herbs. Heavy-metal and pesticide data were not read.

Two different species. Bai zhu (Atractylodes macrocephala) and cang zhu (A. lancea) are accepted separate species in GBIF; the label's Latin name decides which you have. ²¹

Processing changes the herb. Stir-frying, steaming or soil-frying bai zhu changes its chemistry, per our existing summary and the 2021 review; not re-opened. ¹⁶

Body	Action	Date
RxList (consumer reference, not a regulator) (United States)	Evidence rated insufficient for all uses; advises avoiding in pregnancy and breastfeeding; warns of daisy-family allergy. source	Undated page read 2026-10-25

When to get medical help

Unusual bleeding, black stools or easy bruising if you take blood thinners
Yellow skin or eyes, dark urine or severe stomach pain
Vaginal bleeding or cramps in pregnancy (see a doctor; do not self-treat)
Rash, swelling of the lips or face, or trouble breathing after taking it (allergy)
Shakes, sweating or confusion on diabetes medicines

Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

What is atractylodes?

Atractylodes usually means bai zhu, the dried underground stem (rhizome) of Atractylodes macrocephala, used in Chinese medicine for weak digestion, bloating and loose stools. Cang zhu is a different species.

¹⁶

What is the difference between bai zhu and cang zhu?

Bai zhu is Atractylodes macrocephala. Cang zhu is Atractylodes lancea, a separate species with different traditional uses and different main compounds. Evidence for one should not be assumed for the other.

^{21 13}

Has atractylodes itself been proven to help digestion?

No trial of bai zhu on its own was found. Trials of combination formulas, such as Xiangsha Liujunzi for indigestion, are positive but used several herbs.

^{9 14}

What is Si Jun Zi Tang?

Si Jun Zi Tang (Sijunzi decoction, four gentlemen decoction) is a classic Chinese formula that includes bai zhu among other herbs. A pooled analysis of 13 trials found more helper T-cells after digestive cancer surgery, rated low to very low certainty. The results belong to the combination, not to bai zhu.

^{15 17}

What is Yu Ping Feng San?

Yupingfeng powder (jade windscreen) combines astragalus, bai zhu and saposhnikovia. Pooled trials report better results as an add-on in asthma and in children's repeated infections, but it is a combination and the studies are modest in quality.

^{19 18}

Does it help with cancer treatment?

Pooled trials of formulas containing bai zhu with chemotherapy for advanced stomach cancer report better response and fewer side effects. Two small old trials of purified atractylenolide I found better appetite in cancer cachexia. The evidence is low or very low certainty and does not show bai zhu works alone. Tell the cancer team about any herb.

^{10 8}

Is it safe in pregnancy or breastfeeding?

Not known. Traditional Chinese texts use it to protect pregnancy, but no human safety trial exists, lab results on uterine muscle are mixed, and RxList advises avoiding it in pregnancy and breastfeeding. Ask a doctor first.

^{16 24}

Can it affect the liver?

No case reports of liver injury were found, but LiverTox was not checked. Purified atractylenolide I and II damaged the liver of zebrafish embryos in a lab study; that is not human evidence.

⁶

Does it interact with blood thinners?

No human interaction was found. In the lab, two atractylenolides reduced platelet clumping and lengthened bleeding time in mice, so a precaution is reasonable. Ask a pharmacist.

Does it affect blood sugar or blood pressure medicines?

No human interaction was found. Lab work suggests blood-sugar-lowering effects, and one formula trial reported lowering blood pressure. These are theoretical reasons for caution. Ask your prescriber.

^{3 16}

What are the side effects?

Nausea, dry mouth and a bad taste were reported for purified atractylenolide I. Formula trials reported mild stomach upset. People allergic to ragweed or daisies may react.

^{8 24}

Do regulators have a view?

No EMA herbal monograph and no NCCIH page were found for atractylodes. RxList, a consumer reference, rates evidence for all uses as insufficient.

^{20 22 24}

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Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-25
Last substantive update: 2026-10-25
How we research: We built from our existing atractylodes summary and re-read PubMed abstracts for the studies cited, checked plant names in GBIF and NCBI, compounds in PubChem, and read RxList. An EMA monograph and an NCCIH page were not found; LiverTox and LactMed were not checked.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown. If one is added later it will be labelled and kept apart from the evidence.

Sources 24

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

Cai K, Chen J, Li N, et al.. Jianpi Yiwei Granules for Chemotherapy-Induced Gastrointestinal Reactions: A Randomized Double-Blind Placebo-Controlled Trial. Anticancer Agents Med Chem. 2026. PMID 41114481. DOI 10.2174/0118715206427314251002153843. (abstract)
Chen Y, Yang W, Guo L, et al.. Atractylodes lactone compounds inhibit platelet activation. Platelets. 2017. PMID 27560602. DOI 10.1080/09537104.2016.1209477. (abstract)
Deng M, Chen H, Long J, et al.. Atractylenolides (I, II, and III): a review of their pharmacology and pharmacokinetics. Arch Pharm Res. 2021. PMID 34269984. DOI 10.1007/s12272-021-01342-6. (abstract)
Li H, Wang YH, Dong JN, et al.. Research progress on mechanism of Atractylodis Macrocephalae Rhizoma and its combinations in treating constipation. Zhongguo Zhong Yao Za Zhi. 2025. PMID 41508168. DOI 10.19540/j.cnki.cjcmm.20250619.201. (abstract (Chinese review))
Li Z, Gao H, Shen F, et al.. Analysis of the efficacy of Yupingfeng powder combined with acupuncture on allergic rhinitis: systematic review and meta analysis. Allergol Immunopathol (Madr). 2025. PMID 41229058. DOI 10.15586/aei.v53i6.1436. (abstract)
Li Y, Jiang Z, Zhou Z, et al.. Differential toxic phenotypes and liver injury induced by Atractylenolides (I, II, and III): Insights from zebrafish (Danio rerio) models and network toxicology. Comp Biochem Physiol C Toxicol Pharmacol. 2026. PMID 40997982. DOI 10.1016/j.cbpc.2025.110365. (abstract)
Liu Y, Ye F, Qiu GQ, et al.. Effects of lactone I from Atractylodes macrocephala Koidz on cytokines and proteolysis-inducing factors in cachectic cancer patients. Di Yi Jun Yi Da Xue Xue Bao. 2005. PMID 16234118. (abstract (Chinese paper, English abstract))
Liu Y, Jia Z, Dong L, et al.. A randomized pilot study of atractylenolide I on gastric cancer cachexia patients. Evid Based Complement Alternat Med. 2008. PMID 18830451. DOI 10.1093/ecam/nem031. (abstract)
Lv L, Wang FY, Ma XX, et al.. Efficacy and safety of Xiangsha Liujunzi granules for functional dyspepsia: A multi-center randomized double-blind placebo-controlled clinical study. World J Gastroenterol. 2017. PMID 28852318. DOI 10.3748/wjg.v23.i30.5589. (abstract)
Niu X, Gu H, Li J, et al.. Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis. Front Oncol. 2024. PMID 39479020. DOI 10.3389/fonc.2024.1431381. (abstract)
Sun J, Wei R, Wang X, et al.. Pharmacological Effects and Proposed Mechanisms of Atractylodes Medicinal Plants in Liver Diseases: A Narrative Review. Life (Basel). 2026. PMID 42795341. DOI 10.3390/life16091476. (abstract)
Sun J, Qiao J, Tang J, et al.. Herbal Textual Research, Phytochemistry, Pharmacology and Toxicity of Atractylodis Rhizoma: A Comprehensive Review. Molecules. 2026. PMID 41900114. DOI 10.3390/molecules31061015. (abstract)
Thiengsusuk A, Plengsuriyakarn T, Na-Bangchang K. Modulatory Effects of Atractylodin and Beta-Eudesmol on Human Cytochrome P450 Enzymes: Potential Drug-Drug Interactions. Molecules. 2023. PMID 37049902. DOI 10.3390/molecules28073140. (abstract)
Wang L, Ding X, Yao X, et al.. Efficacy and safety of Xiangsha liujunzi decoction for functional dyspepsia: a systematic review and meta-analysis. Front Pharmacol. 2024. PMID 38933675. DOI 10.3389/fphar.2024.1356899. (abstract)
Wu Z, Zhang W, Miao W, et al.. The efficacy of Sijunzi on immune function in patients with gastrointestinal cancers after surgery: Integrating systematic review and network pharmacology. Medicine (Baltimore). 2025. PMID 39928794. DOI 10.1097/MD.0000000000041419. (abstract)
Yang L, Yu H, Hou A, et al.. A Review of the Ethnopharmacology, Phytochemistry, Pharmacology, Application, Quality Control, Processing, Toxicology, and Pharmacokinetics of the Dried Rhizome of Atractylodes macrocephala. Front Pharmacol. 2021. PMID 34803677. DOI 10.3389/fphar.2021.727154. (full-text (selected sections))
Yang L, Fang Z, Zhu J, et al.. The potential of Sijunzi decoction in the fight against gastrointestinal disorders: a review. Front Pharmacol. 2025. PMID 40103588. DOI 10.3389/fphar.2025.1464498. (abstract)
Zhang L, Wang X, Wang D, et al.. Adjuvant treatment with yupingfeng granules for recurrent respiratory tract infections in children: A systematic review and meta-analysis. Front Pediatr. 2022. PMID 36619520. DOI 10.3389/fped.2022.1005745. (abstract)
Zhang Q, Zhang N, Zheng Y, et al.. Efficacy of Yupingfeng powder in the treatment of bronchial asthma in adults: a systematic review and meta-analysis. Front Pharmacol. 2026. PMID 42147341. DOI 10.3389/fphar.2026.1757474. (abstract)
. EMA / HMPC: no Atractylodes monograph found. . . (not found)
. GBIF Backbone Taxonomy: Atractylodes macrocephala Koidz. (3122454) and Atractylodes lancea (Thunb.) DC. (3122433). . . (api)
. NCCIH: no Atractylodes page. . . (http status)
. PubChem name lookups: atractylenolide I (CID 5321018), II (14448070), III (155948), atractylon (3080635). . . (api)
. RxList: Atractylodes (consumer supplement reference, undated). . . (web page text)

Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.