Herbs & Botanicals · Chinese blood-moving root

Chuanxiong

Q: What is chuanxiong?

Chuanxiong, or Sichuan lovage, is the dried root (rhizome) of a Chinese carrot-family plant, Ligusticum chuanxiong in trial papers. It is a traditional herb for headache and for moving blood in Chinese medicine.

Q: Is chuanxiong the same as osha or dong quai?

No. Osha is Ligusticum porteri, a North American plant, and dong quai is Angelica sinensis. All three are carrot-family roots, but their evidence and safety are separate.

Q: What is chuanxiong used for?

Traditionally for headache and blood-circulation problems. In China, injections of its compound ligustrazine with danshen are added to usual care for stroke, angina and heart failure.

Q: Does chuanxiong work for stroke?

For the plain root, the Cochrane review found two low-quality trials with 161 people and insufficient evidence. Reviews of an injection of ligustrazine with danshen report better recovery scores, but they are Chinese add-on trials with named bias, and the injection is not the root.

Q: Does it help migraine?

A low-quality review of 37 articles found the classical formula Chuanxiong Chatiao San beat Western medicine alone, but it is a multi-herb formula. We found no controlled trial of plain chuanxiong for migraine, only lab ideas about senkyunolides.

Q: What is ligustrazine and is it the same as the herb?

Ligustrazine, also called tetramethylpyrazine, is one compound from the root. It is used as a purified drug and injection. Results for it do not apply directly to the whole root.

Q: Is chuanxiong safe with warfarin or other blood thinners?

It may not be. In two rat studies it raised warfarin levels in the blood, and the injection changed clotting tests in surgery trials. No human study was found, so people on warfarin, aspirin or newer blood thinners should not add it without their prescriber.

Q: Is it safe in pregnancy or breastfeeding?

Avoid it. A thesis summary says Chinese guidelines record no safe amount for pregnancy and that high amounts harmed mouse pregnancies. Hospital trials of ligustrazine injection in pregnancy do not show the plain root is safe. Breastfeeding data were not found.

Q: Can it affect blood pressure?

Probably it can add to blood-pressure medicine. A hospital records study found a better response when the injection was added to a blood-pressure drug, but the plain root has not been studied for low blood pressure.

Q: Are the injections safe?

In reviews, adverse events were not significantly different from usual care, but the intervals were wide. Herbal injections as a group carry a recognised risk of allergy-like reactions, shown in animal work on other injections. They should only be given by clinicians.

Ligusticum chuanxiong · also called Sichuan lovage, Szechuan lovage, chuan xiong

Chuanxiong is the dried root of a Chinese carrot-family plant, used for centuries for headache and blood-circulation problems. Most research tests an injection of its compound ligustrazine, given with danshen in Chinese hospitals, not the plain root. Those trials look positive but are low quality, and no good trial of the plain herb was found. The biggest caution is bleeding, especially with warfarin and other blood thinners, and it should be avoided in pregnancy.

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 Chuanxiong

Chuanxiong is the dried root of a Chinese carrot-family plant. It is a traditional blood-moving and headache herb. Most research tests an injection of its compound ligustrazine, usually with danshen, or a multi-herb formula, in Chinese hospitals. The evidence for the plain root is minimal. Bleeding, blood-thinner and pregnancy cautions are important.

What it is

Chuanxiong (Sichuan lovage) is the dried rhizome, the underground stem, of a plant in the carrot family. It is also called Ligusticum chuanxiong in trial papers, although GBIF now lists that name as a synonym of Conioselinum anthriscoides. Its main compounds include ligustrazine (tetramethylpyrazine), ferulic acid, ligustilide and the senkyunolides.

It is sold as sliced root, decoctions, tablets and in formulas. Hospital injections in China use ligustrazine, with danshen in the most studied product.

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Not osha, dong quai or ligustrazine

Osha is Ligusticum porteri, a North American plant. Dong quai is Angelica sinensis, a different Chinese root. Danshen is a mint-family root that is combined with ligustrazine in the injections.

Ligustrazine is a purified compound used as a drug. What is true of it, or of the injection, is not automatically true of the plain root.

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Traditional and current uses

In Chinese medicine chuanxiong is a classical herb for moving blood and for headache. The abstracts we read describe use for centuries in cardiovascular conditions and the formula Chuanxiong Chatiao San for migraine.

Today Chinese hospitals give ligustrazine and danshen-ligustrazine injections for stroke, angina and heart failure, usually on top of usual treatment.

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What the research shows

For the plain root, a 2008 Cochrane review found only two low-quality stroke trials and called the evidence insufficient. We found no controlled trial of the plain root for migraine, angina or blood pressure.

Reviews of Chinese trials of the injection report better scores in stroke (38 trials), angina (11 trials) and heart failure (32 trials), and a formula review reports benefit in migraine (37 articles). The authors describe low quality, regional and publication bias, and add-on designs.

Rat studies show that chuanxiong raised warfarin levels.

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At a glance

Traditional uses history, not proof

Activating blood circulation in cardiovascular and clot-related conditions, for centuries in Chinese medicine (2016 rat study background)
Easing headache and migraine, as a traditional anti-migraine herb (2026 review)
Chuanxiong Chatiao San, a famous classical migraine formula named after it (2019 review)

Studied for research

Stroke: plain root, two low-quality trials, insufficient (Cochrane 2008); ligustrazine-danshen injection added to usual care, low certainty
Angina and heart failure: injection added to usual care, low certainty
Migraine: classical formula, low certainty; plain herb, insufficient
Pregnancy high blood pressure, high blood pressure, diabetic kidney disease, fracture surgery: injections, very low to low certainty
Raised warfarin levels: rat studies, very low certainty

Main compounds

Tetramethylpyrazine / ligustrazine (PubChem 14296)
Ferulic acid (PubChem 445858)
Ligustilide (PubChem 5319022)
Senkyunolide I (PubChem 11521428)
Senkyunolides H and A

Common forms

Dried rhizome (root)
Decoction (long-simmered water extract)
Capsules or tablets, alone or in formulas
Multi-herb formulas such as Chuanxiong Chatiao San
Ligustrazine or danshen-ligustrazine injection (hospital product)
Purified tetramethylpyrazine tablets (drug)

Research links: PubMed: Cochrane review of chuanxiong for acute ischaemic stroke (2008) · PubMed: danshen-ligustrazine injection for acute cerebral infarction, meta-analysis (2024) · PubMed: Chuanxiong Chatiao San for migraine, meta-analysis (2019) · PubMed: chuanxiong and warfarin in rats (2022) · PubMed: ligustrazine injection for angina, meta-analysis (2015) · GBIF: Ligusticum chuanxiong species match · Research Library · Genes & Biomarkers Library

The plant and its history

Accepted scientific name: Ligusticum chuanxiong Hort. (name used in the Pharmacopoeia and trial papers); GBIF lists it as a synonym of Conioselinum anthriscoides
Naming authority: GBIF API 2026-10-25: Ligusticum chuanxiong S.H.Qiu, Y.Q.Zeng, K.Y.Pan, Y.C.Tang & J.M.Xu is a SYNONYM of Conioselinum anthriscoides (key 8393328; confidence 98). Ligusticum striatum Wall. ex DC. is a SYNONYM of Oreocome striata (key 3639584; confidence 97). Which name is correct is disputed; we use the one in the trials.
Synonyms: Ligusticum striatum; Ligusticum wallichii (older name, not checked); Conioselinum anthriscoides (GBIF); Oreocome striata (GBIF and NCBI)
Common names: Chuanxiong (Chinese (pinyin)); Chuan xiong (Chinese (pinyin)); Sichuan lovage (English); Szechuan lovage (English); Rhizoma Chuanxiong (Latin (pharmacopoeia))
Botanical family: Apiaceae, the carrot or parsley family. Dong quai (Angelica sinensis) and osha (Ligusticum porteri) are in the same family but are different plants.
Classification: Plantae > Tracheophyta > Magnoliopsida > Apiales > Apiaceae > Conioselinum (GBIF) or Ligusticum (trial papers) > Conioselinum anthriscoides / Ligusticum chuanxiong
Native range: Not described in the sources read.
Habitat: Not described in the sources read.
What the plant looks like: Roots: The dried rhizome (underground stem) is the medicinal part.; Stems: Not described in the sources read.; Leaves: Not described in the sources read.; Flowers: Not described in the sources read.; Fruit: Not described in the sources read.
Cultivation: Not described in the sources read.
Harvest and processing: Not described in the sources read. A 2025 paper treats the rhizome as raw material for Guanxinning tablets.
Look-alikes and adulterants: Name: Osha (Ligusticum porteri); Note: A North American mountain root of the same genus; a separate herb page on this site covers it. Not interchangeable.; Name: Dong quai (Angelica sinensis); Note: Another Chinese circulation root in the carrot family, with its own blood-thinner questions. A different plant.; Name: Danshen (Salvia miltiorrhiza); Note: A mint-family root combined with ligustrazine in the injections. Not a relative.; Name: Ligustrazine (tetramethylpyrazine); Note: A purified compound studied as a drug, not the herb.
Sustainability and conservation: Not found in the sources read.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Chinese medicine	Described in the abstracts as a classical herb for 'activating blood circulation', used for centuries for cardiovascular and thromboembolic conditions, and as a traditional anti-migraine herb. We did not read a classical text.	p27497635
Chinese medicine - formulas	Chuanxiong Chatiao San is described as a famous classical prescription for migraine; the formula is named after chuanxiong.	p31467571
Modern China	Ligustrazine, a pyrazine compound from the herb, is used as an injection and tablet drug for cerebrovascular and cardiovascular disease.	p29882510
Europe and US	No EMA/HMPC or NCCIH monograph found. Wikipedia-only claims were not used.	s-regulators-not-found

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
Tetramethylpyrazine (ligustrazine) PubChem 14296	pyrazine	Rhizome Not given in the sources read.	Studied as a purified drug and injection for stroke, angina and heart failure; half-life about 1.6 to 1.8 hours in healthy men after a tablet. ^{20 5 8 11}	Meta-analysis
Ferulic acid PubChem 445858	phenolic acid	Rhizome Measured as a marker in 201 batches; no figures in the abstract.	Used as a quality marker; clinical effects not read. ^{20 13}	Laboratory analysis
Ligustilide PubChem 5319022	phthalide	Rhizome Measured as a quality marker; no figures in the abstract.	Quality marker; clinical effects not read. ^{20 13}	Laboratory analysis
Senkyunolide I PubChem 11521428	phthalide	Rhizome Called the most abundant metabolite of the aqueous extract in a rat study.	Raised warfarin exposure in rats like the whole extract; studied for migraine in lab work. ^{20 6 7}	Animal research
Senkyunolides H and A	phthalide	Rhizome Measured as quality markers.	Quality markers; CIDs not looked up. ¹³	Laboratory analysis

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
Warfarin handling and gut bacteria	Not a single gene; gut bacteria (Allobaculum, Dubosiella, Akkermansia and others changed)	In rats with a stroke model, chuanxiong and senkyunolide I raised warfarin exposure, and the authors suggest gut bacteria are part of the route. Reduced gut bacteria alone also raised warfarin levels. ^{6 4}	Animal research
Migraine pain pathway	Trigeminovascular system, CGRP, 5-HT, substance P (reported as lowered in the formula review)	A 2026 review says senkyunolides may calm trigeminal activation, steady blood vessels, reduce inflammation and support the blood-brain barrier. The formula review reports lower 5-HT, substance P and CGRP in patients. ^{7 14}	Lab and human blood markers
Clotting and blood flow	Prothrombin time, fibrinogen, D-dimer, blood viscosity	The injection changed clotting tests in surgery trials and improved blood-flow measures in stroke and migraine reviews. The raw herb showed anti-thrombotic activity in zebrafish. ^{15 8 13}	Meta-analysis

Absorption, metabolism and elimination

Absorption: For purified tetramethylpyrazine phosphate tablets in 20 healthy men, the peak came at about 0.8 to 0.9 hours.
Distribution: A 2026 review says senkyunolides are small molecules that can cross the blood-brain barrier (the review authors' statement, lab work).
Metabolism: Not described in the sources read for the herb. Gut bacteria affected warfarin handling in rats given chuanxiong.
Elimination: Half-life of purified tetramethylpyrazine about 1.6 to 1.8 hours in healthy men; the herb's compounds were not measured in people.
Bioavailability: Relative bioavailability of two tetramethylpyrazine phosphate tablets was 102.4%, i.e. the two tablets were equivalent; absolute bioavailability not given.

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Isolated compounds versus whole extracts

Almost all the positive human trials tested injections of ligustrazine (tetramethylpyrazine), usually with danshen, as an add-on to usual care, or a multi-herb formula. They do not show what the plain rhizome does. In rats the whole extract and one isolated compound (senkyunolide I) both raised warfarin levels, so the whole herb cannot be assumed to be milder than its parts. A purified drug is also different from a decoction or powder in strength and content.

Nutritional composition

Chuanxiong is used as a medicine, not as a significant food source of any nutrient; no nutrient data were read.

11benefits and uses looked at

21studies and sources checked

Low certaintybest evidence rating found

11lab markers tracked in trials

6 low certainty2 very low certainty3 not enough evidence

What is Chuanxiong good for?

The main proposed uses and how strong the human evidence is for each. "Low" and "very low" mean small or poor trials, and "insufficient" means there is not enough to judge. Nearly every row is about an injection or a formula, not the plain root, and each row says so.

Acute ischaemic stroke (plain chuanxiong root)Not enough evidenceThe only Cochrane review of chuanxiong for stroke found two small, low-quality trials with 161 people and said the evidence was insufficient. Stroke needs emergency care. Stroke (danshen-ligustrazine injection added to usual care)Low certaintyA 2024 review of 38 Chinese trials with 3,869 people found a better response and recovery scores when the injection was added to usual care. A smaller review of three trials reported fewer repeat strokes. The authors cite bias and poor quality, and this is an injection, not the root. Angina (ligustrazine injection added to angina drugs)Low certaintyAn 11-trial review with 870 people found better symptom and ECG responses with the injection added. The trials were low quality and Chinese. Heart failure (danshen-ligustrazine injection added to usual care)Low certaintyA 2026 review of 32 Chinese trials with 3,077 people found a higher heart pumping fraction and lower heart-strain blood tests. The authors ask for large long-term trials. Migraine and headache (Chuanxiong Chatiao San formula; plain herb not tested)Low certaintyA 2019 review of 37 articles with 3,307 people found the classical formula beat Western medicine alone on pain scores, attacks and duration, with fewer adverse events, but quality was low. It is a multi-herb formula. For the plain herb we found no controlled trial, only lab ideas about senkyunolides. High blood pressure in pregnancy (ligustrazine injection in hospital)Not enough evidenceA 2024 review of 47 trials with 4,517 women reported better outcomes with the add-on, which the authors call provisional. It does not make the plain root safe in pregnancy. High blood pressure (injection added to a blood-pressure drug)Very low certaintyOne hospital records study of 300 people found a higher response rate (90.5% against 72.4%) with the injection added. It was not randomised and is not about the root. Diabetic kidney disease (injection added to ACE-inhibitor or ARB drugs)Low certaintyA 2024 review found lower creatinine and less urine protein with the injection added. Quality details are not in the abstract and it is not the root. Fracture surgery recovery and clot prevention (injection)Low certaintyA 2020 review of 16 trials with 1,589 people found fewer leg vein clots and lower inflammation markers, and changed clotting tests. The clotting changes are also why bleeding cautions apply. Anti-clotting activity and raised warfarin levels (rat and lab findings)Very low certaintyIn two rat studies chuanxiong raised warfarin blood levels (by 71% in one, 2.42-fold in the other). This is a caution, not a benefit, and there is no human study.

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.

Acute ischaemic stroke (plain chuanxiong root)

Not enough evidence

The only Cochrane review of chuanxiong for stroke found just two small, low-quality trials (161 people) and said the evidence was insufficient. No one can say from these trials whether the plain root helps after a stroke.

2 studiesMany forms exist (decoction, tablets, formulas). The trials' forms we…

Studies, doses and limits

What the trials found

The review (2008) looked for trials of chuanxiong against placebo or no treatment in people within 14 days of an ischaemic stroke. It included two trials with 161 people, both low quality. Neither reported death or dependency. A second Cochrane review, on stroke prevention, is marked withdrawn and we do not use it.

Results

Effect sizes as reported

No usable effect size.

Why this rating

Cochrane reviewers judged the evidence insufficient. Two small low-quality trials, searched only to 2008.

Form and dose studied

Many forms exist (decoction, tablets, formulas). The trials' forms were not given in the abstract. Ask a doctor or pharmacist about amounts.

Who was studied

Adults after a stroke, in hospital settings in China.

Limits

Old review; no newer controlled trial of the plain root was found by us.

Why researchers looked

Chuanxiong is traditionally used to 'move blood', and Chinese hospitals use it in stroke care.

Traditional use

Chuanxiong (Sichuan lovage root) is a classic 'blood-moving' herb in Chinese medicine, used for headache and for blood-vessel and pain conditions. The descriptions of traditional use in the abstracts we read are brief, and we did not read a classical text.

Proposed mechanism Pharmacological theory

Compounds from the root, such as ligustrazine, are thought to widen blood vessels and slow clotting in lab work. This is a theory and was not tested in these two trials.

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

Chuanxiong may affect blood clotting and interact with blood thinners (see Safety). Stroke needs emergency care, not a herb.

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Acute cerebral infarction (ligustrazine-danshen injection added to usual care)

Low certainty

In China, an injection of ligustrazine (a compound from chuanxiong) with danshen is added to usual stroke care. A 2024 review of 38 trials (3,869 people) found better recovery scores than usual care alone, but the trials were Chinese, add-on and prone to bias. It says nothing about the plain root.

2 studiesA hospital injection of the isolated compound, given with danshen. No…

Studies, doses and limits

What the trials found

A 2024 meta-analysis (Frontiers in Pharmacology) pooled 38 trials with 3,869 people. Adding the injection to usual care raised the overall response (RR 1.23), lowered the stroke severity score (NIHSS, -4.35 points) and raised the Barthel Index of daily living (+10.27 points). Adverse events did not differ significantly (RR 1.49, 95% CI 0.91 to 2.46, so a higher rate cannot be ruled out). A 2013 meta-analysis of three trials (643 people) of ligustrazine plus usual care found lower stroke recurrence at 1 year (RR 0.42) and 3 years (RR 0.48) and higher 1-year survival, but called the trials poor quality and noted that only one trial checked safety.

Results

Effect sizes as reported

NIHSS MD -4.35 (95% CI -5.15 to -3.54); Barthel MD 10.27 (7.75 to 12.79); recurrence RR 0.42 (0.18 to 0.94).

Why this rating

Large pooled numbers, but Chinese add-on trials with regional and publication bias named by the authors; the 3-trial review is called poor quality.

Form and dose studied

A hospital injection of the isolated compound, given with danshen. Not a supplement and not the root. Ask a doctor or pharmacist about amounts.

Who was studied

Adults in hospital after acute stroke, mostly in China.

Limits

Not the plain herb; the injection also contains danshen, so results cannot be credited to chuanxiong or even to ligustrazine alone.

Why researchers looked

Ligustrazine is the best-known active compound in chuanxiong, and a hospital injection of it with danshen is widely used in China.

Traditional use

Proposed mechanism Preliminary mechanism

Ligustrazine is thought to improve blood flow and reduce clotting in lab and animal work; the abstracts of the reviews report improved blood-flow measures in patients.

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

Injection reactions and bleeding questions: see the Safety tab.

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Angina (ligustrazine injection added to usual anti-angina drugs)

Low certainty

An 11-trial review (870 people) reported better symptom and ECG responses when ligustrazine injection was added to usual angina drugs. The trials were of low quality and used the injection, not the root.

1 studiesInjection under medical care. Ask a doctor or pharmacist about amount…

Studies, doses and limits

What the trials found

A 2015 meta-analysis of 11 trials (870 people) found that adding ligustrazine injection to usual anti-angina drugs improved symptoms (OR 3.59, 95% CI 2.39 to 5.40) and the ECG (OR 3.42, 2.33 to 5.01) more than the drugs alone. The authors say the trials were of low quality and that more rigorous trials are needed.

Results

Effect sizes as reported

Symptoms OR 3.59 (2.39 to 5.40); ECG OR 3.42 (2.33 to 5.01).

Why this rating

Positive pooled results, but low-quality trials, all add-on, from China, 2015.

Form and dose studied

Injection under medical care. Ask a doctor or pharmacist about amounts.

Who was studied

Adults with angina in Chinese hospitals.

Limits

Not the plain root. Angina is a warning sign for heart disease and must be assessed by a doctor.

Why researchers looked

Ligustrazine injection is used in China for angina, and chuanxiong is traditionally a heart-and-blood-vessel herb.

Traditional use

Proposed mechanism Preliminary mechanism

Lab work suggests relaxing blood vessels and reducing clotting; these mechanisms were not tested in the trials.

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

Do not replace heart medicines. Bleeding and blood-pressure questions: see Safety.

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Heart failure (danshen-ligustrazine injection added to usual care)

Low certainty

A 2026 review of 32 trials (3,077 people) found a higher heart pumping fraction and better heart-strain blood tests when this injection was added to usual care. It is a hospital injection with danshen, and the authors ask for large long-term trials.

1 studiesHospital injection. Ask a doctor or pharmacist about amounts.

Studies, doses and limits

What the trials found

A 2026 meta-analysis (Frontiers in Pharmacology) of 32 trials with 3,077 people found that adding danshen-ligustrazine injection raised the left-ventricle pumping fraction (LVEF, +5.62 points), lowered left-ventricle size (-5.69) and BNP and NT-proBNP, and increased 6-minute walk distance (+60.7). Heart-related adverse events were lower (RR 0.55), with no rise in overall adverse reactions.

Results

Effect sizes as reported

LVEF MD 5.62 (4.42 to 6.81); LVEDD MD -5.69 (-7.46 to -3.92).

Why this rating

Many trials, but Chinese add-on trials with probable bias; the authors call for long-term large trials. Our earlier summary also rated the evidence as low quality.

Form and dose studied

Hospital injection. Ask a doctor or pharmacist about amounts.

Who was studied

Adults with heart failure in Chinese hospitals.

Limits

Not the plain root; also contains danshen.

Why researchers looked

The injection is used in China for heart conditions; heart failure is one of the newest review topics.

Traditional use

Proposed mechanism Preliminary mechanism

The review reports lower inflammation and better vessel-lining markers; those are blood tests, not proof of how the injection works.

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

Heart failure needs a cardiologist. See the Safety tab for bleeding and blood-pressure cautions.

Migraine (Chuanxiong Chatiao San, a classical multi-herb formula)

Low certainty

A 2019 review of 37 articles (3,307 people) found the classical formula Chuanxiong Chatiao San did better than Western medicine alone for migraine, with fewer side effects. It is a formula, not chuanxiong alone, and the trials were low quality.

1 studiesA multi-herb formula; the other herbs are not described in the abstra…

Studies, doses and limits

What the trials found

The 2019 meta-analysis (Evidence-Based Complementary and Alternative Medicine) pooled 37 articles with 3,307 people. The formula, alone or with Western medicine, beat Western medicine alone on total efficiency rate, pain scores (VAS), attacks and headache duration, and had fewer adverse events. The authors write that methodological quality was generally low and the conclusion has limitations.

Results

Effect sizes as reported

Effect sizes not in the abstract.

Why this rating

A big pooled sample but low methodological quality, a multi-herb formula, Chinese trials, and no stated placebo comparisons.

Form and dose studied

A multi-herb formula; the other herbs are not described in the abstract. Ask a doctor or pharmacist about amounts.

Who was studied

Adults with migraine, China.

Limits

We found no controlled trial of plain chuanxiong rhizome for headache.

Why researchers looked

The formula is named after chuanxiong, and the review calls it a famous classical prescription.

Traditional use

Proposed mechanism Preliminary mechanism

The review reports lower pain-signal chemicals (5-HT, substance P, CGRP) and thinner blood in patients. Those are blood tests, and the authors do not prove they cause the benefit.

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

Frequent or sudden severe headache needs a doctor. See Safety for bleeding cautions.

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Headache and migraine (plain chuanxiong and its compounds, senkyunolides)

Not enough evidence

Chuanxiong is called an anti-migraine herb and its compounds called senkyunolides get attention in lab work, but we found no controlled human trial of the plain herb for headache. Promising lab ideas are not a treatment.

1 studiesNot studied in people as a plain herb. Ask a doctor or pharmacist abo…

Studies, doses and limits

What the trials found

A 2026 narrative review (Frontiers in Nutrition) calls senkyunolides promising for migraine but describes mechanisms and formulation problems, not human trial results. We found no randomised trial of the plain rhizome for headache.

Results

Effect sizes as reported

Not applicable.

Why this rating

Only lab and animal work and a narrative review; no controlled trial of the plain herb found.

Form and dose studied

Not studied in people as a plain herb. Ask a doctor or pharmacist about amounts.

Who was studied

Not applicable.

Limits

Promising wording in a review does not equal evidence in people.

Why researchers looked

The root is the main herb of headache formulas, so researchers study its compounds.

Traditional use

Proposed mechanism Preliminary mechanism

A 2026 review says senkyunolides may calm the trigeminal pain pathway, widen or steady blood vessels, reduce inflammation and protect the blood-brain barrier, but they are unstable and hard to make into medicines. It describes lab and animal work.

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

Headache with fever, stiff neck, weakness, or a sudden thunderclap needs urgent care.

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High blood pressure in pregnancy (ligustrazine or danshen-ligustrazine injection, hospital trials)

Not enough evidence

A 2024 review of 47 trials (4,517 pregnant women) reported better outcomes when these hospital injections were added to standard treatment. The authors call their conclusion provisional. It does not show that chuanxiong is safe to take in pregnancy.

2 studiesInjection under medical care. Ask a doctor or pharmacist about amount…

Studies, doses and limits

What the trials found

The 2024 meta-analysis (Biomolecules and Biomedicine) pooled 47 trials with 4,517 women. Adding Salvia-ligustrazine or ligustrazine to Western treatment improved the overall response rate, reduced adverse pregnancy outcomes for mothers and babies, and reduced side effects of the usual treatment. The authors call the conclusions provisional because of potential bias and limited trials.

Results

Effect sizes as reported

Numbers not in the abstract.

Why this rating

Provisional per its authors; injection under hospital supervision; abstract gives no numbers.

Form and dose studied

Injection under medical care. Ask a doctor or pharmacist about amounts.

Who was studied

Pregnant women in hospital, China.

Limits

Does not show the plain root is safe in pregnancy; other sources we found warn against it (see Safety).

Why researchers looked

Chinese hospitals use the injection in pregnancy-related high blood pressure.

Traditional use

Proposed mechanism Not studied

Not described in the abstract.

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

Plain chuanxiong should not be used in pregnancy without a clinician; see Safety.

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Primary high blood pressure (danshen-ligustrazine injection with a blood-pressure drug)

Very low certainty

One 2025 hospital records study of 300 people found a higher response rate (90.5% against 72.4%) when this injection was added to a standard blood-pressure drug. It is retrospective and not a trial of the root.

2 studiesInjection under medical care. Ask a doctor or pharmacist about amount…

Studies, doses and limits

What the trials found

A 2025 retrospective cohort in BMC Complementary Medicine and Therapies compared 137 people given levamlodipine plus danshen-ligustrazine injection for 5 weeks with 163 given levamlodipine alone. The total effective rate was 90.5% against 72.4% (P < 0.001), the vessel-related markers moved further, and adverse reactions did not differ. Blood pressure readings were not given in the abstract.

Results

Effect sizes as reported

Effective rate 90.5% vs 72.4% (P < 0.001).

Why this rating

Retrospective records, not randomised; blood pressure numbers not in abstract; not the root.

Form and dose studied

Injection under medical care. Ask a doctor or pharmacist about amounts.

Who was studied

Adults with hypertension, hospital patients.

Limits

Not a controlled trial; selection of who got the injection is unknown.

Why researchers looked

The injection is used in Chinese cardiovascular care.

Traditional use

Proposed mechanism Preliminary mechanism

The study measured blood markers linked to vessel remodelling (salusin-alpha, catestatin, MMP-2, MMP-9, TIMP-1) but does not prove the mechanism.

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

It adds to the effect of a blood-pressure drug in these records, so people on blood-pressure medicine should ask before combining herbs. See Safety.

^{1 17}

Diabetic kidney disease (danshen-ligustrazine injection with ACE-inhibitor or ARB drugs)

Low certainty

A 2024 review of Chinese trials found lower creatinine and less protein in the urine when this injection was added to ACE-inhibitor or ARB drugs. The abstract gives no trial numbers, and it is an injection, not the root.

1 studiesInjection under medical care. Ask a doctor or pharmacist about amount…

Studies, doses and limits

What the trials found

A 2024 meta-analysis in Medicine (Baltimore) compared the injection plus ACE-inhibitor or ARB with the drug alone. Serum creatinine fell (mean difference -14.69), blood urea nitrogen and several urine protein measures fell (for example 24-hour urine protein, -0.59), and blood sugar, blood pressure, fats and inflammation markers also improved. Adverse events did not differ significantly.

Results

Effect sizes as reported

Creatinine MD -14.69 (-19.38 to -10.00); 24-h urine protein MD -0.59 (-0.86 to -0.32).

Why this rating

Pooled Chinese add-on trials; abstract does not give the number of trials, people or bias ratings.

Form and dose studied

Injection under medical care. Ask a doctor or pharmacist about amounts.

Who was studied

Adults with diabetic kidney disease.

Limits

Kidney disease needs a kidney doctor; herbs can complicate care.

Why researchers looked

The injection is used in China as an add-on in diabetic kidney disease.

Traditional use

Proposed mechanism Not studied

Not described in the abstract.

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

Combining with kidney or blood-pressure drugs needs prescriber input.

¹⁷

Fracture surgery recovery and clot prevention (danshen-ligustrazine injection)

Low certainty

A 2020 review of 16 trials (1,589 people) found fewer leg vein clots and lower inflammation markers around fracture surgery with this injection. It also changed clotting tests, which is why bleeding cautions matter.

1 studiesInjection under medical care. Ask a doctor or pharmacist about amount…

Studies, doses and limits

What the trials found

A 2020 meta-analysis in Medicine (Baltimore) of 16 randomised trials (1,589 people) found a better total effective rate, fewer deep vein thromboses and lower inflammation markers than control treatment, and improved clotting measures (prothrombin time, fibrinogen, D-dimer; P < 0.0001). The authors say higher-quality trials are needed.

Results

Effect sizes as reported

Clotting tests P < 0.0001; sizes not in the abstract.

Why this rating

Chinese trials, control treatment not described in the abstract, effect sizes not given.

Form and dose studied

Injection under medical care. Ask a doctor or pharmacist about amounts.

Who was studied

Adults having fracture surgery.

Limits

The clotting changes cut both ways: they may help prevent clots but could add to bleeding with blood thinners.

Why researchers looked

The injection is given around surgery in China because the herbs are traditionally used for 'blood stasis' (stuck blood).

Traditional use

Proposed mechanism Preliminary mechanism

The review reports effects on clotting tests; the abstract does not explain the mechanism.

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

Tell surgeons and anaesthetists about any chuanxiong product; see Safety.

¹⁵

Anti-clotting activity and warfarin levels (lab and rat findings)

Very low certainty

In rats, chuanxiong raised warfarin blood levels by about two thirds to more than double. A lab test of 201 raw-herb batches also measured anti-clotting activity in zebrafish. No human study of plain chuanxiong with warfarin was found.

3 studiesNot a use to try. The point is the caution for people on warfarin.

Studies, doses and limits

What the trials found

A 2022 study in rats with a stroke model found warfarin exposure (AUC) 71.20% higher and peak level 65.75% higher when chuanxiong aqueous extract was given with it; senkyunolide I gave +64.98% and +64.39%. A 2016 study in healthy rats found warfarin AUC 2.42 times higher with chuanxiong decoction. A 2025 quality study of 201 batches measured marker compounds and anti-thrombotic activity in zebrafish. All of this is animal or lab work; no human trial was found.

Results

Effect sizes as reported

Rat warfarin AUC +71.20% and 2.42-fold in two studies.

Why this rating

Animal and lab only; large rat amounts; no human interaction study; coagulation endpoints such as INR not in the abstracts.

Form and dose studied

Not a use to try. The point is the caution for people on warfarin.

Who was studied

Not applicable.

Limits

Rat results do not give a human number, but two rat studies pointing the same way is enough for caution.

Why researchers looked

In China warfarin is often taken together with chuanxiong-containing prescriptions, so the interaction is studied.

Traditional use

Proposed mechanism Animal research

Rat studies suggest chuanxiong and senkyunolide I change how the body handles warfarin, partly through gut bacteria. Zebrafish tests show anti-thrombotic activity of the raw herb.

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

People on warfarin or other blood thinners should avoid chuanxiong unless their prescriber agrees. See Safety.

^{6 4 13}

Connections to the rest of health

How Chuanxiong 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
Brain Health		Not enough evidence	Acute ischaemic stroke (plain chuanxiong root): The only Cochrane review of chuanxiong for stroke found just two small, low-quality trials (161 people) and said the evidence was insufficient. No one can say from these trials whether the plain root helps after a stroke.	^{16 10}
Healthy Circulation		Not enough evidence	Acute ischaemic stroke (plain chuanxiong root): The only Cochrane review of chuanxiong for stroke found just two small, low-quality trials (161 people) and said the evidence was insufficient. No one can say from these trials whether the plain root helps after a stroke.	^{16 10}
Brain Health	Potential benefit	Low certainty	Acute cerebral infarction (ligustrazine-danshen injection added to usual care): In China, an injection of ligustrazine (a compound from chuanxiong) with danshen is added to usual stroke care. A 2024 review of 38 trials (3,869 people) found better recovery scores than usual care alone, but the trials were Chinese, add-on and prone to bias. It says nothing about the plain root.	^{8 9}
Healthy Circulation	Potential benefit	Low certainty	Acute cerebral infarction (ligustrazine-danshen injection added to usual care): In China, an injection of ligustrazine (a compound from chuanxiong) with danshen is added to usual stroke care. A 2024 review of 38 trials (3,869 people) found better recovery scores than usual care alone, but the trials were Chinese, add-on and prone to bias. It says nothing about the plain root. Angina (ligustrazine injection added to usual anti-angina drugs): An 11-trial review (870 people) reported better symptom and ECG responses when ligustrazine injection was added to usual angina drugs. The trials were of low quality and used the injection, not the root.	^{8 9 11 17 15}
Heart Health	Potential benefit	Low certainty	Angina (ligustrazine injection added to usual anti-angina drugs): An 11-trial review (870 people) reported better symptom and ECG responses when ligustrazine injection was added to usual angina drugs. The trials were of low quality and used the injection, not the root. Heart failure (danshen-ligustrazine injection added to usual care): A 2026 review of 32 trials (3,077 people) found a higher heart pumping fraction and better heart-strain blood tests when this injection was added to usual care. It is a hospital injection with danshen, and the authors ask for large long-term trials.	^{11 2 1 17}
Brain Health	Traditional use	Low certainty	Migraine (Chuanxiong Chatiao San, a classical multi-herb formula): A 2019 review of 37 articles (3,307 people) found the classical formula Chuanxiong Chatiao San did better than Western medicine alone for migraine, with fewer side effects. It is a formula, not chuanxiong alone, and the trials were low quality.	¹⁴
Brain Health		Not enough evidence	Headache and migraine (plain chuanxiong and its compounds, senkyunolides): Chuanxiong is called an anti-migraine herb and its compounds called senkyunolides get attention in lab work, but we found no controlled human trial of the plain herb for headache. Promising lab ideas are not a treatment.	⁷
Blood Pressure Support		Not enough evidence	High blood pressure in pregnancy (ligustrazine or danshen-ligustrazine injection, hospital trials): A 2024 review of 47 trials (4,517 pregnant women) reported better outcomes when these hospital injections were added to standard treatment. The authors call their conclusion provisional. It does not show that chuanxiong is safe to take in pregnancy.	^{3 19}
Womens Wellness		Not enough evidence	High blood pressure in pregnancy (ligustrazine or danshen-ligustrazine injection, hospital trials): A 2024 review of 47 trials (4,517 pregnant women) reported better outcomes when these hospital injections were added to standard treatment. The authors call their conclusion provisional. It does not show that chuanxiong is safe to take in pregnancy.	^{3 19}
Blood Pressure Support	Potential benefit	Very low certainty	Primary high blood pressure (danshen-ligustrazine injection with a blood-pressure drug): One 2025 hospital records study of 300 people found a higher response rate (90.5% against 72.4%) when this injection was added to a standard blood-pressure drug. It is retrospective and not a trial of the root.	^{1 17}
Blood Sugar Balance	Potential benefit	Low certainty	Diabetic kidney disease (danshen-ligustrazine injection with ACE-inhibitor or ARB drugs): A 2024 review of Chinese trials found lower creatinine and less protein in the urine when this injection was added to ACE-inhibitor or ARB drugs. The abstract gives no trial numbers, and it is an injection, not the root.	¹⁷
Inflammation Balance	Potential benefit	Low certainty	Fracture surgery recovery and clot prevention (danshen-ligustrazine injection): A 2020 review of 16 trials (1,589 people) found fewer leg vein clots and lower inflammation markers around fracture surgery with this injection. It also changed clotting tests, which is why bleeding cautions matter.	¹⁵
Healthy Circulation		Very low certainty	Anti-clotting activity and warfarin levels (lab and rat findings): In rats, chuanxiong raised warfarin blood levels by about two thirds to more than double. A lab test of 201 raw-herb batches also measured anti-clotting activity in zebrafish. No human study of plain chuanxiong with warfarin was found.	^{6 4 13}

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Reproductive health	Contraindication	Very low certainty	Avoid in pregnancy; mouse data and a second-hand Pharmacopoeia statement. Preparation or compound: Chuanxiong rhizome	¹⁹
Nervous System	Biological association	Not enough evidence	Studied for: Acute ischaemic stroke (plain chuanxiong root) Studied for: Acute cerebral infarction (ligustrazine-danshen injection added to usual care)	^{16 10 8 9 14 7}
Cardiovascular System	Biological association	Not enough evidence	Studied for: Acute ischaemic stroke (plain chuanxiong root) Studied for: Acute cerebral infarction (ligustrazine-danshen injection added to usual care)	^{16 10 8 9 11 2 3 19 1 17 15 6 4 13}
Heart Circulation	Biological association	Low certainty	Studied for: Angina (ligustrazine injection added to usual anti-angina drugs) Studied for: Heart failure (danshen-ligustrazine injection added to usual care)	^{11 2 1 17}
Pain Inflammation	Biological association	Low certainty	Studied for: Migraine (Chuanxiong Chatiao San, a classical multi-herb formula) Studied for: Headache and migraine (plain chuanxiong and its compounds, senkyunolides)	^{14 7}
Reproductive Health	Biological association	Not enough evidence	Studied for: High blood pressure in pregnancy (ligustrazine or danshen-ligustrazine injection, hospital trials)	^{3 19}
Kidney Urinary	Biological association	Low certainty	Studied for: Diabetic kidney disease (danshen-ligustrazine injection with ACE-inhibitor or ARB drugs)	¹⁷
Bones Joints Muscles	Biological association	Low certainty	Studied for: Fracture surgery recovery and clot prevention (danshen-ligustrazine injection)	¹⁵

E. Health conditions

Connected to	Kind of connection	Evidence status	Context	Studies
Ischemic stroke	Potential benefit	Not enough evidence	Cochrane: two low-quality trials of the plain root; injection trials low certainty. Preparation or compound: Chuanxiong; ligustrazine injection	^{16 8}
Migraine	Potential benefit	Low certainty	Formula review of low quality; plain herb untested. Preparation or compound: Chuanxiong Chatiao San	^{14 7}

G. Root causes and contributing factors

Connected to	Kind of connection	Evidence status	Context	Studies
Medication side effects	Drug or supplement interaction	Very low certainty	Raised warfarin levels in two rat studies; no human data. Preparation or compound: Chuanxiong rhizome (and senkyunolide I)	^{6 4}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Stroke severity score (NIHSS)	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	⁸
Barthel Index (daily living)	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	⁸
Stroke recurrence and survival	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{9 16}
Heart pumping fraction (LVEF) and heart-strain markers (BNP, NT-proBNP)	Biological association	Low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	²
Angina symptoms and ECG response	Biological association	Low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	¹¹
Migraine pain score, attack number and headache duration	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	¹⁴
Blood thickness and flow measures (haemorheology)	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{14 8}
Serum creatinine and urine protein	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	¹⁷
Clotting tests (prothrombin time, fibrinogen, D-dimer)	Biological association	Low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	¹⁵
Warfarin blood level (rat studies)	Biological association	Very low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	^{6 4}
Blood pressure response	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{1 17}

K. Biological pathways

Connected to	Kind of connection	Evidence status	Context	Studies
Trigeminovascular pain signalling (CGRP, substance P, 5-HT)	Preliminary mechanism	Lab and human blood markers	Lowered in patients given the formula in a low-quality review; senkyunolides studied in lab work.	^{14 7}
Gut bacteria (Allobaculum, Dubosiella, Akkermansia, Lactobacillus)	Preliminary mechanism	Animal	Changed in rats with reduced gut bacteria; linked by the authors to warfarin handling.	⁶

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Tetramethylpyrazine (ligustrazine)	Biological association	Meta analysis	Studied as a purified drug and injection for stroke, angina and heart failure; half-life about 1.6 to 1.8 hours in healthy men after a tablet. Preparation or compound: Rhizome	^{20 5 8 11}
Ferulic acid	Biological association	Laboratory analysis	Used as a quality marker; clinical effects not read. Preparation or compound: Rhizome	^{20 13}
Ligustilide	Biological association	Laboratory analysis	Quality marker; clinical effects not read. Preparation or compound: Rhizome	^{20 13}
Senkyunolide I	Biological association	Animal	Raised warfarin exposure in rats like the whole extract; studied for migraine in lab work. Preparation or compound: Rhizome	^{20 6 7}
Senkyunolides H and A	Biological association	Laboratory analysis	Quality markers; CIDs not looked up. Preparation or compound: Rhizome	¹³

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 11 lab markers

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

Other533

The evidence

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

Evidence by outcome

Acute ischaemic stroke (plain chuanxiong root) 2 studies Not enough evidence Acute cerebral infarction (ligustrazine-danshen injection added to usual care) 2 studies Low certainty Angina (ligustrazine injection added to usual anti-angina drugs) 1 studies Low certainty Heart failure (danshen-ligustrazine injection added to usual care) 1 studies Low certainty Migraine (Chuanxiong Chatiao San, a classical multi-herb formula) 1 studies Low certainty Headache and migraine (plain chuanxiong and its compounds, senkyunolides) 1 studies Not enough evidence High blood pressure in pregnancy (ligustrazine or danshen-ligustrazine injection, hospital trials) 2 studies Not enough evidence Primary high blood pressure (danshen-ligustrazine injection with a blood-pressure drug) 2 studies Very low certainty Diabetic kidney disease (danshen-ligustrazine injection with ACE-inhibitor or ARB drugs) 1 studies Low certainty Fracture surgery recovery and clot prevention (danshen-ligustrazine injection) 1 studies Low certainty Anti-clotting activity and warfarin levels (lab and rat findings) 3 studies Very low certainty

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 chuanxiong summary and re-read PubMed abstracts for every study cited except one marked summary-only, checked plant names in GBIF and NCBI Taxonomy and compounds in PubChem. EMA, NCCIH and Memorial Sloan Kettering had no page we could find, and LiverTox and LactMed were not read.

Study library: every study we checked 21

Design Research type Plant part Year from Search

Study	Design	People	Product, dose, length	Result
Hong 2025 The effect of danshen ligustrazine injection as adjuvant therapy on serum levels of salusins, catestatin, MMP-2, MMP-9, and TIMP-1 in patients with primary hypertension. BMC Complement Med Ther · PMID 41034985 · DOI	Retrospective cohort	300 300 people with primary hypertension in hospital (China); 137 got the injection too, 163 did not.	Danshen-ligustrazine injection added to levamlodipine, for 5 weeks Ligustrazine from chuanxiong plus danshen Not stated in the abstract. 5 weeks · vs Levamlodipine alone	Total effective rate was 90.5% with the injection against 72.4% without it, several vessel-related blood markers moved further, and there was no significant difference in adverse reactions. Blood pressure readings were not given in the abstract. Effective rate 90.5% vs 72.4% (P < 0.001) Methods, limits and funding Outcomes: Blood markers of vessel health and tissue remodelling, response rate, adverse reactions. Limitations: Retrospective hospital records, not randomised; markers are indirect; not the plain root. Funding and conflicts: Not stated in the abstract. Read: abstract
Huang 2026 Efficacy and safety of Salvia miltiorrhiza and ligustrazine injection for heart failure: a systematic review and meta-analysis. Front Pharmacol · PMID 41737557 · DOI	Meta-analysis	3077 3,077 people with heart failure in 32 trials (China).	Injection of ligustrazine (tetramethylpyrazine, a compound found in chuanxiong) with Salvia miltiorrhiza (danshen); a hospital product in China, not the plain root Ligustrazine from chuanxiong plus danshen Not stated in the abstract. Not stated in the abstract. · vs Conventional treatment alone	Adding the injection raised LVEF (mean difference 5.62), lowered heart size (LVEDD -5.69), lowered BNP and NT-proBNP, and lengthened the 6-minute walk (MD 60.7). Heart-related adverse events were lower (RR 0.55) with no rise in overall adverse reactions. LVEF MD 5.62 (4.42 to 6.81); LVEDD MD -5.69 (-7.46 to -3.92); 6MWD MD 60.7 Methods, limits and funding Outcomes: Heart pumping fraction (LVEF), heart size, BNP and NT-proBNP, 6-minute walk, adverse events. Limitations: The authors call for large long-term trials; included trials are Chinese add-on trials. Funding and conflicts: Not stated in the abstract. Read: abstract
Ji 2024 The efficacy of Salvia-ligustrazine and Ligustrazine in treating gestational hypertension: A systematic review and meta-analysis. Biomol Biomed · PMID 39115338 · DOI	Meta-analysis	4517 4,517 pregnant women with pregnancy-induced hypertension in 47 trials (China).	Salvia-ligustrazine or ligustrazine injection added to Western treatment (magnesium sulfate, blood-pressure drugs) Ligustrazine from chuanxiong, with or without danshen Not stated in the abstract. Not stated in the abstract. · vs Western treatment alone	The combination did better than Western medicine alone on overall response and on adverse outcomes for mothers and babies, with fewer side effects of the hypertension treatment. The authors call their conclusions provisional because of possible bias and limited trials. Pooled benefit reported; numbers not in abstract Methods, limits and funding Outcomes: Overall response, adverse pregnancy outcomes for mother and baby, side effects. Limitations: Provisional per the authors; hospital injections given under supervision in pregnancy do not show that chuanxiong itself is safe in pregnancy. Funding and conflicts: Not stated in the abstract. Read: abstract
Li 2016 The effects of Chuanxiong on the pharmacokinetics of warfarin in rats after biliary drainage. J Ethnopharmacol · PMID 27497635 · DOI	Animal research rat	32 32 rats, healthy or with bile drainage.	Chuanxiong decoction with warfarin Rhizome (decoction) 10 g/kg decoction in rats (animal study detail, not advice) Not stated in the abstract. · vs Warfarin alone	In healthy rats, chuanxiong decoction raised warfarin exposure (AUC) to 2.42 times that of warfarin alone (p<0.01). Bile drainage changed the picture, so the gut-liver route seems to matter. AUC 2.42-fold in healthy rats Methods, limits and funding Outcomes: Warfarin levels in blood. Limitations: Rat study with a large decoction amount; no human data. Funding and conflicts: Not stated in the abstract. Read: abstract
Li 2018 Pharmacokinetics and bioequivalence study of tetramethylpyrazine phosphate tablets after single-dose administration in healthy Chinese male subjects. Int J Clin Pharmacol Ther · PMID 29882510 · DOI	Pharmacokinetic study	20 20 healthy Chinese men, crossover design.	Tetramethylpyrazine phosphate tablets (a purified drug, not the herb) Isolated compound (from Ligusticum wallichii per the abstract) Single 200 mg tablet (study design detail, not advice) Single dose, 7-day washout · vs A reference tablet	Half-life was about 1.6 to 1.8 hours and peak time about 0.8 to 0.9 hours. The two tablets were bioequivalent and no serious adverse events were reported. T1/2 1.79 and 1.64 h; Tmax 0.76 and 0.94 h Methods, limits and funding Outcomes: Blood levels over 12 hours; bioequivalence. Limitations: Fasted single dose in healthy men; purified drug, so it does not show what the root does. Funding and conflicts: Not stated in the abstract. Read: abstract
Li 2022 Pharmacokinetics effects of chuanxiong rhizoma on warfarin in pseudo germ-free rats. Front Pharmacol · PMID 36686675 · DOI	Animal research rat	48 48 rats with a stroke model (MCAO), some with their gut bacteria reduced.	Chuanxiong Rhizoma (aqueous extract) or senkyunolide I given with warfarin Rhizome Not compared with human use in the abstract. Not stated in the abstract. · vs Warfarin alone	With chuanxiong, warfarin exposure (AUC) was 71.20% higher and peak level (Cmax) 65.75% higher than with warfarin alone. With senkyunolide I the rises were 64.98% and 64.39%. The authors suggest gut bacteria are part of the reason. AUC +71.20%, Cmax +65.75% (chuanxiong); AUC +64.98%, Cmax +64.39% (senkyunolide I) Methods, limits and funding Outcomes: Warfarin levels in blood (AUC and Cmax). Limitations: Rats only; no human data; coagulation tests such as INR were not in the abstract. Funding and conflicts: Not stated in the abstract. Read: abstract
Long 2026 Senkyunolides: a promising natural compounds for the treatment of migraine headaches. Front Nutr · PMID 42039900 · DOI	Narrative review lab and animal (review)	Review of lab and animal work on senkyunolides.	Senkyunolides, compounds from Ligusticum chuanxiong Rhizome compounds Not applicable Not applicable · vs Not applicable	Describes how senkyunolides may act on the pain pathways of migraine, and the problem that they are unstable. It reports no controlled trial of the plain herb. It stresses that clinical translation still has to be done. Not applicable Methods, limits and funding Outcomes: Mechanisms and drug-development problems. Limitations: Narrative review of mostly lab and animal work; 'promising' is the authors' word, not a trial result. Funding and conflicts: Not stated in the abstract. Read: abstract
Ma 2024 Safety and effectiveness of Salvia miltiorrhiza and ligustrazine injection for acute cerebral infarction in Chinese population: a PRISMA-compliant meta-analysis. Front Pharmacol · PMID 39687295 · DOI	Meta-analysis	3869 3,869 people with acute cerebral infarction in 38 trials (China).	Injection of ligustrazine (tetramethylpyrazine, a compound found in chuanxiong) with Salvia miltiorrhiza (danshen); a hospital product in China, not the plain root Ligustrazine from chuanxiong plus danshen Not stated in the abstract. Not stated in the abstract. · vs Usual care alone	Adding the injection to usual care raised the overall response (RR 1.23), lowered the stroke severity score (NIHSS mean difference -4.35) and raised the Barthel Index (+10.27 points). Adverse events did not differ significantly (RR 1.49, 95% CI 0.91 to 2.46). ORR RR 1.23 (1.20 to 1.27); NIHSS MD -4.35 (-5.15 to -3.54); Barthel MD 10.27 (7.75 to 12.79) Methods, limits and funding Outcomes: Overall response, NIHSS stroke score, Barthel Index (daily living), blood-flow properties, adverse events. Limitations: Trials are Chinese add-on trials; the authors themselves cite regional and publication bias. Not the plain root. Funding and conflicts: Not stated in the abstract. Read: abstract
Ni 2013 Medium- and long-term efficacy of ligustrazine plus conventional medication on ischemic stroke: a systematic review and meta-analysis. J Tradit Chin Med · PMID 24660601 · DOI	Meta-analysis	643 643 people with ischaemic stroke in three trials (China).	Ligustrazine (tetramethylpyrazine) plus conventional treatment Isolated compound from chuanxiong Not stated in the abstract. Follow-up of 1 year and 3 years · vs Conventional treatment alone	Recurrence was lower with ligustrazine at 1 year (RR 0.42) and 3 years (RR 0.48), survival was higher at 1 year (RR 1.67). Only one trial checked safety and it reported no adverse events. Quality of all trials was generally poor. Recurrence RR 0.42 (0.18 to 0.94) at 1 year; RR 0.48 (0.27 to 0.83) at 3 years Methods, limits and funding Outcomes: Stroke recurrence, survival, effective rate. Limitations: Three poor-quality trials; wide intervals; safety almost unreported. Funding and conflicts: Research Support, Non-U.S. Gov't (PubMed record). Read: abstract
Not re-read 2016 WITHDRAWN: Chuanxiong preparations for preventing stroke. Cochrane Database Syst Rev · PMID 27258581	Systematic review	Not re-opened.	Chuanxiong preparations Not stated Not stated Not stated · vs Not stated	This Cochrane record is marked as withdrawn. We did not re-open it and do not use its findings. None used Methods, limits and funding Outcomes: Not stated Limitations: Withdrawn review; the reason was not read. Funding and conflicts: Not applicable Read: summary-only
Shao 2015 Efficacy of Ligustrazine Injection as Adjunctive Therapy for Angina Pectoris: A Systematic Review and Meta-Analysis. Med Sci Monit · PMID 26615387 · DOI	Meta-analysis	870 870 people with angina pectoris in 11 trials (China).	Ligustrazine injection added to usual anti-angina drugs Isolated compound from chuanxiong Not stated in the abstract. Not stated in the abstract. · vs Anti-angina drugs alone	Symptoms improved more with the injection (OR 3.59) and so did the ECG (OR 3.42). The authors say the 11 trials were of low quality and that better trials are needed. Symptoms OR 3.59 (2.39 to 5.40); ECG OR 3.42 (2.33 to 5.01) Methods, limits and funding Outcomes: Improvement in angina symptoms and in the ECG. Limitations: Low-quality trials, all Chinese, add-on design; says nothing about the plain root. Funding and conflicts: Research Support, Non-U.S. Gov't (PubMed record). Read: abstract
Tang 2025 Lipopolysaccharide aggravating anaphylactoid reactions caused by traditional Chinese Medicine injections via p38/ERK/NF-κB signaling pathways. J Ethnopharmacol · PMID 39419299 · DOI	Animal research guinea pig	Guinea pigs.	Two other Chinese herbal injections (Shuanghuanglian and Qingkailing), not ligustrazine Not applicable Not applicable Not stated in the abstract. · vs Controls	The abstract says adverse reactions limit Chinese medicine injections and severe anaphylactoid shock is one of the serious ones. In guinea pigs, inflammation made the allergy-like reactions to two named injections worse. It does not test ligustrazine or danshen injection. Not applicable Methods, limits and funding Outcomes: Anaphylactoid (allergy-like) markers and lung damage. Limitations: Different injections, animals; used here only to show that allergy-like reactions are a recognised issue for herbal injections as a class. Funding and conflicts: Not stated in the abstract. Read: abstract
Tao 2025 Comprehensive quality evaluation of crude material of Ligusticum chuanxiong Hort. through high performance liquid chromatography coupled with DenseNet-121 assisted hyperspectral imaging and anti-thrombotic zebrafish bioassay. J Pharm Biomed Anal · PMID 40187127 · DOI	Laboratory analysis lab (plant material, zebrafish)	201 batches of chuanxiong raw material (lab).	Ligusticum chuanxiong Hort. rhizome raw material Rhizome Not applicable Not applicable · vs Not applicable	Developed a method to check quality of the raw herb by measuring ferulic acid, senkyunolide I, H and A, and ligustilide, plus moisture, and tested clotting-related activity in zebrafish. It was applied to 201 batches and showed quality variations between batches. Not applicable Methods, limits and funding Outcomes: Five marker compounds, moisture, anti-clotting activity in a zebrafish model. Limitations: Method paper from a tablet-raw-material setting; the abstract gives no content ranges. Funding and conflicts: Not stated in the abstract. Read: abstract
Wang 2019 A Chinese Prescription Chuanxiong Chatiao San for Migraine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evid Based Complement Alternat Med · PMID 31467571 · DOI	Meta-analysis	3307 3,307 people with migraine in 37 articles (China).	Chuanxiong Chatiao San, a classical multi-herb formula, alone or with Western medicine Multi-herb formula (chuanxiong plus other herbs) Not stated in the abstract. Not stated in the abstract. · vs Western medicine alone	The formula, alone or with Western medicine, beat Western medicine alone on total efficiency rate, pain score, number of attacks and headache duration, and had fewer adverse events (all P < 0.00001). The authors say methodological quality was generally low. Efficiency rate and adverse events P < 0.00001 (no effect sizes in abstract) Methods, limits and funding Outcomes: Total efficiency rate, pain scores (VAS), number of attacks, headache duration, adverse events, blood markers. Limitations: Formula, not the single herb; low-quality Chinese trials; a P value this small across so many low-quality trials suggests bias. Funding and conflicts: Not stated in the abstract. Read: abstract
Xie 2020 Efficacy and safety of the injection of the traditional Chinese medicine salviae miltiorrhizae and ligustrazine hydrochloride for the treatment of perioperative period of fracture: A meta-analysis of randomized controlled trials. Medicine (Baltimore) · PMID 32311985 · DOI	Meta-analysis	1589 1,589 people having fracture surgery in 16 trials (China).	Danshen and ligustrazine hydrochloride injection Ligustrazine from chuanxiong plus danshen Not stated in the abstract. Not stated in the abstract. · vs Control treatment (not described in the abstract)	Better total effective rate, fewer deep vein thromboses and lower inflammation markers. The injection also changed clotting measures (prothrombin time, fibrinogen, D-dimer, P < 0.0001), which shows it acts on the clotting system. Clotting measures P < 0.0001; effect sizes not in abstract Methods, limits and funding Outcomes: Total effective rate, deep vein thrombosis, inflammation markers, clotting tests. Limitations: Direction of the clotting changes is described only as 'improved'. Authors call for higher-quality trials. Funding and conflicts: Not stated in the abstract. Read: abstract
Yuan 2008 Chuanxiong-type preparations for acute ischemic stroke. Cochrane Database Syst Rev · PMID 18843695 · DOI	Systematic review	161 161 people within 14 days of an ischaemic stroke, in two trials (China).	Chuanxiong preparations (the abstract does not give the forms) Rhizome (not stated in abstract) Not stated in the abstract. Not stated in the abstract. · vs Placebo or no treatment	Two trials were included and both were of low quality. Neither reported death or dependency, so no reliable evidence was available. The reviewers found insufficient evidence for any recommendation. No usable effect estimate Methods, limits and funding Outcomes: Death, dependency, other clinical outcomes. Limitations: Only two small low-quality trials; searched to early 2008, so it is old. Authors asked for well-designed trials. Funding and conflicts: Cochrane review; no industry funding stated in the abstract. Read: abstract
Zhang 2024 The effects of Salvia miltiorrhiza and ligustrazine injection combined with ACEI/ARB on diabetic kidney disease: A systematic review and meta-analysis. Medicine (Baltimore) · PMID 38394516 · DOI	Meta-analysis	People with diabetic kidney disease in randomised trials (China); total number not in abstract.	Injection of ligustrazine (tetramethylpyrazine, a compound found in chuanxiong) with Salvia miltiorrhiza (danshen); a hospital product in China, not the plain root, added to ACE-inhibitor or ARB drugs Ligustrazine from chuanxiong plus danshen Not stated in the abstract. Not stated in the abstract. · vs ACE-inhibitor or ARB alone	Compared with ACE-inhibitor or ARB alone, the add-on lowered serum creatinine (MD -14.69), blood urea nitrogen and urine protein measures, and the review also reported better blood sugar, blood pressure, lipids and inflammation markers. Adverse events did not differ significantly. Creatinine MD -14.69 (-19.38 to -10.00); 24-h urine protein MD -0.59 (-0.86 to -0.32) Methods, limits and funding Outcomes: Kidney function, urine protein, blood sugar, blood pressure, fats, inflammation. Limitations: Chinese add-on trials; the abstract does not give trial numbers or bias ratings. Funding and conflicts: Not stated in the abstract. Read: abstract
s-gbif-chuanxiong GBIF Backbone Taxonomy species match: Ligusticum chuanxiong and Ligusticum striatum · Source	Reference database n/a			Methods, limits and funding Read: api
s-hkbu-thesis Hong Kong Baptist University master's thesis: The impact of rhizoma chuanxiong in fetal bone development (2016) · Source	Thesis summary mouse			Methods, limits and funding Read: summary-only
s-pubchem-chuanxiong PubChem compounds: tetramethylpyrazine (CID 14296), ferulic acid (445858), ligustilide (5319022), senkyunolide I (11521428) · Source	Reference database n/a			Methods, limits and funding Read: api
s-regulators-not-found EMA/HMPC, NCCIH, Memorial Sloan Kettering, LiverTox and LactMed lookups for chuanxiong · Source	Regulatory lookup n/a			Methods, limits and funding Read: not-found

What we do not know yet

What the evidence supports: Chinese injection and formula trials with low quality, one Cochrane review of the plain root that found insufficient evidence, and rat warfarin signals.
No controlled trial of plain chuanxiong rhizome was found for migraine, angina, heart failure or blood pressure.
No human study of chuanxiong with warfarin or other blood thinners.
No human pregnancy or uterine study; the pregnancy caution rests on a thesis summary and traditional caution.
No EMA, NCCIH or Memorial Sloan Kettering page found; LiverTox and LactMed not read.
No data on regional quality, heavy metals or substitution beyond one batch-variation study.

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".

Other 11

▼

Stroke severity score (NIHSS)

Lowered in trials

A doctor-scored checklist of a stroke's effects on movement, speech, vision and awareness. Lower is better.

Low certainty

Results and what it means

Why it was measured

It is the standard way to track recovery after a stroke.

Statistical vs. clinical meaning

A real clinical score, but pooled from Chinese add-on trials with named bias.

Safety implication

None for the score itself; see Safety for bleeding.

Study	Result	People	Product
⁸	NIHSS mean difference -4.35 (95% CI -5.15 to -3.54) with the injection added to usual care	Acute cerebral infarction, 38 trials	Danshen-ligustrazine injection

⁸

▲

Barthel Index (daily living)

Raised in trials

A score of how well a person can wash, dress, eat and move without help. Higher is better.

Low certainty

Results and what it means

Why it was measured

It shows whether people can look after themselves after a stroke.

Statistical vs. clinical meaning

A meaningful day-to-day measure.

Safety implication

None noted.

Study	Result	People	Product
⁸	Barthel mean difference +10.27 (7.75 to 12.79)	Acute cerebral infarction, 38 trials	Danshen-ligustrazine injection

⁸

▼

Stroke recurrence and survival

Lowered in trials

How many people have another stroke, or are alive, at 1 year and 3 years.

Very low certainty

Results and what it means

Why it was measured

It is the outcome that matters most after a first stroke.

Statistical vs. clinical meaning

Only three trials, graded poor quality; wide intervals.

Safety implication

Only one of the three trials checked safety.

Study	Result	People	Product
⁹	Recurrence RR 0.42 (1 year) and 0.48 (3 years); survival RR 1.67 at 1 year	643 people, 3 trials	Ligustrazine plus conventional treatment
¹⁶	Neither plain-chuanxiong trial reported death or dependency	161 people, 2 trials	Chuanxiong preparations

^{9 16}

↕

Heart pumping fraction (LVEF) and heart-strain markers (BNP, NT-proBNP)

Mixed results in trials

LVEF is the share of blood the left side of the heart pumps out with each beat. BNP and NT-proBNP are blood markers that rise when the heart is strained.

Low certainty

Results and what it means

Why it was measured

They show how well the heart is working in heart failure.

Statistical vs. clinical meaning

Both heart scans and blood tests moved in the helpful direction, but the trials are Chinese add-on trials.

Safety implication

Cardiovascular adverse events were lower in the review (RR 0.55).

Study	Result	People	Product
²	LVEF MD +5.62; LVEDD MD -5.69; BNP and NT-proBNP lower; 6-minute walk +60.7	Heart failure, 32 trials	Danshen-ligustrazine injection plus conventional treatment

▲

Angina symptoms and ECG response

Raised in trials

Whether chest-pain symptoms and the heart tracing (ECG) improved after treatment.

Low certainty

Results and what it means

Why it was measured

They are the usual measures of angina treatment in Chinese trials.

Statistical vs. clinical meaning

Large odds ratios from low-quality trials.

Safety implication

The review did not report safety numbers in its abstract.

Study	Result	People	Product
¹¹	Symptom improvement OR 3.59; ECG improvement OR 3.42	870 people, 11 trials	Ligustrazine injection plus anti-angina drugs

¹¹

▼

Migraine pain score, attack number and headache duration

Lowered in trials

How bad the pain is on a 0 to 10 scale (VAS), how many attacks happen, and how long a headache lasts.

Low certainty

Results and what it means

Why it was measured

They are the usual migraine trial outcomes.

Statistical vs. clinical meaning

Symptoms matter directly, but quality was low and it is a formula.

Safety implication

Fewer adverse events than Western medicine in this review.

Study	Result	People	Product
¹⁴	Lower VAS, fewer attacks and shorter headaches with the formula (P < 0.00001; sizes not given in the abstract)	3,307 people, 37 articles	Chuanxiong Chatiao San formula

¹⁴

▼

Blood thickness and flow measures (haemorheology)

Lowered in trials

Lab measures of how thick and sticky the blood is, such as plasma viscosity and fibrinogen.

Low certainty

Results and what it means

Why it was measured

Chuanxiong is traditionally a 'blood-moving' herb, so thinner, freer-flowing blood is the lab idea behind its use.

Statistical vs. clinical meaning

These are indirect lab measures, not outcomes patients feel.

Safety implication

Changes in blood thickness and clotting are also why bleeding and blood-thinner cautions apply. See Safety.

Study	Result	People	Product
¹⁴	Plasma viscosity, high- and low-shear viscosity and fibrinogen lowered with the formula (P < 0.00001)	Migraine trials	Chuanxiong Chatiao San
⁸	Haemorheology indexes improved with the injection (P < 0.05)	Acute cerebral infarction	Danshen-ligustrazine injection

^{14 8}

▼

Serum creatinine and urine protein

Lowered in trials

Creatinine in the blood and protein in the urine are lab markers of how well the kidneys are filtering.

Low certainty

Results and what it means

Why it was measured

They are the standard tests for kidney disease.

Statistical vs. clinical meaning

Helpful direction, but pooled Chinese add-on trials.

Safety implication

Kidney disease needs specialist supervision.

Study	Result	People	Product
¹⁷	Creatinine MD -14.69; 24-h urine protein MD -0.59; albumin-creatinine ratio MD -11.93	Diabetic kidney disease, randomised trials	Danshen-ligustrazine injection plus ACEI/ARB

¹⁷

↕

Clotting tests (prothrombin time, fibrinogen, D-dimer)

Mixed results in trials

Blood tests that show how quickly blood clots and how much clotting is going on.

Low certainty

Results and what it means

Why it was measured

They show whether a treatment changes the blood's clotting, which also tells you about bleeding risk.

Statistical vs. clinical meaning

Shows the injection acts on the clotting system; this supports the bleeding caution.

Safety implication

Anyone on warfarin or other blood thinners should ask a prescriber.

Study	Result	People	Product
¹⁵	Prothrombin time, fibrinogen and D-dimer changed (P < 0.0001; direction described as improved)	Fracture surgery, 16 trials	Danshen and ligustrazine hydrochloride injection

¹⁵

▲

Warfarin blood level (rat studies)

Raised in trials

AUC and Cmax describe how much warfarin is in the blood over time and at its peak.

Very low certainty

Results and what it means

Why it was measured

Higher warfarin levels can mean a stronger blood-thinning effect.

Statistical vs. clinical meaning

Animal data only, at amounts not matched to human use.

Safety implication

A reason for caution with warfarin; INR monitoring would be the human test, and no human INR data were found.

Study	Result	People	Product
⁶	AUC +71.20%, Cmax +65.75% with chuanxiong extract in rats	48 rats	Chuanxiong aqueous extract with warfarin
⁴	AUC 2.42 times in healthy rats	32 rats	Chuanxiong decoction with warfarin

^{6 4}

↕

Blood pressure response

Mixed results in trials

Whether blood pressure came down, measured as a response rate or in mmHg.

Very low certainty

Results and what it means

Why it was measured

High blood pressure is a main risk for stroke and heart disease.

Statistical vs. clinical meaning

Suggests an added effect on blood pressure medicines, which matters for people on them.

Safety implication

Possible extra blood-pressure lowering with blood-pressure drugs; no data on plain herb.

Study	Result	People	Product
¹	Total effective rate 90.5% vs 72.4% with the injection added	300 people with primary hypertension	Levamlodipine plus danshen-ligustrazine injection
¹⁷	The review reports improved blood pressure with the add-on in diabetic kidney disease (numbers not in abstract)	Diabetic kidney disease	Danshen-ligustrazine injection plus ACEI/ARB

^{1 17}

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 6

Bleeding and blood thinners: the most important caution. Chuanxiong is a traditional 'blood-moving' herb. In two rat studies it raised warfarin levels in the blood (by about 71% in one, and to 2.42 times in the other). Hospital trials of the ligustrazine-danshen injection changed clotting tests (prothrombin time, fibrinogen, D-dimer). We found no human study of plain chuanxiong with warfarin or any other blood thinner, so the size of the human risk is unknown. Until it is known, anyone taking warfarin, aspirin, clopidogrel, a newer anticoagulant or similar medicines should not add chuanxiong without a prescriber, and a warfarin user would need INR checks. Animal research ^{6 4 15}
Pregnancy: avoid. A master's thesis summary says the Chinese Pharmacopoeia and other guidelines record no safe amount for pregnant women, and high amounts in pregnant mice lowered fetal weight and caused bone malformations (the low amount showed no difference). Chuanxiong is traditionally a 'blood-moving' herb, and Chinese medicine generally treats such herbs with caution in pregnancy, but we did not read the Pharmacopoeia or a classical text and found no human uterine study. Hospital trials give ligustrazine injections to pregnant women with high blood pressure under supervision, which does not show that the plain root is safe. Animal research ^{19 3}
Blood pressure: possible added effect with blood-pressure drugs. A hospital records study of 300 people found that adding danshen-ligustrazine injection to a blood-pressure drug gave a higher response rate, and a review of diabetic kidney disease trials also reported better blood pressure with the add-on to ACE-inhibitor or ARB drugs. This is injection data, and no one tested the plain root for low blood pressure or dizziness. People on blood-pressure medicine or with low blood pressure should ask first. Cohort study ^{1 17}
Injections are hospital medicines, not supplements. Most human trials of 'chuanxiong' used injections of ligustrazine, with or without danshen, given in hospitals in China. Reviews of those trials report adverse events not significantly different from usual care, but the intervals are wide (for stroke: RR 1.49, 95% CI 0.91 to 2.46). Herbal injections as a class carry a recognised risk of allergy-like (anaphylactoid) reactions in animal work on other injections. Injections should only be given by clinicians; they say nothing about teas, powders or capsules. Meta-analysis ^{8 2 12}
No regulator monograph and almost no safety data for the plain root. We found no EU (EMA/HMPC), NCCIH or Memorial Sloan Kettering page for chuanxiong, and no human safety series for the plain rhizome. Absence of a warning is not proof of safety. None found ²¹
Not the same as osha, dong quai or isolated ligustrazine. Osha is Ligusticum porteri, a different plant. Dong quai is Angelica sinensis, a different root. Isolated ligustrazine (tetramethylpyrazine) is a purified compound used as a drug. Their evidence and safety cannot be swapped with chuanxiong's. Authoritative guidance ^{18 20}

Side effects 6

Effect	How often	Severity and recovery	Evidence
Adverse events in injection trials (ligustrazine with danshen) Stroke review: RR 1.49 (0.91 to 2.46), not significant but wide. Heart failure review: no rise in overall adverse reactions and fewer cardiovascular events (RR 0.55). Specific symptoms were not listed in the abstracts.	Not established	not described in the abstracts Not described.	Meta-analysis ^{8 2 17 1}
Allergy-like (anaphylactoid) reactions to herbal injections Guinea-pig work on two other Chinese herbal injections; the authors call anaphylactoid shock one of the serious adverse reactions that limit herbal injections. Not tested on ligustrazine-danshen injection.	Not established	can be severe Not described.	Animal research ¹²
Possible extra bleeding or bruising when combined with blood thinners Inferred from higher warfarin levels in rats; no human bleeding data found.	Not established	potentially serious Not described.	Animal research ^{6 4}
Fewer adverse events than Western migraine medicine (multi-herb formula) A low-quality review of Chuanxiong Chatiao San reported fewer adverse events than Western medicine (P < 0.00001); types were not given in the abstract.	Not established	not described Not applicable	Meta-analysis ¹⁴
Purified tetramethylpyrazine tablets, single dose in healthy men No serious adverse events reported in 20 men after a single tablet. It is a purified drug, not the herb.	Not established	none serious Not applicable	Pharmacokinetic study ⁵
Adverse effects of the plain root taken by mouth We found no human adverse-effect series for the plain rhizome.	Not established	unknown Unknown	None found ²¹

Liver

We found no case report of liver injury from chuanxiong in PubMed, and no agency liver monograph. LiverTox was not read, so this is not a statement that no entry exists. The Cochrane stroke review and injection meta-analyses reported no liver outcomes in their abstracts. ^{21 16}

How often. No frequency of liver injury from chuanxiong was found.

Monitoring. No agency monitoring advice was found. Stop and get medical help for yellow skin or eyes, dark urine, pale stools, severe itching or ongoing nausea.

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

Medicines and supplements 6

With	Why it matters	Importance	Evidence	What to do
Warfarin anticoagulant	Rats given chuanxiong extract had much higher warfarin blood levels, and the authors link this to the gut-bacteria route; senkyunolide I did the same.	Rat data only (AUC +71.20% and 2.42-fold in two studies). No human study found. In China warfarin is often prescribed alongside chuanxiong-containing prescriptions, which is why it has been studied.	Animal research Very low certainty ^{6 4}	Do not combine without the prescriber who manages the warfarin; INR checks would be needed.
Other blood thinners and antiplatelets (aspirin, clopidogrel, apixaban, rivaroxaban, dabigatran) and NSAIDs anticoagulant or antiplatelet	Chuanxiong is traditionally a blood-moving herb, and its injection changed clotting tests in surgery trials, so extra bleeding is plausible.	Based on pharmacology and clotting-test changes; no human bleeding study found.	Pharmacological theory Not enough evidence ^{15 13}	Ask the prescriber or pharmacist before combining.
Other herbs that move or thin blood (danshen, dong quai, ginkgo, garlic, turmeric and similar) herb-supplement	Added effect on clotting is plausible when several blood-moving herbs are used together; the injection trials combined chuanxiong's ligustrazine with danshen.	No study of the plain herbs together was found.	Pharmacological theory Not enough evidence ⁸	Avoid stacking blood-moving herbs; tell your prescriber about all herbs.
Blood-pressure medicines (levamlodipine, ACE inhibitors, ARBs) antihypertensive	In hospital records and trials, adding the ligustrazine-danshen injection to blood-pressure drugs gave a better response and lower blood pressure.	Injection data; effect of the plain root unknown. Low blood pressure or dizziness has not been studied.	Cohort study Very low certainty ^{1 17}	People on blood-pressure medicine should ask before using chuanxiong.
Surgery and anaesthesia perioperative	Clotting tests (prothrombin time, fibrinogen, D-dimer) changed with the injection around fracture surgery.	Injection data in surgery; no study of the plain herb before surgery. Consumer advice to stop 1 to 2 weeks before surgery was seen only in search snippets and is not verified.	Meta-analysis Low certainty ¹⁵	Tell the surgeon and anaesthetist about any chuanxiong product; ask them when to stop.
Medicines broken down by liver enzymes or moved by transporters prescription	Not studied in people for the plain herb. The warfarin findings suggest herb-drug effects are possible.	No enzyme or transporter data were read.	None found Not enough evidence ²¹	Ask a pharmacist about narrow-range medicines.

Who should check first 8

Situation	Advice	Evidence
Pregnancy	Avoid. Chinese guidance is cited as having no safe amount for pregnancy (thesis summary, Pharmacopoeia not read), and high amounts harmed mouse pregnancies.	Animal research ¹⁹
Breastfeeding, and children	No data found (LactMed not read). Avoid unless a clinician agrees.	None found ²¹
Taking warfarin or other blood thinners, or having a bleeding disorder or recent bleeding	Avoid unless the prescriber agrees; see the interaction notes.	Animal research ^{6 4}
Stroke caused by bleeding in the brain, or an unknown type of stroke	A blood-moving herb is not appropriate without a doctor knowing the stroke type. Call emergency services for any stroke signs.	Pharmacological theory ¹⁶
Before surgery or dental extraction	Tell the team and ask when to stop.	Meta-analysis ¹⁵
Low blood pressure, or taking blood-pressure medicine	Ask a prescriber first.	Cohort study ¹
Allergy to carrot-family (Apiaceae) plants	Cross-reaction is plausible because chuanxiong is in the same family; this was not verified in the sources read.	Pharmacological theory ¹⁸
Injection products	Only under a clinician's care; stop at once and get help for hives, swelling, wheezing or collapse.	Animal research ¹²

Overdose, product quality and regulators

Summary. The medicinal part is the dried rhizome. No poisoning series, overdose guidance or long-term toxicity study of the plain root was found. Animal data and the interaction signals are the main concerns.

Animal. A mouse study in a thesis summary reports lower fetal weight and bone malformations at high amounts in pregnancy. Two rat studies show raised warfarin exposure. Zebrafish tests show anti-clotting activity of the raw herb.

Human doses studied. Purified tetramethylpyrazine tablets were given once to 20 healthy men with no serious adverse events. Injection trials report adverse events similar to usual care. These do not describe the plain root.

High dose or long term signals. None found for the plain root. Long-term use has not been studied in the sources read.

Overdose response. Not found in the sources read.

Genotoxicity. Not found in the sources read.

Toxic plant parts. The rhizome is the medicinal part. Other plant parts were not described in the sources read. Wild plants in the carrot family include deadly look-alikes; this is a general warning, not from a source we read, so buy from a reliable supplier rather than collecting.

A 2025 quality study of 201 batches of chuanxiong raw material measured five marker compounds and moisture and found quality varied between batches. Region of origin is a standard quality question in Chinese herbs, but the abstract does not say how quality varied by region, and we found no data on heavy metals, pesticides or substitution.

Batch-to-batch quality variation. A 2025 method study of 201 batches (ferulic acid, senkyunolides I, H, A and ligustilide, moisture, hyperspectral images, zebrafish anti-clotting test) says quality variations were visualised on a control chart. Ranges and growing regions were not in the abstract. ¹³

Regional origin and substitution. Not verified in the sources read. The herb is grown and traded in China; whether cheaper related roots are substituted was not studied by us. ²¹

Body	Action	Date

When to get medical help

Sudden weakness or numbness of the face, arm or leg, trouble speaking, or sudden severe headache: call emergency services (possible stroke).
Black or bloody stools, vomiting blood, blood in the urine, a nosebleed that will not stop, or unusual large bruises, especially if you take a blood thinner.
Vaginal bleeding or pain in pregnancy.
Hives, swelling of the lips or face, wheezing, faintness or collapse (any injection or product).
Fainting or severe dizziness if you also take blood-pressure medicine.
Yellow skin or eyes, dark urine or pale stools.

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 chuanxiong?

Chuanxiong, or Sichuan lovage, is the dried root (rhizome) of a Chinese carrot-family plant, Ligusticum chuanxiong in trial papers. It is a traditional herb for headache and for moving blood in Chinese medicine.

^{18 4}

Is chuanxiong the same as osha or dong quai?

No. Osha is Ligusticum porteri, a North American plant, and dong quai is Angelica sinensis. All three are carrot-family roots, but their evidence and safety are separate.

¹⁸

What is chuanxiong used for?

Traditionally for headache and blood-circulation problems. In China, injections of its compound ligustrazine with danshen are added to usual care for stroke, angina and heart failure.

^{4 8 11 2}

Does chuanxiong work for stroke?

For the plain root, the Cochrane review found two low-quality trials with 161 people and insufficient evidence. Reviews of an injection of ligustrazine with danshen report better recovery scores, but they are Chinese add-on trials with named bias, and the injection is not the root.

^{16 8}

Does it help migraine?

A low-quality review of 37 articles found the classical formula Chuanxiong Chatiao San beat Western medicine alone, but it is a multi-herb formula. We found no controlled trial of plain chuanxiong for migraine, only lab ideas about senkyunolides.

^{14 7}

What is ligustrazine and is it the same as the herb?

Ligustrazine, also called tetramethylpyrazine, is one compound from the root. It is used as a purified drug and injection. Results for it do not apply directly to the whole root.

^{20 5}

Is chuanxiong safe with warfarin or other blood thinners?

It may not be. In two rat studies it raised warfarin levels in the blood, and the injection changed clotting tests in surgery trials. No human study was found, so people on warfarin, aspirin or newer blood thinners should not add it without their prescriber.

^{6 4 15}

Is it safe in pregnancy or breastfeeding?

Avoid it. A thesis summary says Chinese guidelines record no safe amount for pregnancy and that high amounts harmed mouse pregnancies. Hospital trials of ligustrazine injection in pregnancy do not show the plain root is safe. Breastfeeding data were not found.

^{19 3}

Can it affect blood pressure?

Probably it can add to blood-pressure medicine. A hospital records study found a better response when the injection was added to a blood-pressure drug, but the plain root has not been studied for low blood pressure.

^{1 17}

Are the injections safe?

In reviews, adverse events were not significantly different from usual care, but the intervals were wide. Herbal injections as a group carry a recognised risk of allergy-like reactions, shown in animal work on other injections. They should only be given by clinicians.

^{8 2 12}

Can chuanxiong harm the liver?

We found no case report of liver injury in PubMed, and LiverTox was not read, so the human liver risk is unknown. Stop and seek help for yellow skin or eyes or dark urine.

^{21 16}

Does a regulator approve chuanxiong?

We found no European Medicines Agency, NCCIH or Memorial Sloan Kettering page for it. Not found does not mean it is proven safe. Check with a doctor or pharmacist about suitability and amounts.

²¹

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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 chuanxiong summary and re-read PubMed abstracts for every study cited except one marked summary-only, checked plant names in GBIF and NCBI Taxonomy and compounds in PubChem. EMA, NCCIH and Memorial Sloan Kettering had no page we could find, and LiverTox and LactMed were not read.
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 21

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

Hong D, He C, Dai W, et al.. The effect of danshen ligustrazine injection as adjuvant therapy on serum levels of salusins, catestatin, MMP-2, MMP-9, and TIMP-1 in patients with primary hypertension.. BMC Complement Med Ther. 2025. PMID 41034985. DOI 10.1186/s12906-025-05017-3. (abstract)
Huang P, Ren G, Wang Y, et al.. Efficacy and safety of Salvia miltiorrhiza and ligustrazine injection for heart failure: a systematic review and meta-analysis.. Front Pharmacol. 2026. PMID 41737557. DOI 10.3389/fphar.2026.1692629. (abstract)
Ji R, Gan Q, Shu X, et al.. The efficacy of Salvia-ligustrazine and Ligustrazine in treating gestational hypertension: A systematic review and meta-analysis.. Biomol Biomed. 2024. PMID 39115338. DOI 10.17305/bb.2024.10743. (abstract)
Li H, Zhang C, Fan R, et al.. The effects of Chuanxiong on the pharmacokinetics of warfarin in rats after biliary drainage.. J Ethnopharmacol. 2016. PMID 27497635. DOI 10.1016/j.jep.2016.08.005. (abstract)
Li H, Wang B, Yuan G, et al.. Pharmacokinetics and bioequivalence study of tetramethylpyrazine phosphate tablets after single-dose administration in healthy Chinese male subjects.. Int J Clin Pharmacol Ther. 2018. PMID 29882510. DOI 10.5414/CP203270. (abstract)
Li H, Zhou Y, Liao L, et al.. Pharmacokinetics effects of chuanxiong rhizoma on warfarin in pseudo germ-free rats.. Front Pharmacol. 2022. PMID 36686675. DOI 10.3389/fphar.2022.1022567. (abstract)
Long Y, Li D, Jian X, et al.. Senkyunolides: a promising natural compounds for the treatment of migraine headaches.. Front Nutr. 2026. PMID 42039900. DOI 10.3389/fnut.2026.1750201. (abstract)
Ma Z, Zhang H, Zhao F, et al.. Safety and effectiveness of Salvia miltiorrhiza and ligustrazine injection for acute cerebral infarction in Chinese population: a PRISMA-compliant meta-analysis.. Front Pharmacol. 2024. PMID 39687295. DOI 10.3389/fphar.2024.1425053. (abstract)
Ni X, Ni X, Liu S, et al.. Medium- and long-term efficacy of ligustrazine plus conventional medication on ischemic stroke: a systematic review and meta-analysis.. J Tradit Chin Med. 2013. PMID 24660601. DOI 10.1016/s0254-6272(14)60002-9. (abstract)
Not re-read. WITHDRAWN: Chuanxiong preparations for preventing stroke.. Cochrane Database Syst Rev. 2016. PMID 27258581. (summary-only)
Shao H, Zhao L, Chen F, et al.. Efficacy of Ligustrazine Injection as Adjunctive Therapy for Angina Pectoris: A Systematic Review and Meta-Analysis.. Med Sci Monit. 2015. PMID 26615387. DOI 10.12659/msm.895362. (abstract)
Tang S, Qiu Z, Liu F, et al.. Lipopolysaccharide aggravating anaphylactoid reactions caused by traditional Chinese Medicine injections via p38/ERK/NF-κB signaling pathways.. J Ethnopharmacol. 2025. PMID 39419299. DOI 10.1016/j.jep.2024.118946. (abstract)
Tao Y, Yang Y, Bao J, et al.. Comprehensive quality evaluation of crude material of Ligusticum chuanxiong Hort. through high performance liquid chromatography coupled with DenseNet-121 assisted hyperspectral imaging and anti-thrombotic zebrafish bioassay.. J Pharm Biomed Anal. 2025. PMID 40187127. DOI 10.1016/j.jpba.2025.116859. (abstract)
Wang Y, Shi Y, Zhang X, et al.. A Chinese Prescription Chuanxiong Chatiao San for Migraine: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.. Evid Based Complement Alternat Med. 2019. PMID 31467571. DOI 10.1155/2019/2301680. (abstract)
Xie J, Chen S, Ding S, et al.. Efficacy and safety of the injection of the traditional Chinese medicine salviae miltiorrhizae and ligustrazine hydrochloride for the treatment of perioperative period of fracture: A meta-analysis of randomized controlled trials.. Medicine (Baltimore). 2020. PMID 32311985. DOI 10.1097/MD.0000000000019777. (abstract)
Yuan Y, Zeng X, Luo Y, et al.. Chuanxiong-type preparations for acute ischemic stroke.. Cochrane Database Syst Rev. 2008. PMID 18843695. DOI 10.1002/14651858.CD005569.pub2. (abstract)
Zhang Z, Luo L, Li X, et al.. The effects of Salvia miltiorrhiza and ligustrazine injection combined with ACEI/ARB on diabetic kidney disease: A systematic review and meta-analysis.. Medicine (Baltimore). 2024. PMID 38394516. DOI 10.1097/MD.0000000000035853. (abstract)
. GBIF Backbone Taxonomy species match: Ligusticum chuanxiong and Ligusticum striatum. . . (api)
. Hong Kong Baptist University master's thesis: The impact of rhizoma chuanxiong in fetal bone development (2016). . . (summary-only)
. PubChem compounds: tetramethylpyrazine (CID 14296), ferulic acid (445858), ligustilide (5319022), senkyunolide I (11521428). . . (api)
. EMA/HMPC, NCCIH, Memorial Sloan Kettering, LiverTox and LactMed lookups for chuanxiong. . . (not-found)

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.