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Caring SunshineIngredientes

Flor de vellocino chino

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Otros Nombres

Bilderdykia multifloraChinese climbing knotweedChinese cornbindChinese knotweedFagopyrum multifloraFagopyrum multiflorumFallopia multifloraFallopia multiflora var. hypoleucaFleece-flower rootFo-TiHe Shou PianHe Shou WuHelxine multiflorumHeshouwuHo Shou WuJiao TengPleuropterus cordatusPleuropterus hypoleucusPleuropterus multiflorusPolygonum hypoleucumPolygonum multiflorumPolygonum multiflorum var. angulatumPolygonum multiflorum var. hypoleucumReynoutria multifloraReynoutria multiflora var. hypoleucaShen MinSheng He Shou WuShou Wu PianShou Wu TengTuber fleeceflowerYe Jiao TengZhi He Shou WuZi Shou Wu

Sinopsis

Chinese Fleeceflower (Polygonum multiflorum Thunb.): A Comprehensive Reference

1. Identity and Nomenclature

Botanical and Chemical Names

Chinese fleeceflower (Polygonum multiflorum Thunb.) is a perennial vine of the Polygonaceae family. The plant is also placed under the synonymous binomial Fallopia multiflora (Thunb.) Haraldson, and its dried tuberous root is officially designated in the pharmacopeial literature as Polygoni Multiflori Radix.

P. multiflorum is native to China and is also known as Shou Wu Pian, He Shou Pian, Fo-Ti, and Chinese knotweed. It is officially listed in the Chinese Pharmacopoeia and is one of the most popular perennial Chinese traditional medicines, known as He shou wu (何首乌) in China and East Asia, and as Fo-ti in North America. In English botanical contexts, the name "fleeceflower" and "flowery knotweed" are also applied. There is a distinct and unrelated herb known as baishouwu, the white-colored root derived from Cynanchum bungei, which has been reported to have properties similar to He shou wu and has historically been used as a substitute.

Botanical Description and Source

Chinese fleeceflower is a commonly used and ancient herbal remedy prepared from the root of the tuber. The plant is native to China but has been cultivated widely elsewhere, including the United States. Fleeceflower root is the dried root tuber of Polygonum multiflorum Thunb. (Family Polygonaceae), and it is produced in most parts of China, in Taiwan, and in Japan. It is collected in autumn and winter when leaves wither; after cutting off the two ends, the root is washed clean, cut into pieces, and then dried.

Common Dosage Forms and Preparations

In clinical and commercial settings, P. multiflorum is encountered in several distinct forms, each with different phytochemical profiles and traditional applications:

  • Raw root (sheng heshouwu / Radix Polygoni Multiflori): The raw root, often referred to as sheng shouwu, is traditionally employed for purposes like detoxification, clearing carbuncles, and as a laxative. This raw form is considered to carry a higher risk of toxicity, especially gastrointestinal upset, due to its natural compounds.
  • Processed root (zhi heshouwu / Radix Polygoni Multiflori Praeparata): The processed form, known as zhi heshouwu, is used for its tonic and anti-aging properties. In clinical practice, the processed product has high selectivity to the liver, heart, and kidney, and its tonic effect is considered better than the raw product; it is used to tonify the liver and kidney, nourish blood, and blacken hair.
  • Tablets and standardized extracts: Analysis of residual tablets of Shou Wu Pian demonstrated the stilbene glycoside tetrahydrostilbine-glucopyranoside as the major constituent, with only trace amounts of anthraquinones.
  • Decoctions and powders: Traditional preparation as a water decoction remains common. Modern commercial preparations include capsules, tinctures, and standardized dry extracts.

2. Traditional and Historical Use

Recorded History and Foundational Texts

He Shou Wu has been an official entry in the Chinese Pharmacopoeia since the Tang dynasty, over 1200 years ago. It was first recorded in the Kai Bao Ben Cao (Kaibao Materia Medica, compiled during the Song dynasty, 973 A.D.), with documented pharmacological effects of treating anti-sores and anti-aging, as well as anaemia and postpartum diseases. The herb was first recorded in the Ri Huazi Bencao (Tang Dynasty, 713 A.D.) and was then incorporated into the Kaibao Bencao (Song Dynasty, 973 A.D.).

The Compendium of Materia Medica (Ben Cao Gang Mu) stated that P. multiflorum can treat pain in the loins and knees, while Ben Cao Xin Bian and Ben Cao Qiu Zhen recorded its use to treat headache, hemorrhoids, cutaneous pruritus, and immune-related disease. The Zhong Hua Yao Dian also stated that it can be used to treat constipation and hyperlipidemia.

Legendary Origins of the Name

The Chinese common name for fo-ti, he-shou-wu, was the name of a Tang dynasty man whose infertility was supposedly cured by fo-ti. In addition, his long life was attributed to the tonic properties of this herb. Since then, Traditional Chinese Medicine has used fo-ti to treat premature aging, weakness, vaginal discharges, numerous infectious diseases, angina pectoris, and erectile dysfunction.

Traditional Applications in Chinese Medicine

As an element of traditional Chinese medicine for centuries, P. multiflorum was used as a liver and kidney tonic, for life longevity, and for hair blackening. Within the TCM framework, the herb is classified according to its organ-channel affinities and energetic properties. He Shou Wu is considered warm, bitter, and astringent, entering the Liver, Lung, and Kidney channels. It primarily tonifies Kidney Jing, which strengthens and nourishes the hair. It tonifies the Liver and Kidney to treat Yin and Blood deficiency, relieves toxic Fire and treats carbuncles, scrofula, and acne, moistens the intestines to treat constipation, and expels wind to treat skin rashes.

Extracts of the roots of P. multiflorum have been used for centuries in traditional Chinese medicine for a multitude of conditions and as an agent to prevent aging. Specific conditions for which it was historically prescribed include: backache, dizziness, graying of the hair, and constipation. The Compendium of Materia Medica (Ben cao Gang mu) specifically reported that it exerts liver-tonic and hair-blacking effects.

Processing Methods in Historical Context

The root of the plant is used as the effective therapeutic agent after common processing by steaming with black bean, rehmannia juice, or a wine- or ginger-black bean mixture. The black bean method — using dry, mature seeds of Glycine max (L.) Merr. — is the most commonly used processing method, as described in Xian Shou Li Shang Xu Duan Mi Fang (Secret Formulary for Traumatology and Fracture Taught by Immortal), which was written during the Tang Dynasty. That work first proposed: "10 lb, cooked with half a catty of black bean."

The traditional processing method of "Jiuzheng Jiushai" refers to steaming the root with black bean juice together for several hours and drying them, and repeating the whole process nine times until the epidermis and interior of the root are dark brown. In current practice, the traditional nine-cycle method was commonly replaced with a single steaming within a few hours, as codified in the 2020 edition of the Chinese Pharmacopeia.

3. Key Constituents and Active Compounds

Overall Phytochemical Profile

More than 100 chemical compounds have been isolated from this plant, and the major components have been determined to be stilbenes, quinones, flavonoids, and others. More specifically, more than 103 constituents have been isolated and identified, which include stilbenes, quinones, flavonoids, phospholipids, and other compounds.

Stilbenes

2,3,4′,5-Tetrahydroxystilbene-2-O-β-D-glucoside (TSG, C20H22O9) is the main and unique active ingredient isolated from Polygonum multiflorum Thunb. Stilbene glucosides and anthraquinones are recognized as the two major characteristic constituents of raw P. multiflorum (PM). The stilbene family in PM includes TSG, polydatin, resveratrol, rhaponiticin, and cis-TSG. The structure of TSG is similar to that of resveratrol (3,4′,5-trihydroxy-trans-stilbene), which is well known for its numerous biological activities, especially in cardiovascular protection and neuroprotection.

The chemical profiles demonstrate that TSG, emodin-8-O-β-D-glucoside (EMG), and physcion-8-O-β-D-glucoside (PG) are the dominant compounds in raw PM, while the processed form (P. multiflorum praeparata) mainly contains TSG, emodin, and physcion.

Anthraquinones

The anthraquinone family of compounds in PM includes emodin, physcion, aloe-emodin, chrysophanol, rhein, and their respective glycosides. Anthraquinones such as emodin, rhein, and chrysophanol are associated with the herb's traditional laxative action, particularly in its raw form. Anthraquinones are also implicated in the liver toxicity observed with the herb, with studies identifying rhein as a potential hepatotoxicant.

Other Compounds

The major constituents of fo-ti include anthraquinones, phospholipids (e.g., lecithin), tannins, and tetrahydroxystilbene glucoside. Additional compound classes identified include polysaccharides, gallic acid, and a growing number of novel stilbene oligomers. From 2015 to 2020, most of the newly isolated compounds were predominantly dianthrones and stilbenes. In 2016, four new dianthrones were isolated and named polygonumnolides C1–C4.

Effect of Processing on Chemical Composition

The content of 2,3,5,4′-tetrahydroxystilbene-2-O-β-D-glucoside (TSG) changes after processing. Quantitative analyses have revealed that processing significantly enhances TSG levels, especially in the epidermis, while emodin and physcion remain more stable. Analysis of different processed PM samples showed that the addition of black beans and steaming times significantly affect the content and composition of polysaccharides in PM.

4. Established Mechanisms of Action

Antioxidant Activity

TSG is an antioxidant agent that exhibits remarkable antioxidative activities both in vivo and in vitro. The antioxidant effect of TSG is achieved by its radical-scavenging effects. The medicinal effects of PM in the treatment of age-related diseases are possibly mediated by the antioxidant capacity of this plant, because free radical-induced oxidative stress has been implicated in the aging process.

Neuroprotective Mechanisms

TSG can inhibit apoptosis and protect neuronal cells against injury through multifunctional cytoprotective pathways. TSG can enhance cognitive performance and prevent or treat Alzheimer's disease in multistages and multitargets, and may act as an effective neuroprotective agent against Parkinson's disease through modulation of the PI3K/Akt signaling pathway and ROS-mediated JNK, p38, and mitochondrial pathways. TSG can decrease acetylcholinesterase (AChE) activity and increase the expression of protein phosphatase-2A (PP-2A) and microtubule-associated protein-2 (MAP-2) in the hippocampus of model rats following oral administration at doses of 30, 60, and 120 mg/kg/day for 11 weeks.

Cardiovascular and Lipid-Modulating Mechanisms

Polygonum multiflorum stilbene glycoside has been shown (in experimental studies) to reduce plasma cholesterol, LDL cholesterol, very-low-density lipoprotein cholesterol, and plasma triglyceride. Most of the reported cardiovascular effects are attributed to TSG's antioxidant, anti-inflammatory, free radical-scavenging, and cardioprotective activity.

Molecular Signaling Pathways

TSG shows anti-inflammation, antioxidation, neuroprotection, cardiovascular protection, hepatoprotection, anti-osteoporosis, memory enhancement, and anti-aging activities through regulating multiple molecular mechanisms, including NF-κB, AMPK, PI3K-AKT, JNK, ROS-NO, Bcl-2/Bax/Caspase-3, and ERK1/2 pathways.

Anti-Aging Mechanisms

Mechanistically, TSG alleviates oxidative stress, inflammation, and apoptosis while enhancing mitophagy, mitochondrial function, telomerase activity, and epigenetic regulation.

Inhibition of Drug-Metabolizing Enzymes

The adverse effects of P. multiflorum, including abnormal bilirubin metabolism, have been studied as a public health concern. UGT1A1 (UDP-glucuronosyltransferase 1A1) is the only enzyme responsible for bilirubin metabolism, and anthraquinone and dianthrone constituents of PM have been found to inhibit this enzyme. Additionally, PMT constituents — including trans-resveratrol, TSG, emodin, chrysophanol, aloe-emodin, and physcion — have been found to inhibit P-glycoprotein (P-gp)-mediated drug transport.

5. Scientific Evidence by Area of Use

5.1 Neurodegenerative Diseases (Alzheimer's and Parkinson's Disease)

Therapeutic potential of P. multiflorum has been demonstrated in conditions like Alzheimer's disease and Parkinson's disease, which is attributed to the presence of various stilbenes, quinones, flavonoids, phospholipids, and other compounds.

The available evidence for neurodegenerative diseases is predominantly preclinical. Pharmacological studies of PMT extract claimed that this medicinal plant may be beneficial in preventing Parkinson's disease and Alzheimer's disease. TSG, one of the bioactive compounds purified from its roots, significantly antagonized age-related α-synuclein overexpression in the hippocampus of an APP transgenic mouse model of Alzheimer's disease, and possessed neuroprotection in the MPTP mouse model of Parkinson's disease. TSG performs prophylactic and therapeutic activities against Alzheimer's disease, Parkinson's disease, and cerebral ischemia/reperfusion injury; it is also antiatherosclerotic and anti-inflammatory. However, the mechanisms underlying these pharmacological activities remain unclear.

Evidence strength: Clinical studies retrieved by systematic literature review provided information relevant to pharmacokinetics–pharmacodynamics analysis, sleep disorders, dyslipidemia treatment, and neurodegenerative diseases, but large-scale randomized controlled human trials specifically for Alzheimer's or Parkinson's disease are not established. The bulk of neuroprotection evidence remains animal and cell-based.

5.2 Dyslipidemia and Cardiovascular Disease

Laboratory studies and clinical practice have demonstrated that PMT possesses anti-atherosclerotic activities and has been reported to exert preventive activity against cardiovascular diseases and to reduce hyperlipidemia.

In systematic review evidence, TSG has demonstrated cardiovascular protection including reducing atherosclerosis and hypertension. A 2025 systematic review of TSG specifically evaluated 290 studies identified for full-text retrieval; after eligibility assessment, 104 reports were deemed eligible, encompassing studies from database inception to present, with 48 studies published within 2020–2024 included in the final analysis. These findings included cardiovascular protection studies (n = 10 in the TSG-focused subset), but the review notes that most evidence derives from preclinical models.

Evidence strength: Animal and/or in vitro studies have examined potential effects on atherosclerosis and dyslipidemia. Direct human cardiovascular intervention trials are limited and mostly embedded within multi-ingredient TCM formulas, making attribution to PM alone difficult.

5.3 Sleep Disorders (Insomnia)

In the first large-scale survey done in Taiwan of the use of Chinese herbal medicines for the treatment of insomnia in a Chinese population, P. multiflorum was found to be the most commonly prescribed single Chinese herb. Furthermore, among the Chinese herbal formulas used to treat insomnia, P. multiflorum was found to be a significantly important constituent ingredient.

Evidence strength: The evidence for insomnia is based on survey-level prescription data from Taiwan. No large-scale randomized controlled trials specifically examining P. multiflorum as a monotherapy for insomnia were identified in the reviewed literature.

5.4 Alopecia and Hair Growth

TSG exhibits significant effects on hair regrowth. Depilated mice treated with TSG demonstrated marked hair regrowth, which was associated with the inhibition of apoptotic factors including Fas, p53, Bax, active caspase-3, and procaspase-9 activities. In an in vitro study using human dermal papilla cells (DPCs), DPCs determine the fate of hair follicles including the anagen-to-telogen transition and play a pivotal role in androgenic alopecia (AGA); this study examined the hair growth-promoting effects of PM extract in cultured human DPCs and their underlying mechanisms. PM extract increased the viability and mitochondrial activity in cultured human DPCs in a dose-dependent manner.

Evidence strength: Evidence for hair growth is largely preclinical (animal models and human cell culture). Laboratory studies and clinical practice have referenced anti-alopecia activities. Robust double-blind, placebo-controlled clinical trials in humans demonstrating clinical benefit for hair loss are not established in the reviewed literature.

5.5 Anti-Aging

Systematic review evidence demonstrates that TSG exhibits anti-aging effects including lifespan extension, reduction in bone loss (e.g., mitigating osteoporosis), and delay of gonadal aging. Despite the growing body of evidence highlighting TSG's anti-aging properties and potential therapeutic applications, the intricate pharmacological mechanisms underlying these effects remain incompletely understood. Further research is needed to elucidate these mechanisms and expand the clinical significance of TSG in addressing aging-related conditions.

Evidence strength: Preclinical and early systematic review data are available; clinical human data demonstrating measurable anti-aging effects in humans are not yet established.

5.6 Cancer

TSG, the quality control marker and main active ingredient of P. multiflorum, has been reported for the first time to possess the ability to induce ferroptosis in triple negative breast cancer (TNBC) cell lines and to inhibit the proliferation of TNBC cells. Treatment with TSG triggers the production of lipid peroxides, 4-hydroxynonenal (4-HNE), and reactive oxygen species (ROS) in TNBC cells. Both in vivo and in vitro experiments confirmed the inhibitory effects of TSG on TNBC cell proliferation and metastasis.

Evidence strength: Cancer-related findings are entirely preclinical (in vitro cell lines and animal models). No human clinical trials for oncological indications were identified. These findings are preliminary only.

5.7 Cognitive Performance and Memory

P. multiflorum extracts are traditionally used in the Ayurvedic medical system and in Traditional Chinese Medicine for the treatment of cognitive disorders; however, clinical studies are lacking.

Evidence strength: Very limited. Most available data come from animal models, with insufficient human trial evidence.

6. Body Systems and Health Areas Associated with P. multiflorum

  • Hepatic and renal systems: Traditionally used as a liver and kidney tonic. The processed root and its active ingredients have been studied for effects on nonalcoholic fatty liver disease, alcoholic fatty liver disease, viral hepatitis, liver fibrosis, and liver cancer — though this dual profile (potential hepatoprotection and hepatotoxicity) is a central pharmacological paradox of this herb.
  • Nervous system: Modern pharmacological studies have confirmed that TSG exhibits significant activities in treating inflammatory diseases, neurodegenerative diseases, cardiovascular diseases, hepatic steatosis, osteoporosis, depression, and diabetic nephropathy.
  • Cardiovascular system: It is used in TCM for reducing triglyceride and cholesterol levels.
  • Musculoskeletal system: In bone cell studies, P. multiflorum steamed in black bean juice decreased RANKL expression while increasing osteoprotegerin, alkaline phosphatase, Runx2, and osterix, suggesting potential use as an alternative treatment for bone diseases such as osteoporosis.
  • Integumentary system (skin and hair): Traditional use for premature graying and hair loss, supported by preclinical cell and animal research.
  • Gastrointestinal system: The raw root's anthraquinone content confers laxative properties traditionally used for constipation.

7. Dosage Forms and Reported Dosages

Dosages reported in the scientific literature vary considerably by study type, preparation, and intended outcome. The following are dosages reported directly in source studies and reviews:

  • Animal neuroprotection studies (TSG): TSG was administered at doses of 30, 60, and 120 mg/kg/day for 11 weeks via intragastric route in rat models.
  • Animal studies (emodin inhibition of AChE): Emodin-8-O-β-D-glucopyranoside (EG) was tested in vitro against AChE at doses ranging from 23.1 to 92.6 μmol/mL.
  • Commercial tablet preparations: Standardized products such as Shou Wu Pian are commercially available, but consistent standardized human dosages across clinical studies have not been established in the reviewed literature.
  • Processing proportions (traditional): For 100 kg of slices of the roots, 10 kg of black bean is used to prepare the black bean juice.

No universally accepted or pharmacopeia-specified therapeutic dosage range for human use has been identified in the sources reviewed. Clinical studies have provided information relevant to pharmacokinetics–pharmacodynamics analysis, but establishing definitive human dosing remains an area needing further study.

8. Safety Considerations and Drug Interactions

Hepatotoxicity: Clinical Evidence and Regulatory Status

Polygonum multiflorum has been implicated in numerous reports of clinically apparent acute liver injury which can be severe and even fatal. The NIH LiverTox database assigns it a Likelihood Score of A: a well-established cause of clinically apparent liver injury.

Serious adverse events are rare, although hepatotoxicity has been increasingly reported, particularly from China and East Asia. Several published cases and a large case series from China, Korea, and Japan of clinically apparent acute liver injury have been attributed to use of Polygonum multiflorum. In one published case series, 25 patients were diagnosed with toxic hepatitis following ingestion of P. multiflorum. The 25 patients (median age, 48 years; M:F = 18:7) were admitted to hospital between 2007 and 2009.

The clinical features of liver injury resulting from ingestion of PM or its preparations include nausea, vomiting, diarrhea, abdominal pain, restlessness, difficulty breathing, tic, upper gastrointestinal bleeding, hybrid hepatitis, and cholestasis hepatitis. Liver injury has been reported in individuals aged 5 to 78 years, and the occurrences in men and women are almost equal.

Hepatotoxicity from P. multiflorum is usually self-limited but can be prolonged and is occasionally fatal. Recurrence with restarting the herb is common, and rechallenge should be avoided.

Proposed Mechanism of Hepatotoxicity

The mechanism of hepatotoxicity is not known, but the injury is usually attributed to the anthraquinones (such as emodin) which are major constituents in P. multiflorum. Research has found that emodin can conjugate with glutathione (GSH), forming emodin-GSH and depleting GSH in PM-induced liver injury rats. The HLA allele B*35:01 appears to be a major risk factor for liver injury from P. multiflorum, suggesting that the injury is immunologically mediated. Identification of genetic biomarkers of susceptible people has indicated that Polygoni Multiflori Radix has the risk of inducing liver injury only in a few specific populations and is safe for most populations.

However, the specific components of PM responsible for the reported hepatotoxic effects have not yet been definitively identified. Moreover, many of the reports are contradictory, while studies on the mechanism involved in PM-induced liver damage are not yet comprehensive.

Other Toxicological Concerns

PM has certain toxicity, including hepatotoxicity, nephrotoxicity, and embryotoxicity; however, these toxic effects can be effectively reduced by processing and compatibility. In addition to reports of liver injury from PM radix, liver injury induced by PM caulis (the stem) has also been reported. Clinical cases of PM drug-induced liver injury (DILI) have ranged from mild liver injury to severe liver failure, as well as the death of an individual patient.

Regulatory Actions

The UK Medicines and Healthcare Products Regulatory Agency (MHRA) notified the public of a case of liver damage caused by PM preparations; Canada, Australia, the United Kingdom, and other countries made similar notifications. Multinational drug regulatory authorities have successively introduced policies to regulate and even limit the use of PM and its preparations. In 2005, the China Food and Drug Administration (CFDA) Adverse Drug Reaction Information Bulletin (No. 9) recommended that patients take PM-containing preparations under the guidance of doctors, strictly observe symptoms and contraindications, and avoid overdose or long-term usage.

Drug–Drug and Herb–Drug Interactions

Studies on this herb indicate that significant herb–drug interactions exist. Several commonly used traditional Chinese medicines have been reported to interact with P-glycoprotein (P-gp). PMT constituents — including trans-resveratrol, TSG, emodin, chrysophanol, aloe-emodin, and physcion — have been found to inhibit P-gp-mediated digoxin transport in MDR1-MDCKII cells. This interaction has potential clinical significance for co-administered P-gp substrate medications.

The anthraquinone and dianthrone constituents of P. multiflorum have been found to inhibit UGT1A1, the only enzyme responsible for bilirubin metabolism, which may explain some of the abnormal bilirubin metabolism observed clinically.

Impact of Preparation on Safety

It is reported that the hepatotoxicity of P. multiflorum will be reduced after processing, and the toxicity could be completely eliminated by nine cycles of steaming and sunning. These toxic effects can be effectively reduced by processing and compatibility. Most patients with PM-induced hepatotoxicity recovered their liver function with conservative management.

References

Condiciones de Salud

Condiciones de salud que Flor de vellocino chino puede ayudar a apoyar.

  • Chinese fleeceflower (Polygonum multiflorum / He Shou Wu) has been used for centuries in Traditional Chinese Medicine (TCM) to nourish the liver and kidney, organs considered central to hair growth and pigmentation in TCM theory. Its use for preventing premature graying and hair thinning is documented in classical Chinese medical texts. Scientific evidence remains preliminary, largely from in vitro and animal studies.

  • FiebreTradicional

    Chinese fleeceflower (Polygonum multiflorum, He Shou Wu) has been used in Traditional Chinese Medicine for over a thousand years to nourish hair, prevent premature graying, and address hair loss, based on its role in tonifying kidney and liver. Scientific evidence from human clinical trials is limited, and the herb carries hepatotoxicity risk.

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