Atractylodes Macrocephala
Also known as: Baizhu, Dongbaizhu, Wuzhu, Yuzhu, Atractylodes macrocephala Koidz., Atractylodes macrocephala
Overview
Atractylodes macrocephala, commonly known as Baizhu, is the dried rhizome of a plant belonging to the Asteraceae family. It is a widely utilized herb in Traditional Chinese Medicine (TCM), primarily valued for its role in supporting gastrointestinal and digestive health. Traditionally, it is employed to strengthen the spleen and stomach, reduce dampness, and promote fluid metabolism within the body. Modern research, including increasing numbers of clinical trials and systematic reviews, particularly from Chinese clinical settings, supports its use. It is often studied in combination with other herbs for various conditions, including gastrointestinal disorders and as an adjunct therapy in cancer treatment. While the quality of evidence varies, several systematic reviews and meta-analyses based on randomized controlled trials provide a moderate level of research maturity, indicating its potential therapeutic benefits and a generally favorable safety profile.
Benefits
Atractylodes macrocephala offers several evidence-based benefits, particularly in gastrointestinal health and as an adjunct in cancer therapy. For advanced gastric cancer (AGC) patients undergoing neoadjuvant chemotherapy (NAC), its combination with TCM formulas has been shown to significantly improve objective response rate (ORR), disease control rate (DCR), and quality of life (QOL), while also reducing adverse drug reactions (ADRs). This benefit is supported by meta-analyses of randomized controlled trials, indicating moderate to high clinical relevance. In gastrointestinal mucosal repair, polysaccharides and lactones from A. macrocephala promote healing by modulating inflammatory pathways and matrix metalloproteinases, as demonstrated in experimental studies. Furthermore, when combined with Paeonia lactiflora, it shows efficacy and safety in relieving symptoms of irritable bowel syndrome (IBS), a finding supported by meta-analysis. Secondary benefits include anti-inflammatory effects via downregulation of NF-κB, COX-2, and IL-8, and immune modulation through increased peripheral blood lymphocytes in cancer patients. These benefits are observed over weeks to months, aligning with treatment durations for chronic conditions and chemotherapy cycles.
How it works
Atractylodes macrocephala exerts its therapeutic effects primarily through anti-inflammatory and immunomodulatory mechanisms. Its active compounds, including polysaccharides and lactones, inhibit key inflammatory pathways such as NF-κB and COX-2, and reduce the production of pro-inflammatory cytokines like IL-8 in gastric tissues. This action contributes to its gastrointestinal mucosal repair properties. It also modulates heat shock proteins (HSP70) and influences matrix metalloproteinases (MMP-2, MMP-9) and their tissue inhibitors, promoting E-cadherin expression crucial for mucosal integrity. In cancer patients, it appears to enhance the immune system by increasing peripheral blood lymphocyte levels, suggesting an immunomodulatory role that may contribute to its efficacy as an adjunct therapy. While specific human pharmacokinetic data are limited, animal studies confirm systemic effects of its bioactive constituents.
Side effects
Atractylodes macrocephala is generally well tolerated in clinical trials, including studies involving cancer patients and individuals with IBS. Common side effects are rare and typically mild, primarily limited to occasional gastrointestinal discomfort. No significant adverse events have been directly attributed to A. macrocephala alone in the reviewed meta-analyses. Serious or uncommon side effects are not well documented, and no reports of severe toxicity have been found at typical clinical doses. Regarding drug interactions, while no direct contraindications have been established, caution is advised when used in conjunction with chemotherapy agents due to potential interactions that require monitoring. Similarly, caution is recommended in cases of polypharmacy. In TCM theory, its use is traditionally contraindicated in individuals with 'yin deficiency with heat signs.' Safety in specific populations such as pregnant or lactating women, or pediatric use, has not been established, as most evidence is derived from adult populations. Therefore, its use in these groups should be approached with caution and under professional guidance.
Dosage
The optimal dosage for Atractylodes macrocephala is not standardized, as clinical studies often use various formulations and doses, frequently in combination with other herbs. In traditional Chinese medicine (TCM) practice, typical formulations containing A. macrocephala range from 3-15 grams of dried rhizome per day. However, the exact dosage depends on the specific preparation (e.g., decoction, extract, powder) and the therapeutic indication. There is no clearly defined maximum safe dose, as no toxicity has been reported at typical clinical doses. It is commonly administered orally, often as a decoction or extract, with timing often aligned with meals in TCM practice. Polysaccharide-enriched extracts have been specifically studied for their role in mucosal repair. The absorption and bioavailability of A. macrocephala may be influenced by co-administration with other herbs and the individual's gastrointestinal health status. No specific cofactors are identified as required for its efficacy, and it is most frequently used as part of multi-herb formulas.
FAQs
Is Atractylodes macrocephala safe to use with chemotherapy?
Evidence suggests it may improve chemotherapy efficacy and reduce side effects in gastric cancer patients, but its use should always be supervised by healthcare professionals due to potential interactions.
How quickly can benefits be expected?
Clinical benefits in cancer adjunct therapy and IBS typically appear over several weeks. Mucosal repair effects have been observed in animal models within days to weeks.
Can it be used alone or only in combination?
Most clinical evidence supports its use in combination with other herbs or conventional treatments, rather than as a standalone therapy.
Are there any known drug interactions?
No major drug interactions have been widely reported, but caution is advised when combining it with chemotherapy and in situations of polypharmacy.
Research Sources
- https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1431381/full – This systematic review and meta-analysis evaluated the efficacy and safety of Atractylodes macrocephala-containing Traditional Chinese Medicine (TCM) combined with neoadjuvant chemotherapy (NAC) for advanced gastric cancer. It found statistically significant improvements in objective response rate, disease control rate, quality of life, and a reduction in adverse drug reactions, despite heterogeneity in herbal combinations.
- https://pubmed.ncbi.nlm.nih.gov/39479020/ – This PubMed entry corresponds to the same Frontiers in Oncology article, providing a summary of its findings. It highlights the potential of A. macrocephala-containing TCM to enhance the effectiveness and reduce side effects of chemotherapy in advanced gastric cancer patients.
- https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2021.727154/full – This review summarizes experimental studies on the bioactive compounds of Atractylodes macrocephala, demonstrating its anti-inflammatory and mucosal repair mechanisms. It details how the herb modulates pathways like NF-κB, COX-2, IL-8, and MMPs, supporting its role in gastrointestinal health, though it notes limitations in human pharmacokinetic data.
- https://pubmed.ncbi.nlm.nih.gov/38186470/ – This PubMed entry refers to a systematic review and meta-analysis published in Cureus, which assessed the efficacy and safety of an Atractylodes macrocephala-Paeonia lactiflora formula for irritable bowel syndrome (IBS). The study concluded that the formula showed significant symptom improvement with a low risk of bias, and trial sequential analysis confirmed the robustness of the findings.
- https://apm.amegroups.org/article/view/83531/html – This source appears to be related to the same research as the Cureus PubMed entry, focusing on the Atractylodes macrocephala-Paeonia lactiflora formula for IBS. It likely provides further details on the methodology and results of the meta-analysis, reinforcing the evidence for symptom relief in IBS patients.
