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DOI: 10.1055/s-0045-1814435
Research Progress on Chemical Constituents and Pharmacological Effects of Zexie (Alismatis Rhizoma)
Authors
Abstract
As a diuretic and dampness-eliminating medicinal agent in traditional Chinese medicine (TCM), Zexie (Alismatis Rhizoma) is commonly used for symptoms such as dysuria, edema and abdominal distension, diarrhea with oliguria, and dizziness due to phlegm–fluid retention. Systematic phytochemical studies have revealed that the active components of Zexie (Alismatis Rhizoma) are primarily triterpenoids, along with sesquiterpenes, polysaccharides, sterols, alkaloids, phenolic acids, and lignans. These components form the material basis for its pharmacological activities. Recent breakthroughs in pharmacological research have expanded beyond its traditionally recognized diuretic and anti-inflammatory effects: Its antiurolithiasis effect has been clearly linked to inhibiting the crystallization of stone components and promoting stone expulsion; its renal protective effect can ameliorate kidney injury by reducing oxidative stress and suppressing inflammatory responses in renal tissues; its lipid-lowering mechanism involves regulating lipid metabolism pathways and reducing lipid deposition; in terms of anticancer activity, it exhibits proliferation inhibition and apoptosis induction in various tumor cells such as liver, lung, and colon cancers; additionally, it shows significant antibacterial activity against pathogens, including Escherichia coli and Staphylococcus aureus.
CRediT Authorship Contribution Statement
Wanbing Shang: Investigation and writing—original draft. Haoyue Yuan: Investigation. Linlin Li: Investigation. Bian Wang: Conceptualization, writing-review & editing, and funding acquisition.
Publication History
Received: 29 July 2025
Accepted: 22 September 2025
Article published online:
30 December 2025
© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Chinese Pharmacopoeia Commission. Pharmacopoeia of the People's Republic of China: 2020 Edition Volume I. Beijing: China Medical Science Press; 2020: 239-240
- 2 Wang YH, Zhao JC, Weng QQ. et al. Herbal textual research on Alismatis Rhizoma in famous classical formulas. Chin J Exp Tradit Med Formula 2022; 28 (10) 229-237
- 3 Jin LY, Wang YJ, Li CY. et al. Textual research on origin of Alismatis Rhizoma in Chinese Pharmacopoeia. Chin J Exp Tradit Med Formula 2020; 26 (15) 177-182
- 4 Liu SS, Guo J, Li ZA. et al. Advances in studies on chemical compositions of Alismatis Rhizoma and their biological activities. Zhongguo Zhongyao Zazhi 2020; 45 (07) 1578-1595
- 5 Wang P, Song T, Shi R. et al. Triterpenoids from Alisma species: phytochemistry, structure modification, and bioactivities. Front Chem 2020; 8: 363
- 6 Kamiya K, Murata T, Nishikawa M. Biological-active triterpenes of Alismatis Rhizoma. III. The X-ray crystallography of alisol A (23, 24)-acetonide 11-monobromoacetate. Chem Pharm Bull (Tokyo) 1970; 18 (07) 1362-1368
- 7 Cai LN, Wang HS, Cao HX. et al. Study on chemical constituents of Alisma orientalis. Nat Prod Res Dev 1996; 8 (01) 5-9
- 8 Mai ZP, Zhou K, Ge GB. et al. Protostane triterpenoids from the rhizome of Alisma orientale exhibit inhibitory effects on human carboxylesterase 2. J Nat Prod 2015; 78 (10) 2372-2380
- 9 Ma Q, Han L, Bi X. et al. Structures and biological activities of the triterpenoids and sesquiterpenoids from Alisma orientale. Phytochemistry 2016; 131: 150-157
- 10 Li Q. Study on Active Components in Nauclea officinalis . Basis of Nauclea officinalis and Alisma orientale . Hangzhou: Zhejiang University; 2013
- 11 Oshima Y, Iwakawa T, Hikino H. Alismol and alismoxide, sesquiterpenoids of Alisma rhizomes. Phytochemistry 1983; 22 (01) 183-185
- 12 Liang ZW, Zhang JQ, Yang L. et al. Isolation of protostane triterpenoids, nor-triterpenoids and sesquiterpenes from rhizoma alismatis and their anti-inflammatory activities research. Mod Tradit Chin Med Mater Med-World Sci Technol 2021; 23 (12) 4613-4621
- 13 Yu JY, Wang J, Liang H. et al. Sesquiterpenes from Alisma plantago-aquatica . J Chin Pharm Sci 2016; 25 (08) 614-620
- 14 Feng L, Liu TT, Huo XK. et al. Alisma genus: Phytochemical constituents, biosynthesis, and biological activities. Phytother Res 2021; 35 (04) 1872-1886
- 15 Tao Y, Jiang E, Yan J, Cai B. A biochemometrics strategy for tracing diuretic components of crude and processed Alisma orientale based on quantitative determination and pharmacological evaluation. Biomed Chromatogr 2020; 34 (02) e4744
- 16 Zhang X, Li XY, Lin N. et al. Diuretic activity of compatible triterpene components of Alismatis Rhizoma. Molecules 2017; 22 (09) 1459
- 17 Chen DQ, Feng YL, Tian T. et al. Diuretic and anti-diuretic activities of fractions of Alismatis Rhizoma. J Ethnopharmacol 2014; 157: 114-118
- 18 Wu XY, Chen C, Zhang GW. Effects of aqueous extract of Rhizoma Alismastis on diuretic activity and kidney medulla AQP2 expression in normal rats. J Clin Med Pract 2010; 14 (21) 5-7
- 19 Liu SL, Feng ZJ, Lv YC. et al. Clinical study on the effect of Alisma orientalis on hemodynamics in cirrhotic portal hypertension. J Chin Hepatol 2006; 22 (02) 119-120
- 20 Feng YL, Chen H, Tian T, Chen DQ, Zhao YY, Lin RC. Diuretic and anti-diuretic activities of the ethanol and aqueous extracts of Alismatis Rhizoma. J Ethnopharmacol 2014; 154 (02) 386-390
- 21 Qu SY, Peng KL, Su Q. et al. Effect of total triterpenoid extract from Alisma orientalis on calcium oxalate stone formation in rat urinary system. Acta Medicinae Universitatis Scientiae et Technologiae Huazhong 2011; 40 (06) 634-639
- 22 Cao ZG, Liu JH, Zhou SW. et al. Effect of active constituents from Alisma orientalis on renal stone formation and bikunin expression in stone model rats. Natl Med J Chin 2004; 84 (15) 1276-1279
- 23 Li HY, Liu JH, Cao ZG. et al. An in vitro and in vivo study of water and lipid soluble extracts from Alisma orientalis on urinary oxalate calcium stone formation. Chin J Urol 2003; (10) 658-662
- 24 Cao ZG, Liu JH, Zhou SW. et al. Effect of Alisma orientalis extract on renal stone formation and the expression of inter-alpha-trypsin inhibitor in rat urolithiasis model. Chin J Exp Surg 2004; (03) 295-297
- 25 Zhou SY, Zhou YD, Du GH. Protective effect of extracts from Radix et Rhizoma Rhei and Alisma orientalis against acute kidney injury induced by diethylene glycol. Chin Pharm 2009; 20 (09) 641-643
- 26 Utsunomiya M, Koide T, Yamaguchi S, Yoshioka T, Sonoda T, Sugiyama K. The effect of kanpou medicine on the growth and aggregation of calcium oxalate crystals in vitro. Hinyokika Kiyo 1991; 37 (10) 1097-1101
- 27 Kawamura K, Moriyama M, Nakajima C, Miyazawa K, Suzuki K, Tsugawa R. The inhibitory effects of Takusha on the formation, growth and aggregation of calcium oxalate crystals in vitro. Hinyokika Kiyo 1993; 39 (08) 695-700
- 28 Cao ZG, Su H, Zhu YP. et al. Adjuvant expulsive effect of Chinese medicine Alisma orientalis on upper urinary tract stones. Acta Univ Med Anhui 2008; 43 (05) 573-575
- 29 Miao H, Zhang L, Chen DQ, Chen H, Zhao YY, Ma SC. Urinary biomarker and treatment mechanism of Rhizoma Alismatis on hyperlipidemia. Biomed Chromatogr 2017; 31 (04) e3829
- 30 Dan H, Wu J, Peng M. et al. Hypolipidemic effects of Alismatis rhizome on lipid profile in mice fed high-fat diet. Saudi Med J 2011; 32 (07) 701-707
- 31 Xu F, Yu H, Lu C, Chen J, Gu W. The cholesterol-lowering effect of alisol acetates based on HMG-CoA reductase and its molecular mechanism. Evid Based Complement Alternat Med 2016; 2016: 4753852-4753852
- 32 Jin HZ, Jiang QZ, Jin CT. et al. Study on the mechanism of cholesterol-lowering Chinese medicines. Paper presented at: Abstracts of the World Congress on Integrative Medicine; 1997: 373
- 33 Park YJ, Kim MS, Kim HR. et al. Ethanol extract of alismatis rhizome inhibits adipocyte differentiation of OP9 cells. Evid Based Complement Alternat Med 2014; 2014: 415097
- 34 Han CW, Kang ES, Ham SA, Woo HJ, Lee JH, Seo HG. Antioxidative effects of Alisma orientale extract in palmitate-induced cellular injury. Pharm Biol 2012; 50 (10) 1281-1288
- 35 Hong XZ. Research of the Efficacy and the Mechanism of the Alisma orientalis Methanolic Extract on Nonalcoholic Fatty Liver Disease. Hangzhou: Zhejiang University; 2006
- 36 Huo XK, Liu J, Yu ZL. et al. Alisma orientale extract exerts the reversing cholestasis effect by activation of farnesoid X receptor. Phytomedicine 2018; 42 (15) 34-42
- 37 Meng Q. Liver protective effects and pharmacological mechanisms of alisol B 23-acetate. Dalian: Dalian Medical University; 2015
- 38 Huang XQ, Zhang X, Xiong LY. et al. Protective effect of Alisma orientalis polysaccharides on carbon tetrachloride-induced acute liver injury in mice. J Li-shizhen Zhong Yi Xue 2017; 28 (06) 1300-1302
- 39 Luan ZL, Huo XK, Dong PP. et al. Highly potent non-steroidal FXR agonists protostane-type triterpenoids: Structure-activity relationship and mechanism. Eur J Med Chem 2019; 182: 111652
- 40 Meng Q, Chen X, Wang C. et al. Alisol B 23-acetate promotes liver regeneration in mice after partial hepatectomy via activating farnesoid X receptor. Biochem Pharmacol 2014; 92 (02) 289-298
- 41 Meng Q, Chen XL, Wang CY. et al. Alisol B 23-acetate protects against ANIT-induced hepatotoxity and cholestasis, due to FXR-mediated regulation of transporters and enzymes involved in bile acid homeostasis. Toxicol Appl Pharmacol 2015; 283 (03) 178-186
- 42 Dai MX, Jin SN, Song CW. et al. Research progress on chemical constituents and pharmacological effects of Alisma Rhizoma and its processed products. Chin Tradit Herbal Drugs 2023; 54 (05) 1620-1635
- 43 Miao XD, Li CT. Study the molecular mechanism of anti-inflammatory effects of Rhizoma Alismatis based on network pharmacology-molecular socking. Pract Clin J Integr Tradit Chin West Med 2023; 23 (16) 1-5
- 44 Lin GC, Chen YH, Yang LH. et al. Effects of different compatibility ratio of alisma decoction on blood lipid metabolism and macrophage TNF-α and IL-6 in hyperlipidemic rats. Chin Health Standard Manage 2018; 9 (19) 112-114
- 45 Lin N, Huang JF, Zhang X. et al. Anti-inflammatory activity of total triterpenes from Alisma Orie. Fujian J Tradit Chin Med 2018; 49 (04) 68-69
- 46 Wang J, Li H, Wang X, Shen T, Wang S, Ren D. Alisol B-23-acetate, a tetracyclic triterpenoid isolated from Alisma orientale, induces apoptosis in human lung cancer cells via the mitochondrial pathway. J Biochem Biophys Res Commun 2018; 505 (04) 1015-1021
- 47 Zhu HC, Tao MJ, Yang YL. et al. Study on the chemical constituents of water extract from Alisma orientale . J Pharm Res 2020; 39 (11) 621-627
- 48 Liang SY, Liu QQ, Huang S. et al. Determination of four active components in Liuwei Dihuang Pill residue and its antioxidant activity. J Hunan Univ Chin Med 2021; 41 (05) 707-713
- 49 Murata T, Imai Y, Hirata T, Miyamoto M. Biological-active trieterpenes of Alismatis rhizoma. I. Isolation of the alisols. Chem Pharm Bull (Tokyo) 1970; 18 (07) 1347-1353
- 50 Nakajima Y, Satoh Y, Katsumata M. et al. Terpenoids of Alisma orientale rhizome and the crude drug alismatis rhizoma. Phytochemistry 1994; 36 (01) 119-127
- 51 Yoshikawa M, Hatakeyama S, Tanaka N. et al. Crude drugs from aquatic plants. I. on the constituents of Alismatis Rhizoma. (1). Absolute stereostructures of alisols E 23-acetate, F, and G, three new protostane-type triterpenes from Chinese Alismatis Rhizoma. Chem Pharm Bull (Tokyo) 1993; 41 (11) 1948-1954
- 52 Peng GP, Zhu GY, Lou FC. Studies on triterpenoids from Alisma orientalis III. Nat Prod Res Dev 2002; 14 (06) 7-10
- 53 Yoshikawa M, Murakami T, Ikebata A. et al. Absolute stereostructures of alismalactone 23-acetate and alismaketone-a 23-acetate, new seco-protostane and protostane-type triterpenes with vasorelaxant effects from Chinese Alismatis Rhizoma. Chem Pharm Bull (Tokyo) 1997; 45 (04) 756-758
- 54 Li HM, Chen XJ, Luo D. et al. Protostane-type triterpenoids from Alisma orientale . Chem Biodivers 2017; 14 (12) e1700452
- 55 Yoshikawa M, Tomohiro N, Murakami T. et al. Studies on Alismatis Rhizoma. III. Stereostructures of new protostane-type triterpenes, alisols H, I, J-23-acetate, K-23-acetate, L-23-acetate, M-23-acetate, and N-23-acetate, from the dried rhizome of Alisma orientale . Chem Pharm Bull (Tokyo) 1999; 47 (04) 524-528
- 56 Peng GP, Lou FC. Studies on triterpenoids from Alisma orientalis produced in Sichuan. Nat Prod Res Dev 2001; 13 (04) 1-4
- 57 Fukuyama Y, Pei-Wu G, Rei W, Yamada T, Nakagawa K. 11-deoxyalisol C and alisol D: New protostane-type triterpenoids from Alisma plantago-aquatica . Planta Med 1988; 54 (05) 445-447
- 58 Wang YL, Zhao JC, Liang JH. et al. A bioactive new protostane-type triterpenoid from Alisma plantago-aquatica subsp. orientale (Sam.) Sam. Nat Prod Res 2019; 33 (06) 776-781
- 59 Peng GP, Zhu GY, Lou FC. Two novel terpenoids from Alisma Orientalis Juzep. Nat Prod Res Dev 2002; 14 (04) 5-8
- 60 Xu N, Zhang HD, Xie X. A new triterpene in rhizome of Alisma orientale . Chin Tradit Herbal Drugs 2012; 43 (05) 841-843
- 61 Cang J, Wang C, Huo XK. et al. Sesquiterpenes and triterpenoids from the rhizomes of Alisma orientalis and their pancreatic lipase inhibitory activities. Phytochem Lett 2017; 19: 83-88
- 62 Geng PW, Yoshiyasu F, Toshihide Y. et al. Triterpenoids from the rhizome of Alisma plantago-aquatica . Phytochemistry 1988; 27 (04) 1161-1164
- 63 Hu XY, Guo YQ, Gao WY, Zhang TJ, Chen HX. Two new triterpenes from the rhizomes of Alisma orientalis. J Asian Nat Prod Res 2008; 10 (5-6): 481-484
- 64 Jiang ZY, Zhang XM, Zhang FX. et al. A new triterpene and anti-hepatitis B virus active compounds from Alisma orientalis. Planta Med 2006; 72 (10) 951-954
- 65 Zhou AC, Zhang CF, Zhang M. A new protostane triterpenoid from the rhizome of Alisma Orientale. Chin J Nat Med 2008; (02) 109-111
- 66 Hu XY, Guo YQ, Gao WY. et al. A new triterpenoid from Alisma orientalis. Chin Chem Lett 2008; 19 (04) 438-440
- 67 Jin HG, Jin Q, Ryun Kim A. et al. A new triterpenoid from Alisma orientale and their antibacterial effect. Arch Pharm Res 2012; 35 (11) 1919-1926
- 68 Zhao M, Xu LJ, Che CT. Alisolide, alisols O and P from the rhizome of Alisma orientale . Phytochemistry 2008; 69 (02) 527-532
- 69 Matsuda H, Kageura T, Toguchida I, Murakami T, Kishi A, Yoshikawa M. Effects of sesquiterpenes and triterpenes from the rhizome of Alisma orientale on nitric oxide production in lipopolysaccharide-activated macrophages: Absolute stereostructures of alismaketones-B 23-acetate and -C 23-acetate. Bioorg Med Chem Lett 1999; 9 (21) 3081-3086
- 70 Xin XL, Zhao XY, Huo XK. et al. Two new protostane-type triterpenoids from Alisma orientalis. Nat Prod Res 2018; 32 (02) 189-194
- 71 Xin XL, Mai ZP, Wang X. et al. Protostane alisol derivatives from the rhizome of Alisma orientale. Phytochem Lett 2016; 16: 8-11
- 72 Wang C, Huo XK, Luan ZL. et al. Alismanin A, a triterpenoid with a C (34) skeleton from Alisma orientale as a natural agonist of human pregnane X receptor. Org Lett 2017; 19 (20) 5645-5648
- 73 Qiu DF. Studies on the chemical constituents from Alisma orientalis. Lanzhou: Lanzhou University; 2009
- 74 Yoshikawa M, Hataketama S, Tanaka N. et al. Orientalol-A, orientalol-B, and orientalol-C, sesquiterpene constituents from Chinese Alismatis Rhizoma, and revised structures of alismol and alismoxide. Chem Pharm Bull (Tokyo) 1992; 40 (09) 2582-2584
- 75 Peng GP, Tian G, Huang XF, Lou FC. Guaiane-type sesquiterpenoids from Alisma orientalis. Phytochemistry 2003; 63 (08) 877-881
- 76 Li HM, Fan M, Xue Y. et al. Guaiane-type sesquiterpenoids from Alismatis Rhizoma and their anti-inflammatory activity. Chem Pharm Bull (Tokyo) 2017; 65 (04) 403-407
- 77 Yu ZL, Peng YL, Wang C. et al. Alismanoid A, an unprecedented 1,2-seco bisabolene from Alisma orientale, and its protective activity against H2O2-induced damage in SH-SY5Y cells. New J Chem 2017; 41 (21) 12664-12670
- 78 Zhang CF, Zhou AC, Zhang M. Chemical constituents from Alismatis Rhizoma and screening for their immunosuppressive activity. Chin J Chin Mater Med 2009; 34 (08) 994-998
- 79 Zhao XY, Wang G, Wang Y. et al. Chemical constituents from Alisma plantago-aquatica subsp. orientale (Sam.) Sam and their anti-inflammatory and antioxidant activities. Nat Prod Res 2018; 32 (23) 2749-2755
- 80 Jiang ZY, Zhang XM, Zhou J. et al. Two new sesquiterpenes from Alisma orientalis. Chem Pharm Bull (Tokyo) 2007; 55 (06) 905-907
- 81 Peng GP, Lou FC. Studies on the chemical constituents of Alisma orientalis. Nat Prod Res Dev 2001; 13 (03) 1-3
- 82 Zhang JQ, Jin QH, Li SY. et al. Orientalol L–P, novel sesquiterpenes from the rhizome of Alisma orientale (Sam.) Juzep and their nephrotoxicity on HK2 cells. New J Chem 2018; 42 (16) 13414-13420
- 83 Yoshikawa M, Fukuda Y, Hatakeyama S. et al. Sulfoorientalols a, b, c, and d, four new biologically active sesquiterpenes from Alismatis rhizoma. J Chem Pharm Bull (Tokyo) 1993; 41 (06) 1194-1196
- 84 Peng GP, Luo FC, Huang XF. et al. Structure of orientanone from Alisma orientalis, a novel sesquiterpene originating from guaiane-type carbon skeleton by isopropyl shift. Tetrahedron 2002; 58 (44) 9045-9048
- 85 Yoshikawa M, Yamaguchi S, Matsuda H, Tanaka N, Yamahara J, Murakami N. Crude drugs from aquatic plants. V. On the constituents of alismatis rhizoma. (3). Stereostructures of water-soluble bioactive sesquiterpenes, sulfoorientalols a, b, c, and d, from Chinese alismatis rhizoma. Chem Pharm Bull (Tokyo) 1994; 42 (12) 2430-2435
- 86 Peng GP, Lou FC. Isolation and identification of diterpenes from alisma orientalis juzep. Yao Xue Xue Bao 2002; 37 (12) 950-954
- 87 Lu YM. Study on the Separation of Hypoglycemic Constituents from Alisma orientalis by Chromatography. Nanchang: Nanchang University; 2014
- 88 Peng X, Tan L, Yao B. et al. Studies on the constituents from the rhizome of Ailsma orientalis. J Chin Pharm Sci 1999; 8 (03) 173-174
- 89 Zhang Y. Study on Chemical Constituents and Biological Activities of Two Medicinal Plants. Ji'nan: Shandong University; 2015
- 90 Hong CQ, Piao XL, Lou CX. Isolation and identification of chemical constituents from Alisma orientale. J Chongqing Inst Technol 2008; 22 (04) 78-81 (Nat Sci Ed)
- 91 Xin XL, Yu ZL, Tian XG. et al. Phenylpropanoid amides from Alisma orientalis and their protective effects against H2O2-induced damage in SH-SY5Y cells. Phytochem Lett 2017; 21: 46-50
- 92 Shimizu N, Ohtsu S, Tomoda M, Gonda R, Ohara N. A glucan with immunological activities from the tuber of Alisma orientale . Biol Pharm Bull 1994; 17 (12) 1666-1668
- 93 Tomoda M, Gonda R, Shimizu N, Ohara N. Characterization of an acidic polysaccharide having immunological activities from the tuber of Alisma orientale . Biol Pharm Bull 1994; 17 (05) 572-576
- 94 Zhang Z, Wang D, Zhao Y, Gao H, Hu YH, Hu JF. Fructose-derived carbohydrates from Alisma orientalis. Nat Prod Res 2009; 23 (11) 1013-1020
- 95 Geng PW, Yoshiyasu F, Wang R. et al. An acylated sitosterol glucoside from Alisma plantago-aquatica . Phytochemistry 1988; 27 (06) 1895-1896
- 96 Huang YS, Yu QQ, Chen Y, Cheng MJ, Xie LP. Phenolic constituents from Alisma plantago-aquatica Linnaeus and their anti-chronic prostatitis activity. Chem Cent J 2017; 11 (01) 120
