Pinelliae Rhizoma: A systematic review on botany, ethnopharmacology, phytochemistry, preclinical and clinical evidence

Background Pinelliae Rhizoma (PR), also known as Banxia in Chinese, Hange in Japanese, and Banha in Korean, is a famous herbal medicine in East Asia that is derived from the dry tuber of Pinellia ternata (Thunb.) Breit. (PT). It has been widely used in the dispensing granule, classical prescription, and herbal formula for the treatment of conditions, such as cough, infection, phlegm, nausea, asthma, inflammation, and other illnesses. Due to the traditional use of PR and its classical prescriptions, several studies on different aspects of PR have been conducted in the past decades. However, there is no systematic review that comprehensively synthesizes all the available evidence concerning the multifunctional roles and therapeutic potential of PR. The review aims to address this gap by examining emerging evidence from metabonomics, preclinical studies, and clinical trials. Additionally, it aims to explore potential trends and prospects for future research on this medicinal plant. Methods A systematic literature search was conducted in six electronic databases, including PubMed, Web of Science, Scopus, ScienceDirect, Wanfang, and China National Knowledge Infrastructure, to identify relevant articles pertaining to PR, published from the inception of the databases until March 2023. Results PR has 107 compounds with a wide range of pharmacological activities, including anti-inflammatory, immune regulation, anti-viral, anti-cancer, anti-asthma, anti-tussive and expectorant, anti-oxidant, anti-obesity, anti-atherosclerosis, anti-microbial, emetic and anti-emetic, anti-convulsant and anti-epileptic, sedative and hypnotic, learning and memory improvement, and anti-depressant effects. Metabonomic studies have indicated that raw PR may exhibit cardiotoxicity and pregnancy toxicity while showing no apparent hepatorenal toxicity. However, few pharmacokinetic investigations have been conducted on PR, limiting its clinical translation. Moreover, there is limited data on the clinical safety of PR, as only four clinical trials have assessed its positive effects in the context of pediatric epilepsy, nausea and vomiting, soft tissue injury, and chronic sinus tract. Conclusions This systematic review summarizes preclinical and clinical evidence on the effects of PR. Since all of the components identified were derived from the plant’s tuber, future phytochemical studies should focus on other parts of the plant. Due to its multiple pharmacological effects, the mechanisms underlying the effect of PR and its compounds on different diseases and new clinical applications of PR need to be further explored. Moreover, future research on PR should primarily comprise metabonomic and pharmacokinetic studies, alongside conducting well-designed clinical trials. We believe that this review will provide fascinating information and helpful suggestions for further research and development of herbal medicine.