P. edulis Salisb.; P. officinalis Thunb.; and others Paeoniaceae Bai shao (root without bark); chi shao (P. lactiflora Pall. and P. anomala subsp. veitchii (Lynch) D.Y.Hong & K.Y.Pan, root with bark); Chinese peony; red peony; white peony Paeoniae radix Roots The main constituent of peony root is the monoterpene glycoside, paeoniflorin, together with 2′-O-benzoylpaeoni-florin, albiflorin R2 and albiflorin R3 (Fu et al. 2013; He et al. 2004; WHO 1999). The root also contains flavonoids, proanthocyanidins, tannins, complex polysaccharides, terpenoids and triterpenoids (Anon. 2001). No clinical data on P. lactiflora root as a single herb extract are available, although studies have been carried out in China on its use in cardiovascular, gynaecological and inflammatory disorders. In combination with other herbs, peony has some other important applications for which clinical data are available. Toki-shakuyaku-san has been used to treat gynaecological symptoms in TCM. It contains P. lactiflora radix, Atractylodes lancea (Thunb.) DC. (red atractylodes) rhizome, Alisma plantago-aquatica L. (alisma) rhizome, Wolfiporia extensa (Peck) Ginns (syn. Poria cocos F.A. Wolf, hoelen) sclerotium, Cnidium monnieri (L.) Cusson (cnidium) rhizome and Angelica dahurica (Hoffm.) Benth. & Hook.f. ex Franch. & Sav. (Chinese angelica) radix. The formulation normalised the irregular menstrual cycle, healed cervical pseudo-erosion and reduced leukorrhagia in young women with insufficient luteal function (Sakamoto et al. 1996). In some patients with mild or moderate anaemia, it was found to be a potentially useful alternative to iron supplementation in cases of severe side effects caused by oral iron supplements (Akase et al. 2003). In a study comparing its effects in women with luteal insufficiency with women with normal menstrual cycles, Toki-shakuyaku-san improved luteal insufficiency with no adverse effects on the hormonal levels of prolactin, gonadotropins, steroids, angiotensin II, ANP and renin in blood or urine (Usuki et al. 2002). The analgesic effect of Toki-shakuyaku-san was also assessed in women suffering from dysmenorrhoea, over two menstrual cycles. This double-blind study showed that it was effective in the treatment of dysmenorrhoea compared to control (Kotani et al. 1997).
Peony
Paeonia lactiflora Pall.
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Menstrual irregularities and dysmenorrhoea:
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