Quick summary

Alisma orientale, a traditional Chinese medicinal herb, has been studied primarily in preclinical and traditional contexts for conditions related to metabolic syndrome, including nonalcoholic fatty liver disease (NAFLD), hyperlipidemia, hyperuricemia, and diabetes. It contains bioactive triterpenoids such as Alisol A 24-acetate and Alisol B 23-acetate that may contribute to observed pharmacological effects. Limited clinical evidence suggests potential benefit in metabolic and liver conditions, but high-quality controlled trials are lacking, and evidence is mostly preclinical or indirect via compound action. Safety data are limited and should be interpreted cautiously.

What is it

Alisma orientale is a perennial aquatic plant widely used in Traditional Chinese Medicine (TCM). It is known for its rhizomes, which are harvested and processed for medicinal use. The herb contains several bioactive compounds, particularly triterpenoids, thought to underlie its pharmacological activities.

Traditional uses

Traditionally, Alisma orientale has been used in TCM formulas to promote urination, resolve dampness, and support liver and kidney health. It is commonly included in herbal prescriptions addressing metabolic, liver, and urinary disorders, including gout, edema, and fatty liver disease.

Active compounds

Main bioactive constituents of Alisma orientale include triterpenoids such as Alisol A 24-acetate and Alisol B 23-acetate. These compounds have been investigated for possible roles in modulating lipid metabolism, inflammation, and uric acid handling.

Potential benefits with evidence levels

Metabolic-associated fatty liver disease (MAFLD)/NAFLD

Evidence level: Limited clinical and low-quality systematic review evidence.

Alisma orientale and its extracts have shown potential to improve liver enzymes, lipid metabolism, steatosis, and inflammation in NAFLD/MAFLD in preclinical studies. Meta-analyses of Traditional Chinese Medicine formulas containing Alisma suggest some benefits; however, systematic reviews report low-quality and heterogeneous evidence supporting these effects.

  • PMID 41451376: Overview highlighted associations between Alisma-containing formulas and improved liver enzymes and metabolic outcomes in NAFLD, but evidence quality was low.
  • PMID 31275407: Preclinical studies showing reduction in hepatic triglyceride accumulation and markers of steatohepatitis and fibrosis.
  • PMID 31324247: Meta-analysis indicated HuoXueHuaYu therapy including Alisma species improved biochemical markers and imaging in NAFLD.

Hyperlipidemia

Evidence level: Limited clinical evidence from meta-analyses of Chinese patent medicines including Alisma formulations.

Some meta-analyses indicate traditional Chinese medicines containing Alisma may help reduce total cholesterol and triglycerides. However, direct high-quality clinical evidence specifically for Alisma is limited.

  • PMID 38482041: Meta-analysis including Chinese medicines containing hawthorn and Alisma showed improvements in lipid profiles with some methodological limitations.
  • PMID 40837400: Network meta-analysis ranks TCM formulas containing Alisma among top adjunct therapies combined with statins for lipid lowering.

Hyperuricemia and gout

Evidence level: Preclinical and traditional use with limited clinical research.

Alisma orientale is used in traditional anti-gout formulas. Experimental data suggest potential uric acid lowering effects by modulating uric acid transport and xanthine oxidase activity. Clinical evidence remains insufficient.

  • PMID 41488145: Review describes TCM including Alisma’s potential multi-target effects on uric acid metabolism and hyperuricemia.
  • PMID 33205687: Meta-analysis of Guizhi-Shaoyao-Zhimu decoction containing Alisma showed reductions in uric acid and inflammatory markers in gout, with no increased adverse events.

Type 2 diabetes mellitus (T2DM) and metabolic syndrome

Evidence level: Limited clinical evidence mostly from TCM formula combinations containing Alisma.

Alisma orientale is a component of multi-herb TCM formulas. Some randomized controlled trials suggest improvements in glycemic control and metabolic parameters when these formulas are combined with conventional Western medicines. Standalone clinical evidence for Alisma is limited.

  • PMID 41852476: Systematic review of TCM RCTs for T2DM and metabolic-associated fatty liver disease mentions directionally favorable biochemical changes with formulas including Alisma.
  • PMID 41189619: Qingre Lishi decoction with Alisma components showed reductions in glucose and insulin resistance markers.
  • PMID 37223050: Network meta-analysis indicates some TCM combined with Western therapy, including Alisma-related formulas, improved glucose control.

Side effects

No specific adverse effects of Alisma orientale have been identified in the available clinical data. Reported adverse events typically occurred in the context of multi-herb formulations, limiting causal attribution to Alisma alone. Overall, the herb is generally regarded as having low toxicity within traditional dosage ranges.

Drug interactions

No direct evidence of drug interactions involving Alisma orientale was found in the literature. However, data remain insufficient and should be interpreted cautiously, especially when used in combination with other herbs or pharmaceuticals.

Who should avoid it

There are no explicit contraindications documented for Alisma orientale. Nonetheless, individuals should exercise careful clinical judgment due to limited safety data and potential interactions within multi-herb products. Use during pregnancy and breastfeeding is not supported by specific safety information and should be approached with caution.

Evidence limitations

  • Most studies involve multi-herb TCM formulas containing Alisma rather than isolated herb or isolated constituents.
  • High-quality, large-scale randomized controlled trials specifically assessing Alisma orientale are lacking.
  • Clinical evidence is predominantly from East Asian populations and may lack generalizability.
  • Methodological limitations and heterogeneity in available systematic reviews reduce certainty of findings.
  • Safety and drug interaction data are inconclusive and based mainly on observational or indirect evidence.

References

  • PMID 41852476: Systematic review of TCM for T2DM and MASLD including Alisma.
  • PMID 41451376: Overview of TCM for NAFLD mentioning Alisma-containing formulas.
  • PMID 31275407: Pharmacology of Alisma orientale against NAFLD and metabolic syndrome.
  • PMID 31324247: Meta-analysis of HuoXueHuaYu therapy including Alisma improving liver function in NAFLD.
  • PMID 38482041: Meta-analysis of TCM containing hawthorn and Alisma for hyperlipidemia.
  • PMID 41488145: Review on hyperuricemia treatments including Alisma.
  • PMID 33205687: Meta-analysis of Guizhi-Shaoyao-Zhimu decoction including Alisma in gout treatment.
  • PMID 37324461: Analysis of adverse drug reactions linked to traditional medicines including Alisma.

Last reviewed

June 2024

Disclaimer: This information is provided for educational purposes only and does not substitute professional medical advice. Consult a healthcare provider before using herbal products, especially if you are pregnant, nursing, have existing health conditions, or are taking other medications.