Research Progress on the Herbal and Pharmacological Effects and Bioactive Constituents of Plants in the Genus Polygonatum for the Treatment of Diseases Associated with Kidney Essence Deficiency-Liaoning Chaohua Pharmaceutical Co., Ltd.

Research Progress on the Herbal and Pharmacological Effects and Bioactive Constituents of Plants in the Genus Polygonatum for the Treatment of Diseases Associated with Kidney Essence Deficiency

Release Date:

2021-04-02

Research Progress on the Herbal and Pharmacological Effects and Bioactive Constituents of Plants in the Genus Polygonatum for the Treatment of Diseases Associated with Kidney Essence Deficiency

Abstract: Polygonatum, a commonly used traditional Chinese medicinal herb for tonifying the kidney and consolidating essence, is rich in polysaccharides, saponins, flavonoids, and other bioactive constituents. It exhibits a wide range of pharmacological activities, including anti-osteoporosis, anti-rheumatoid arthritis, antidiabetic, anti-aging, neuroprotective effects against Alzheimer’s disease, protection against cerebrovascular disorders, antipsychotic properties, lipid-modulating effects, immunomodulatory activity, and efficacy in treating infertility. This review systematically collates and analyzes the materia medica, pharmacological actions, and underlying chemical constituents of Polygonatum species in the treatment of conditions associated with kidney–essence deficiency, with the aim of providing a reference for the development of functional pharmaceuticals based on these plants.

Kidney essence is the primordial substance of life, governing the entire process of human growth, development, robustness, reproduction, aging, and death. It performs vital physiological functions such as nourishing bones, replenishing marrow, strengthening the brain, transforming blood, generating vital energy, producing reproductive essence, and maintaining righteous qi to ward off pathogenic factors and resist disease. Diseases associated with kidney-essence deficiency primarily include osteoporosis, infertility, Alzheimer’s disease, senescence, oligospermia, anemia, and rheumatic disorders—most of which represent stubborn clinical challenges that remain difficult to overcome in Western medicine. As China’s population continues to age at an accelerating pace, kidney-essence-deficiency–related diseases are increasingly emerging as a major social issue facing the nation. Traditional Chinese medicine is a treasured heritage of China, representing the culmination of thousands of years of practical experience by the Chinese people. In traditional Chinese medicine, the primary therapeutic approach for kidney-essence deficiency is “tonifying the kidneys and benefiting the essence,” and identifying medicinal herbs within this category holds great promise as a key avenue for addressing this condition. Polygonatum sibiricum, a time-honored herb in Chinese tradition for tonifying the kidneys and benefiting the essence, is classified as both a medicine and a food, possessing such beneficial effects as prolonging life, promoting youthful vitality, lightening the complexion, enhancing skin radiance, moistening the body, lightening the physique, and delaying aging. Since ancient times, it has been revered by Buddhists, Confucians, Daoists, and health practitioners as a dietary staple for cultivating immortality and nurturing well-being. ^[1] Modern research indicates that plants of this genus primarily contain polysaccharides, saponins, and flavonoids. ^[2-4] , with blood-glucose-lowering effects ^[5-10] , Lipid regulation ^[11-14] Equal activity. Previous research by the team has revealed that plants of this genus exhibit anti-aging, blood-glucose-lowering, lipid-regulating, and anti-osteoporosis effects. ^[4] Given their traditional therapeutic uses and the evidence from modern research, the author has conducted a systematic review and cross-validation analysis of the materia medica, modern formulation development and application, ethnopharmacological applications, modern pharmacological studies, and studies on the material basis of plants in this genus, with the aim of providing a reference for the development of functional foods or pharmaceuticals based on these plants for the treatment of disorders associated with kidney essence deficiency.

1 A Pharmacognostic Study on the Use of Plants in the Genus Polygonatum for Diseases Associated with Kidney Essence Deficiency

1.1 Analysis of Kidney Essence Deficiency Syndrome and Its Related Diseases

Kidney essence is composed of two components: yin essence and yang essence. The yin portion of kidney essence is known as kidney yin, also referred to as primordial yin or true yin, and it functions to nourish and moisten. The yang portion of kidney essence is known as kidney yang, also referred to as primordial yang or true yang, and it functions to warm and transform. ^[15] The relationship among kidney essence, kidney qi, kidney yin, and kidney yang is that kidney essence gives rise to kidney qi, a process accomplished through the transformation and vaporization of kidney yin by kidney yang. ^[15] The kidneys store essence and govern the bones and generate marrow; they can transform essence into marrow and transport it upward to the brain, thereby replenishing the brain’s marrow. ^[16] If kidney deficiency prevents the generation of marrow to nourish the brain, resulting in insufficient marrow sea or diminished marrow and empty brain, the vital functions of the spirit will be impaired, manifesting as dementia, tinnitus, memory decline, depression, and psychiatric disorders. ^[16] When kidney essence is deficient, yang cannot be warmed and transformed, leading to stagnation of dampness and resulting in obesity. With insufficient kidney yang and qi, the body’s vital energy becomes weak, creating an opening for pathogenic factors such as wind, cold, dampness, heat, phlegm, and blood stasis to invade. This invasion obstructs the body’s meridians, joints, muscles, and collaterals; where there is blockage, there is pain, making one prone to bi syndrome—namely, rheumatoid arthritis. ^[17] Kidney essence is the innate essence inherited from one’s parents. Under the stimulation and propulsion of kidney yang and kidney qi, a portion of this parental kidney essence is transformed into reproductive essence, which constitutes the fundamental basis for the procreation and propagation of offspring in both men and women. When kidney essence is deficient, men may experience oligospermia (azoospermia) and subsequent infertility, while women may suffer from anovulation and consequent infertility, ultimately leading to infertility. ^[18] Human growth, development, and aging are regulated by the essence and vital energy stored in the kidneys; the very processes of life are, in essence, transformations driven by the decline of this renal essence and vital energy. Deficiency of kidney essence is a fundamental cause of aging. Research has shown that kidney deficiency leading to senescence corresponds to various aspects of aging as described in modern medicine, including free-radical damage and dysfunctions of the nervous, endocrine, and immune systems. ^[19] Renal essence deficiency also readily leads to impaired immune function and reduced proliferation and functionality of stem cells. ^[20] Furthermore, diabetes falls under the category of “xiao ke” in traditional Chinese medicine, first mentioned in the “Ling Shu: Five Transformations” chapter of the Inner Canon: “When all five zang organs are weak and flabby, one is prone to xiaodan; xiaodan is none other than xiaoke.” This passage clearly identifies the weakness of the five zang organs as the fundamental cause of diabetes, with the kidney being the root of this weakness. The kidney governs the storage of essence; if the kidney fails to store essence, vital essence will leak out, thereby giving rise to diabetes. Clinically, the manifestation of insulin resistance reflects excessive deficiency of kidney essence. ^[21] In summary, the kidney stores essence, governs reproduction, and promotes bone formation and marrow production to nourish the brain. Deficiency of kidney essence is most likely to give rise to diseases related to the bones, reproductive system, dementia, aging, and metabolic disorders, primarily including osteoporosis, infertility, dementia, senescence, oligospermia, anemia, rheumatic diseases, and various metabolic disorders. As a herb that tonifies the kidney and replenishes essence, Polygonatum rhizome has long been regarded in traditional Chinese medicine as a valuable remedy for health preservation, wellness, and the prolongation of life.

1.2 An Analysis of the Historical Herbal Applications of Polygonatum Species in the Treatment of Diseases Associated with Kidney Essence Deficiency

The earliest recorded use of plants of the genus Polygonatum in treating conditions associated with kidney essence deficiency dates back to the “Letter of Farewell to Shan Juyuan” by Ji Kang, included in the anthology Wen Xuan compiled by Xiao Tong of the Southern Liang dynasty: “I have also heard a Daoist’s words that taking Polygonatum and other herbs can prolong life; I wholeheartedly believe this.” In his “Miscellaneous Records,” Zhang Hua of the Western Jin dynasty noted: “Polygonatum, the herb of the sun, when taken, can lead to longevity,” thereby confirming its efficacy in extending life and enhancing health. The “Shennong’s Classic of Materia Medica” records: “Regular consumption of Polygonatum can remove facial darkening, improve complexion, impart luster, lighten the body, and prevent aging.” Tao Hongjing of the Liang dynasty, in his “Supplementary Records of Famous Physicians,” further added that Polygonatum “nourishes the five劳 and seven injuries, strengthens the sinews and bones, enhances resistance to cold and heat, and moistens the heart and lungs.” The Northern Song’s “Comprehensive Collection of Sacred Remedies” states: “Regular intake of Polygonatum can invigorate qi and consolidate essence, replenish the dantian, promote blood circulation and maintain youthful appearance, thus achieving longevity and immortality.” The “Classic of Immortal Herbs and Mushrooms” notes: “Polygonatum broadens the middle jiao and benefits qi, harmonizes the five zang organs, fortifies the bone marrow, doubles one’s strength, ensures long-term youthfulness, brightens the complexion, turns gray hair black, and regenerates lost teeth.” Lan Mao’s “Yunnan Herbal Compendium” from the Ming dynasty records: “Polygonatum primarily addresses the five劳 and seven injuries, strengthens the sinews and bones, nourishes the spleen and stomach, opens the heart and lungs, enables fasting without harm, tonifies deficiency, and replenishes essence—its effects are readily apparent upon consumption.” The “Compendium of Materia Medica” states: “Polygonatum tonifies all forms of deficiency, alleviates chills and fever, replenishes essence and marrow, and gently balances qi and blood while moistening… thereby harmonizing the five zang organs, plumping the muscles, and strengthening the bone marrow.” The “Supplementary Notes” further note: “The root of Polygonatum resembles tender ginger; after nine rounds of steaming and drying, it can serve as a substitute for grain and is also known as ‘rice cake.’” In summary, since ancient times in China, Polygonatum has been used to tonify various deficiencies and to treat osteoporosis, rheumatic diseases, senility, premature graying, asthenospermia, and oligospermia, providing herbal evidence for the use of this genus in treating disorders related to kidney essence deficiency.

1.3 An Analysis of the Application of Formulas Containing Plants of the Genus Polygonatum in the Treatment of Diseases Associated with Kidney Essence Deficiency

Plants of the genus Polygonatum serve as key ingredients in numerous medicinal formulas. The “Elixir of Eternal Youth” recorded in Shoushi Baoyuan—comprising Xianmao, Shan Zhu Yu, White He Shou Wu, Red He Shou Wu, Bu Gu Zhi, Huang Jing, Large Huai Sheng Di Huang, Large Huai Shu Di Huang, Jusheng Zi, Huai Shan Yao, Gan Gou Qi Zi, Tian Men Dong, Mai Men Dong, Bai Fu Ling, Liao Wu Wei Zi, Xiao Hui Xiang, Fu Pen Zi, Tender Deer Antler, and Huai Niu Xi—is said to nourish kidney water, replenish essence and marrow, strengthen tendons and bones, support primordial yang, moisten the skin, sharpen hearing and vision, calm the heart and enhance intelligence, darken gray hair and blacken beard, fortify teeth and gums, reverse aging, prolong life, invigorate sexual vitality, dispel disease and lighten the body, and promote longevity and immortality. The “Great Agarwood Pill” described in Desheng Tang Fang—containing Agarwood, Mu Xiang, Ding Xiang, White Sandalwood, Walnut Kernel, Goji Berries, Star Anise, Fennel, Fenugreek, Whole Scorpion, Sichuan Pangolin, Sichuan Melia Fruit, Mu Tong, Cistanche, Yuan Zhi, Leek Seed, Lotus Stamen, Sichuan Morinda, Dried Yam, Shan Zhu Yu, Shan Yao, Xian Ling Pi, Qing Pi, Bai Fu Ling, Niu Xi, Huang Jing, and Tian Men Dong—has the effect of filling essence and tonifying marrow. The “Innate Great Creation Pill” mentioned in Surgical Orthodoxy—composed of Purple Placenta, Shu Di Huang, Dang Gui, Fu Ling, Ginseng, Goji Berries, Tu Si Zi, Cistanche Slices, Huang Jing, Bai Zhu, He Shou Wu, Chuan Niu Xi, Xian Mao, Gu Sui Bu, Ba Ji Tian, Salted Bu Gu Zhi, Processed Yuan Zhi, Mu Xiang, Da Qing Yan, Ding Xiang, and Black Jujube—is credited with tonifying the innate constitution and treating deficiency-induced damage; it is indicated for initial pain in the muscles and bones caused by external cold invasion that, if left unchecked, may develop into swelling and tenderness, as well as for all types of labor-related internal injuries and infertility in both men and women. The “Banlong Erzhi Bai Bu Pill” recorded in Yitong—made of Deer Antler, Huang Jing, Goji Berries, Huai Shu Di Huang, Tu Si Zi, Jin Ying Zi, Tian Men Dong, Mai Men Dong, Chuan Niu Xi, Longan Flesh, and Paper Mulberry Seeds—is said to consolidate the root and protect primordial energy, generate essence and nourish blood, restore natural vitality, greatly tonify deficiency, strengthen primordial yang and increase offspring, fortify tendons and bones, improve complexion, extend lifespan, enhance hearing and vision, and make the beard and mustache lustrous and dark. The “Erjing Pill” documented in Shengji Zonglu—consisting of Huang Jing and Goji Berries—is believed to assist qi and consolidate essence, safeguard and stabilize the dantian, invigorate blood circulation and maintain youthful appearance, and promote longevity and immortality. The “Huangjing Wine” described in Shenghui—prepared with Huang Jing, Tian Men Dong, Shu, Pine Needles, and Goji Root—is said to prolong life and nourish the body, turn white hair black again, and regrow lost teeth. The “Huangjing Paste” recorded in Qianjin—made from Huang Jing—has the effects of shedding old skin, lightening complexion, altering facial features, changing the hairline, and promoting longevity and youthfulness. The “Zishen Rongjing Pill” detailed in Wu Shi Jiu Fang—comprising Huang Jing, Cistanche, Processed He Shou Wu, Jin Ying Zi, Huai Shan, Chi Shao, Hawthorn, Wu Wei Zi, and Buddha’s Hand—is said to nourish the kidneys and consolidate the root, tonify the liver and kidneys, invigorate blood circulation and unblock the meridians, and is indicated for diabetes of the kidney-deficiency type. In summary, medicinal formulas containing plants of this genus have therapeutic applications for diseases associated with deficiency of kidney essence and vital energy.

1.4 An Analysis of the Ethnomedicinal Applications of Plants in the Genus Polygonatum for Treating Diseases Associated with Kidney Essence Deficiency

This study, through a review of ethnopharmacological literature, reveals the medicinal applications of plants belonging to the genus Polygonatum for conditions associated with kidney essence deficiency, as summarized in Table 1. ^[22] It primarily involves 10 medicinal plants, which are traditionally used by ethnic minority groups to treat conditions such as rheumatism, tinnitus, kidney deficiency, depletion of essence and vital energy, impotence, nocturnal emission, lumbosacral and leg pain, premature graying in young people, internal heat with polydipsia, and general debility and fatigue.

2 Clinical Application Analysis of Polygonatum Species and Their Preparations in the Treatment of Diseases Associated with Kidney Essence Deficiency

Through a review of such standards as the Chinese Pharmacopoeia, the Standards for New Drug Approval, the Ministry of Health’s Pharmaceutical Standards for Traditional Chinese Medicine Preparations, the Compilation of National Standards for Traditional Chinese Patent Medicines, the First Volume of the Ministry of Health’s Pharmaceutical Standards for Tibetan Medicines, the Mongolian Medicine Section of the Ministry of Health’s Pharmaceutical Standards, the Registration Standards, the Standards Issued by the National Pharmaceutical Standards Bureau, and the Single-Page Standards of the National Medical Products Administration, this study found that among the more than 200 traditional Chinese patent medicines currently listed in China that contain Polygonatum, over 160 are indicated for the treatment of conditions associated with kidney essence deficiency. Their therapeutic effects primarily include tonifying the kidney and nourishing yin, generating body fluids and relieving thirst, strengthening the kidney and enhancing yang, replenishing essence and enriching marrow, fortifying the brain and calming the heart, tonifying the kidney and filling the essence, strengthening tendons and bones, nourishing yin and augmenting yang, supporting vital energy and consolidating the root, regulating menstruation and nourishing blood, warming the uterus and arresting leukorrhea, nourishing the liver and kidney, benefiting essence and invigorating the brain, providing tonic and strengthening effects, and tranquilizing and calming the spirit. Representative patent medicines include “Shengjing Tablets,” indicated for symptoms such as lumbosacral soreness and weakness, dizziness and tinnitus, mental fatigue and physical debility, as well as oligospermia, asthenospermia, hypospermia, and non-liquefied semen in men—all attributable to kidney yang deficiency; “Bushen Pills,” indicated for symptoms such as mental exhaustion and fatigue, blurred vision and hearing loss, and erectile dysfunction with reduced sperm count; “Naolingsu Capsules,” indicated for neurasthenia, forgetfulness and insomnia, and erectile dysfunction with seminal emission; “Shengfa Pills,” indicated for premature graying, thinning, and dry, brittle hair resulting from deficiency of essence, blood, and qi; “Tianmeng Capsules,” indicated for dizziness and tinnitus, declining vision and hearing, insomnia and forgetfulness, poor appetite, and lumbosacral soreness and weakness; “Naoling Tablets,” indicated for neurasthenia, forgetfulness and insomnia, and erectile dysfunction with seminal emission; “Kangshailing Ointment,” indicated for dizziness and blurred vision, exhaustion of vital energy, and insomnia with forgetfulness; “Shenjing Zhike Pills,” indicated for diabetes mellitus caused by dual deficiency of qi and yin and internal heat-induced fluid depletion; “Kelening Capsules,” indicated for the treatment of diabetes mellitus due to dual deficiency of qi and yin; and “Compound Erjingling,” indicated for the treatment of senile dementia. In summary, most modern preparations developed using plants of this genus as raw materials possess therapeutic efficacy for conditions associated with kidney essence deficiency.

Clinical efficacy is the gold standard for evaluating drug effectiveness. To further assess whether plants of this genus and their preparations are indeed effective in treating diseases associated with kidney essence deficiency, this study conducted a comprehensive literature search across databases including PubMed, CNKI, VIP, and Wanfang. The search revealed that these plants and their formulations do exhibit clinical efficacy in the treatment of conditions arising from kidney essence deficiency, as summarized in Table 2. Notably, proprietary Chinese medicines such as “Huangjing Zanyu Capsules,” “Shengjing Granules,” “Hailong Huangjing Powder,” “Baxian Zhongyu Decoction,” and “Shengjing Capsules” have been shown to improve sperm motility and quality, exert therapeutic effects on idiopathic teratozoospermia and functional premature beats, and reduce adverse reactions. Formulas aimed at tonifying the uterus and promoting fertility can significantly alleviate clinical symptoms in patients with diminished ovarian function, enhance quality of life, normalize hormonal profiles, strengthen ovarian function, and thereby promote ovulation and facilitate conception. Furthermore, Polygonatum and its formulations demonstrate definite therapeutic efficacy in metabolic disorders such as diabetes, diabetic nephropathy, diabetes complicated by hyperlipidemia, diabetic peripheral neuropathy, and hyperlipidemia; they also exhibit remarkable efficacy in knee osteoarthritis, cervical spondylosis, senile dementia, depression, and ischemic cerebrovascular disease. In addition, Polygonatum and its preparations possess immunomodulatory, anti-aging, and anti-fatigue effects in clinical practice. In summary, plants of this genus and their preparations demonstrably exhibit clinical efficacy in the treatment of diseases associated with kidney essence deficiency.

3 Pharmacological Effects and Bioactive Constituents of Plants in the Genus Polygonatum for the Treatment of Diseases Associated with Kidney Essence Deficiency

To further investigate the pharmacological mechanisms and key bioactive compounds of the genus Polygonatum in the treatment of disorders associated with kidney essence deficiency, this study systematically reviewed the literature and comprehensively collated and analyzed the principal therapeutic effects and constituent profiles of species within this genus for such conditions, thereby providing modern scientific evidence to support their use in managing kidney essence deficiency–related diseases.

3.1 Analysis of the Efficacy and Active Ingredients of Anti-Osteoporosis Drugs

The kidney governs the bones; deficiency of kidney essence readily gives rise to osteoporosis, which is primarily characterized by deterioration of bone microarchitecture, reduced bone mass, increased bone fragility, and a heightened risk of fractures. Research has demonstrated the anti-osteoporotic effects of plants belonging to the genus Polygonatum, as reported by Ye Songqing et al. ^[74] Studies have shown that Polygonatum polysaccharides can improve the biomechanical properties and bone mineral density in ovariectomized rats with osteoporotic fractures by modulating bone repair and bone metabolism-related factors; Wu Ping et al. ^[75] Studies have shown that polysaccharides from Polygonatum sibiricum can inhibit bone resorption in an ovariectomized rat model of osteoporosis, thereby preventing bone loss and exerting a preventive and therapeutic effect on osteoporosis; Peng Xiaoming et al. ^[76] Studies have shown that polysaccharides from Polygonatum sibiricum can induce the differentiation of bone marrow mesenchymal stem cells from LRP5-knockout mice into osteoblasts by modulating the phosphorylation level of glycogen synthase kinase-3β (GSK-3β) in these cells, thereby inactivating GSK-3β, increasing nuclear β-catenin levels, and enhancing Tcf/Lef–mediated transcriptional activity, ultimately promoting the osteogenic differentiation of BMSCs; Yan Fangna et al. ^[77] Studies have shown that Polygonatum polysaccharides can improve bone microarchitecture, reduce bone turnover, increase the expression of osteoprotegerin (OPG)—a bone-resorbing inhibitory factor—and decrease the expression of receptor activator of nuclear factor-κB ligand (RANKL)—a bone-resorbing differentiation factor; Nong Mengni et al. ^[78] Studies have shown that polysaccharides from Polygonatum sibiricum can promote the differentiation of mouse bone marrow mesenchymal stem cells into osteoblasts by upregulating β-catenin expression in these cells and facilitating its nuclear translocation, thereby enhancing the transcriptional activity of the β-catenin/TCF complex and activating the Wnt/β-catenin signaling pathway to facilitate the in vitro induction of bone marrow mesenchymal stem cells toward osteoblast differentiation; Zeng Gaofeng et al. ^[79] Studies have shown that polygonatum polysaccharides exert a bone-protective effect in ovariectomized rats with osteoporotic fractures by reducing osteocalcin levels and inhibiting the positive expression of tartrate-resistant acid phosphatase; Du et al. ^[80] Studies have shown that polysaccharides from Polygonatum sibiricum can inhibit RANKL-induced activation of the receptor activator of nuclear factor κB and exert a preventive effect against lipopolysaccharide-induced bone resorption; Zong et al. ^[81] Studies have shown that polygonatum polysaccharides can promote the proliferation of BMSCs during osteogenic differentiation and enhance their viability; Zeng et al. ^[82] Studies have shown that administration of Polygonatum polysaccharides to ovariectomized rats can reverse bone loss and prevent osteoporosis. In summary, plants of this genus exhibit anti-osteoporotic effects, with Polygonatum polysaccharides as the principal bioactive constituents. The underlying mechanism involves the activation of the Wnt/β-catenin signaling pathway by these polysaccharides, which promotes the in vitro differentiation of bone marrow mesenchymal stem cells into osteoblasts and facilitates fracture healing. ^[74] Plants of this genus have long been used in traditional medicine for purported therapeutic effects such as “strengthening the tendons and bones and fortifying the bone marrow,” and modern pharmacological and chemical studies have further confirmed the presence of bioactive constituents responsible for these effects.

3.2 Analysis of the Efficacy and Constituents of Anti-Rheumatic Drugs

No reports have yet been published on the anti-rheumatic effects of plants in the genus Polygonatum; however, studies have already investigated the clinical application of its preparations. Wang Jinjie et al. ^[83] Studies have shown that Polygonatum preparations can alleviate knee joint pain and improve joint range of motion, while reducing the serum levels of interleukin-1 (IL-1), IL-33, and human matrix metalloproteinase 13 (MMP-13) in patients with knee osteoarthritis, thereby effectively suppressing inflammatory responses; Xie Dujuan ^[84] Research has demonstrated that the traditional Chinese medicinal formula incorporating Polygonatum as a single herb exhibits favorable therapeutic efficacy in the treatment of rheumatoid arthritis, thereby substantiating the anti-rheumatic properties of Polygonatum. In summary, plants of this genus have long been recognized in traditional medicine for their “wind-damp–dispelling” effects, and clinical applications have further confirmed their efficacy in alleviating wind-damp conditions; however, more in-depth modern research is warranted to strengthen the evidence supporting these traditional claims.

3.3 Antidiabetic Efficacy and Component Analysis

The antidiabetic effects of plants in the genus Polygonatum have been investigated in the literature. Wang et al. ^[85] Studies have shown that polysaccharides from Polygonatum sibiricum can promote glycogen synthesis in peripheral tissues and enhance glucose utilization; Yan et al. ^[86] Studies have shown that polysaccharides and total saponins from Polygonatum kingianum can prevent type 2 diabetes by modulating the gut microbiota via oral administration; Lu et al. ^[5] Studies have shown that total saponins of Polygonatum kingianum can promote glycogen synthesis in peripheral tissues and enhance glucose utilization; Jiang Xianmin ^[87] Research indicates that Polygonatum cyrtonema P. cyrtonema Hua polysaccharides can promote L -Cellular secretion of GLP-1 exerts a glucose-lowering effect; Naidu et al. ^[88] Research indicates that Polygonatum cyrtonema P. verticillatum (Linn.) All. The steroidal saponin diosgenin found in the rhizomes can reduce insulin resistance by modulating dysregulated lipid distribution and metabolism in plasma and tissues, thereby exerting a hypoglycemic effect; Song et al. ^[89] Research indicates that Polygonatum kingianum P. kingianum Saponin compound ginsenoside Rb from the rhizomes of Coll. et Hemsl. ₁ Insulin sensitivity can be enhanced by inhibiting 11β-HSD1; Guo et al. ^[ninety] Research indicates that Polygonatum sibiricum P. punctatum The steroidal saponin protodioscin found in the rhizomes of Royle ex Kunth exhibits efficacy in alleviating hyperglycemia and hyperlipidemia in diabetic patients; Zhang et al. ^[8] Research indicates that Polygonatum odoratum P. odoratum (Mill.) Flavonoid compounds in the rhizome of Druce: (±)-5,7-dihydroxy-6,8-dimethyl-3-(2′-hydroxy-4′-methoxybenzyl)chroman-4-one, ( E )-5,7-dihydroxy-6,8-dimethyl-3-(4′-hydroxybenzylidene)chroman-4-one, 4′-Demethylleucomin 7- O -beta- D - Glucopyranoside, isoflavone iridin, and 5,4′-dihydroxy-7-methoxy-6-methylflavane exhibit significant insulin-sensitizing effects in 3T3-L1 adipocytes and may serve as potential insulin sensitizers; Lin et al. ^[ninety-one] Studies have shown that the high isoflavonoid compounds 4,5,7-trihydroxy-6,8-dimethylhomoisoflavanone and 4,5,7-trihydroxy-6-methyl-8-methoxyhomoisoflavanone found in the rhizomes of Polygonatum odoratum can act as agonists of the peroxisome proliferator-activated receptor-γ (PPARγ) target; Dong et al. ^[7] Studies have shown that the high-isoflavone compounds 4,5,7-trihydroxy-6,8-dimethylhomoisoflavanone, 4,5,7-trihydroxy-6-methyl-8-methoxyhomoisoflavanone, and 4′,7-dihydroxy-8-methoxy-6-methylhomoisoflavone found in the rhizomes of Polygonatum odoratum exhibit activity in inhibiting the formation of advanced glycation end products (AGEs) in diabetic rats, thereby exerting a hypoglycemic effect; Gong Huiling et al. ^[ninety-two] Studies have shown that polysaccharides from Polygonatum species can lower blood glucose levels and enhance insulin expression in diabetic rats. In summary, plants of the genus Polygonatum exhibit antidiabetic pharmacological activity, with polysaccharides, flavonoids, and saponins as the major bioactive constituents. To date, bioactive, homogeneously purified polysaccharides and individual compounds have been isolated and characterized from the crude extracts, highlighting their significant potential for further development. Traditional records document that these plants possess the therapeutic effect of “xiaoke,” which refers to the treatment of diabetes; modern pharmacological and chemical studies have confirmed the presence of bioactive components responsible for this effect, thereby providing a solid scientific basis for the use of Polygonatum species in the treatment of diabetes.

3.4 Analysis of Lipid-Regulating Drug Efficacy and Its Constituents

Studies have shown that plants of the genus Polygonatum possess lipid-regulating effects, as reported by Zhao Hongli et al. ^[93] These findings indicate that polysaccharides from Polygonatum sibiricum can reduce serum lipid levels and alleviate hepatic steatosis in diabetic rats, with the underlying mechanism likely involving the downregulation of sterol-regulatory element-binding protein-1c (SREBP-1c) and stearoyl-CoA desaturase-1 (SCD-1) expression. ^[93] ;Ko et al. ^[94] These findings indicate that the ethanol extract of Polygonatum sibiricum can modulate the expression of genes involved in adipogenesis and fatty acid oxidation in mouse preadipocytes (3T3-L1), thereby enhancing the regulation of C ₂ -C ₁₂ Gene expression underlying myocardial cellular energy homeostasis ameliorates obesity via the sirtuin-1 and peroxisome proliferator-activated receptor γ coactivator-1α pathways; Yang et al. ^[95] These findings indicate that polysaccharides from Polygonatum sibiricum can reduce the number of foam cells and endothelial cell damage, thereby exhibiting lipid-regulating activity; Chen Yao et al. ^[96] The results demonstrate that Polygonatum sibiricum polysaccharides can effectively reduce total cholesterol, triglycerides, low-density lipoprotein, and the atherosclerosis index in rats by decreasing TNF-α secretion from adipocytes and restoring impaired insulin signaling pathways, thereby ameliorating dysregulation of glucose and lipid metabolism; Wang Yanfang ^[97] These findings indicate that polysaccharides from Polygonatum kingianum can activate PPARγ, thereby promoting adipocyte differentiation, reducing cell size, alleviating hepatic steatosis, increasing the levels of adipokines, improving gut microbiota composition, facilitating intestinal epithelial cell repair, decreasing intestinal permeability, inhibiting the TLR4/NF-κB signaling pathway, and ameliorating systemic lipid metabolic disorders; Kong Xia et al. ^[98] The results demonstrate that polysaccharides from Polygonatum can reduce serum levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), while increasing serum high-density lipoprotein cholesterol (HDL-C). These polysaccharides also upregulate the mRNA and protein expression of peroxisome proliferator-activated receptor alpha (PPAR-α) and PPAR-β in the liver, whereas downregulating the mRNA and protein expression of PPAR-γ, SREBP-1c, IL-6, and TNF-α in the liver, thereby exerting a preventive and therapeutic effect on hyperlipidemia. In summary, plants of this genus exhibit lipid-regulating activity, with polysaccharides as the primary bioactive constituents. The mechanisms underlying their hypoglycemic effects likely involve downregulation of SREBP-1c and SCD-1 protein expression, activation of the coactivator-1α pathway of nuclear receptor γ, activation of PPAR-γ to promote adipocyte differentiation, inhibition of the TLR4/NF-κB signaling pathway, and upregulation of hepatic PPAR-α and PPAR-β mRNA and protein expression, coupled with downregulation of hepatic PPAR-γ, SREBP-1c, IL-6, and TNF-α mRNA and protein expression. Traditionally, these plants have been documented to treat conditions such as “kidney-deficiency–type obesity”; this study, through a comprehensive review and analysis of their lipid-regulating pharmacological activities and chemical constituents, further confirms that they indeed contain bioactive components effective for treating obesity.

3.5 Anti-Aging Pharmacological Effects and Ingredient Analysis

Aging is the process by which the tissues and organs of the human body undergo functional degenerative changes, regulated by the body’s vital essence and qi. Studies have shown that plants of the genus Polygonatum possess anti-aging effects; Xue Chunmiao et al. ^{[ninety-nine]} These findings indicate that polysaccharides from Polygonatum sibiricum exhibit a pronounced yin-nourishing effect and can delay aging by exerting antioxidant activity in a yin-deficiency mouse model. Wang et al. ^[100] It was demonstrated that the high isoflavone compounds 4,5,7-trihydroxy-6-methyl-8-methoxybiochanin A and 3-(4′-hydroxybenzyl)-5,7-dihydroxy-6-methylchroman-4-one in the rhizomes of Polygonatum odoratum possess DPPH radical-scavenging activity, thereby exerting antioxidant effects; Zhou et al. ^[101] Indicates that the rhizomes of Polygonatum odoratum contain high levels of isoflavone compounds (3 R )-5,7-dihydroxy-8-methyl-3-(2,4-dihydroxybenzyl)-chroman-4-one, (3 R )-5,7-dihydroxy-8-methyl-3-(4-hydroxybenzyl)-chroman-4-one、(3 R )-5,7-dihydroxy-3-(2-hydroxy-4-methoxybenzyl)-chroman-4-one, (3 R )- 5,7-dihydroxy-3-(4- O -hydroxybenzyl)-chroman-4-one, (3 R )-5,7-Dihydroxy-8-methoxy-3-(2′-hydroxy-4′-methoxy-benzyl)-chroman-4-one exhibits DPPH radical-scavenging activity and exerts antioxidant effects; Wang Yuqin et al. ^[102] The results indicate that polysaccharides from Polygonatum sibiricum can significantly reduce malondialdehyde (MDA) levels in rat serum and skeletal muscle, while enhancing the activities of endogenous superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in rat serum as well as endogenous SOD activity in skeletal muscle, thereby improving the body’s antioxidant capacity and contributing to protection against injury and aging. Wang Aimei et al. ^[103] These findings indicate that Polygonatum sibiricum can effectively increase the levels of SOD, GSH-Px, and Na in the brain tissue of aged mice. ⁺ , K ⁺ -ATPase, Ca ²⁺ -ATPase activity and reduced MDA levels indicate a significant anti-aging effect. In summary, plants of this genus indeed possess anti-aging pharmacological properties, with flavonoids as the primary active constituents; to date, several bioactive monomeric compounds have been isolated and purified. The underlying mechanism is associated with free-radical scavenging. In addition, total polysaccharides also contribute to anti-aging effects by lowering malondialdehyde levels in the body and enhancing the activities of superoxide dismutase and glutathione peroxidase, among other enzymes. Traditionally, these plants have been used for purposes such as “lightening pigmentation, moisturizing, health preservation, weight reduction, anti-aging, general health maintenance, and prolonging life.” This study, through a comprehensive review and analysis of the anti-aging efficacy and chemical constituents of plants in this genus, further confirms the presence of anti-aging bioactive components.

3.6 Analysis of the Efficacy and Composition of Immunomodulatory Drugs

The immune system is the body’s most important defense barrier against disease, and studies have shown that plants of the genus Polygonatum possess immunomodulatory effects. Liu Na et al. ^[104] These findings indicate that Polygonatum polysaccharides can enhance cellular phagocytic capacity and bolster immunomodulatory activity, with the underlying mechanism involving modulation of the P38 MAPK (mitogen-activated protein kinase) and NF-κB (nuclear factor kappa beta) signaling pathways; Fu Yu et al. ^[105] These findings indicate that polysaccharides from Polygonatum sibiricum can inhibit apoptosis of human peripheral blood lymphocytes, with the underlying mechanism likely involving the regulation of the expression levels of apoptosis-related proteins Bcl-2, Bax, and Fas; Gu Xiaolong et al. ^[106] It has been demonstrated that Polygonatum sibiricum exhibits immunomodulatory effects, restoring the immune function of immunocompromised mouse models to normal levels; Hua Yan et al. ^[107] These findings indicate that Polygonatum polysaccharides can inhibit the exercise-induced increase in serum CK levels and elevate CD3. ^plus , CD4 ^plus , CD8 ^plus , CD4 ^plus/CD8^plus , IgG, IgA, and IgM levels, delay the onset of exercise-induced fatigue, and enhance both humoral and cellular immune functions; Long Tingting ^[108] These findings indicate that Polygonatum polysaccharides can inhibit tumor growth in LLC-bearing mice and increase the indices of immune organs as well as CD4+ T cell counts. ^plus/CD8^plus the proportion of T lymphocytes, as well as the levels of nitric oxide and cytokines in serum. In summary, plants of this genus exhibit immunomodulatory effects, with polysaccharides being the primary bioactive constituents; the underlying mechanisms are mainly associated with modulation of the P38 MAPK and NF-κB signaling pathways and regulation of the expression levels of apoptosis-related proteins such as Bcl-2, Bax, and Fas. Traditionally, these plants have been used to “tonify deficiency,” and the clinical manifestation of “deficiency syndrome” is characterized by impaired immune function. This study, supported by a review of the literature, demonstrates that these plants indeed contain bioactive components with “tonifying-deficiency” efficacy.

3.7 Analysis of the Efficacy and Ingredients of Medications for Treating Infertility

The kidneys store essence and govern reproduction; infertility is associated with deficiency of kidney essence. Li Dimin et al. ^[109] Studies have shown that, compared with the raw form, the processed form of Polygonatum sibiricum increases the weights of the thymus and spleen, as well as the weights of the testes and prostate–seminal vesicle complex in juvenile male mice; Yang Zisheng. ^[110] Studies have shown that the aqueous extract of Polygonatum sibiricum can effectively improve testicular tissue structure and physiological function, with its mechanism of action related to the regulation of the TXNIP-NLRP3-Caspase-1 and Cyt-c-Caspase-9-Caspase-3 signaling pathways; Wang Desheng et al. ^[111] The results indicate that both Qiangjing Decoction and Huangjing Zanyu Capsules can upregulate C-kit protein expression, promote spermatogonial differentiation, facilitate spermatogenesis, ameliorate spermatogenic dysfunction, upregulate cystic fibrosis transmembrane conductance regulator (CFTR) expression, regulate spermatogenesis, modulate sperm capacitation, and enhance fertilization capacity; Binbin et al. ^[112] Studies have shown that “Qiangjing Decoction” can repair damage to the spermatogenic epithelium and increase Na ^plus , K ^plus -ATPase and Ca ²^plus -ATPase activity, thereby improving sperm concentration, motility, and spermatogenic function. In summary, plants of the genus Polygonatum exhibit therapeutic effects on infertility, particularly in cases of oligospermia and asthenospermia in males. The principal bioactive constituents are total polysaccharides, and the underlying mechanisms likely involve modulation of the TXNIP-NLRP3-Caspase-1 and Cyt-c-Caspase-9-Caspase-3 signaling pathways, upregulation of C-kit protein expression, and upregulation of CFTR protein expression. Traditionally, these plants have been used to treat “prolonged infertility in both men and women, enhance sexual potency, and increase seminal fluid.” This study, through pharmacological evaluation and analysis of active constituents, further substantiates that plants of this genus indeed contain bioactive compounds with efficacy in treating male and female infertility, enhancing sexual potency, and increasing seminal fluid.

3.8 Anti-Alzheimer's Disease ( Alzheimer's disease , AD ) Pharmacological Effects and Ingredient Analysis

The kidneys govern the bones, generate marrow, and communicate with the brain. Polygonatum, a genus of plants traditionally used as a tonic to tonify the kidneys and consolidate essence, has been shown in research to possess anti–Alzheimer’s disease effects. Alzheimer’s disease is a condition associated with deficiency of kidney essence, typically occurring in old age, and its main clinical manifestations include progressive memory impairment, declining cognitive function, and language deficits. Xu Lingling ^[113] These findings indicate that “Compound Erjingling Polysaccharide” exerts anti-AD effects by significantly upregulating the expression of B-cell lymphoma-2 (Bcl-2) protein, downregulating Bax protein expression, inhibiting Caspase-3 proteolytic degradation, and reducing N -Methyl- D -Aspartate receptor ( N -methyl- D -aspartate receptor, NMDA)-evoked inward current, reducing intracellular Ca ² ^plus Overload protection, neuroprotection of hippocampal neurons, enhancement of memory, and preventive effects against Alzheimer’s disease; Lu Lian-di et al. ^[114] These findings indicate that Polygonatum polysaccharides can promote the recovery of learning and memory abilities in a rat model of vascular dementia; Tang Wei et al. ^[115] These findings indicate that Polygonatum polysaccharides can improve learning and memory abilities in rats with chronic cerebral ischemia and mitigate ultrastructural damage to the brain; Wang Wei et al. ^[116] These findings indicate that Polygonatum polysaccharides can improve the general behavioral assessments and histological changes in rats with chronic cerebral ischemia, enhance neuronal structure in these animals, and reduce the protein expression of Aβ1-42 in the prefrontal cortex and hippocampus; Wei Xiaoming et al. ^[117] Studies have shown that Polygonatum sibiricum can significantly improve spatial learning and memory in AD model rats, with its mechanism of action possibly related to the regulation of α7 nicotinic acetylcholine receptor (α7 nAChR) expression; Huang Fang et al. ^[118] Studies have shown that polysaccharides from Polygonatum sibiricum can significantly reduce the number of errors in maze tests in rats and markedly enhance their learning and memory abilities; Yang Wenming et al. ^[119] Studies have shown that Polygonatum sibiricum markedly facilitates learning and memory in mice by enhancing choline acetyltransferase (ChAT) activity and increasing acetylcholine levels in the cerebral cortex and hippocampus, which constitutes the primary mechanism underlying its cognitive-enhancing effects; Zhang Feng et al. ^[120] Studies have shown that polysaccharides from Polygonatum sibiricum can ameliorate scopolamine-induced memory acquisition deficits in mice; Ma Fengqiao ^[121] These findings indicate that Polygonatum sibiricum can inhibit the expression of Caspase-3 in hippocampal tissue, ameliorate degenerative changes in neurons in the CA1 region of the hippocampus, and enhance learning and memory abilities in AD rats; by Geng Zhenyan et al. ^[122] Studies have shown that polygonatum saponins can reverse behavioral abnormalities in depressed mice and increase the levels of norepinephrine, dopamine (DA), and 5-hydroxytryptamine (5-HT) in the brain. In summary, plants of the genus Polygonatum do indeed exhibit anti–Alzheimer’s effects, with total polysaccharides being the primary active constituents, followed by total saponins. The underlying mechanisms may involve upregulating Bcl-2 protein expression, downregulating Bax (Bcl-2-associated X protein) expression, and reducing the levels of amyloid beta 42 peptide (Aβ) in the prefrontal cortex and hippocampus. _1-42 ) Protein expression, regulation of α7nAChR expression, enhancement of ChAT activity leading to increased acetylcholine levels in the cerebral cortex and hippocampus of mice, suppression of Caspase-3 expression in hippocampal tissue, and improvement of neuronal degeneration in the CA1 region of the hippocampus—all these factors are involved. In traditional applications, plants of this genus have long been used to “tonify essence, harmonize qi and blood, and moisten the body.” The above analysis confirms that these plants indeed contain bioactive constituents with the functional properties of tonifying essence and invigorating the mind.

3.9 Pharmacological Efficacy and Constituent Analysis of Drugs for Cerebrovascular Diseases

The kidneys govern the bones, generate marrow, and connect to the brain. Cerebrovascular diseases are also associated with deficiency of kidney essence. Chen Juan et al. ^[123] Studies have shown that polysaccharides from Polygonatum sibiricum markedly improve the behavioral deficits in Parkinson’s disease rats, with the underlying mechanism likely involving upregulation of PPAR-γ expression, which in turn suppresses inflammatory responses and apoptosis while promoting the regeneration of dopaminergic neurons; Li Wei et al. ^[124] These findings indicate that Polygonatum kingianum can mitigate global cerebral ischemia/reperfusion injury, with the underlying mechanism involving the reduction of reactive oxygen species levels; Zhou Zhijun et al. ^[125] Studies have shown that “Huangjing Wan” exerts a protective effect against oxidative free radical damage, lipid peroxidation, and various inflammatory cytokine-mediated injury induced by cerebral ischemia-reperfusion in rats; Ye Yun et al. ^[126] Studies have shown that polysaccharides from Polygonatum spp. exert neuroprotective effects by reducing cerebral nitric oxide levels and attenuating neuronal apoptosis following ischemia-reperfusion injury. In summary, plants of the genus Polygonatum indeed possess anti-cerebrovascular disease activity, with total polysaccharides as the principal bioactive constituents; the underlying mechanisms likely involve upregulation of PPARγ expression, reduction of oxidative stress and lipid peroxidation, and attenuation of inflammatory cytokine-mediated damage.

3.10 Analysis of Antipsychotic Efficacy and Composition

Neuropsychiatric disorders fall under the category of kidney essence deficiency syndrome. Chen Chen ^[127] Studies have shown that polysaccharides from Polygonatum sibiricum can ameliorate depression-like behaviors in chronic stress-induced depressive model mice, increase the levels of monoamine neurotransmitters (5-HT and DA) in the brains of these mice, and reduce serum IL-2 levels. Hu Tingting et al. ^[128] The findings indicate that the combination of “Huangjing Granules” and fluoxetine for the treatment of depression not only enhances the latter’s antidepressant efficacy but also reduces adverse reactions. Huang Ying et al. ^[129] Studies have shown that the clinical efficacy of combining Polygonatum sibiricum with mirtazapine in treating depressive disorders in elderly patients after cerebral infarction is significantly superior to that of mirtazapine alone, and it can also reduce adverse reactions. Wang Junming et al. ^[130] Studies have shown that aqueous and ethanol extracts of Polygonatum sibiricum can significantly reduce the immobility time of mice in the forced swim test (FST) and the tail suspension test (TST); Wei Haojie et al. ^[131] Studies have shown that polygonatum saponins improve the behavioral outcomes in rats with chronic stress-induced depression by modulating the 5-HT1A receptor/cAMP/PKA/CREB signaling pathway, thereby exerting an antidepressant effect; Huang Ying ^[132] These findings indicate that polygonatum saponins can ameliorate the behavioral abnormalities in CUMS-induced depressive rats, increase the serum levels of Zn, Mn, and Mg while decreasing the Cu level, thereby elevating the Zn/Cu ratio, and also elevate the serum 5-HT level in these rats; Xu Weiping et al. ^[133] Studies have shown that total saponins of Polygonatum can enhance the immune function in rats with a chronic stress-induced depression model; Zhu Lingli et al. ^[134] Studies have shown that total saponins of Polygonatum can ameliorate depression-like behaviors in rats subjected to a chronic stress-induced depression model, effectively inhibiting the downregulation of BDNF and TrkB expression in hippocampal neurons and markedly alleviating pathological changes. This effect is achieved by suppressing the reduction of BDNF and TrkB, thereby mitigating stress-induced cellular damage; Geng Zhenyan et al. ^[135] Studies have shown that polygonatum saponins can reverse behavioral abnormalities in depressed mice and increase the levels of NE, DA, and 5-HT in the brain. In summary, plants of the genus Polygonatum indeed exhibit antipsychotic effects, with total saponins and total polysaccharides as the main active constituents. The antipsychotic mechanism of total polysaccharides may involve increasing the levels of 5-HT and DA while reducing IL-2 levels. The antipsychotic mechanism of total saponins may be related to modulation of the 5-HT1A receptor/cAMP/PKA/CREB signaling pathway, elevation of serum Zn, Mn, and Mg ion levels in CUMS-induced depressive rats, reduction of Cu levels, suppression of hippocampal expression of BDNF and TrkB, and increased levels of NE, DA, and 5-HT in the brain.

4 Conclusion and Outlook

With the increasingly severe aging of China’s population and the relaxation of the two-child policy, diseases associated with kidney essence deficiency have become a major social issue in the country. Plants of the genus Polygonatum are renowned in traditional Chinese medicine for “tonifying the kidneys and benefiting the essence,” and have long been used in health preservation, wellness maintenance, and the promotion of longevity; they were even regarded by Daoists as essential ingredients for cultivating immortality. Through a systematic review and cross-validation of the herbal, formula, proprietary-medicine, ethnic-medicine, clinical, modern pharmacological, and material-base applications of this genus in treating kidney-essence-deficiency–related disorders, the author has found that historical herbal texts document a wide range of purported effects, including “strengthening the sinews and bones, augmenting the essence, replenishing deficiency, eliminating facial darkening, enhancing complexion, imparting luster, lightening the body, tonifying the five劳 and seven injuries, moistening the heart and lungs, supporting qi to consolidate the essence, replenishing the dantian, invigorating blood circulation to maintain youthful appearance, and promoting longevity and immortality.” Moreover, numerous formulas and proprietary medicines have been developed using these plants as raw materials, and such preparations have already been clinically applied in the treatment of kidney-deficiency–related conditions, demonstrating clear therapeutic efficacy. Modern pharmacological and chemical studies further reveal that Polygonatum species exhibit anti‑osteoporosis, anti‑rheumatic, lipid‑regulating, hypoglycemic, anti‑aging, immunomodulatory, and therapeutic effects on infertility, senile dementia, cerebrovascular diseases, and psychiatric disorders, with polysaccharides, saponins, and flavonoids serving as the principal active constituents. These findings substantiate the presence of pharmacologically active components in Polygonatum species for treating kidney-essence-deficiency–related ailments. Notably, flavonoids are the primary anti‑aging agents; several individual flavonoid compounds have now been isolated and purified. Saponins exert hypoglycemic, lipid‑regulating, and antipsychotic activities; while individual saponin compounds have been identified for their hypoglycemic effects, total saponins remain the dominant active fraction in lipid regulation and antipsychotic therapy, warranting further investigation. Polysaccharides, meanwhile, constitute the main pharmacologically active substances for combating senile dementia, cerebrovascular diseases, psychiatric disorders, infertility, immune modulation, anti‑aging, lipid regulation, diabetes, and osteoporosis; current research is largely focused on total polysaccharides, with no studies yet reported on the pharmacological effects of homogeneous polysaccharide fractions. However, the author’s earlier research group has already isolated and purified more than 20 homogeneous polysaccharide compounds from this genus. ^[136] Further research is warranted. This study systematically collates and analyzes the therapeutic applications of plants in this genus for conditions associated with kidney essence deficiency, thereby laying the foundation for the subsequent development of functional foods targeting such conditions.

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