PubMed-compiled information sheet
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Compiled from 29 PubMed articles · model: gemma4:31b
Summary
Paeonia suffruticosa, also known as tree peony or Moutan cortex, is a medicinal plant used in traditional oriental medicine for its anti-inflammatory, antioxidant, and cardioprotective properties [PMID:36501418, PMID:31030097].
Background
Paeonia suffruticosa Andrews is a medicinal peony species whose root bark (Moutan cortex) is a standard herbal medicine in China, Japan, and Korea [PMID:36822345, PMID:42123880]. It has been introduced into the European Pharmacopoeia Supplement 9.4 in 2018 [PMID:36501418].
Traditional uses
Historically, it has been used to treat female genital disorders, extravasated blood, cardiovascular issues, stagnant blood disorders [PMID:36822345], heart disease, menstrual irregularities, uterine fibroids, arthritis, and cough [PMID:30000962], and for addressing women's ailments by replenishing kidney Yin [PMID:38493906].
Active compounds
Key bioactive compounds include paeonol, paeoniflorin, and 1,2,3,4,6-penta-O-galloyl-beta-D-glucose [PMID:36501418, PMID:22070681]. Other constituents include albiflorin, benzoylpaeoniflorin, liquiritin, flavonoids, proanthocyanidins, tannins, terpenoids, triterpenoids, complex polysaccharides [PMID:30000962], and alpha-linolenic acid [PMID:42123880]. Suffruticosol A is also isolated from this species [PMID:35852295].
Mechanism of action
Paeonol acts as a natural radical scavenger with antioxidant and anti-inflammatory effects [PMID:40124777]. It may modulate the GPR30 receptor to alleviate neuropsychiatric symptoms [PMID:38493906] and regulate the AMPK/Nrf2/GPX4 pathway to ameliorate chondrocyte ferroptosis [PMID:40124777]. Paeoniflorin may induce apoptosis and inhibit proliferation in tumors via NF-kappaB, Bcl-2, and MAPK signaling pathways [PMID:35279012]. Root extracts may regulate the IRS1/PI3K/FOXO pathway to ameliorate photoaging [PMID:40115263].
Clinical evidence
Evidence CInflammation and Pain
Paeonol injections have been successfully applied in China for nearly 50 years for inflammation and pain-related indications [PMID:31030097].
Evidence CCardiovascular Disease
Paeonol improves endothelium injury, reduces inflammation, ameliorates oxidative stress, and represses platelet activation [PMID:34443563].
Evidence DPostmenopausal Neuropsychiatric Symptoms
Paeonol ameliorated anxiety, depression, and cognitive impairments in ovariectomized mice [PMID:38493906].
Evidence DOsteoblast Differentiation
Suffruticosol A increased osteogenic alkaline phosphatase activity and RUNX2 levels in pre-osteoblasts [PMID:35852295].
Safety & adverse effects
The herb is generally well tolerated, though it can occasionally cause gastrointestinal upset and allergic skin reactions, particularly with topical application [PMID:30000962].
Pregnancy & lactation
Paeony may lower serum prolactin and potentially suppress lactation; therefore, it is probably best to avoid during breastfeeding [PMID:30000962]. No data exist on the safety and efficacy of peony in nursing mothers or infants [PMID:30000962].
Evidence summary
Evidence consists primarily of review articles and preclinical animal or in vitro studies (Levels C and D). Clinical application of paeonol for inflammation is noted in China, but broader clinical trial data for other conditions are limited.
PubMed sources
- 1.PMID: 30000962 (2006) — Phytochemical variation among the traditional Chinese medicine Mu Dan Pi from Paeonia suffruticosa (tree peony). · Phytochemistry
- 2.PMID: 36501418 (2022) — Paeonia × suffruticosa (Moutan Peony)-A Review of the Chemical Composition, Traditional and Professional Use in Medicine, Position in Cosmetics Industries, and Biotechnological Studies. · Plants (Basel, Switzerland)
- 3.PMID: 40115263 (2025) — Paeonia suffruticosa Andrews root extract ameliorates photoaging via regulating IRS1/PI3K/FOXO pathway. · Frontiers in pharmacology
- 4.PMID: 38493906 (2024) — Paeonol alleviates postmenopause-induced neuropsychiatric symptoms through the modulation of GPR30 in ovariectomized mice. · Journal of ethnopharmacology
- 5.PMID: 31030097