Comprehensive review of tujia “Lian” medicinal botanical drugs: traditional classification system, phytochemical, and pharmacological profile

Tujia medicine categorizes drugs with similar effects into several major classes based on their ordinal numbers, primarily using the 36 and 72 ordinal number systems for organization. The drugs that mainly function to dispel wind and cold, promote blood circulation and disperse blood stasis, eliminate fire, dispel qi, relieve pain, and address dampness. Additionally, clearing the lymphatic system is collectively known as the "Seventy-Two Lian" method. This narrative review aims to provide a classification of "Seventy-Two Lian" and their attributions to alias, source, nature, flavor, and efficiency. It also summarizes the modern pharmacological effects of each species and its corresponding "Lian" drug. The goal is to provide a comprehensive overview of the current state of the Tujia "Lian" drugs and to promote further research and the use of these resources. The literature search for "Lian" drugs was conducted across various scientific databases, including SciFinder, Web of Science, Elsevier, PubMed, and CNKI, as well as ancient books and monographs. It collected the names, plant sources, and medicinal parts of "Lian" drugs from these sources, and identified the replaced Latin names in Chinese Plant Intelligence (https://www.iplant.cn). Relevant pharmacological studies were searched across various databases using Latin names and common names. The "Seventy-Two Lian" has a long history within Tujia ethnomedicine. Alongside its traditional uses, modern pharmacological effects have gained widespread attention. Recent studies have shown that "Lian" drugs generally exhibit a range of effects, including anti-inflammatory, analgesic, antibacterial, antioxidant, antitumor, antiviral, insecticidal, antidiabetic, neuroprotective, and hepatoprotective effects, as confirmed by <i>in vivo</i> and <i>in vitro</i> studies. Additionally, this review article addresses the limitations of current "Lian" drug research and other pharmacological aspects, as well as future opportunities for toxicological studies. Tujia ethnomedicines, as an essential part of traditional Chinese medicine (TCM), have developed a unique theoretical framework and drug classification approach through extensive medical practice. This study focuses on the characteristic "Lian" drugs of the Tujia ethnic group, reviewing their botanical origins, medicinal properties (nature, flavor, and meridian tropism), and traditional uses. The "Lian" drugs of the Tujia people exhibit significant efficacy in clearing heat and detoxifying the body, promoting blood circulation to remove stasis, dispelling wind and dampness, stopping bleeding, and promoting diuresis. By integrating modern phytochemical and pharmacological research, this study examines the active metabolites and biological activities of these medicinal botanical drugs, providing critical theoretical foundations and practical guidance for the Tujia ethnic medicines.