Gastrodia elata BI.:A Comprehensive Review of Its Traditional Use, Botany, Phytochemistry, Pharmacology, and Pharmacokinetics

Materials and Methods This article collects information from relevant documents, including scientific papers, books, and dissertations concerning Gastrodia elata BI. Results To date, research on Gastrodia elata BI. has identified about 100 active compounds. Many compounds in Gastrodia elata BI. have biological activities, such as sedation and hypnosis, anticonvulsion, improvement of learning and memory, protection of neurons, antidepressive effects, lowering of blood pressure, promotion of angiogenesis, protection of cardiomyocytes, antiplatelet aggregation, anti-inflammatory activity, and amelioration of labor pains. Conclusion Although many traditional uses of this plant have been confirmed, it is necessary to continue to study the relationship between its structure and function, clarify the mechanisms of pharmacological effects, and explore new clinical applications so as to better delineate the quality control standards for Gastrodia elata BI.


Introduction
As a traditional Chinese medicine, Gastrodia elata BI. (GB) has a long history, being recorded in many ancient books. Te plant is mainly grown in Hubei, Sichuan, Yunnan, Guizhou, and Shaanxi [1]. Tere are nine preparations listed in the Pharmacopoeia of the People's Republic of China [2], namely,

Botany
GB is a saprophytic herb in the Orchidaceae Gastrodia genus, with a plant height of about 2 m. Tere are no roots and no leaves; only the above-ground fower stems and underground tubers that cannot conduct photosynthesis. Te growth process requires fungal infection to provide nutrition. [26] Te picture of GB is shown in Figure 2.

Tubers.
According to the characteristics of diferent developmental stages, GB tubers can be divided into a protocorm, a vegetative propagation stem, a rice hemp, a white hemp, and a sisal hemp.
Protocorms are bulbs formed by the symbiotic germination of GB seeds, Mycena osmundicola Lange, M. orchidicola Fanet Guo, and other small mushrooms, with an average length of 0.4-0.7 mm and a diameter of 0.3-0.5 mm. 6 The central nervous system The cardiovascular system The skeletal system The digestive system The endocrine system The respiratory system Powder To cure apoplexy, paralysis, facial paralysis, lassitude, difculty walking, and qi paralysis, and body aches and pains Tai, 1996 Longnao Tianma Jian Cucumis melo L., Lemna minor, ACD, Sanguisorba ofcinalis L., SNH, GB To cure all winds, paralysis, pain in joints, and upsurge of kidney wind poison, head and face weakness, swelling, tinnitus, hard of hearing, stufy nose, dry mouth. It also cures the woman's blood and wind attack, body pain, dizziness, drowsiness, skin itching, rash and sores, and migraine headache Tai, 1996 Niuhuang Xiao Wuxi Yuan GB, ACD, Sanguisorba ofcinalis L., SNH To cure all wind syndrome: numbness of the hands and feet, facial paralysis, dizziness, pain in the limbs, paralysis of apoplexy, epilepsy, face swelling and tinnitus, heavy pain, woman's blood winds, head spins and vomits, skin swollen and itchy, and body painful Tai, 1996 Evidence-Based Complementary and Alternative Medicine 3 Tai, 1996 Shexiang  Evidence-Based Complementary and Alternative Medicine 5   [2] Tianma Toutong Tablets GB, ADBH, STE, Ligusticum chuanxiong Hort., ADS, BCB Nourish blood and dispel wind, dispel the pain of cold [2] Evidence-Based Complementary and Alternative Medicine 7  Tianma Toufengling Capsule GB, URMH, RGL, SNH, ADS, Ligusticum chuanxiong Hort., EUO, Viscum coloratum(Komar)Nakai, ABB, CMR Nourish yin and suppress yang, dispel rheumatism, and strengthen muscles and bones [2] Zhennaoning Capsules BBL, GB, LCH, AHFSVM, ADBH, PLO, LSO, Sus scrofa extinguish the wind, clearing the meridians [2] Quantianma Capsule GB To calm the liver, extinguish wind, and relieve spasm [2] Qiangli Gastrodia Eucommia Capsule GB, EUO, ABB, Viscum coloratum(Komar)Nakai, SNH, RGL, ADS, ACD, AKR, NTC, APM, LSO To calm the liver and eliminate wind, promote blood circulation and dispel cold, relax muscles, and relieve pain [2] Tianshu Capsules Ligusticum chuanxiong Hort., GB Activating blood, calming the liver, dredging the collaterals, and relieving pain [2] Yianmu-Depressurization Tablet GB, Hyriopsis cumingii (Lea), URMH, CMR, Morus alba L To calm the liver and suppress the yang Evidence-Based Complementary and Alternative Medicine   GB, AES Clear the meridians, activate blood, refreshing brain, and removing blood stasis [2] Evidence-Based Complementary and Alternative Medicine 9 10 Evidence-Based Complementary and Alternative Medicine ADS, PGM, Dioscorea opposita Tunb., SMB Nourishes the kidney, nourishes the brain, nourishes the blood, and calms the nerves Evidence-Based Complementary and Alternative Medicine Vegetative propagation stems are formed by the differentiation and growth of protocorms, and these can also germinate through asexual reproduction of the white hemp and rice hemp [27][28][29].
Rice hemp refers to small tubers with a length of less than 2 cm formed by the growth of the apical or lateral buds of the vegetative propagation stem through sexual or vegetative propagation. Because it resembles a grain of rice, it is also called hemp, and is most suitable for asexual propagation and expansion [30].
White hemp refers to underground tubers with strong snow-white top buds. Small and medium white hemp can only be used for hemp seed cultivation and cannot be used as a medicine. Large white hemp can be used for both cultivation and as a medicine.
Sisal refers to the tubers of GB with terminal fower buds formed by the growth and reproduction of white hemp. It has the three characteristics of terminal fower stalk bud, tail umbilicus, and ring pattern around the body. It has a high content of active ingredients and is mostly harvested as commercial GB. [31].

Flower Stems and Flowers.
Te top bud of the sisal sprouts and grows to form a GB tuber. Its height is 0.5-1.3 m; the diameter is 1-1.5 cm, and there are generally 5-7 nodes. Tere are sheath-like phimosis membranous scales alternating on the nodes. Te early stage of the fower stem is feshy and solid, and the fruit is mature. Te fower stem becomes hollow and the color becomes darker. Te inforescences of GB are racemes, which are mostly formed in the winter of the frst year. Te inforescences are drawn out and bloom in the second year. Generally, each plant can have 30 to 70 fowers. Te fowers are bisexual and symmetrical. Te ovary and pedicel are composed of several parts, with various fower colors. Under natural conditions, GB relies on insect pollination. Both self-pollination and crosspollination can produce fruits [32,33].

Fruits and Seeds.
Te fruit of GB is a long oval capsule with a length of 1.5 to 1.7 cm and a diameter of 0.9 cm. It has six longitudinal ridges and is similar in color to the stem. Each fruit contains 10,000 to 50,000 seeds [31]. Te seeds of GB are small and powdery. Under the microscope, the mature seeds are spindle-shaped, with a length of 0.8 mm and a width of 0.15-0.2 mm. Te seeds have no endosperm and are composed of embryos and seed coats. Te seed coats are white and translucent and are composed of parenchyma cells. Te embryo is oval, light brown, or dark brown [32,33].

Phenolic Compounds Containing a Benzene Ring.
Tere are more than 40 phenolic compounds isolated from GB. Te phenolic compounds containing a benzene ring are shown in Table 2 and the chemical structure is shown in Figure 3.

Phenolic Compounds Containing Two or More Benzene
Rings. Phenolic compounds containing two or more benzene rings are shown in Table 3 and the chemical structure is shown in Figure 4.

Organic Acids and Lipids.
Te organic acids separated from Gastrodia are tabulated in Table 4 and the chemical structure is shown in Figure 5.

Steroids and Teir
Glycosides. Five steroids have been isolated and identifed from GB, as shown in Table 5 and the chemical structure is shown in Figure 6.

Other
Categories. In addition to phenols, organic acids, and steroids, Gastrodia contains other compounds, including polysaccharides, furan aldehydes, adenosines, amino acids, and peptides. Te specifc ingredients are shown in Table 6 and the chemical structure is shown in Figure 7.

Pharmacology
GB has a wide range of efects, including the central nervous system, cardiovascular system, skeletal system, digestive system, endocrine system, urinary system, and respiratory system. Tis is shown in Table 7, Figure 8.

Te Efect of GB on the Central Nervous System
5.1.1. Hypnosis and Sedation. GB has hypnotic and sedative efects [57]. Studies have shown that the main efect of fresh GB on sleep depends on the chemical composition of phenols [40], and gastrodin has a prominent efect among the phenols [59,85]. Te memory improvement caused by Gastrodia can ameliorate oxidative stress and boost neurotransmitter levels. Te mechanism may be related to the up-regulation of central dopamine (DA) system activity, the regulation of dopamine receptor 2(D2)-mediated signaling pathways, and the regulation of monoamine neurotransmitters in the hypothalamus and hippocampus.

Anti-Parkinson's Disease.
GB also has signifcant effects on Parkinson's disease (PD), slowing the pathological process of Alzheimer's disease(AD) to a certain extent, reducing the deposition of beta-amyloid (Aβ), and improving learning and memory ability in AD dementia mouse models [60]. Studies have shown that GB extract can signifcantly improve the behavior of Parkinson's disease model mice [61], and Gastrodia extract can improve the cognitive dysfunction of PD rats [50,61]. Te decoctions had a therapeutic efect on transgenic Parkinson's mice [63]. Te mechanism may be related to the enhancement of the human body's antioxidant capacity, protection of DA neurons in the brain, regulation of the level of monoamines in the brain, inhibition of a variety of apoptosis-related signaling pathways, activation of Wnt signaling pathways [65,92], regulation of the Kelch-like epoxylopropylamine-related protein 1 (keap1)-nuclear factor E2 related factor2(Nrf2)/ heme oxygenase-1(HO-1) pathway, or enhancement of the expression of downstream antioxidant genes and Superoxide dismutase(SOD) enzyme activity [66]. In addition, through studying the changes in the intestinal fora, three probiotics, Lactobacillus johnsonii, Lactobacillus reuteri, and Lactobacillus murine, were found in high doses of GB decoctions, each of which can help prevent and delay Alzheimer's disease. Tese fndings present new ideas and methods [67]. [69]. Studies have shown that gastrodin can alleviate depression-like behavior in chronic unpredictable stress model (CUMS)-induced depressed rats. Gastrodin injection has also been used to treat patients with schizophrenia and immune dysfunction [70]. Te antidepressant mechanism involves an increase in the monoamine neurotransmitters in the central nervous system, anti-infammatory efects, increases in the number of new neurons, the rearrangement of the nerve cytoskeleton, and regulation of the expression of T helper cell 17 (T17) and related infammatory factors [71].

Anticonvulsant.
GB has anticonvulsant efects, and GB stalks and seeds also have good anticonvulsant efects [73,102]. Te mechanism of action is similar to that of carbamazepine.

Antivertigo.
Gastrodin injection has antivertigo efects and can efectively control acute vertigo [103]. It is efective in the treatment of post-traumatic vertigo [75]. Gastrodin had a signifcant efect on the treatment of middle-aged and elderly patients with vertigo [76].

Analgesia.
Gastrodin can efectively reduce pain and reduce the levels of serum infammatory factors. Its mechanism of action may be related to the signifcant downregulation of c-fos gene expression in spinal dorsal horn tissue [72].

Antiepileptic. Gastrodia has antiepileptic efects.
Studies have confrmed that gastrodin can prolong the incubation period of generalized tonic-clonic seizure (GTCS) and minimal clonic seizure (MCS) in rats with pentylenetetrazole-induced epilepsy and improve cognitive function. Te mechanism may be through regulating the abnormal expression of COX-2 [78], regulating the Nrf2/ HO-1 classical antioxidant signal pathway, thereby reducing the expression of infammatory factors iNOS [79], and regulating the level of monoamines in the brain to exert its Gastrodin [38] antiepileptic efect [104], improve rat cognitive impairment, and protect nerves. Gastrodia can reduce the expression of serine-threonine protein kinase (p-AKT) and caspase 3 protein to resist the efect of resistance, thus triggering the model to play a protective role [80]. Gastrodin protected the brain of rats with pilocarpine-induced epilepsy by inhibiting the TLR4/NF-κB signaling pathway [81]. Gastrodin injection inhibited the levels of proapoptotic factors in the cerebral cortex of rats with epileptic seizures after ischemic stroke, increased the levels of antiapoptotic factors, and reduced the level of p38 protein kinase in the body. It has the efect of protecting brain nerves and appears to be safe [50].

Protects Nerve Cells.
Gastrodia has a protective efect on nerve cells. An experiment compared the protective efects of GB powder and four on nerve cells. Te results showed that GB had a strong efect, and its mechanism of action may be related to the levels of 7-Aminobutyrate transaminase(GABA-T) mRNA and protein expression in the rat hippocampus [82].

Protects Cardiomyocytes.
Te efect of Gastrodia in protecting cardiomyocytes is mainly related to gastrodin. Gastrodin can inhibit the opening of mitochondrial permeability transition pore (mPTP) when cardiomyocytes undergo oxidative stress damage and thereby reduce apoptosis and reduce oxidative stress damage [83]. Gastrodin can also reduce autophagy, improve the clearance of autophagosomes, and reduce cell apoptosis [74]. Gastrodin upregulated the expression of 14-3-3η protein, inhibited cardiomyocyte oxidative damage [105], downregulated the degree of cardiomyocyte oxidative stress, reduced cell apoptosis, and acted as an anti-infammatory [84]. Tese efects functioned to protect cardiomyocytes.

Antihypertension.
Gastrodia can efectively reduce hypertension caused by various factors, including essential hypertension [106], senile refractory hypertension [101], and spontaneous hypertension. Te mechanism may be related to the inhibition of the release of vascular infammatory substances s [20]. Te results of a meta-analysis indicated that the blood pressure-lowering mechanism of gastrodin may be related to the involvement of 19 key target genes in 15 biological processes by infuencing 14 hypertension pathways [107].

Antiplatelet Aggregation and Antihrombosis.
Gastrodia extract G2 had the efect of inhibiting platelet aggregation induced by adenosine diphosphate (ADP).
In vitro experiments in rabbits demonstrated that the extract inhibited platelet activating factor (PAF)-induced platelet aggregation, confrming the antiplatelet aggregation efect of Gastrodia extract [86]. Experiments have examined the in vitro and in vivo activated partial thromboplastin timing and platelet aggregation rate induced by adenosine diphosphate as indicators to analyze the antiplatelet aggregation and antithrombotic efects of the drug, confrming that gastrodin can reduce platelet aggregation and thrombosis within a certain range [87]. Te possible anticoagulant mechanism of gastrodin is related to its interference with the knob-hole interaction between fbrin molecules, which effectively inhibits the formation of blood clots and reduces the risk of thrombosis [88]. Te ethyl acetate extract of Gastrodia signifcantly stimulated plasmin activity [108]. At the same time, phenolic compounds isolated from the methanol extract of Gastrodia had a strong inhibitory efect on platelet aggregation induced by U46619 [109].

Promotes Angiogenesis. Gastrodiol components increased the expression of Vascular Endothelial Growth
Factor Receptor 2 (VEGFR-2), α-SMA, and Smad-3 and reduce the expression of Ang-2 in the brain of middle cerebral artery occlusion/reper-fusion (MCAO/R) rats and promoted angiogenesis and maturation after cerebral ischemia [89]. Angiogenesis experiments with microvesselsdefcient zebrafsh showed that gastrodin signifcantly promoted angiogenesis [90]. Gastrodin promoted Vascular endothelial growth factor-A(VEGF-A) secreted by M2 macrophages to activate vascular endothelial cells and promote angiogenesis [110]. Experiments have shown that the ethanol extract of Gastrodia increased angiogenesis in a mouse lower limb ischemia model, and its mechanism may be related to the promotion of the expression of the proangiogenesis factor VEGF-A and its receptors VEGFR-2 and Angpt2 [35].

Skeletal System.
Gastrodin can increase the proliferation of primary osteoblasts, activate the Nrf2/Keapl signaling pathway, reduce mitochondrial oxidative stress damage, maintain the steady state of mitochondrial membrane potential and the normal production of ATP to inhibit cell apoptosis, and promote the formation of osteogenic calcium nodules. Tese efects promote osteogenic diferentiation and improve osteoporosis. Te antioxidant capacity of rats was improved through treatment with diferent doses of gastrodin; the oxidative stress products and fuorine content of the body were reduced, and the damage of fuoride to bone and dentin was reduced to a certain extent. [100].

Digestive
System. Gastrodia has a certain protective efect on the gastric mucosa [91], and at the same time, it has a relaxing efect on the smooth muscle of the ileum [45]. Gastrodin can prevent the loss of liver cell mitochondrial membrane potential caused by alcohol, reduce the release of cytochrome C in mitochondria, and inhibit the activation of caspase-3 in liver cells, thereby inhibiting liver cell apoptosis and returning abnormal liver function to normal. It can also  Evidence-Based Complementary and Alternative Medicine efectively improve the pathological changes of the liver [92]. Tese studies show that Gastrodia can be used as an efective drug for the treatment of liver disease [93].

Endocrine System. Studies have shown that
Gastrodia extract can improve glucose metabolism, lipid metabolism, and insulin resistance [94]. In type 2 diabetic rat animal models, Gastrodia signifcantly improved hypothalamic insulin signaling, enhanced insulin sensitivity, and reduced hepatic glycogen output in a hyper insulinemic state [95]. In addition, gastrodin (100 µmol/L intervention for 24 h) had an inhibitory efect on human retinal endothelial cell damage induced by high glucose, and its mechanism may be related to the regulation of the Silent Information Regulator 1 (SIRT1)/TLR4/NF-κBp65 signaling pathway [64].

Urinary
System. Gastrodia can efectively improve the contractility of bladder smooth muscle [97]. Studies have shown that gastrodin can reduce the levels of renal infammatory factors and also inhibit oxidative stress by regulating Nrf2-mediated antioxidant signals and by activating AMPK. In addition, gastrodin inactivates the receptors of advanced glycation end products and the high mobility group box-1 (HMGB1) pathway and inhibits the activation of TLR, NF-κB, and transforming growth factor-β (TGF-β). Tis suggests that gastrodin can inhibit carbon tetrachloride-induced renal infammation and fbrosis through the AMPK/Nrf2/HMGB1 pathway [44].

Respiratory System.
In IgE-mediated guinea pig asthma animal models, phenolic compounds extracted from Gastrodia (intervened at a dose of 12.5 mg/kg for 24 h) significantly inhibited the airway resistance in the acute and remission phases of asthma and efectively inhibited the recruitment of white blood cells, reduced histamine release, and inhibited eosinophil peroxidase (EPO) and phospholipase A activities. Tis suggests that Gastrodia extract may have certain clinical applications in the treatment of asthma [98].

Strengthens
Immunity. Both the polysaccharides and water extracts of Gastrodia could promote the increase of mouse immunoglobulin levels and increase thymus and spleen indexes. In addition, Gastrodia injection improved the function of mouse phagocytes and serum lysozyme activity, enhanced the immune response and nonspecifc efects of mouse T cells, and promoted the formation of specifc antibodies, indicating that Gastrodia can enhance immunity [99].

Other Efects
5.9.1. Antioxidant. Te antioxidant capacity of rats was improved through treatment with diferent doses of gastrodin. Te oxidative stress products and fuorine content of the body were reduced, and the damage of fuoride to bone and dentin was reduced to a certain extent. Reference [100] GB polysaccharides have a certain scavenging efect on ferrous ions, ABTS free radicals, hydroxyl free radicals, and DPPH free radicals. Te scavenging efect is in the order of hydroxyl free radicals > DPPH free radicals > ABTS free radicals > metal ion free radicals [35]. Gastrodin has antioxidant and antiapoptotic efects in H 2 O 2 -induced oxidative stress damage. Gastrodin inhibits H 2 O 2 -induced oxidative damage and apoptosis of LSECs by activating the p38 MAPK/Nrf2/HO-1 pathway; it can reduce liver ischemiareperfusion injury in mice through anti-infammatory, antioxidant, and antiapoptotic efects [52]. Gastrodia extract can efectively improve the antioxidant capacity of rats, improve the level of oxidative stress-related indicators in rats, and thereby improve the hypoxia capacity of the rat body [53].

Treatment of Deafness and Tinnitus.
Gastrodin acupoint injection for sudden deafness accompanied by tinnitus can not only promote the disappearance of tinnitus but also improve the clinical efect [77]. Gastrodin injection is also used in the clinical treatment of patients with vertigo and tinnitus, with signifcant curative efect [101].

5.9.3.
Antitumor. Vascular dementia rats as experimental subjects were injected with GB extract, and the extract had a signifcant efect on improving the learning and memory of the mice. Te main mechanism of action may be related to reducing oxidative damage in the hippocampus and scavenging free radicals [111]. Gastrodin signifcantly reduced the cerebral infarction volume and edema volume of rats with transient middle cerebral artery occlusion and significantly improved the neurological functions of patients [112]. In addition, gastrodin also inhibited neuronal apoptosis caused by glutamate and hypoxic-ischemic sugar and reduced the levels of nitric oxide and calcium ions in extracellular glutamate. Gastrodin also had an efect on the expression of aging-related genes in the brain tissue of rapidly aging mice. Te antiaging efect of gastrodin is mainly through regulating the expression levels of some aging-related genes. Te efective phenolic components in

Evidence-Based Complementary and Alternative Medicine
Gastrodia can reduce the area of infarcts in the whole brain and cortex, improve the distribution of neurons in the hippocampus and cortex of mice, reduce the activity of caspase-3, and enhance the expression of Bcl-2, confrming that gastrodin's neuroprotective efect is related to its mechanism of weakening the apoptotic pathway.

5.9.4.
Whitening. Gastrodia extract signifcantly reduced the melanin content in normal human melanocytes without obvious cytotoxicity. In addition, zebrafsh in vivo experiments showed that Gastrodia extract efectively reduced melanin production without adverse side efects and no obvious cytotoxicity. Tis suggests that the extract of GB has a powerful whitening efect [113,114].

Pharmacokinetics
In recent years, many domestic and foreign scholars have studied the pharmacokinetics of GB. Te pharmacokinetics of gastrodin was studied by intragastric administration of gastrodin (100 mg/kg). Te results showed that gastrodin could be detected in plasma at 4.98 minutes after administration. Tmax was (0.42 ± 0.14) h, and t1/2 was (1.13 ± 0.06) h [115]. Te measured half-life difers in different species (Te t1/2 of intravenous injection in rats, rabbits and dogs is 8.41 h, 38.4 h, 105 min respectively) [19]. Gastrodin can pass through the blood-brain barrier [116], and can also be metabolized to 4-hydroxy-benzyl alcohol to enter the blood-brain barrier to exert an efect on the central system [117], and fnally be excreted through the bile [118]. Te Tmax of 4-hydroxy-benzyl alcohol was 15 min, and the Cmax of plasma, bile, and brain were 109 ng/mg, 77.7 ng/ mg, and 34.7 ng/mg [118]. Parishin is one of the active ingredients proven to have clinical efcacy. It is completely metabolized into gastrodin, 4-hydroxy-benzyl alcohol, parishin B and parishin C within 5 minutes in the body. Four metabolites are rapidly eliminated in the body [119]. N6-(4hydroxybenzyl)-adenosine has obvious neuroprotective effect, Tmax is 69 min, t1/2 is 7.75 h [120]. 4hydroxybenzaldehyde has protective efect on cerebral ischemia/reperfusion injury, in Rapid in vivo absorption, short half-life and low absolute bioavailability [121]. 4-Methoxybenzyl alcohol has a good brain protection efect, with a short half-life (t1/2 0.317 ± 0.094 h) [122]. GB extracts are mostly indexed by gastrodin and p-hydroxybenzyl alcohol. Other components in GB extract cause gastrodin and     Evidence-Based Complementary and Alternative Medicine 23

Future Perspectives and Conclusions
In summary, GB is a traditional Chinese medicine with a long history of use, and it is frequently employed in clinical practice. At present, many chemical components have been isolated and identifed from this plant. Tere is no doubt that GB is an important Chinese medicine, and because of this, many professions have made signifcant contributions to the research on GB. However, in the research on GB, new problems and challenges continue to appear, and we need further research and exploration to meet the requirements of clinical use. First, as a traditional Chinese medicine, GB has been studied more intensely in recent years, with more research being conducted on phenolic compounds, other compounds rarely being reported. Second, there are few studies on GB kinetics and toxicology. Tis aspect should receive more attention from researchers, and in vivo verifcation studies should be conducted to ensure drug safety. In particular, GB is used as medicine and food by villagers. It is commonly used to stew chickens, for example. Te proper amount, efects of long-term use, and whether it can be toxic still need in-depth research. Tird, when the GB medicinal materials are sold, they will be advertised as having a tonic efect that may be related to the pharmacological efects of GB such as antivertigo and enhancement of immunity, but whether there is actually a tonic efect and the specifc pharmacological conditions still need in-depth research. Fourth, in China the wild resources of GB are declining, and the market resources are not in high demand. Tere are many kinds of "GB" in the medicinal material market. It is necessary to analyze and identify the various "GB" according to market conditions and identify those that can be used for medicinal purposes and those that can be used as health food. Tere are also some artifcially cultivated GB. In view of the fact that there are many types and diferent quality of GB on the market, research on medicinal materials should be strengthened to ensure their quality.
In general, GB as a commonly used traditional Chinese medicine requires further research. Tis article systematically introduces the research status of GB at home and abroad in recent years, including traditional applications, phytochemistry, pharmacology, and pharmacokinetics. Although signifcant progress has been made, there are still problems associated with various aspects of the plant. Tis article also proposes some suggestions for solving these problems. Terefore, to further develop and utilize this Chinese medicine, we need to make continuous eforts in the future.

Data Availability
Te data that support the fndings of this study are available from scientifc papers, books, and dissertations concerning GB. Some dissertations and scientifc databases were used, including Baidu Scholars, Science Net, Weipu, Wanfang, and CNKI.

Conflicts of Interest
Te authors declare that they have no conficts of interest.

Authors' Contributions
Ya-Nan Wu collated documents and wrote the manuscript; Si-Hua Wen helped to perform the arrangement of tables and pictures; Shang-Shang Yu and Wei Zhang Kai Yang polished the language; Kai Yang and Ding Liu helped to organize the literature; Chong-Bo Zhao and and Jing Sun contributed signifcantly to design, analysis, manuscript preparation, and revision.