Cold tea is one of the most commonly used traditional medicines among the She people. Modern studies have shown that the active ingredients of cold tea, in addition to volatile oils, include flavonoids, coumarins, anthraquinones, and other non-volatile compounds, with flavonoids being the dominant component. Modern pharmacological studies suggest that the anticancer effects of flavonoids in cold tea are closely linked to their ability to induce apoptosis and inhibit angiogenesis. In She medicine, cold tea is primarily used to treat conditions caused by food stagnation, such as fullness, chronic gastritis, gastric and duodenal ulcers leading to bloating, gastric pain, and acid reflux, as well as playing a crucial role in the prevention and treatment of colds and influenza (Liu et al., 2013; Samanta, 2022; Luo et al., 2024). Diren, derived from the whole plant Melastomadodecandrum (Lour.), is known for its sweet and astringent taste. Modern clinical studies have confirmed that Diren has notable hemostatic effects, particularly in treating gastrointestinal bleeding. Studies show that Diren is rich in polysaccharides, flavonoids, amino acids, phenols, and both macro and trace elements, contributing to its hemostatic, antioxidant, analgesic, anti-inflammatory, and hypoglycemic effects. Flavonoid compounds from Diren have demonstrated apoptosis-inducing and immune-modulatory properties, enhancing its potential as an adjunct therapy in gastrointestinal cancers. Further reports highlight its antitumor, hypoglycemic, and hypolipidemic properties, while showing no toxic side effects on normal cells (Zheng et al., 2021; Xie et al., 2016; Yao et al., 2021). Jinxian Diao Hulu: Many bioactive compounds, such as dandelion terpenes, flavonoids, and sterols, These compounds contribute to its anti-tumor, immune regulating, hepatoprotective, anti-inflammatory, and antiviral properties, and no toxicity has been observed. It is used clinically to treat febrile seizures, pneumonia, and various cancers in children (Gezici and Şekeroğlu, 2019; Chang et al., 2013). Xiaoye Rong 1934: a shrub commonly used in She medicine in Eastern and Southeastern China, is used to treat various conditions such as infantile malnutrition, indigestion, diarrhea, hernia, gout, and joint pain. The plant has been widely studied for its phytochemical components, and research has begun to explore its potential antitumor effects through pathways such as oxidative stress inhibition and immune modulation (Li et al., 2022; Lu et al., 2022). Tu Mu Xiang: Tu Mu Xiang, also known as “Hong Mu Xiang” or “Nan Wu Wei Zi Gen,” is a common herbal remedy among the She people of Fujian province. Research has shown that its source plants include multiple species from the Magnoliaceae family, particularly the roots and stems of Schisandra chinensis. These compounds exert anticancer activity by modulating apoptosis pathways and suppressing metastasis-related signaling (Yang et al., 2017; Zhang et al., 2022). Scutellaria baicalensis: Commonly used in She medicine for its multiple pharmacological effects, particularly anticancer properties. The key component baicalin has been shown to induce apoptosis in cancer cells, inhibit tumor angiogenesis, and reduce metastasis (Liu Y. et al., 2024). Panax notoginseng: Known for its effects on blood circulation and pain relief, it has demonstrated significant potential in anticancer therapy by inducing apoptosis and inhibiting the proliferation and invasion of cancer cells (Hawthorne et al., 2022). Lonicera japonica: Widely used for its anti-inflammatory and detoxifying properties, its active ingredients, such as chlorogenic acid and quercetin, show anticancer activity by inhibiting cell proliferation and inducing apoptosis (Ma et al., 2024; Park et al., 2017). Ganoderma lucidum: This popular herb enhances immunity and exhibits antioxidant, anti-inflammatory, and anticancer properties through its polysaccharide content (Cör et al., 2018; Sohretoglu and Huang, 2018). Hedyotis diffusa: An important part of She medicine, its active ingredients are widely used for their anti-cancer, anti-inflammatory, and anti-oxidant effects, particularly in the treatment of liver and stomach cancers (Figure 1) (Shao et al., 2011).

In comparison with conventional therapies such as paclitaxel or platinum-based chemotherapy, these She medicinal herbs provide multi-targeted mechanisms—including apoptosis regulation, immune modulation, and microenvironment adjustment—highlighting their potential as complementary or alternative options in integrative cancer therapy.

From the perspective of medicinal parts, Asteraceae family herbs in She Medicine most frequently utilize the whole plant with 37 species falling into this category, followed by root and rhizome, flower, fruit and seed, and stem wood types (Sharma M. et al., 2022). There are 20 species with two or more medicinal parts, including Artemisia lactiflora Wall. ex DC. and Eupatorium japonicum Thunb. This reflects the traditional emphasis on maximizing pharmacological utility by using multiple plant parts (Lei et al., 2014; Yarnell, 2015). For example, Rubus chingii (Eastern raspberry) has dry roots that are used in She medicine to treat wind pain, improve vision, expel toxins, and soothe nausea. It is applied for treating conditions such as tuberculosis and spinal cord compression (Sheng et al., 2020; Yu et al., 2019) Di Ren: A commonly used herb in She medicine, the whole plant is used. It is sweet and slightly cool, containing polysaccharides and flavonoids. It has hemostatic, antioxidant, and anti-inflammatory properties. The highest concentration of active compounds is found in the leaves (Sze et al., 2010). Shi Liang Cha: Derived from the dry leaves of Lyonia species, it has a cooling, slightly bitter, and pungent nature. It is used in treating wind-heat symptoms, with significant antioxidant and anti-tumor effects. It is clinically applied for diseases like colds and diarrhea (Ma et al., 2017). Di Jin Ju: The whole plant is used and is beneficial for activating blood flow and expelling wind, and it treats gastric pain. This herb has been used in She communities for generations (Wali et al., 2022). The use of whole plants or multiple parts enhances the synergistic efficacy of She Medicine. This holistic approach differs from modern single-compound therapies by preserving the complex phytochemical interactions essential for therapeutic effects.

Flavonoids, triterpenes, alkaloids, and polyphenols found in She medicine exhibit a wide range of biological functions, including anticancer properties. For example, flavonoids in Shiliang tea may be the basis of its cardiovascular protection, antibacterial, antiviral and anticancer activities (Wang et al., 2020; Li and Jiang, 2018). Anthraquinone compounds such as rhein methyl ether and rhein-8-O-β-D-glucoside contribute to antibacterial, anti-inflammatory, and potentially cytotoxic effects in cancer cells. Harringtonine (HT), a natural alkaloid from Cephalotaxus, has shown strong efficacy against leukemia and is currently used in the treatment of acute leukemia and lymphoma (Luo et al., 2004). The study of HT derivatives showed that ht1 enhanced the antiproliferative activity of HL-60 cells, with an IC₅₀ value approximately 2,000 times lower than that of HT itself (Ochi et al., 2022; Sakamoto et al., 2018). These results highlight the importance of chemical modification in enhancing bioactivity. In Sanjiaofeng dew, extraction efficiency of active ingredients like flavonoids is influenced by solid-liquid ratios and microwave irradiation time, which are critical factors in maximizing anticancer efficacy during preparation. These components induce tumor cell apoptosis and inhibit proliferation by modulating key signaling pathways (Abotaleb et al., 2018; Raina et al., 2020).

In recent years, notable advances have been made in the phytochemical investigation of She medicine herbs. For example, the flavonoids in the extract of Liquidambar sanjiaoensis are essential for anti-cancer and immune regulation (Luo et al., 2004). The pharmacological effects of Di Ren and San Jiao Feng Lu are directly related to the contents of flavonoids and phenols. By analyzing the content of gallic acid and quercetin in different parts of Rehmannia glutinosa, the researchers determined the best harvest time of Rehmannia glutinosa (Yue-ling et al., 2017). Its extracts, rich in quercetin and gallic acid, show significant variability across plant parts and seasons, affecting therapeutic efficacy (Engström et al., 2015). Quercetin, a key flavonoid, reduces oxidative stress and inhibits tumor cell proliferation through cell cycle arrest (Xie et al., 2011). Its concentration reached its peak in early May, making it a critical compound for maximizing anticancer activity during harvesting (Xie et al., 2012).

Many herbs in she medicine contain bioactive compounds such as flavonoids, saponins, quinones and terpenes, considered core contributors to their anticancer activity^198,199. For example, astragaloside IV from Astragalus enhances immune responses and suppresses tumor progression (Zhou et al., 2017). The chemical constituents of Euphorbia officinalis, including flavonoids and quercetin, have been proved to inhibit the proliferation of tumor cells (Engström et al., 2015; Yang et al., 2021). Quercetin not only regulates the cell cycle but also significantly increases the apoptosis rate of malignant cells. Researchers have employed advanced analytical techniques such as high-performance liquid chromatography (HPLC) and gas chromatography–mass spectrometry (GC-MS) to identify and quantify bioactive ingredients in Camellia and other She herbs. Emerging tools including single-cell sequencing, network pharmacology, and molecular docking are increasingly used to uncover the intricate anticancer mechanisms of She herbal medicines (Huang et al., 2024; Qi and Zou, 2023; Ni et al., 2025; Jiao et al., 2021).

At the cellular level, the components of She medicine can induce tumor cell apoptosis by modulating apoptosis-related genes and activating intrinsic and extrinsic apoptotic pathways (Yang et al., 2023a; Yang et al., 2023b). For example, triptolide activates caspase enzymes and suppresses Bcl-2 expression to initiate programmed cell death (Davis and Salton, 1975; Safarzadeh et al., 2014; Lefkowitz, 1975). In AML, homoquercetin upregulates MCL-1 and ROS levels, activates Bax, and promotes mitochondrial release of cytochrome c to trigger apoptosis (Figure 2). At the molecular level, HT showed anti-cancer effect on gefitinib resistant NSCLC cell lines by targeting Smad3 and TGF-β signaling pathways. It also regulates alternative splicing of Bcl-x and caspase-9 through a PP1-dependent mechanism (Cao et al., 2015; Qin et al., 2015; Wang et al., 2021; Gao et al., 2007). At the tissue level, She medicine inhibits tumor angiogenesis, invasion, and metastasis. This is achieved through comprehensive regulation of the tumor microenvironment, such as downregulating pro-inflammatory cytokines and restoring intestinal microbiota balance (Yang W. et al., 2023; Liang et al., 2024; Zhou et al., 2023a). Immunocytochemical and pathway studies have shown that She medicines enhance immune surveillance and counteract tumor immune evasion by modulating the infiltration of tumor-associated macrophages and T-cell subtypes. They also inhibit key pathways like NF-κB, offering mechanistic insights into their immunomodulatory effects (Ding et al., 2025). Some She medicines, such as Astragalus and Codonopsis, stimulate macrophage and T cell activity, amplifying antitumor immune responses (Patanapongpibul and Chen, 2019). With the integration of single-cell transcriptomics, bioinformatics, and experimental validation, researchers can now delineate She medicine’s impact on immune cell subtypes within the tumor microenvironment, providing robust evidence for its immunotherapeutic value (Yang et al., 2023b; Liang et al., 2024; Qian et al., 2024; Yu and Pan, 2024; Luo et al., 2023).

Genetic analysis of ITS2 sequences in raspberry and related species revealed distinct molecular markers, offering new insights into Rubus taxonomy and the evolutionary basis of anticancer activity in She herbal species (Song et al., 2012). A new she medicine crushing device was designed to improve processing efficiency and standardization, ensuring uniform quality for research and clinical use (Thapliyal et al., 2024). The device enhances purity and consistency, which are essential for reproducibility in pharmacological studies. Simultaneously, bioactive scaffolds are being used to deliver She herbal extracts to tumor tissues with enhanced targeting and controlled release, forming a novel strategy for She medicine-based anticancer drug delivery systems (Jia et al., 2024; Li et al., 2024). In summary, She medicine presents a promising approach to cancer therapy through its chemically diverse components and multi-target mechanisms.

Numerous clinical studies suggest that She medicinal herbs can be used as adjuncts to chemotherapy drugs to improve their efficacy (Wang et al., 2012; Wang et al., 2018; Murasawa et al., 2023). For instance, extracts from Bai Ji (Radix Bletillae) and Tripterygium wilfordii L. have been shown to significantly enhance the efficacy of standard chemotherapeutic regimens while concurrently reducing drug resistance and toxicity (Zhou et al., 2023b). In advanced cancer patients, She medicine is often employed to alleviate cancer-related symptoms, such as pain and fatigue, and to improve appetite and sleep quality, ultimately enhancing patients’ overall quality of life (Mystakidou et al., 2007). The use of golden-thread gourds (Cocculus trilobus) in She folk medicine has demonstrated empirical effectiveness in tumor management. Recent studies conducted by Chinese research institutions have confirmed its anticancer activity, particularly by inducing apoptosis in liver cancer and leukemia cell lines (Mystakidou et al., 2007; Dai et al., 2013). Mechanistic investigations suggest involvement of caspase-3 activation and modulation of mitochondrial pathways, indicating that this herb holds promise as a supplementary treatment. These findings align with a growing body of literature that supports the integrative use of traditional medicine in reducing chemotherapy side effects and enhancing clinical response.

In traditional She medicine, many She medicinal herbs are widely used not only for cancer but also for a variety of other chronic and inflammatory conditions. One notable example is the externally applied formula “She Medicine Twelve-Hour Ointment,” which exemplifies the distinctive therapeutic approach of She ethnomedicine and offers insights for translational applications in modern integrative medicine (Yu et al., 2016). Research has shown that the ointment possesses favorable stability and reproducibility during preparation, and exhibits significant analgesic and anti-inflammatory activity. The clinical application of this ointment in musculoskeletal pain, soft tissue injuries, and even localized cancer-related pain syndromes underscores the need for further exploration into topical She herbal therapeutics.