The 2nd edition of The holistic Prevention, Management and Treatment of Dementia under The Microscope of Conventional Medicine: TCM Spleen Qi deficiency - Herbal Peony (Chi Shao)

Kyle J. Norton (Scholar)

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Abstract
Dementia is defined as neuro degeneration syndrome among elder, affecting memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement over 47 millions
of worldwide population, mostly in the West. The evaluation of the syndrome by holistic medicine has been lacking, especially through conventional medicine research and studies. The aim of this essay is to provide accurate information of how effective of holistic medicine in prevention, management and treatment of dementia through searching data base of PubMed.
This is the third time, a research paper has been written this way to general public that you will not find any where in the net.

Dementia is a neuropsychiatric disorder induced of cognitive impairment and behavioral disturbances. The behavioral and psychological symptoms of dementia (BPSD) are common, with a progressive loss of memory and other mental abilities, affecting a person's ability to perform usual tasks in everyday life.

Treatments in Traditional Chinese Herbal Medicine

B.3.3. Spleen Qi deficiency
Spleen is a vital organ, according to traditional Chinese medicine, with function in absoring nutrients and transporting them to body's organs and cells. Spleen Qi deficiency is a condition of the inability of the spleen in maximized transportation of nutrients to body organs, including the brain. Prolong period of malnutrition of brain cells may induce abnormal functions in information transmitting or death of neurons, causing cognitive impairment(844), including learning and memory deficits(842) and changes in brain tissues and behavior patterns(843)(842).

Herbal medicine for Spleen Qi deficiency
1. Peony (Chi Shao)
Chi Shao or Chi Shao Yao with bitter, sour taste and cool in nature is also known as Peony Root, used in TCM as antispasmodic(1000)(1001), anti-inflammatory(1002)(1003), anti allergic(1004) antibiotic(1005), anticonvulsant(1006), analgesic(1007), anxiolytic(1008) agents and to lower blood pressure(1009), dilate peripheral blood vessels, coronary arteries against heart attack(1010), treat viral hepatitis(1011), chronic constipation(1012), asthma(1013), whooping cough(1014), diabetes(1015)(1016), etc., as it clears heat, cools blood, eliminates blood accumulation, calms paindilates, etc., by enhancing the functions of liver and spleen channels(1017).
Phytochemicals
1. Essential oil
2. Resin
3. Paeoniflorin
4. Paeonol
5. Paeonin
6. Albiflorin
7. Triterpenoids
8. Sistosterol
9. Oxypaeoniflorin
10. Benzoylpaeoniflorin
11. Benzoic acid
12. β sitosterol
13. Gallotannin
14. Pedunculagin
15. 1-O-Galloylpedunculagin
16. Eugeniin
17. Tannin acid
18. Etc.

Herbal shao yao used in traditional Chinese medicine for treatment and prevention of dementia(1018)(1019), may be due to its effectiveness of phytochemicals, including major constituent paeoniflorin, in exertion of its neuroprotective effects(1020)(1021) through anti oxidative stress(1022), anti inflammatory(1023), improved neural synapse plasticity(1024) mechanisms, against β-amyloid (Aβ) accumulation(1025) induced senile dementia and aging-induced cognitive dysfunction(1026).

1.1. Parkinson's disease PD
Strong evidences suggested that peony, possesses wide pharmacological effects in nervous system(1027)(1028). Paeoniflorin, a phytochemical isolated from peony, in PC12 cells induced by 6-OHDA found in patient with Parkinson's disease(1030), showed to suppress mitochondria apoptosis, through its antioxidant capability in increasing glutathione (GSH)(1032), by inhibiting reactive oxygen species (ROS)(1031). In Parkinson's disease (PD) progressive loss of dopaminergic neurons involved movement and in mouse model with mitochondrial dysfunction, peony significantly inhibited mitochondria-mediated apoptosis, via the regulation of expression of immunity, inhibition of cytochrome C associated with the inner membrane of the mitochondrion. release and caspase-3, a protein encoded by in CASP3gene, activation(1031). According to University of Miami, polyphenols of bai shao, included baicalin, baicalein, wogonin (in scutellaria) paeonol, paeonoside, and paeoniflori, exerted neuroprotective efficacy, probably through improving cerebral blood circulation, involved alleviation of the symptoms of degenerative diseases, Alzheimer's disease (AD) andParkinson's disease (PD)(1033).

1.2. In Alzheimer's disease AD
Abeta42 deposition in hippocampus has shown to induce brain inflammation causes of early onset of Alzheimer's disease AD(1034)(1035). Paeonol(2'-hydroxy-4'-methoxyacetophenone;1-(2-hydroxy-4-methoxyphenyl)ethan-1-one), found in peony, not only protected the nervous system against accumulation of amyloid peptide, Aβ1-42, through its anti-inflammatory and free radical scavenging properties, but also slowed down and regulated the pathogenic processes associated with AD, through morphological, biochemical and behavioral activities(1036). Aqueous extract of the dry root ofPeony in Abeta((1-42))-induced rats, also inhibited Abeta-induced neurotoxicity, through ameliorated cognitive deficit, cell apoptosis in dose-dependent manner(1037).

1.3. In cognitive impairment
Cognitive impairment is common in patients with the neurodegenerative disease, including Alzheimer's disease (AD) and Parkinson's disease (PD, Paeoniflorin, isolated from the aqueous extract of peony, in rat model, not only showed to promote the cognitive ability, exhibited anti-depressant-like effect and reduced toxicity, but also attenuated the oxidative stress induced Aβ(1-42) by regulating choline acetyltrasferase and the activity of acetylcholine esterase in the hippocampus of Aβ(1-42)(1038)(1039). In Chronic cerebral hypoperfusion, associated with the cognitive deficits of AD, the phytochemical also attenuated cognitive deficit and brain damage through ameliorated astrocytes(star-shaped glial cells in CNS) and microglias(glial cell in CNS) in hippocampus(1040). According to Shanghai Institute of Materia Medica, on cerebral infarction induced neurological symptoms, paeoniflorin (PF) significantly reduced the infarct volume causes of cognitive impairment(1041).

1.4. In learning and memory
Supplementation of paeonol extracted from peony, in d-galactose (D-gal)-induced aging mice, significantly improved the learning and memory ability through reduction of oxidative stress, cognitive impairment and neurotoxicity, according to China Pharmaceutical University(1042). Danggui-Shaoyao-San (DSS), the herbal formula containing peony and 5 other herbs, used to treat gynecological disorders and neural dysfunctions, in the same model study, showed effectively in improved cognitive ability, through ameliorating oxidative stress induced neuronal apoptosis in the brain(1043). Paeoniflorin, a major constituent of peony, also exhibited its beneficial effect on learning and memory impairment in rodents, by reversed the suppressible effects of adenosine as shown on passive avoidance test and inhibition of long-term potentiation (LTP)(1044).

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References
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(1002) Moutan cortex radicis improves lipopolysaccharide-induced acute lung injury in rats through anti-inflammation by Fu PK1, Yang CY, Tsai TH, Hsieh CL.(PubMed)

(1003) Paeonol attenuates high-fat-diet-induced atherosclerosis in rabbits by anti-inflammatory activity by Li H1, Dai M, Jia W.(PubMed)

(1004) Antiallergic effect of the root of Paeonia lactiflora and its constituents paeoniflorin and paeonol. by Lee B1, Shin YW, Bae EA, Han SJ, Kim JS, Kang SS, Kim DH.(PubMed)

(1005) Growth-inhibiting, bactericidal, and urease inhibitory effects of Paeonia lactiflora root constituents and related compounds on antibiotic-susceptible and -resistant strains of Helicobacter pylori by Ngan LT1, Moon JK, Shibamoto T, Ahn YJ.(PubMed)

(1006) Peony root extract upregulates transthyretin and phosphoglycerate mutase in mouse cobalt focus seizure by Kajiwara K1, Sunaga K, Tsuda T, Sugaya A, Sugaya E, Kimura M.(PubMed)

(1007) Clinical efficacy of aconitum-containing traditional Chinese medicine for diabetic peripheral neuropathic pain by Feng L1, Liu WK, Deng L, Tian JX, Tong XL.(PubMed)

(1008) Anxiolytic-like effect of paeonol in mice. by Mi XJ1, Chen SW, Wang WJ, Wang R, Zhang YJ, Li WJ, Li YL.(PubMed)

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(1010) The protective effect of peony extract on acute myocardial infarction in rats by Mo X1, Zhao N, Du X, Bai L, Liu J.(PubMed)

(1011) Paeoniflorin protects against concanavalin A-induced hepatitis in mice. by Chen M1, Cao L2, Luo Y3, Feng X4, Sun L5, Wen M6, Peng S7.(PubMed)

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(1017) Shao Yao(Complementary and Alternative Healing University)

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