Friday, 10 February 2017

The holistic Prevention, Management and Treatment of Dementia : TCM Treatment due to Heart (Yang) Qi deficiency - Herbal Dan shen

Kyle J. Norton (Scholar) 
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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.

   TCM Treatment of Dementia Induced by Heart (Yang) Qi deficiency - Herbal Dan shen

Based on Chinese ancient medical records, causes of dementia are the results of (*)
B.1. Deficiency of Qi, mainly due to
B.2. Heart (Yang) Qi deficiency
Heart Qi deficiency is a condition of the inability of the heart in transportation of nutrients to body organs, including the brain through blood circulation. Prolong period of malnutrition of brain cells may induce abnormal function of brain's cells in information transmitting or death of neurons, causing cognitive impairment(844), including learning and memory deficits(842), changes in brain tissue and behavior patterns(843)(842).
1. Dan shen
Dan Shen is also known as Red Sage Root with taste of the bitter and slightly cold in nature, used in TCM as antithrombotic(845), antihypertonic (lowering blood pressure)(846), antimicrobial(847), anti-inflammatory(848)(849), agents and to treat coronary and cerebrovascular disease, dysmenorrhea, amenorrhea, hepatitis, hepatocirrhosis, restlessness, insomnia, irritability,(850) etc., by enhancing the functions of heart and liver channels.

1. Cryptotanshinone
2. Hydroxytanshinone,
3. Methyltanshinonate
4. Methylene tanshiquinone
5. Przewatanshinquinone A
6. Przewatanshinquinone B
7. Miltirone
8. Dihydrotanshinone I
9. Tanshinol A
10. Tanshinol B
11. Tanshinol C,
12. Nortanshinone
13. 1, 2, 15, 16-tetrahydrotanshiquinone
14. Danshensuan A, B, C
15. Protocatechuic acid,
16. Protocatechuic aldehyde
17. Etc.

1.1. Dementia
According to Mashhad University of Medical Sciences, dan shen in the pharmacological effects on the central nervous system, showed to exert its neuroprotective activity through antiparkinsonian, relaxant, analgesic and memory enhancing(850). In PC12 cells, combination application of salvianolic acid B (Sal B) and Ginkgo biloba extract EGb 761, effectively inhibited the formation of amyloid fibrils and protected PC12 cells(855) from beta-AP25-35-induced cytotoxicity and ROS accumulation(854).

1.2. Alzheimer's disease (AD)
Simple poly hydroxycinnamic acids and diterpenoid quinone, found in dan shen improved cognitive deficits in mice model, through protection of neuronal cells, prevention of amyloid fibril formation and preformed amyloid fibril disaggregation related to Alzheimer's disease(851). Salvianolic acid B (Sal B)isolated from dan shen, in animal model, not only prevented Abeta-induced cytotoxicity(857) but also improved cognitive deficits and protection of neuronal cells(852), through its effects on suppressing the production of ROS, calcium flux, and apoptosis(853), promoted amyloid precursor protein (APP) metabolism toward the non-amyloidogenic products pathway in cortical neuronal cell(856) and multifunctional machenisms(857). Compound Danshen Tablets (CDST), in rat model, exhibited spatial cognitive protection through decreased beta-APP expression in the cortex and hippocampus, detected via immunohistochemistry(859).

1.3. In learning and memory impairment
In diabetic rats model, dan shen injection improved the learning and memory decline, through upregulation of expression of MKP-1 in reduced inflammation(861) and hyperglycemia(860). HX106N, a Chimese herbal formula, containing dan shen, in Aβ25-35 peptide mice, enhanced on memory impairment and oxidative stress through increased levels of heme oxygenase-1 (HO-1)(862). In a joint study of renowned institutions, in mouse model, myelophil, a combination of extracts taken from Astragali Radix and Salviae Miltiorrhizae Radix, significantly exhibited its anti-amnesic properties in memory impairment, through the modulation of cholinergic activity(863). Tanshinones, a group of diterpenoids found in dan shen, also improved learning and memory impairments, through its inhibitory effect on acetylcholinesterase(864)

1.4. In neuroprotective effects
Tanshinone IIA (Tan IIA), one of the major active constituents of dan shen exerted its neuroprotective effects, by inhibiting transcription and translation of genes involved AD development(858). In neurotoxicity of β-amyloid protein (Aβ), contributed Alzheimer's disease (AD), dan shen extract suppressed the increased intracellular reactive oxygen species levels, through deduction of decreased the protein expression involved in the development of neurodegenerative disease, including ADs(865). According to Eur J Pharmacol and University of Sydney, salvianolic acid B (SalB) found in dan shen, in mouse model, exhibited neuroprotective effects in an amyloid β (Aβ) peptide-induced Alzheimer's disease, through its anti-inflammatory, anti-oxidative effects(866) and ameliorated cholinergic dysfunction- or Aβ(25-35)-induced memory impairment(867), respectively.
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(*) Traditional Chinese Medicine for Senile Dementia by Zhihong Lin,1 Jie Gu,1 Jin Xiu,1 Tingyan Mi,1 Jie Dong,1 and Jyoti Kumar Tiwari2(Hindawi)
(842) Folate deficiency in rat pups during weaning causes learning and memory deficits. by Berrocal-Zaragoza MI1, Sequeira JM1, Murphy MM2, Fernandez-Ballart JD2, Abdel Baki SG3, Bergold PJ3, Quadros EV1.(PubMed)
(843) Changes in brain tissue and behavior patterns induced by single short-term fasting in mice. by Hisatomi Y1, Asakura K, Kugino K, Kurokawa M, Asakura T, Nakata K.(PubMed)
(844) Combined low calcium and lack magnesium is a risk factor for motor deficit in mice. by Taniguchi R1, Nakagawasai O, Tan-no K, Yamadera F, Nemoto W, Sato S, Yaoita F, Tadano T.(PubMed)
(845) Antiplatelet and antithrombotic activities of salvianolic acid A by Fan HY1, Fu FH, Yang MY, Xu H, Zhang AH, Liu K.(PubMed)
(846) The anti-hypertensive effect of Danshen (Salvia miltiorrhiza) and Gegen (Pueraria lobata) formula in rats and its underlying mechanisms of vasorelaxation. byb Ng CF1, Koon CM, Cheung DW, Lam MY, Leung PC, Lau CB, Fung KP.(PubMed)
(847) [Roles of reactive oxygen species in Streptomyces pactum Act12-induced tanshinone production in Salvia miltiorrhiza hairy roots].[Article in Chinese] by Yan Y, Zhao X, Zhang SC, Liu Y, Liang ZS.(PubMed)
(848) [Clinical observation of treating 62 patients with severe aplastic anemia failing in immunosuppressive therapy by integrative medicine].[Article in Chinese] by Su EY1, Fang YH, Chen HS.(PubMed)
(849) Anti-Inflammatory and Immunomodulatory Mechanism of Tanshinone IIA for Atherosclerosis. by Chen Z1, Xu H2.(PubMed)
(850) The pharmacological effects of Salvia species on the central nervous system by Imanshahidi M1, Hosseinzadeh H.(PubMed)
(851) Danshen diversity defeating dementia by Hügel HM1, Jackson N2.(PubMed)
(852) Salvianolic acid B inhibits Abeta fibril formation and disaggregates preformed fibrils and protects against Abeta-induced cytotoxicty. by Durairajan SS1, Yuan Q, Xie L, Chan WS, Kum WF, Koo I, Liu C, Song Y, Huang JD, Klein WL, Li M.(PubMed)
(853) [Comparison of the inhibitory activities of salvianolic acid B and Ginkgo biloba extract EGb 761 on neurotoxicity of beta-amyloid peptide].[Article in Chinese] by Liu CS1, Hu JF, Chen NH, Zhang JT.(PubMed)
(854) [Comparison of the inhibitory activities of salvianolic acid B and Ginkgo biloba extract EGb 761 on neurotoxicity of beta-amyloid peptide].[Article in Chinese] by Liu CS1, Hu JF, Chen NH, Zhang JT.(PubMed)
(855) Tanshinone IIA protects PC12 cells from β-amyloid(25-35)-induced apoptosis via PI3K/Akt signaling pathway. by Dong H1, Mao S, Wei J, Liu B, Zhang Z, Zhang Q, Yan M.(PubMed)
(856) Cryptotanshinone, a compound from Salvia miltiorrhiza modulates amyloid precursor protein metabolism and attenuates beta-amyloid deposition through upregulating alpha-secretase in vivo and in vitro by Mei Z1, Zhang F, Tao L, Zheng W, Cao Y, Wang Z, Tang S, Le K, Chen S, Pi R, Liu P.(PubMed)
(857) Salvianolic acid A, a polyphenolic derivative from Salvia miltiorrhiza bunge, as a multifunctional agent for the treatment of Alzheimer's disease. by Cao YY1, Wang L, Ge H, Lu XL, Pei Z, Gu Q, Xu J.(PubMed)
(858) Tanshinone IIA reduces the risk of Alzheimer's disease by inhibiting iNOS, MMP‑2 and NF‑κBp65 transcription and translation in the temporal lobes of rat models of Alzheimer's disease. by Jiang P1, Li C1, Xiang Z2, Jiao B2.(PubMed)
(859) Effects of compound danshen tablets on spatial cognition and expression of brain beta-amyloid precursor protein in a rat model of Alzheimer's disease by Qin RA1, Yao XX, Huang ZY.(PubMed)
(860) Protective effects of Salvia miltiorrhiza injection against learning and memory impairments in streptozotocin-induced diabetic rats by Cai H1, Lian L2, Wang Y2, Yu Y2, Liu W2.(PubMed)
(861) Targeting mitogen-activated protein kinase phosphatase-1 (MKP-1): structure-based design of MKP-1 inhibitors and upregulators by Doddareddy MR1, Rawling T, Ammit AJ.(PubMed)
(862) Ameliorating effects of HX106N, a water-soluble botanical formulation, on Aβ25-35-induced memory impairment and oxidative stress in mice. by Lee DS1, Choi J, Kim SH, Kim S.(PubMed)
(863) Ethanol extract of Astragali Radix and Salviae Miltiorrhizae Radix, Myelophil, exerts anti-amnesic effect in a mouse model of scopolamine-induced memory deficits. by Lee JS1, Kim HG1, Han JM1, Kim DW2, Yi MH2, Son SW3, Kim YA1, Lee JS4, Choi MK1, Son CG5.(PubMed)
(864) Tanshinone congeners improve memory impairments induced by scopolamine on passive avoidance tasks in mice by Kim DH1, Jeon SJ, Jung JW, Lee S, Yoon BH, Shin BY, Son KH, Cheong JH, Kim YS, Kang SS, Ko KH, Ryu JH.(PubMed)
(865) Neuroprotection against Aβ25-35-induced apoptosis by Salvia miltiorrhiza extract in SH-SY5Y cells by Yu H1, Yao L2, Zhou H3, Qu S1, Zeng X1, Zhou D1, Zhou Y1, Li X1, Liu Z4.(PubMed)
(866) Neuroprotective effects of salvianolic acid B on an Aβ25-35 peptide-induced mouse model of Alzheimer's disease. by Lee YW1, Kim DH, Jeon SJ, Park SJ, Kim JM, Jung JM, Lee HE, Bae SG, Oh HK, Son KH, Ryu JH.(PubMed)
(867) Cognitive dysfunctions induced by a cholinergic blockade and Aβ 25-35 peptide are attenuated by salvianolic acid B by Kim DH1, Park SJ, Kim JM, Jeon SJ, Kim DH, Cho YW, Son KH, Lee HJ, Moon JH, Cheong JH, Ko KH, Ryu JH.(PubMed)

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