Saturday, 11 February 2017

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

Kyle J. Norton (Scholar) 
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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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 Ren shen (Ginseng) 

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)..

Herbal medicine for Heart Qi deficiency
2. Ren shen (Ginseng)
Ren Shen is a smells aromatic, tastes sweet and slightly warm herbs, also known as Gingshen, used in TCM as improved immune system(868)(869), Anti Cancer(870)(871), Anti aging(872)(873), Anti stress(874)(875), antiErectile dysfunction(876)(877), etc. agents and to generates fluids, reduces thirst, treats symptoms of diabetes(878)(879), for xinqixu (heart qi deficient) related coronary heart disease (CHD)(880)(881), anxiety(882)(883), insomnia(884)(885), depression(886)(887), neurodegenertive disorders(888)(889)(890), bleeding in the vagina not during period(891), seizures(892)(893), chronic fatigue(894)(895), etc. as it strongly tonifies Original Qi, the Spleen and the Lungs, promotes generation of Body Fluids, calms thirst and the Mind,(896) etc. by enhancing the functions of spleen and lung channels(897).

1. Saponins
2. Panaxynol
3. Ginsenyne
4. Alpha pansinsene
5. Beta pansinsene
6. Beta farnesene
7. Bicyclogermacrene
8. Beta elemene
9. Gama elemene
10. Alpha neodovene
11. Beta neodovene
12. Alpha humulene
13. Beta humulene
14. Ccaryophyllene
15. Beta gurjunene
16. Alpha gurjunene
17. Alpha selinene
18. Beta selinene
19. Gama selinene
20. Selin-4, alpha guaiene
21. Gama cubebene
22. Beta patchoulene
23. Hepatadecanol-1
24. Etc.

Herbal ren shen used in the treatment and prevention of dementia(898) in traditional Chinese medicine, may be due to its effectiveness of phytochemicals in ameliorated amyloid pathology(899)(900) and related cognitive deficits(901). In aging related dementia, based on the history of use, and pharmacological investigation, ren shen showed a strong evidence in cognitive improvement, through cholinesterase inhibitory activity and cholinergic function(902). According to Beijing University of Chinese Medicine, combination extract of Renshen (Panax Ginseng), Yinyanghuo (Herba Epimedii Brevicornus), Yuanzhi (Radix Palygalae) and Jianghuang (Rhizoma Curcumae Longae) (GEPT) exhibited neuroprotecting mechanism for preventing and treating of AD(903).

2.1. In Alzheimer's disease
Alzheimer's disease is a brain disorder named after German physician Alois Alzheimer. The disease destroys brain cells involved inflammation, mitochondrial dysfunction or oxidative stress(904), causing problems with thinking and behavior severe(904) enough to affect language communication(905), memory(906), lifelong hobbies or social life(907).
Ginseng extracts, in Alzheimer's disease (AD) patients significantly attenuated amyloid plaque deposition in short- and long-term memory impairment. through its phytochemical gintonin effect via the mediation in promotion of non-amyloidogenic processing(908). In amyloid β peptide induced AD cell model, ginsenoside Rg1, the main chemical constituent of ginseng, improved the memory impairment associated with Alzheimer's disease (AD), through suppressing the signaling transduction pathways and decreasing the inflammation factors(909)(910); increasing cell viability, reducing oxidative damage (including apoptosis), restoring mitochondrial membrane potential(911). According to the join 17-months old male APP/PS1 mice study by University of Michigan and Yunnan University of Traditional Chinese Medicine, total saponin in leaves of Panax notoginseng (LPNS) attenuated reactive oxygen species (ROS) accumulation and cell death in brain cells through activation of Nrf2 (nuclear translocation) and upregulation of downstream antioxidant systems(912).
Unfortunately, according to the review over 20 databases from the inception to January 2009 and included all randomized clinical trials (RCTs) from Korea Institute of Oriental Medicine, the use of ginseng for treatments of Alzheimer's disease is scarce and inconclusive(913).

2.2. In Parkinson's and Huntington's diseases
Parkinson's disease is a progressive disorder of the nervous system, affecting movement of muscles(917)(918), speech(919), poster, balance, auto functioning(920), etc., with disease's symptoms worsen over time. According to a multicenter study, phosphorylated forms, pS129 is associated to the severity and progression of Parkinson diseases(914). NFE2L2 gene, an important regulator of the cellular protection against oxidative stress, if defects can contribute to the pathogenesis of the disease(915)(916). In the pathogenesis of Parkinson's disease (PD), Ginsenoside Rb, effectively inhibited or reversed the aggregation process and may represent a viable therapeutic strategy against PD and related disorders, through anti-amyloidogenic and antineurotoxical effects(921). Its water extract in induced cytotoxicity of SH-SY5Y human neuroblastoma cells, also exhibited significant protective effects possibly through the suppression of ROS generation(922). According to Russian Academy of Medical Sciences, use of ginseng and other herbs, such as eleutherococcus, Rhodiola rosea, etc., in a complex therapy for Parkinson's disease, may be due to theirs normalized immune, antioxidant, and hormonal parameters(923).
In Huntington's disease, Ginsenosides, the main chemical constituents of ginseng, showed to exert its neuroprotective effect against neurons from glutamate-induced apoptosis in vitro(924).

2.3. In cognitive impairment
Klotho Gene Deficiency has been found to associate with oxidative stress related cognitive impairment(925). In aging mice model, ginseng exhibited anti oxidative stress in ameliorated lipid peroxidation, restored antioxidant capacity(926), and reduced accumulation of intercellular messenger, nitric oxide (NO)(927) activities, may be used as a potential treatment of herbal medicine for cognitive impairment(927). Ginsenoside Rb1, a major chemical constituent found in ginseng, showed to inhibit cognitive impairment caused by diabetes, through GSK3β, (a negative regulator in the hormonal control of glucose homeostasis)-mediated endoplasmic reticulum(ER) stress due tophysiological and pathological insults, in high glucose-treated hippocampal neurons(928).

2.4. In neuroprotective effects
In high glucose-induced neurotoxicity in primary cultured rat hippocampal neurons, Ginsenoside Rb1 exerted a wide variety of neuroprotective effects by inhibiting CHOP signaling pathway involved in apoptosis signal in ER stress- and CHOP-mediated apoptosis(940), oxidative stress(926), mitochondrial dysfunction(929)(941) and neuroinflammation(941). According to University Complutense of Madrid, Ginseng and its major constituents as potential neuroprotective agents against progression of Parkinson's disease(943), may be due to its effectiveness in inhibition of oxidative stress(926), neuroinflammation(941), toxins-induced apoptosis(944) and regulation of channels and receptors activity(945)(942).

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(868) Immune system effects of echinacea, ginseng, and astragalus: a review by Block KI1, Mead MN.(PubMed)
(869) Effect of the combination of ginseng, oriental bezoar and glycyrrhiza on autonomic nervous activity and immune system under mental arithmetic stress. by Zheng A1, Moritani T.(PubMed)

(870) Protopanaxadiol, an active ginseng metabolite, significantly enhances the effects of fluorouracil on colon cancer by Wang CZ1, Zhang Z2, Wan JY3, Zhang CF4, Anderson S5, He X6, Yu C7, He TC8, Qi LW9, Yuan CS10.(PubMed)
(871) Panaxadiol, a purified ginseng component, enhances the anti-cancer effects of 5-fluorouracil human colorectal cancer cells. by Li XL1, Wang CZ, Mehendale SR, Sun S, Wang Q, Yuan CS.(PubMed)
(872) Ginsenoside Rg1 prevents cognitive impairment and hippocampus senescence in a rat model of D-galactose-induced aging. by Zhu J1, Mu X1, Zeng J2, Xu C1, Liu J1, Zhang M1, Li C1, Chen J3, Li T3, Wang Y1.(PubMed)
(873) Hormesis-based anti-aging products: a case study of a novel cosmetic by Rattan SI1, Kryzch V, Schnebert S, Perrier E, Nizard C.(PubMed)
(874) Anti-stress effects of Ginkgo biloba and Panax ginseng: a comparative study by Rai D1, Bhatia G, Sen T, Palit G.(PubMed)
(875) Proof of the mysterious efficacy of ginseng: basic and clinical trials: clinical effects of medical ginseng, korean red ginseng: specifically, its anti-stress action for prevention of disease by Kaneko H1, Nakanishi K.(PubMed)
(876) Ginsenoside Rg3 improves erectile function in streptozotocin-induced diabetic rats. by Liu T1, Peng YF, Jia C, Yang BH, Tao X, Li J, Fang X.(PubMed)
(877) Second look at the potential use of ginseng berry extract for treating erectile dysfunction by Watson DC1.(PubMed)
(878) Antidiabetic effects of malonyl ginsenosides from Panax ginseng on type 2 diabetic rats induced by high-fat diet and streptozotocin by Liu Z1, Li W, Li X, Zhang M, Chen L, Zheng YN, Sun GZ, Ruan CC.(PubMed)
(879) Hypoglycemic effects of malonyl-ginsenosides extracted from roots of Panax ginseng on streptozotocin-induced diabetic mice. by Liu Z1, Wang LJ, Li X, Hu JN, Chen Y, Ruan CC, Sun GZ.(PubMed)
(880) [Effect of renshen jianxin capsule for alleviating insulin resistance in patients with coronary heart disease and glucose tolerance impairment].[Article in Chinese] by Li AM1, Zhao J.(PubMed)(881) [Effect of panax quinquefolius saponin on insulin sensitivity in patients of coronary heart disease with blood glucose abnormality].[Article in Chinese] by Zhang Y1, Lu S, Liu YY.(PubMed)
(882) The nootropic properties of ginseng saponin Rb1 are linked to effects on anxiety by Churchill JD1, Gerson JL, Hinton KA, Mifek JL, Walter MJ, Winslow CL, Deyo RA.(PubMed)
(883) Chronic oral administration of ginseng extract results in behavioral change but has no effects in mice models of affective and anxiety disorders by Einat H1.(PubMed)
(884) Effects of Korean red ginseng (Panax Ginseng Meyer) on bisphenol A exposure and gynecologic complaints: single blind, randomized clinical trial of efficacy and safety. vt Yang M1, Lee HS, Hwang MW, Jin M.(PubMed)
(885) Hypnotic effects and binding studies for GABA(A) and 5-HT(2C) receptors of traditional medicinal plants used in Asia for insomnia by Cho SM1, Shimizu M, Lee CJ, Han DS, Jung CK, Jo JH, Kim YM.(PubMed)
(886) The antidepressant effects and mechanism of action of total saponins from the caudexes and leaves of Panax notoginseng in animal models of depression by Xiang H1, Liu Y, Zhang B, Huang J, Li Y, Yang B, Huang Z, Xiang F, Zhang H.(PubMed)
(887) Antidepressant effects of ginseng total saponins in the forced swimming test and chronic mild stress models of depression. by Dang H1, Chen Y, Liu X, Wang Q, Wang L, Jia W, Wang Y.(PubMed)
(888) Potential neuroprotective activity of Ginseng in Parkinson's disease: a review by González-Burgos E1, Fernandez-Moriano C, Gómez-Serranillos MP.(PubMed)
(889) Panax ginseng is neuroprotective in a novel progressive model of Parkinson's disease by Van Kampen JM1, Baranowski DB2, Shaw CA3, Kay DG4.(PubMed)
(890) Effects of Panax ginseng in Neurodegenerative Diseases. by Cho IH1.(PubMed)
(891) Ginseng and vaginal bleeding by Greenspan EM.(PubMed)
(892) Anticonvulsant activity of ginseng on seizures induced by chemical convulsants by Lian XY1, Zhang ZZ, Stringer JL.(PubMed)
(893) Anticonvulsant and neuroprotective effects of ginsenosides in rats by Lian XY1, Zhang Z, Stringer JL.(PubMed)
(894) Ginseng in the treatment of fatigue in multiple sclerosis: a randomized, placebo-controlled, double-blind pilot study by Etemadifar M1, Sayahi F, Abtahi SH, Shemshaki H, Dorooshi GA, Goodarzi M, Akbari M, Fereidan-Esfahani M.(PubMed)
(895) Can ginseng alleviate cancer-related fatigue? by Viale PH.(PubMed)
(896) REN SHEN(TCM assistant)
(897) ren shen (ginseng)(Complementary and Alternative Healing University)
(898) Panax ginseng ginsenoside-Rg2 protects memory impairment via anti-apoptosis in a rat model with vascular dementia by Zhang G1, Liu A, Zhou Y, San X, Jin T, Jin Y.(PubMed)
(899) Ginsenoside Rh2 promotes nonamyloidgenic cleavage of amyloid precursor protein via a cholesterol-dependent Qiu J1, Li W2, Feng SH3, Wang M3, He ZY4.(PubMed)
(900) Cerebrolysin decreases amyloid-beta production by regulating amyloid protein precursor maturation in a transgenic model of Alzheimer's disease. by Rockenstein E1, Torrance M, Mante M, Adame A, Paulino A, Rose JB, Crews L, Moessler H, Masliah E.(PubMed)
(901) Ginsenoside Rg5 improves cognitive dysfunction and beta-amyloid deposition in STZ-induced memory impaired rats via attenuating neuroinflammatory responses by Chu S1, Gu J2, Feng L3, Liu J4, Zhang M5, Jia X5, Liu M6, Yao D7.(PubMed)
(902) Comparative study of korean white, red, and black ginseng extract on cholinesterase inhibitory activity and cholinergic function. by Lee MR1, Yun BS, In OH, Sung CK.(PubMed)
(603) A combination extract of Renshen (Panax Ginseng), Yinyanghuo (Herba Epimedii Brevicornus), Yuanzhi (Radix Palygalae) and Jianghuang (Rhizoma Curcumae Longae) decreases glycogen synthase kinase 3beta expression in brain cortex of APPV7171 transgenic mice by Shi J1, Tian J, Zhang X, Zeng C, Wei M, Wang P, Wang Y.(PubMed)
(904) Cell cycle re-entry in Alzheimer's disease: a major neuropathological characteristic? by Lopes JP1, Oliveira CR, Agostinho P.(PubMed)
(905) Speech-language interventions in Alzheimer's disease. A functional communication approach. by Glickstein JK1, Neustadt GK.(PubMed)
(906) Designer receptors enhance memory in a mouse model of Down syndrome by Fortress AM1, Hamlett ED1, Vazey EM1, Aston-Jones G1, Cass WA2, Boger HA1, Granholm AC3.(PubMed)
(907) Isolation Housing Exacerbates Alzheimer's Disease-Like Pathophysiology in Aged APP/PS1 Mice by Huang H1, Wang L1, Cao M1, Marshall C1, Gao J1, Xiao N1, Hu G1, Xiao M2(PubMed)
(908) Gintonin, a ginseng-derived lysophosphatidic acid receptor ligand, attenuates Alzheimer's disease-related neuropathies: involvement of non-amyloidogenic processing by Hwang SH1, Shin EJ, Shin TJ, Lee BH, Choi SH, Kang J, Kim HJ, Kwon SH, Jang CG, Lee JH, Kim HC, Nah SY.(PubMed)
(909) Effects of ginsenoside Rg1 on the expression of toll-like receptor 3, 4 and their signalling transduction factors in the NG108-15 murine neuroglial cell line by Zhao BS1, Liu Y2, Gao XY3, Zhai HQ4, Guo JY5, Wang XY6.(PubMed)
(910) Ginsenoside Rg1 attenuates lipopolysaccharide-induced inflammatory responses via the phospholipase C-γ1 signaling pathway in murine BV-2 microglial cells by Zong Y1, Ai QL, Zhong LM, Dai JN, Yang P, He Y, Sun J, Ling EA, Lu D.(PubMed)
(911) Notoginsenoside R1 attenuates amyloid-β-induced damage in neurons by inhibiting reactive oxygen species and modulating MAPK activation by Ma B1, Meng X1, Wang J1, Sun J1, Ren X2, Qin M1, Sun J1, Sun G3, Sun X4.(PubMed)
(912) Antioxidative effects of Panax notoginseng saponins in brain cells by Zhou N1, Tang Y2, Keep RF3, Ma X4, Xiang J5.(PubMed)
(613) Ginseng for cognitive function in Alzheimer's disease: a systematic review. by Lee MS1, Yang EJ, Kim JI, Ernst E.(PubMed)
(914) Phosphorylated α-synuclein in Parkinson's disease: correlation depends on disease severity. by Stewart T, Sossi V, Aasly JO, Wszolek ZK, Uitti RJ, Hasegawa K, Yokoyama T, Zabetian CP, Leverenz JB, Stoessl AJ, Wang Y, Ginghina C, Liu C, Cain KC,Auinger P, Kang UJ, Jensen PH, Shi M, Zhang J.(PubMed)
(915) Genetic associations of Nrf2-encoding NFE2L2 variants with Parkinson's disease - a multicenter study by von Otter M, Bergström P, Quattrone A, De Marco EV, Annesi G, Söderkvist P, Wettinger SB, Drozdzik M, Bialecka M, Nissbrandt H, Klein C, Nilsson M,Hammarsten O, Nilsson S, Zetterberg H.(PubMed)
(916) Association of Nrf2-encoding NFE2L2 haplotypes with Parkinson's disease. by von Otter M1, Landgren S, Nilsson S, Celojevic D, Bergström P, Håkansson A, Nissbrandt H, Drozdzik M, Bialecka M, Kurzawski M, Blennow K, Nilsson M,Hammarsten O, Zetterberg H.(PubMed)
(917) Voluntary control of facial musculature in Parkinson's disease. by Marneweck M1, Hammond G2.(PubMed)
(918) Discrimination and recognition of facial expressions of emotion and their links with voluntary control of facial musculature in Parkinson's disease by Marneweck M1, Palermo R1, Hammond G1.(PubMed)
(919) The intrinsic resting state voice network in Parkinson's disease by New AB1, Robin DA, Parkinson AL, Eickhoff CR, Reetz K, Hoffstaedter F, Mathys C, Sudmeyer M, Grefkes C, Larson CR, Ramig LO, Fox PT, Eickhoff SB.(PubMed)
(920) Effects of Stochastic Vestibular Galvanic Stimulation and LDOPA on Balance and Motor Symptoms in Patients With Parkinson's Disease by Samoudi G1, Jivegård M1, Mulavara AP2, Bergquist F3.(PubMed)
(921) Ginsenoside Rb1 inhibits fibrillation and toxicity of alpha-synuclein and disaggregates preformed fibrils. by Ardah MT1, Paleologou KE2, Lv G3, Menon SA1, Abul Khair SB1, Lu JH4, Safieh-Garabedian B5, Al-Hayani AA6, Eliezer D3, Li M7, El-Agnaf OM8(PubMed)
(922) Protection against 1-methyl-4-phenylpyridinium ion (MPP+)-induced apoptosis by water extract of ginseng (Panax ginseng C.A. Meyer) in SH-SY5Y cells by Hu S1, Han R, Mak S, Han Y.(PubMed)
(923) Therapeutic efficacy of the neuroprotective plant adaptogen in neurodegenerative disease (Parkinson's disease as an example). by Bocharov EV1, Ivanova-Smolenskaya IA, Poleshchuk VV, Kucheryanu VG, Il'enko VA, Bocharova OA.(PubMed)
(924) Ginsenosides protect striatal neurons in a cellular model of Huntington's disease. by Wu J1, Jeong HK, Bulin SE, Kwon SW, Park JH, Bezprozvanny I.(PubMed)
(925) Panax ginseng reduces oxidative stress and restores antioxidant capacity in aged rats by Ramesh T1, Kim SW, Hwang SY, Sohn SH, Yoo SK, Kim SK.(PubMed)
(926) Melatonin attenuates memory impairment induced by Klotho gene deficiency via interactive signaling between MT2 receptor, ERK, and Nrf2-related antioxidant potential by Shin EJ1, Chung YH1, Le HL1, Jeong JH1, Dang DK1, Nam Y1, Wie MB1, Nah SY1, Nabeshima Y1, Nabeshima T1, Kim HC1.(PubMed)
(927) Modulation of nitrergic signalling pathway by American ginseng attenuates chronic unpredictable stress-induced cognitive impairment, neuroinflammation, and biochemical alterations by Rinwa P1, Kumar A.(PubMed)
(928) Ginsenoside Rb1 protects hippocampal neurons from high glucose-induced neurotoxicity by inhibiting GSK3β-mediated CHOP induction by Liu D1, Zhang H2, Gu W1, Liu Y2, Zhang M1.(PubMed)
(929) Neuroprotective effects of ginsenoside Rb1 on high glucose-induced neurotoxicity in primary cultured rat hippocampal neurons by Liu D1, Zhang H, Gu W, Liu Y, Zhang M.(PubMed)
(930) -(939)
(940) Ginsenoside Rb1 protects hippocampal neurons from high glucose-induced neurotoxicity by inhibiting GSK3β-mediated CHOP induction by Liu D1, Zhang H2, Gu W1, Liu Y2, Zhang M1.(PubMed)
(941) Modulation of nitrergic signalling pathway by American ginseng attenuates chronic unpredictable stress-induced cognitive impairment, neuroinflammation, and biochemical alterations by Rinwa P1, Kumar A.(PubMed)
(942) Potential neuroprotective activity of Ginseng in Parkinson's disease: a review by González-Burgos E1, Fernandez-Moriano C, Gómez-Serranillos MP.(PubMed)
(943) Panax ginseng is neuroprotective in a novel progressive model of Parkinson's disease by Van Kampen JM1, Baranowski DB2, Shaw CA3, Kay DG4.(PubMed)
(944) Neuroprotective actions of the ginseng extract G115 in two rodent models of Parkinson's disease by Van Kampen J1, Robertson H, Hagg T, Drobitch R.(PubMed)
(945) Ginseng ginsenoside pharmacology in the nervous system: involvement in the regulation of ion channels and receptors by Nah SY1.(PubMed)

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