Tuesday, 14 February 2017

The holistic Prevention, Management and Treatment of Dementia due to Spleen Qi deficiency - TCM Herbal Peony (Chi Shao)

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 Spleen Qi deficiency - TCM Herbal Peony (Chi Shao)

Based on Chinese ancient medical records, causes of dementia are the results of (*)
B.1. Deficiency of Qi, mainly due to
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).

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).
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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(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)

(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)
(1009) [Effects of yishenjiangyafang on blood pressure and protecting renal function in RPH rats].[Article in Chinese] by Chen ML1, Liu WJ, Wang CY, Zhu XM, Yin JF, Wang DX, Liu P.(PubMed)
(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)
(1012) [Treatment of irritable bowel syndrome by Chinese medicine and pharmacy: an analysis of data mining on experiences of experts].[Article in Chinese] by Zhang BH1, Gao R, Li ZH, Li BS, Wang FY, Tang XD.(PubMed)
(1013) Antioxidant and anti-inflammatory effects of Schisandra and Paeonia extracts in the treatment of asthma by Chen X1, Huang Y1, Feng J1, Jiang XF1, Xiao WF1, Chen XX1.(PubMed)
(1014) The effect of a traditional Chinese prescription for a case of lung carcinoma by Kamei T1, Kumano H, Iwata K, Nariai Y, Matsumoto T.(PubMed)
(1015) [Effect of a peony root preparation on the status of the insulin and hemostatic system in animals during development of alloxan diabetes].[Article in Russian] by Ul'ianov AM, Tarasov IuA, Liapina LA, Pastorova VE, Uspenskaia MS.(PubMed)
(1016) Immunomodulatory and Antidiabetic Effects of a New Herbal Preparation (HemoHIM) on Streptozotocin-Induced Diabetic Mice by Kim JJ1, Choi J1, Lee MK2, Kang KY3, Paik MJ3, Jo SK4, Jung U4, Park HR4, Yee ST5.(PubMed)
(1017) Shao Yao(Complementary and Alternative Healing University)
(1018) Comparative pharmacokinetics of paeoniflorin in plasma of vascular dementia and normal rats orally administrated with Danggui-Shaoyao-San or pure paeoniflorin by Liu J1, Wang JS, Kong LY.(PubMed)
(1019) A traditional medicinal herb Paeonia suffruticosa and its active constituent 1,2,3,4,6-penta-O-galloyl-beta-D-glucopyranose have potent anti-aggregation effects on Alzheimer's amyloid beta proteins in vitro and in vivo by Fujiwara H1, Tabuchi M, Yamaguchi T, Iwasaki K, Furukawa K, Sekiguchi K, Ikarashi Y, Kudo Y, Higuchi M, Saido TC, Maeda S, Takashima A, Hara M,Yaegashi N, Kase Y, Arai H.(PubMed)
(1020) Neuroprotective effect of paeoniflorin on cerebral ischemic rat by activating adenosine A1 receptor in a manner different from its classical agonists by Liu DZ1, Xie KQ, Ji XQ, Ye Y, Jiang CL, Zhu XZ.(PubMed)
(1021) Neuroprotective effects of paeoniflorin, but not the isomer albiflorin, are associated with the suppression of intracellular calcium and calcium/calmodulin protein kinase II in PC12 cells by Wang D1, Tan QR, Zhang ZJ.(PubMed)
(1022) Paeoniflorin inhibition of 6-hydroxydopamine-induced apoptosis in PC12 cells via suppressing reactive oxygen species-mediated PKCδ/NF-κB pathway.by Dong H1, Li R2, Yu C1, Xu T1, Zhang X1, Dong M3.(PubMed)
(1023) Paeonol attenuates cigarette smoke-induced lung inflammation by inhibiting ROS-sensitive inflammatory signaling by Liu MH1, Lin AH1, Lee HF2, Ko HK3, Lee TS1, Kou YR1.(PubMed)
(1024) [Advance in studies on effect of paeoniflorin on nervous system].[Article in Chinese] by Hu ZY1, Xu L, Yan R, Huang Y, Liu G, Zhou WX, Zhang YX.(PubMed)
(1025) Paeonol increases levels of cortical cytochrome oxidase and vascular actin and improves behavior in a rat model of Alzheimer's disease by Zhou J1, Zhou L, Hou D, Tang J, Sun J, Bondy SC.(PubMed)
(1026) Paeoniflorin attenuates learning impairment of aged rats in operant brightness discrimination task by Ohta H1, Matsumoto K, Shimizu M, Watanabe H.(PubMed)
(1027) [Effects of total paeony glucosides on mRNA expressions of Toll receptors and interleukin-33 in the brain tissue of D-galactose induced aging rats: an experimental research].[Article in Chinese] by Zhang HY1, Liu ZJ, Chen ZW.(PubMed)
(1028) [Advance in studies on effect of paeoniflorin on nervous system].[Article in Chinese] by Hu ZY1, Xu L, Yan R, Huang Y, Liu G, Zhou WX, Zhang YX.(PubMed)
(1028a) Neuroprotective effect of paeoniflorin on cerebral ischemic rat by activating adenosine A1 receptor in a manner different from its classical agonists by Liu DZ1, Xie KQ, Ji XQ, Ye Y, Jiang CL, Zhu XZ.(PubMed)
(1029) Mechanism of 6-hydroxydopamine neurotoxicity by Glinka Y1, Gassen M, Youdim MB.(PubMed)
(1030) Paeoniflorin inhibition of 6-hydroxydopamine-induced apoptosis in PC12 cells via suppressing reactive oxygen species-mediated PKCδ/NF-κB pathway by Dong H1, Li R2, Yu C1, Xu T1, Zhang X1, Dong M3.(PubMed)
(1031) Effects of the root bark of Paeonia suffruticosa on mitochondria-mediated neuroprotection in an MPTP-induced model of Parkinson's disease by Kim HG1, Park G2, Piao Y3, Kang MS4, Pak YK3, Hong SP1, Oh MS5.(PubMed)
(1032) Protective effect of paeoniflorin against glutamate-induced neurotoxicity in PC12 cells via Bcl-2/Bax signal pathway by Sun R1, Wang K, Wu D, Li X, Ou Y.(PubMed)
(1033) Polyphenols and neuroprotection against ischemia and neurodegeneration. by Lin B1.(PubMed)
(1034) Apolipoprotein E and Alzheimer disease: risk, mechanisms, and therapy by Chia-Chen Liu,1 Takahisa Kanekiyo,2 Huaxi Xu,1 and Guojun Bu1(PMC)
(1035) Increased A beta 42(43)-plaque deposition in early-onset familial Alzheimer's disease brains with the deletion of exon 9 and the missense point mutation (H163R) in the PS-1 gene by Ishii K1, Ii K, Hasegawa T, Shoji S, Doi A, Mori H.(PubMed)
(1036) Abeta-42 deposition precedes other changes in PS-1 Alzheimer's disease by Lippa CF, Nee LE, Mori H, St George-Hyslop P.(PubMed)
(1037) Peoniflorin attentuates Abeta((1-42))-mediated neurotoxicity by regulating calcium homeostasis and ameliorating oxidative stress in hippocampus of rats by Zhong SZ1, Ge QH, Li Q, Qu R, Ma SP.(PubMed)
(1038) A review of cognitive impairments in dementia with Lewy bodies relative to Alzheimer's disease and Parkinson's disease with dementia by Metzler-Baddeley C1.(PubMed)
(1039) Paeoniflorin attenuates amyloid-beta peptide-induced neurotoxicity by ameliorating oxidative stress and regulating the NGF-mediated signaling in rats. by Lan Z1, Chen L2, Fu Q1, Ji W1, Wang S1, Liang Z1, Qu R3, Kong L4, Ma S5.(PubMed)
(1040) Paeoniflorin attenuates chronic cerebral hypoperfusion-induced learning dysfunction and brain damage in rats by Liu J1, Jin DZ, Xiao L, Zhu XZ.(PubMed)
(1041) Effects of paeoniflorin on the cerebral infarction, behavioral and cognitive impairments at the chronic stage of transient middle cerebral artery occlusion in rats by Xiao L1, Wang YZ, Liu J, Luo XT, Ye Y, Zhu XZ.(PubMed)
(1042) Paeonol attenuates neurotoxicity and ameliorates cognitive impairment induced by d-galactose in ICR mice by Zhong SZ1, Ge QH, Qu R, Li Q, Ma SP.(PubMed)
(1043) Danggui-Shaoyao-San ameliorates cognition deficits and attenuates oxidative stress-related neuronal apoptosis in d-galactose-induced senescent mice by Lan Z1, Liu J, Chen L, Fu Q, Luo J, Qu R, Kong L, Ma S.(PubMed)
(1044) Ameliorative effects of paeoniflorin, a major constituent of peony root, on adenosine A1 receptor-mediated impairment of passive avoidance performance and long-term potentiation in the hippocampus by Tabata K1, Matsumoto K, Murakami Y, Watanabe H.(PubMed)

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