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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
A. In General herbal Chinese medicine
According to the Unilever R&D Shanghai, and Unilever R&D Vlaardingen, Dr. and the team of researchers, traditional Chinese medicine (TCM), in 3000 years' literary history, the top 5 TCM herb ingredients including Poria cocos(720), Radix polygalae, Radix glycyrrhizae, Radix angelica sinensis, and Radix rehmanniae have been used extensively for treatment of dementia(*).
A.4. Radix angelica sinensis(Dang Qui)
Dang Qui (Angelica sinensis), a sweet, acrid, bitter, warm herb is a GenusAngelica from the family Apiaceae, indigenous to China, used as a Queen herb in traditional Chinese medicine as antispasmodic(771), analgesic(772) and vasodilatory(772) agents, and to balance the hormones(773) in women for a normal menstrual cycle and menstruation with condition of blood stasis(774)(775) and clots(775) by strengthening heart, spleen, and liver channels. The herb is also used to treat constipation(775), reduced swelling(776), expels pus(775), etc.
Phytochemicals
1. Beta-sitosterol
2. Coumarins
3. Butylidine
4. Phthalide
5. Ligustilide
6. Sesquiterpenes
7. Carvacrol
8. B-pinene
9. Camphene,
10. P-cymene,
11. B-phellandrene
12. Myrcene
13. 6-n-butyl-cycloheptadiene-1,4, 2-methyl-dodecane-5-one,
14. Acetophenone,
15. B-bisabolene,
16. Isoacroraene,
17. Acoradiene
18. Etc.
Dang qui used in the treatment and prevention of dementia(777) in traditional Chinese medicine, may be due to their effectiveness of phytochemicals in ameliorated amyloid pathology and related cognitive deficits(778). In aging related dementia, based on the history of use, and pharmacological investigation, dang Qui showed a strong evidence in memory improving, through iestrogen-like, cholinergic, antioxidant, anti-inflammatory, antiapoptotic, neurogenetic, and anti-Aβ activities(736). Palmul-chongmyeong-tang, a traditional Chinese medicine formula containing dang qui, exhibited improvement of learning and memory deficits, through reduction of loss of cholinergic immunoreactivity induced by cerebral ischemia(780).
Phthalide, a phytochemical found abundantly in dang qui, also an important bio-active constituent in Si-Wu-Tang and Fo-Shou-San, showed effectively in protect neurons against ROS-induced apoptosis by modulating apoptosis-related genes(781). Z-Ligustilide (LIG), a characterized phthalide, in rat study, exhibited anti vascular dementia and cerebrovascular insufficient activities through its antioxidant effect and improved cholinergic activity(782).
1. In cognitive impairments
In patients with cognitive impairment associated with chronic cerebral hypoperfusion, dang qui prevented neurotoxic effects of β-amyloid (Aβ), through its anti oxidative stress, inflammation and apoptosis functions(783). Its phytochemical Ligustilide (LIG), a main lipophilic component of Danggui also exhibited neuroprotective effect through anti-apoptosis of neuron and anti-proliferation of astrocyte both in cortex and in hippocampus in rat study(784).
2. Oxidative stress
Oxidative stress has been known to induced neurotoxicity and the underlying mechanisms causes of
Alzheimer's disease (AD). Decursin (D) and decursinol angelate (DA) found in dang qui, significantly suppressed Aβ aggregation and increased cellular resistance to Aβ-induced oxidative injury in the rat study(785). Coumarins, another chemical found in from Angelica, also effectively induced neuroprotective activity against glutamate-induced oxidative stress causes of cognitive deficits and brain damage(786), According to Seoul National University, 4 other new dihydropyranocoumarins were isolated from Angelica gigas roots through neuroprotective activity-guided isolation and were characterized as decursinol derivatives 4"-hydroxytigloyldecursinol, 4"-hydroxydecursin, (2"S,3"S)-epoxyangeloyldecursinol, and (2"R,3"R)-epoxyangeloyldecursinol, also exhibited significant protective activity against glutamate-induced neurotoxicity(787). In transgenic mice model, traditional Chinese herbal formula Jangwonhwan (LMK03-Jangwonhwan), containing dang qui, improved cognitive impairment through detection and inhibition of AD-like pathology, such as cytotoxicity and Abeta(1-42)and Abeta(1-40) levels and beta-amyloid plaque deposition(788)
3. Behavioral and psychological symptoms
In behavioral and psychological symptoms of dementia patients, combination of ferulic acid and Angelica archangelica extract oral administration, significantly attenuated neuropsychiatric symptoms in 19 of 20 patients, including delusions, hallucinations, agitation/aggression, anxiety, apathy/indifference, irritability/lability and aberrant behavior, according toNational Hospital Organization Kikuchi Hospital(789). Yokukansan, also known as TJ-54, composed of seven herbs, including dang qui, showed to inhibit a variety of effects on various neurological symptoms, such as memory disturbance and behavioral and psychological symptoms of dementia(791) without adverse effects(790), probably through its neuroprotective effect against glutamate-induced excitotoxicity(792). In ischemic brain tissue, Z-Ligustilide (LIG), a phytochemical found in dang qui, oral administration of 10 or 40 mg/kg/day, significantly reduced malondialdehyde levels and increased superoxide dismutase activity, probably through its antioxidant effect in improved cholinergic activity(793), anti-apoptosis of neuron and anti-proliferation of astrocyte both in cortex, hippocampus(794) and ameliorated cognitive dysfunction(795) in 2VO rats study.
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References
(736) Traditional chinese medicine for senile dementia by Lin Z1, Gu J, Xiu J, Mi T, Dong J, Tiwari JK.(PubMed)
(777) Chinese herbs for dementia diseases. by Hügel HM1, Jackson N, May BH, Xue CC.(PubMed)
(778) Smart Soup, a traditional Chinese medicine formula, ameliorates amyloid pathology and related cognitive deficits by Hou Y1, Wang Y2, Zhao J1, Li X1, Cui J1, Ding J2, Wang Y3, Zeng X1, Ling Y4, Shen X5, Chen S2, Huang C4, Pei G6.(PubMed)
(779) Traditional chinese medicine for senile dementia by Lin Z1, Gu J, Xiu J, Mi T, Dong J, Tiwari JK.(PubMed)
(780) Neuroprotective effect of palmul-chongmyeong-tang on ischemia-induced learning and memory deficits in the rat by Yun YJ1, Lee B, Hahm DH, Kang SK, Han SM, Lee HJ, Pyun KH, Shim I.(PubMed)
(781) Identification and comparative quantification of bio-active phthalides in essential oils from si-wu-tang, fo-shou-san, radix angelica and rhizoma chuanxiong by Tang Y1, Zhu M, Yu S, Hua Y, Duan JA, Su S, Zhang X, Lu Y, Ding A.(PubMed)
(782) Postischemic administration of Z-Ligustilide ameliorates cognitive dysfunction and brain damage induced by permanent forebrain ischemia in rats. by Kuang X1, Du JR, Liu YX, Zhang GY, Peng HY.(PubMed)
(783) Radix Angelica Sinensis that contains the component Z-ligustilide promotes adult neurogenesis to mediate recovery from cognitive impairment. by Xin J1, Zhang J, Yang Y, Deng M, Xie X.(PubMed)
(784) Ligustilide alleviates brain damage and improves cognitive function in rats of chronic cerebral hypoperfusion. by Feng Z1, Lu Y, Wu X, Zhao P, Li J, Peng B, Qian Z, Zhu L.(PubMed)
(785) Protective effects of decursin and decursinol angelate against amyloid β-protein-induced oxidative stress in the PC12 cell line: the role of Nrf2 and antioxidant enzymes by Li L1, Li W, Jung SW, Lee YW, Kim YH.(PubMed)
(786) Decursinol and decursin protect primary cultured rat cortical cells from glutamate-induced neurotoxicity. by Kang SY1, Kim YC.(PubMed)
(787) Four new neuroprotective dihydropyranocoumarins from Angelica gigas by Kang SY1, Lee KY, Sung SH, Kim YC.(PubMed)
(788) A modified preparation (LMK03) of the oriental medicine Jangwonhwan reduces Abeta(1-42) level in the brain of Tg-APPswe/PS1dE9 mouse model of Alzheimer disease by Seo JS1, Jung EY, Kim JH, Lyu YS, Han PL, Kang HW.(PubMed)
(789) Effect of ferulic acid and Angelica archangelica extract on behavioral and psychological symptoms of dementia in frontotemporal lobar degeneration and dementia with Lewy bodies. by Kimura T1, Hayashida H, Murata M, Takamatsu J.(PubMed)
(790) Use of Yokukansan (TJ-54) in the treatment of neurological disorders: a review. by de Caires S1, Steenkamp V.(PubMed)
(791) Effects of yokukansan, a traditional Japanese medicine, on memory disturbance and behavioral and psychological symptoms of dementia in thiamine-deficient rats. by Ikarashi Y1, Iizuka S, Imamura S, Yamaguchi T, Sekiguchi K, Kanno H, Kawakami Z, Yuzurihara M, Kase Y, Takeda S.(PubMed)
(792) Neuroprotective effects of yokukansan, a traditional Japanese medicine, on glutamate-mediated excitotoxicity in cultured cells by Kawakami Z1, Kanno H, Ueki T, Terawaki K, Tabuchi M, Ikarashi Y, Kase Y.(PubMed)
(793) Postischemic administration of Z-Ligustilide ameliorates cognitive dysfunction and brain damage induced by permanent forebrain ischemia in rats. by Kuang X1, Du JR, Liu YX, Zhang GY, Peng HY.(PubMed)
(794) Ligustilide alleviates brain damage and improves cognitive function in rats of chronic cerebral hypoperfusion by Feng Z1, Lu Y, Wu X, Zhao P, Li J, Peng B, Qian Z, Zhu L.(PubMed)
(795) Postischemic administration of Z-Ligustilide ameliorates cognitive dysfunction and brain damage induced by permanent forebrain ischemia in rats. by Kuang X1, Du JR, Liu YX, Zhang GY, Peng HY.(PubMed)
1 Stephanie Roll,1 Christoph Schwarzbach,2 Christoph Vauth,2 and Stefan N Willich1(