Tuesday, February 10, 2015

(4th edited )Most common diseases of 50 plus - Diseases of Central Nervous system(CNS): TCM Ren shen (Ginseng) treatments of Dementia Caused by Heart Qi Deficiency

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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.


                     Diseases of Central Nervous system


                             Dementia

About 5-8% of all people over the age of 65 have some form of dementia, and this number doubles every five years above that age. Dementia is the loss of mental ability, severe enough to interfere with people's every life and Alzheimer's disease is the most common type of dementia in aging people.

V. Treatments
C. In traditional Chinese Medicine Perspective(*)
Based on Chinese ancient medical records. causes of dementia are the results of (810)
C.2. Deficiency of Qi, mainly due to 
C.2.2. 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) and 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), anti Erectile dysfunction(876)(877), etc. agent and to generates fluids and reduce thirst and 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).

Ingredients
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 in 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 memory, 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 showed significantly in attenuated amyloid plaque deposition as well as 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. The 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 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 associated to oxidative stress related cognitive impairment(925). In aging mice model, ginseng exhibited anti oxidative stress in ameliorated lipid peroxidation and restores antioxidant capacity(926), and reduced accumulation of intercellular messenger, nitric oxide (NO)(927) may be 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 to physiological 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) and neuroinflammation(941), decrease of toxins-induced apoptosis(944) and regulation of channels and receptors activity(945)(942).


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Reprinted from Norton Journal, Volume I, Most Common Diseases of Ages of 50 Plus - Chapter of Diseases of Central Nervous system(CNS): Dementia - Treatments in Traditional Chinese Herbal Medicine by Kyle J. Norton  

References
(*) http://www.hindawi.com/journals/ecam/2012/692621/ 
(842) http://www.ncbi.nlm.nih.gov/pubmed/25313575
(843) http://www.ncbi.nlm.nih.gov/pubmed/24224039
(844) http://www.ncbi.nlm.nih.gov/pubmed/23391905
(868) http://www.ncbi.nlm.nih.gov/pubmed/15035888
(869) http://www.ncbi.nlm.nih.gov/pubmed/18635912
(870) http://www.ncbi.nlm.nih.gov/pubmed/25625815
(871) http://www.ncbi.nlm.nih.gov/pubmed/19277659
(872) http://www.ncbi.nlm.nih.gov/pubmed/24979747
(873) http://www.ncbi.nlm.nih.gov/pubmed/23548988
(874) http://www.ncbi.nlm.nih.gov/pubmed/14737017
(875) http://www.ncbi.nlm.nih.gov/pubmed/15215639
(876) http://www.ncbi.nlm.nih.gov/pubmed/25442300
(877) http://www.ncbi.nlm.nih.gov/pubmed/24824453
(878) http://www.ncbi.nlm.nih.gov/pubmed/23147499
(879) http://www.ncbi.nlm.nih.gov/pubmed/19277974
(880) http://www.ncbi.nlm.nih.gov/pubmed/19960983
(881) http://www.ncbi.nlm.nih.gov/pubmed/18198636
(882) http://www.ncbi.nlm.nih.gov/pubmed/12435210
(883) http://www.ncbi.nlm.nih.gov/pubmed/17089329
(884) http://www.ncbi.nlm.nih.gov/pubmed/25063041
(885) http://www.ncbi.nlm.nih.gov/pubmed/20804838
(886) http://www.ncbi.nlm.nih.gov/pubmed/21273053
(887) http://www.ncbi.nlm.nih.gov/pubmed/19632285
(888) http://www.ncbi.nlm.nih.gov/pubmed/25349145
(889) http://www.ncbi.nlm.nih.gov/pubmed/24316034
(890) http://www.ncbi.nlm.nih.gov/pubmed/23717136
(891) http://www.ncbi.nlm.nih.gov/pubmed/6834589
(892) http://www.ncbi.nlm.nih.gov/pubmed/15660764
(893) http://www.ncbi.nlm.nih.gov/pubmed/16782310
(894) http://www.ncbi.nlm.nih.gov/pubmed/23301896
(895) http://www.ncbi.nlm.nih.gov/pubmed/25032018
(896) http://www.tcmassistant.com/herbs/ren-shen.html
(897) http://alternativehealing.org/ren_shen.htm
(898) http://www.ncbi.nlm.nih.gov/pubmed/18083315
(899) http://www.ncbi.nlm.nih.gov/pubmed/24854439
(900) http://www.ncbi.nlm.nih.gov/pubmed/16511867
(901) http://www.ncbi.nlm.nih.gov/pubmed/24503167
(902) http://www.ncbi.nlm.nih.gov/pubmed/23717087
(903) http://www.ncbi.nlm.nih.gov/pubmed/23789219
(904) http://www.ncbi.nlm.nih.gov/pubmed/19519302
(905) http://www.ncbi.nlm.nih.gov/pubmed/8485510
(906) http://www.ncbi.nlm.nih.gov/pubmed/25632113
(907) http://www.ncbi.nlm.nih.gov/pubmed/25568286
(908) http://www.ncbi.nlm.nih.gov/pubmed/22543851
(909) http://www.ncbi.nlm.nih.gov/pubmed/25340298
(910) http://www.ncbi.nlm.nih.gov/pubmed/22214447
(911) http://www.ncbi.nlm.nih.gov/pubmed/24975829
(912) http://www.ncbi.nlm.nih.gov/pubmed/24916704
(913) http://www.ncbi.nlm.nih.gov/pubmed/19584437 
(914) http://www.ncbi.nlm.nih.gov/pubmed/25637461
(915) http://www.ncbi.nlm.nih.gov/pubmed/25496089
(916) http://www.ncbi.nlm.nih.gov/pubmed/20196834
(917) http://www.ncbi.nlm.nih.gov/pubmed/25467144
(918) http://www.ncbi.nlm.nih.gov/pubmed/24933489
(919) http://www.ncbi.nlm.nih.gov/pubmed/25627959
(920) http://www.ncbi.nlm.nih.gov/pubmed/25573070
(921) http://www.ncbi.nlm.nih.gov/pubmed/25449909 
(922) http://www.ncbi.nlm.nih.gov/pubmed/21349320
(923) http://www.ncbi.nlm.nih.gov/pubmed/21165417
(924) http://www.ncbi.nlm.nih.gov/pubmed/19185022 
(925) http://www.ncbi.nlm.nih.gov/pubmed/23084645
(926) http://www.ncbi.nlm.nih.gov/pubmed/25550330
(927) http://www.ncbi.nlm.nih.gov/pubmed/24132508
(928) http://www.ncbi.nlm.nih.gov/pubmed/24535619
(929) http://www.ncbi.nlm.nih.gov/pubmed/24223941
(940) http://www.ncbi.nlm.nih.gov/pubmed/24535619
(941) http://www.ncbi.nlm.nih.gov/pubmed/24132508
(942) http://www.ncbi.nlm.nih.gov/pubmed/25349145
(943) http://www.ncbi.nlm.nih.gov/pubmed/24316034
(944) http://www.ncbi.nlm.nih.gov/pubmed/14637121
(945) http://www.ncbi.nlm.nih.gov/pubmed/24678300

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