Most common diseases of 50 plus - Diseases of Central Nervous system(CNS): TCM Herbal Chai Hu (Bupleurum) in treatments of Dementia Caused by Spleen Qi Deficiency

By Kyle J. Norton 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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                     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 (*)
C.3. 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 absorbing nutrients and transport 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).

Herbal medicine for Spleen Qi deficiency
2. Bupleurum
Chai Hu  the bitter, slightly cold herb is also known as bupleurum root, used in TCM as antitrypanosomal, antimicrobial and antiviral, such as cold and influenza, alternated chill and fever, malaria(1047), cytotoxic(1045)  and anti-cancer agent(1046) and to treat irregular menses, prolapse of uterus and rectum(1048), etc., as it regulates and clears heat, improve liver function, raises Yang(1048) resolves depression and stagnation, etc. by enhancing the functions of liver, gall bladder, pericardium, triple burner channels.

Phytochemicals
 1. β-terpinene
2. imonene
3. β-fenchene

4. ulegone

5. Isoborneol
6. β-terpineol
7. α-copaene
8. Humulene
9. A-farnesene10. Aromadendrene
11. Cis-caryophyllene
12. β-elemene,13. Gamma-muurolene
14. Patchoulane
15. Pootkatone
16. Ledol
17. Etc.

Herbal chai hu used in the treatment and prevention of dementia(1049)(1050) in traditional Chinese medicine, may be due to its effectiveness of phytochemicals in exertion of its neuroprotective effects(1051) through its cytoprotection of neuron, and the neuroprotective mechanisms (1052), against apoptosis of neurons(1051) due Aβ oligomer-induced neuronal damage(1060) in concentration of corticosterone on hippocampal neurons(1059) in a dose-dependent manner.

Yokukansan, a popular herbal combination in Japan and China, containing chai hu,  may be the next potential herbal formula used for treatment, Alzheimer's disease, Lewy body disease, Parkinson's disease, especially for the behavioral and psychiatric symptoms of dementia (BPSD)(1064)(1065)(1066).

2.1. In dementia symptoms
In dementia, Yokukansan, also known as TJ-54, is composed of sev Angelica acutiloba, Atractylodes lancea, Bupleurum falcatum, Poria cocos, Glycyrrhiza uralensis, Cnidium officinale and Uncaria rhynchophylla,(1052)showed to ameliorated the memory disturbance, anxiety-like behavior, the increase in aggressive behaviors,  the decrease in social behaviors, ameliorates learning deficits and non-cognitive defects(1055) through improvement of neuronal and astroglial cells, via inhibit glutamate-mediated excitotoxicity(1053)(1054). According to ¹Keimei Memorial Hospital in Japan, the formula also showed to improve behavioral and psychological symptoms of dementia (BPSD) together with donepezil in patients with Alzheimer's disease (AD)(1056).

2.2. In Alzheimer's disease and dementia with Lewy bodies
In Alzheimer's disease, Yokukansan improved psychological symptoms of dementia (BPSD)(1058), such as  hallucinations, agitation, anxiety, irritability or abnormal behavior(1057)  in elderly patients with Alzheimer's disease (AD)(1056). In patients with dementia with Lewy bodies Kampo medicine, yokukansan (YKS), including chai hu, also improved behavioural and psychological symptoms of dementia (BPSD), through neuropsychiatric Inventory scores(1061).

2.3. In Parkinson's disease
In neuropsychiatric symptoms in patients with Parkinson's disease, yokukansan, containing Chai hu, using the Unified PD Rating Scale part III (UPDRS-III) and Hoehn and Yahr scale, showed effectively in ameliorated symptoms of delusions, agitation, depression, euphoria, disinhibition with aberrant motor activity tended to improve but irritability showed no change with oral administration of (7.5 g/day) for 12 weeks(1062). In behavioral and psychological symptoms, the herbal formula, also exhibited improvements of these symptoms, without worsening cognitive function, ability to perform activities of daily living, or parkinsonism, after 4 weeks(1063). Yokukansankachimpihange, another formula containing chai hu, showed to exhibit anti hallucinate effects, through its major phytochemical atractylenolide III and β-eudesmol, through its antagonistic activity against serotonin receptors induced non-motor symptom of Parkinson's disease and various forms of dementias(1067).

According to traditional Chinese medicine, the effectiveness of a herbal formula, is not results of single ingredient or single herb, but the combination of all ingredients of all herbs in the formula, even some of herbs in  the formula may show an significant efficacy in Western studies and clinical trials.

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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
(845) http://www.ncbi.nlm.nih.gov/pubmed/20451955
(846) http://www.ncbi.nlm.nih.gov/pubmed/21855622
(1045) http://www.ncbi.nlm.nih.gov/pubmed/24438177
(1046) http://www.ncbi.nlm.nih.gov/pubmed/21143894
(1047) http://www.ncbi.nlm.nih.gov/pubmed/20796273
(1048) http://alternativehealing.org/chai_hu.htm
(1049) http://www.ncbi.nlm.nih.gov/pubmed/20812276
(1050) http://www.ncbi.nlm.nih.gov/pubmed/19801831
(1051) http://www.ncbi.nlm.nih.gov/pubmed/23694845
(1052) http://www.ncbi.nlm.nih.gov/pubmed/?term=Bupleurum+Alzheimer's+disease
(1053) http://www.ncbi.nlm.nih.gov/pubmed/19801831
(1054) http://www.ncbi.nlm.nih.gov/pubmed/19409210
(1055) http://www.ncbi.nlm.nih.gov/pubmed/19146938
(1056) http://www.ncbi.nlm.nih.gov/pubmed/20170698
(1057) http://www.ncbi.nlm.nih.gov/pubmed/20184936
(1058) http://www.ncbi.nlm.nih.gov/pubmed/19538824
(1059) http://www.ncbi.nlm.nih.gov/pubmed/25022209
(1060) http://www.ncbi.nlm.nih.gov/pubmed/23838475
(1061) http://www.ncbi.nlm.nih.gov/pubmed/23279145
(1062) http://www.ncbi.nlm.nih.gov/pubmed/24169925
(1063) http://www.ncbi.nlm.nih.gov/pubmed/19948198
(1064) http://www.ncbi.nlm.nih.gov/pubmed/23055705
(1065) http://www.ncbi.nlm.nih.gov/pubmed/19079814
(1066) http://www.ncbi.nlm.nih.gov/pubmed/25246794
(1067) http://www.ncbi.nlm.nih.gov/pubmed/25237752