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Saturday, July 2, 2016

The Holistic prevention, management and treatment of Polycystic Ovarian Syndrome: TCM Herbal Medicine for Kidney Yang deficiency -Fructus Schisandrae

Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
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.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

                Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome is defined as endocrinologic diseases among reproductive-age women caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries associated with a high risk for metabolic disorder(1) as resulting of enlarged ovaries(2), leading to hormone imbalance(excessive androgen and anti-müllerian hormone (AMH) )(1)(3)(4)(5), induced Hirsutism(6)(7), reproductive disorder(10(12)), risks of type 2 diabetes(9)(10)(11), metabolic syndrome(10)(12) and early cardiovascular disease(8)(13), acne(10)(14), endometrial cancer(18)(19),weight gain and obesity(15)(16)(17). The syndrome effects over 5% of women population or 1 in 20 women.
Unfortunately, according to studies, women with PCOs after the reproductive age, are associated to continuously increase risk of type II diabetes, with no increasingaltered glucose tolerance(20), CVD and hypertension(21).


Management and Treatment according to Traditional Chinese Medicine Perspective

While conventional medicine focus of using synthetic medication to induce ovulation and assisted artificial insemination for infertility couple, if the medicine fail, traditional Chinese medicine views polycystic ovarian syndrome in different approaches.

Polycystic ovary syndrome, according to traditional Chinese medicine is a medical condition characterized by accumulative of fluid over a prolonged period of time causes of dampness and phlegms(1247a)(1247b) build up on the ovaries due to the effects of vary differentiations, affecting not only the women’s menstrual cycle, but also ovulation and fertility(1247a)(1247b).

Depending to differentiation, most common diagnosis of polycystic ovary syndrome can be classified into              

                           Kidney yang deficiency

Along with common symptoms mentioned above, women with PCOs diagnosed with kidney yang deficiency may also experience yang vacuity induced cold expressive syndrome, including
lumbago, cold limbs, fatigue, cold aversion, feverish sensation in chest, palms and soles(1573),
difficulty in urination, enuresis, incontinence, declining libido and edema(1574) as a result of kidneys no longer perform their function in store fluid to moister and warm the body for healthy function in the body's organs and tissues, inducing adrenal insufficient chronic lower back pain(1575)(1580), depression(1575), hypothyroidism(1579)(1575), nephritis(1578)(1575), ...(1575), leading to failure in transform damp heat expression, promoted accentuation of inflammatory development of phlegm(1583).
Kidney yang deficiency has shown to alter carbohydrate and lipid metabolisms (free fatty acids, 1-monolinoleoylglycerol, and cholesterol), gut microbiota metabolism (indole-3-propionic acid), indued anovulatory infertility( 1581) and hypertension(1582) of which related to symptoms of PCOs(1576)(1577).

Herbal medicine for kidney yang deficiency

6. Fructus Schisandrae (Wu Wei Zi)
(See stress management herbs in herbal medicine for more infomation)
[Schisandra also is known as Wu Wei Zi, a twining shrub living its life by climbing on other vegetation, belongings to the family Schisandraceae, native to Asia and North America, The warm, sweet, bitter, sour, acrid, salty herb has been used in tradional Chinese medicine as antioxidant(1218)(1219), anti stress(1220)(1221), anti microbial(1224)(1225)(1226) agent and to improve metabolism(1227)(1228), enhance central nervous system(1229)(1230)(1233), treat hypertension(1231)(1232) and hypotension during exhaustion of circulatory function(1217), coughing(1234)(12135), insomnia(1237), premenstrual syndrome (PMS)(1239), menopausal symptoms(1240), depression(1233), irritability(1233), erectile dysfunction (ED)(1238), lower cholesterol(1241) and regulate blood glucose(1233), improve memory(1222)(1223), etc.
by promoting function of lung and kidney channels(1217).

Phytochemical contituents(1217)

1. Schizandrin
2. Deoxyschisandrin
3. Gamma-schisandrin
4. Schisandrol
5. Pseudo-gamma-schisandrin
6. Schizandrate B
7. Gomisin A, B, C, F, G
8. Angeloylgomisin H
9. Tigloylgomisin H
10. Benzoylgomisin H
11. Epigomisin O
12. Malic acid
13. Citric acid
14. Tartaric acid
15. Succinic acid
16. A-pinene
17. Camphene
18. B-pinene
19. Byrcene
20. A-terpinene
21. Limonene
22. G-terpinene
23. P-cymene
24. Etc.

In chronic psychological stress male rat model, schisandra protect against stress induced complications such as carbohydrate metabolism(1227) and neurosis, psychogenic depression, astheno-depressive states, schizophrenia and alcoholism disorders(1233) and improved mental performance(1233).through its reduction of the levels of corticosterone (CORT) and glucose and protect the structure of the adrenal cortex(1227).
In physiological stress, the herbal medicine also exerted its stress-protective effect against a broad spectrum of harmful factors including heat shock, skin burn, cooling, frostbite, immobilisation, swimming under load in an atmosphere with decreased air pressure, aseptic inflammation, irradiation, and heavy metal intoxication(1233).
In oxidative stress induced damage heart(1242) tissues in animal models, schisandrin B (Sch B), a dibenzocyclooctadiene derivative isolated from the fruit of Schisandra chinensis attenuated cardiotoxicity via antioxidant and anti-inflammatory effects(1242). In oxidative stress induced liver damage, oral administration of Schisandra Lignans Extract (SLE)(1243)(1244) or triterpenoid(1245) a chemical constituent from Schisandra chinensis significantly reduced liver damage(1243)(1244)(1245) in experimental animal model, through its effects of balance of oxidation and reduction in cells(1243) or upregulating cell cycle progression(1244) and anti tumor antigen(1244), or ameliorating oxidative stress(1245).]

In metabolic syndrome, beside protecting against depression(1233), irritability(1233), high level of bad cholesterol(1241) and fluctuation of blood glucose(1233), memory lose(1222)(1223),... Schisandra also exhibited anti insulin resistance(1834)(1835), anti lipid disorder metabolism(1836) induced hypercholesterolemia(1837), anti hypertension(1838)(1839). suppressed carbohydrate disorder metabolism(1842) induced hyperglycemia(1843), obesity(1840)(1841),...... causing complications of diabetes(1844)(1845) and cardiovascular disease(1838)(1846)(1847).

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References
(1) Adiposity and metabolic dysfunction in polycystic ovary syndrome by Sam S.(PubMed)
(2) A "kiss" before conception: triggering ovulation with kisspeptin-54 may improve IVF by Young SL.(PubMed)
(3.) Androgen hyperfunction and excessive heterosexual hair growth in women, with special attention to the polycystic ovarian syndrome by Lunde O1.(PubMed)
(4) Expression of anti-Müllerian hormone in letrozole rat model of polycystic ovary syndrome by Du DF1, Li XL, Fang F, Du MR.(PubMed)
(5) [Serum levels of anti-muller hormone in women with polycystic ovary syndrome and healthy women of reproductive age].[Article in Bulgarian] by Parahuleva N, Pehlivanov B, Orbecova M, Deneva T, Uchikova E.(PubMed)
(6) [Current opinions on the etiology and pathophysiology of hirsutism].[Article in Polish] by Krysiak R1, Kedzia A, Okopień B.(PubMed)
(7) The clinical evaluation of hirsutism by Somani N1, Harrison S, Bergfeld WF.(PubMed)
(8) Polycystic ovary syndrome and insulin: our understanding in the past, present and future by Mayer SB1, Evans WS, Nestler JE.(PubMed)
(9) Association of mean platelet volume with androgens and insulin resistance in nonobese patients with polycystic ovary syndrome by Dogan BA1, Arduc A2, Tuna MM1, Karakılıc E1, Dagdelen I1, Tutuncu Y1, Berker D1, Guler S1.(PubMed)
(10) Approach to the patient: contraception in women with polycystic ovary syndrome by Yildiz BO1.(PubMed)
(11) Polycystic ovarian syndrome (PCOS): a significant contributor to the overall burden of type 2 diabetes in women by Talbott EO1, Zborowski JV, Rager JR, Kip KE, Xu X, Orchard TJ.(PubMed)
(12) Prevalence of vitamin D deficiency in Slovak women with polycystic ovary syndrome and its relation to metabolic and reproductive abnormalities by Figurová J1, Dravecká I, Javorský M, Petríková J, Lazúrová I.(PubMed)
(13) Role of Insulin Sensitizers on Cardiovascular Risk Factors in Polycystic Ovarian Syndrome: A Meta-Analysis by Thethi TK1, Katalenich B2, Nagireddy P3, Chabbra P4, Kuhadiya N5, Fonseca V1.(PubMed)
(14) Acne in hirsute women by Lumezi BG1, Pupovci HL1, Berisha VL1, Goçi AU2, Gerqari A3.(PubMed)
(15) Obesity and polycystic ovary syndrome by Naderpoor N1, Shorakae S, Joham A, Boyle J, De Courten B, Teede HJ.(PubMed)
(16) Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan by Teede H1, Deeks A, Moran L.(PubMed)
(17) Metabolic Evidence of Diminished Lipid Oxidation in Women WithPolycystic Ovary Syndrome. by Whigham LD1, Butz DE2, Dashti H3, Tonelli M3, Johnson LK1, Cook ME2, Porter WP4, Eghbalnia HR5, Markley JL6, Lindheim SR7, Schoeller DA8, Abbott DH9, Assadi-Porter FM10.(PubMed)
(18) Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis by Barry JA1, Azizia MM1, Hardiman PJ2.(PubMed)
(19) Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study by Gottschau M1, Kjaer SK2, Jensen A1, Munk C1, Mellemkjaer L3.(PubMed)
(20) Polycystic ovary syndrome: metabolic consequences and long-term management by Carmina E1.(PubMed)
(21) Arterial stiffness is increased in asymptomatic nondiabetic postmenopausal women with a polycystic ovary syndrome phenotype by Armeni E1, Stamatelopoulos K, Rizos D, Georgiopoulos G, Kazani M, Kazani A, Kolyviras A, Stellos K, Panoulis K, Alexandrou A, Creatsa M, Papamichael C, Lambrinoudaki I.(PubMed)
(1246) [Clinical study of area of Jiangsu province of polycystic ovarian syndrome correlation distribution of traditional Chinese medicine syndrome type and improper diet]. [Article in Chinese] by Feng Y, Gao YP.(PubMed)
(1247) [Preliminary study on relationship of disease-syndrome-symptom of ovulatory disorder infertility based on factor analysis]. [Article in Chinese] by Li M, Ma K, Shan, J.(PubMed)
(1247a) A Comprehensive Treatment of Polycystic Ovarian Syndrome (PCOS) byLiqin Zhao
(1834) Schisphenlignans A-E: five new dibenzocyclooctadiene lignans from Schisandra sphenanthera by Liang CQ1, Hu J, Shi YM, Shang SZ, Du X, Zhan R, Xiong WY, Zhang HB, Xiao WL, Sun HD.(PubMed)
(1835) Six new lignans from the leaves and stems of Schisandra sphenantheraby Liang CQ1, Hu J, Luo RH, Shi YM, Shang SZ, Gao ZH, Wang RR, Zheng YT, Xiong WY, Zhang HB, Xiao WL, Sun HD.(PubMed)
(1936) Dietary pulp from Fructus Schisandra Chinensis supplementation reduces serum/hepatic lipid and hepatic glucose levels in mice fed a normal or high cholesterol/bile salt diet by Sun N, Pan SY1, Zhang Y, Wang XY, Zhu PL, Chu ZS, Yu ZL, Zhou SF, Ko KM.(PubMed)
(1937) Dietary Fructus Schisandrae extracts and fenofibrate regulate the serum/hepatic lipid-profile in normal and hypercholesterolemic mice, with attention to hepatotoxicity by Pan SY1, Yu Q, Zhang Y, Wang XY, Sun N, Yu ZL, Ko KM.(PubMed)
(1838) Cardioprotective effects of aqueous Schizandra chinensis fruit extract on ovariectomized and balloon-induced carotid artery injury rat models: effects on serum lipid profiles and blood pressure. Kim EY1, Baek IH, Rhyu MR.(PubMed)
(1839) Therapeutic potential of Schisandra chinensis extracts for treatment of hypertension. Introduction to: 'antihypertensive effect of gomisin A from Schisandra chinensis on angiotensin II-induced hypertension via preservation of nitric oxide bioavailability' by Park et al. Alexander JS1, Wang Y.(PubMed)
(1840) Fatty acid synthase inhibitory activity of dibenzocyclooctadiene lignans isolated from Schisandra chinensis by Na M1, Hung TM, Oh WK, Min BS, Lee SH, Bae K.(PubMed)
(1841) The high throughput screening of neuropeptide FF2 receptor ligands from Korean herbal plant extracts by Do EU1, Piao LZ, Choi G, Choi YB, Kang TM, Shin J, Chang YJ, Nam HY, Kim HJ, Kim SI.(PubMed)
(1842) [Effects of fructus schisandrae on the function of the pituitary-testis axis and carbohydrate metabolism in rats undergoing experimental navigation and high-intensity exercise]. [Article in Chinese] by Xia P1, Sun LJ, Wang J.(PubMed)
(1843) The beneficial effects of combined grape pomace and omija fruit extracts on hyperglycemia, adiposity and hepatic steatosis in db/db mice: a comparison with major index compounds by Cho SJ1, Park HJ1, Jung UJ2, Kim HJ3, Moon BS4, Choi MS5.(PubMed)
(1844)Antidiabetic Effect of Schisandrae Chinensis Fructus Involves Inhibition of the Sodium Glucose Cotransporter by Qu Y1, Chan JY, Wong CW, Cheng L, Xu C, Leung AW, Lau CB.(PubMed)
(1845) Advanced glycation end-products inhibitors isolated from Schisandra grandiflora by Poornima B1, Anand Kumar D, Siva B, Venkanna A, Vadaparthi PR, Kumar K, Tiwari AK, Suresh Babu K.(PubMed)
(1846) The protective effects of Schisandra chinensis fruit extract and its lignans against cardiovascular disease: a review of the molecular mechanisms by Chun JN1, Cho M2, So I3, Jeon JH4.(PubMed)
(1847) Beneficial effects of schisandrin B on the cardiac function in mice model of myocardial infarction by Chen P1, Pang S, Yang N, Meng H, Liu J, Zhou N, Zhang M, Xu Z, Gao W, Chen B, Tao Z, Wang L, Yang Z.(PubMed)

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