Most common diseases of 50 plus - Diseases of Central Nervous system(CNS): Dementia - Treatments in Traditional Chinese Herbal Medicine: Radix Angelica Sinensis(Dang Qui)

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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(*)
C.1.4. Radix angelica sinensis(Dang Qui)
Dang Qui (Angelica sinensis), a sweet, acrid, bitter, warm herb is a Genus Angelica from the family Apiaceae, indigenous to China, used as a Queen herb in traditional Chinese medicine as antispasmodic(771), analgesic(772) and vasodilatory(772) agent, 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), reduce 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 Yuan zhi, 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). it phytochemical Ligustilide (LIG), a main lipophilic component of Danggui (Chinese Angelica root, 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 ahs 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 effective 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 (a), 4″-hydroxydecursin (b), (2″S,3″S)-epoxyangeloyldecursinol (c), and (2″R,3″R)-epoxyangeloyldecursinol (d), also exhibited significant protective activity against glutamate-induced neurotoxicity(787). In transgenic mice medel, traditional Chinese herbal formula Jangwonhwan (LMK03-Jangwonhwan), containing dang qui, inmproved 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 administartion,significiat attenuated neuropsychiatric symtopms in 19 of 20 patients , including delusions, hallucinations, agitation/aggression, anxiety, , apathy/indifference, irritability/lability and aberrant behavior, according to National 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 symtoms, 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 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 and improved cholinergic activity(793) and anti-apoptosis of neuron and anti-proliferation of astrocyte both in cortex and in hippocampus(794) and ameliorated cognitive dysfunction(795) in 2VO rats study.

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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/
(771) http://www.ncbi.nlm.nih.gov/pubmed/24521480
(772) http://www.ncbi.nlm.nih.gov/pubmed/21315572
(773) http://www.ncbi.nlm.nih.gov/pubmed/23746954
(774) http://www.ncbi.nlm.nih.gov/pubmed/16124612
(775) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174116/
(776) http://www.ncbi.nlm.nih.gov/pubmed/22700248
(777) http://www.ncbi.nlm.nih.gov/pubmed/22303969
(778) http://www.ncbi.nlm.nih.gov/pubmed/25386946
(779) http://www.ncbi.nlm.nih.gov/pubmed/21808655
(780) http://www.ncbi.nlm.nih.gov/pubmed/17268076
(781) http://www.ncbi.nlm.nih.gov/pubmed/20110895
(782) http://www.ncbi.nlm.nih.gov/pubmed/17889286
(783) http://www.ncbi.nlm.nih.gov/pubmed/23937197
(784) http://www.ncbi.nlm.nih.gov/pubmed/23022689
(785) http://www.ncbi.nlm.nih.gov/pubmed/21389625
(786) http://www.ncbi.nlm.nih.gov/pubmed/17637179
(787) http://www.ncbi.nlm.nih.gov/pubmed/15679317
(788) http://www.ncbi.nlm.nih.gov/pubmed/20669372
(789) http://www.ncbi.nlm.nih.gov/pubmed/21272180
(790) http://www.ncbi.nlm.nih.gov/pubmed/20812276
(791) http://www.ncbi.nlm.nih.gov/pubmed/19801831
(792) http://www.ncbi.nlm.nih.gov/pubmed/19409210
(793) http://www.ncbi.nlm.nih.gov/pubmed/17889286
(794) http://www.ncbi.nlm.nih.gov/pubmed/23022689
(795) http://www.ncbi.nlm.nih.gov/pubmed/17889286