Astragalus Root

Astragalus root, dried rehmannia root, the root of red-rooted salvia, and other herbs which can reinforce qi and promote blood circulation have a strong inhibitory effect on aldose reductase.

From: Bioactive Food as Dietary Interventions for Diabetes (Second Edition), 2019

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Breast Cancer

Tieraona Low Dog MD, in Women's Health in Complementary and Integrative Medicine, 2005

Astragalus (Astragalus membranaceus).

Astragalus root has been shown to stimulate the immune system in vivo106 and inhibit chemotherapy-induced immunosuppression in animals.7 It is one of the main herbs used in Chinese fu-zheng therapy to enhance the immune system during chemotherapy and radiation therapy. (Fu-zheng is a form of traditional Chinese herbalism that literally means “to restore normalcy and balance to the body.”) Astragalus is often prescribed in traditional Chinese medicine to those with low vitality, fatigue, weakness, and lack of appetite.80 Research is lmited primarily to in vitro and animal models, and no rigorous randomized trials are available with which to evaluate the value of astragalus during chemotherapy. However, the herb is quite safe and is consumed regularly as part of the Asian diet: Astragalus root is often cooked in soup. The typical dose is 1000 to 2000 mg/day.

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Tonifying herbs

Dr med.Carl-Hermann Hempen, Dr med., Dr sc. nat.Toni Fischer, in A Materia Medica for Chinese Medicine, 2009

1. Tonifies Spleen and Lung qi

Astragali radix (huang qi) p. 706 raises the yang qi, consolidates wei qi, distributes water and decreases oedema, promotes healing of ulcerations and furuncles
Codonopsis radix (dang shen) p. 710 similar to ginseng, but weaker
Ginseng radix (ren shen) p. 714 most powerful yuan (original or primal) qi tonic, generates fluids, used in emergencies to treat collapse
Panacis quinquefolii radix (xi yang shen) p. 804 similar to ginseng, but cold and stronger fluid-generating properties
Pseudostellariae radix (hai er shen) p. 728 similar to ginseng, but weaker, appropriate to treat weak patients who cannot digest strong tonics
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Development & Modification of Bioactivity

Min Yang, ... De-an Guo, in Comprehensive Natural Products II, 2010

3.13.9 Radix Astragali (Huangqi)

Huangqi (Radix Astragali), the dried roots of Astragalus membranaceus (Fisch.) Bge. or A. membranaceus (Fisch.) Bge. var. mongholicus (Bge.) Hsiao (Fabaceae), is a well-known TCM, and used as adjunctive therapy in the treatment of colds and influenza, chronic diarrhea, edema, abnormal uterine bleeding and diabetes mellitus, and as a cardiotonic agent.502,503 Both pharmacology and clinical practices indicate that Huangqi exhibits hepatoprotective, immune modulation, antiviral, cardiotonic, and antiaging activities and was also used for adjunct cancer therapy.503,504 The main constituents of the root of Huangqi include flavonoids, saponins, polysaccharides, amino acids, and other components. In Figure 17 we summarize the saponins and flavonoids isolated from this plant.

Figure 17. Phenolic compounds and saponins isolated from Astragalus membranaceus.

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Herbs that release the exterior: warming and cooling acrid herbs

Dr med.Carl-Hermann Hempen, Dr med., Dr sc. nat.Toni Fischer, in A Materia Medica for Chinese Medicine, 2009

Combinations

Sweating → Astragali radix (huang qi) p. 706

Painful obstruction syndrome → Notopterygii rhizoma (qiang huo) p. 38, Angelicae dahuricae radix (bai zhi) p. 22, Clematidis radix (wei ling xian) p. 356

Pain due to damp-cold in blood deficiency → Gentianae radix (long dan cao) p. 178

Pain due to wind-damp diarrhoea, dampness in the Spleen → Atractylodis rhizoma (cang zhu) p. 286

Headaches, body aches, paraesthesias, wind, phlegm, obstructed channels → Arisaematis rhizoma preparata (zhi tian nan xing) p. 624

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Lymphomas

Tai Lahans L.AC., M.TCM, M.Ed., in Integrating Conventional and Chinese Medicine in Cancer Care, 2007

12. Formula for combined chemotherapy and radiotherapy70

huang qi (Astragali Radix; Astragalus membranaceus) 30–60 g
dang shen (Codonopsis Radix; Codonopsis pilosula root) 15–30 g
bai zhu (Atractylodis macrocephalae Rhizoma; Atractylodes macrocephala) 15 g
fu ling (Poria; Poria cocos) 10 g
chen pi (Citri reticulatae Pericarpium; Citrus reticulata pericarp) 10 g
ji xue teng (Spatholobi Caulis; Spatholobus suberectus) 15 g
dang gui (Angelicae sinensis Radix; Angelica sinensis) 10 g
gou qi zi (Lycii Fructus; Lycium chinensis fruit) 10 g
bei sha shen (Glehniae Radix; Glehnia) 10 g
nu zhen zi (Ligustri lucidi Fructus; Ligustrum lucidum fruit) 10 g
tu si zi (Cuscutae Semen; Cuscuta seed) 10 g
yin yang huo (Epimedii Herba; Epimedium grandiflorum) 10 g

Si jun zi tang is embedded in this formula and helps to support and protect the middle jiao which, in turn, supports the blood. The blood-regulating and blood-nourishing herbs potentiate the yin-nourishing herbs to support normal blood levels, which are injured during chemotherapy. The yin-nourishing and blood-regulating herbs also potentiate radiation and help to protect normal tissue from injury by toxic heat (radiation). The two yang tonic herbs support the source.

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Colorectal Cancer

Tai Lahans L.AC., M.TCM, M.Ed., in Integrating Conventional and Chinese Medicine in Cancer Care, 2007

BU ZHONG YI QI TANG19

Surgery for colorectal cancer is quite extensive and, therefore, a period of time anywhere from 2 weeks to 1 month is given prior to chemotherapy for the patient to recuperate. This time gives the body a period in which to heal from the surgical trauma and to re-establish normal qi and blood flow and rebuild qi and blood. A very common formula to aid in this process follows.

huang qi (Astragali Radix; Astragalus membranaceus) 20 g
chai hu (Bupleuri Radix; Bupleurum) 10 g
dang shen (Codonopsis Radix; Codonopsis pilosula root) 15 g
sheng ma (Cimicifugae Rhizoma; Cimicifuga) 10 g
bai zhu (Atractylodis macrocephalae Rhizoma; Atractylodes macrocephala) 12 g
chen pi (Citri reticulatae Pericarpium; Citrus reticulata pericarp) 5 g
dang gui (Angelicae sinensis Radix; Angelica sinensis) 10 g
zhi gan cao (Glycyrrhizae Radix; Glycyrrhiza uralensis pan fried) 5 g

The previous formula can be used with Xiao yao san:38

bai zhu (Atractylodis macrocephalae Rhizoma; Atractylodes macrocephala) 10 g
chai hu (Bupleuri Radix; Bupleurum) 10 g
fu ling (Poria; Poria cocos) 10 g
dang gui (Angelicae sinensis Radix; Angelica sinensis) 10 g
bai shao (Paeoniae Radix alba; Paeonia lactiflora root) 10 g
bo he (Menthae haplocalycis Herba; Mentha haplocalyx) 5 g

The modified combination of these two formulas together will lift, tonify, smooth, and regulate the qi. Also the blood-nourishing and qi tonics in the formulas will nourish the blood and move it in a way so as to prevent stasis without precipitating bleeding. The actual amounts of the herbs in the combined formula will depend on the needs of the patient for whom it is being written. Some patients may need a higher dose of qi tonics and others may enter surgery already anemic and will require more blood nourishing. If constipation persists, then more qi tonics and mild laxatives may be needed to further modify the formula. When the diaphragm is stopped during abdominal surgery, this interferes with the lung qi circulation. Some forms of constipation are the result of the lung and colon losing their relationship as coupled organs. Jie geng acts as a bridge in this case to get the colon peristalsis engaged again.

During this post-surgery time, and depending on the regimen that is planned for the given patient, it is still important to address the constitutional diagnosis for the cancer. A small part of the constitutional formula may be given as part of the above combined formula. For example, if the constitutional diagnosis for the cancer is damp heat, then lower jiao damp heat draining herbs can be added to modify the formula for post-surgery. Another example would be to add herbs that are specific to blood stasis or damp phlegm, depending on the constitutional diagnosis, and then combine specifically anticancer herbs for colorectal cancer. If damp phlegm is part of the constitutional diagnosis, then gua lou shi (Trichosanthis Fructus; Trichosanthes fruit) and tian nan xing (Arisaematis Rhizoma preparatum; Arisaema erubescens rhizome) would be good additions.

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Cervical and Uterine Cancers

Tai Lahans L.AC., M.TCM, M.Ed., in Integrating Conventional and Chinese Medicine in Cancer Care, 2007

Formula

huang qi (Astragali Radix; Astragalus membranaceus) 20 g
dang shen (Codonopsis Radix; Codonopsis pilosula root) bai zhu (Atractylodis macrocephalae 15 g
Rhizoma; Atractylodes macrocephala) 15 g
fu ling (Poria; Poria cocos) 15 g
bu gu zhi (Psoraleae Fructus; Psoralea) 15 g
sheng ma (Cimicifugae Rhizoma; Cimicifuga) 15 g
suan zao ren (Ziziphi spinosae Semen; Ziziphus spinosa seed) 10 g
ji xue teng (Spatholobi Caulis; Spatholobus suberectus) 30 g
gou qi zi (Lycii Fructus; Lycium chinensis fruit) 15 g
shu di (Rehmanniae Radix preparata; Rehmannia) 15 g
dang gui (Angelicae sinensis Radix; Angelica sinensis) 10 g
fu zi (Aconiti Radix preparata; Aconitum carmichaelii) 6 g
long yan rou (Longan Arillus; Dimocarpus longan aril) 15 g
gan cao (Glycyrrhizae Radix; Glycyrrhiza; licorice root) 6 g

The first four herbs are Si jun zi tang, the main qi tonic formula for the spleen. Bu gu zhi, and long yan rou are both kidney yang tonic herbs that warm the source and help reduce diarrhea and increase the kidneys' ability to transform and move fluids. This supports fluid metabolism and reduces ascites and edema. Sheng ma lifts the yang and helps support spleen qi to transport and transform fluids. Spleen support is important to treat cachexia, a condition in which the body begins to metabolise its muscle mass for organ support. Many patients with advanced disease do not die of cancer but rather from malnourishment. Suan zao ren calms the spirit and reinforces the yin and blood. It should be used carefully as it also moistens the stool and can exacerbate diarrhea or loose stool caused by spleen and kidney yang deficiency. Here it also protects the yin in a formula that is very warming. Ji xue teng, gou qi zi, shu di, and dang gui all nourish the blood to contain the blood in bloody leukorrhea and to treat the anemias present from malnutrtion. Fu zi rescues the yang to draw back the kidney fire, the source. It is especially good for alleviating diarrhea, warming the channels and relieving pain. Gan cao is a harmonising herb but can also work with rou gui (Cinnamomum bark) to enter the channels and relieve pain.

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Leukemia

Tai Lahans L.AC., M.TCM, M.Ed., in Integrating Conventional and Chinese Medicine in Cancer Care, 2007

1. Leukocytopenia and thrombocytopenia60

huang qi (Astragali Radix; Astragalus membranaceus) 25 g
ji xue teng (Spatholobi Caulis; Spatholobus suberectus) 20 g
jiao gu lan (Herba Gynostemmatis; Gynostemma) 15 g
bai zhu (Atractylodis macrocephalae Rhizoma; Atractylodes macrocephala) 15 g
gou qi zi (Lycii Fructus; Lycium chinensis fruit) 15 g
ren shen (Ginseng Radix; Panax ginseng) 10 g
he shou wu (Polygoni multiflori Radix preparata; Polygonum multiflorum root) 15 g
dang shen (Codonopsis Radix; Codonopsis pilosula root) 15 g
shi wei (Pyrrosiae Folium; Pyrrosia leaves) 15 g
nu zhen zi (Ligustri lucidi Fructus; Ligustrum lucidum fruit) 15 g
fu ling (Poria; Poria cocos) 15 g
tu si zi (Cuscutae Semen; Cuscuta seed) 15 g
shu di (Rehmanniae Radix preparata; Rehmannia) 15 g
bu gu zhi (Psoraleae Fructus; Psoralea) 10 g
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Prostate Cancer

Tai Lahans L.AC., M.TCM, M.Ed., in Integrating Conventional and Chinese Medicine in Cancer Care, 2007

Formula

Special formula

huang qi (Astragali Radix; Astragalus membranaceus) 20 g
bu gu zhi (Psoraleae Fructus; Psoralea) 15 g
yi zhi ren (Alpiniae oxyphyllae Fructus; Alpinia oxyphylla fruit) 15 g
mu dan pi (Moutan Cortex; Paeonia suffruticosa root cortex) 15 g
fu ling (Poria; Poria cocos) 15 g
gou qi zi (Lycii Fructus; Lycium chinensis fruit) 15 g
nu zhen zi (Ligustri lucidi Fructus; Ligustrum lucidum fruit) 15 g
yin yang huo (Epimedii Herba; Epimedium grandiflorum) 15 g
yu zhu (Polygonati odorati Rhizoma; Polygonatum odoratum) 15 g
dang shen (Codonopsis Radix; Codonopsis pilosula root) 15 g
ze xie (Alismatis Rhizoma; Alisma) 10 g
shan yao (Dioscoreae Rhizoma; Dioscorea opposita) 15 g
shu di (Rehmanniae Radix preparata; Rehmannia) 20 g
tai zi shen (Pseudostellariae Radix; Pseudostellaria heterophylla) 20 g
mai dong (Ophiopogonis Radix; Ophiopogon) 10 g
bai zhu (Atractylodis macrocephalae Rhizoma; Atractylodes macrocephala) 10 g
gan cao (Glycyrrhizae Radix; Glycyrrhiza; licorice root) 10 g

Dang shen, fu ling, bai zhu and gan cao form the basic qi tonic formula Si jun zi tang. Bu gu zhi, yi zhi ren, yin yang huo, shan yao all tonify the kidney qi. Bu gu zhi is very high in genistein, which is an anticancer substance and prevents the promotion of prostate cancer cells. Gou qi zi, shu di, yu zhu, nu zhen zi and mai dong all act synergistically to nourish the blood and yin and, thereby, gently move the blood. The yin-nourishing herbs help to protect the yin in a formula that is warming and drying. Tai zi shen benefits fluids while tonifying the qi. The yang tonics in the formula are warming. Tai zi shen helps to support the tonifying action without being warming, and therefore, drying. Huang qi is an antineoplastic herb that lifts the yang, increases white blood cells (WBCs) and natural killer (NK) cells. Dong ling cao (Rabdosiae rubescentis Herba; Rabdosia) could be added to this formula to help regulate testosterone levels in a prostate cancer that will probably be treated hormonally.

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Breast Cancer

Tai Lahans L.AC., M.TCM, M.Ed., in Integrating Conventional and Chinese Medicine in Cancer Care, 2007

Formula base for the AC regimen117

huang qi (Astragali Radix; Astragalus membranaceus) 20 g
dan shen (Salviae miltiorrhizae Radix; Salvia miltiorhiza root) 15 g
bai zhu (Atractylodis macrocephalae Rhizoma; Atractylodes macrocephala) 12 g
fu ling (Poria; Poria cocos) 12 g
ze xie (Alismatis Rhizoma; Alisma) 12 g
tian dong (Asparagi Radix; Asparagus) 12 g
gou qi zi (Lycii Fructus; Lycium chinensis fruit) 15 g
huang jing (Polygonati Rhizoma; Polygonatum) 15 g
mai dong (Ophiopogonis Radix; Ophiopogon) 12 g
san qi (Notoginseng Radix; Panax notoginseng) 10 g
ji xue teng (Spatholobi Caulis; Spatholobus suberectus) 15 g
he shou wu (Polygoni multiflori Radix preparata; Polygonum multiflorum root) 10 g
bei sha shen (Glehniae Radix; Glehnia) 10 g
zhi ban xia (Pinelliae Rhizoma 12 g
wu zhu yu (Evodiae Fructus; Evodia) 10 g
shi di (Kaki Calyx; Diospyros kaki calyx) 10 g
shen qu (Massa medicata fermentata; medicated leaven) 12 g
xi yang shen (Panacis quinquefolii Radix; Panax quinquefolium) 10 g
nu zhen zi (Ligustri lucidi Fructus; Ligustrum lucidum fruit) 15 g
da zao (Jujubae Fructus; Ziziphus jujuba; jujube) 6 g

Adriamycin is an antitumor antibiotic made from the culture broth of various species of Streptomyces. It is metabolised by the liver and causes myelosuppression with the nadir at days 10-14. Nausea and vomiting are moderate risks. Alopecia is universal. Hyperpigmentation of the nail beds occurs and is temporary. Adriamycin is associated with acute and chronic cardiotoxicity. Pretreatment cardiograms including a MUGA-scan to establish the baseline ejection fraction is important. This is repeated every three courses, or at least at the end of treatment with Adriamycin.

The AC regimen injures the spleen qi thus causing a damp stasis that can lead to nausea and vomiting. The spleen injury also leads to spleen failing to nourish the blood, which manifests as anemia in the form of neutropenia. This regimen also injures the essence and leads to general bone marrow suppression, which can manifest as a low hemoglobin count and RBC counts that are decreased. The spleen injury can cause disharmony between the stomach and spleen leading to stomach qi flushing upwards manifesting as nausea and vomiting and either stomach heat or cold, which can cause mouth sores, mucositis, inflammation/ulceration of the gastrointestinal mucosa, and headaches. This regimen also injures the kidneys, which can manifest as painful urinary dysfunction (PUD) and essence deficiency. The injury to the liver can cause injury to the heart via the Five Phase cycle.

Huang qi is a prime herb in maintaining spleen and lung function; it raises WBC counts and increases phagocytosis and NK cells. Dan shen works as a blood-cracking herb to improve the blood circulation generally in order to increase the overall effect of the AC regimen. Huang qi, bai zhu and fu ling are the primary elements of Si jun zi tang, the main formula to tonify the spleen qi. This formula can be found in many formulas designed to treat the side effects of chemotherapy. Ze xie clears heat and generates fluids. Gou qi zi, huang jing, tian dong, mai dong, ji xue teng, he shou wu, nu zhen zi and bei sha shen all work together to nourish the blood and generate fluids. Blood- and yin-nourishing herbs potentiate one another since the yin and blood are in some ways one and the same; the blood plasma is the yin component of blood, the WBCs and the RBCs are the qi component of blood – the active component of the fluid. The yin-nourishing herbs in this cluster also nourish the yin of the zang fu and help clear heat manifesting as inflammation along with ze xie. These herbs together help maintain normal organ and digestive function.

The digestive injuries caused by the AC regimen are also ameliorated by the herbs that warm the middle jiao. Ban xia is the empiric herb for nausea and vomiting. It redirects the stomach qi, along with wu zhu yu and shi di, both of which are warming herbs that treat nausea. Xi yang shen is a yin-nourishing herb that also tonifies the qi. This makes it a very valuable herb for treating the fatigue that is common with certain kinds of chemotherapeutic agents. Da zao is added as a harmonising herb that also generates fluids. Although chemotherapies are heat- and toxin-clearing drugs from the classical point of view and would, therefore, be cold in nature, they are so strong and have such an intense cumulative effect that it is only in the very early phase of treatment that we see injury by cold. That same injury transforms to heat soon in the first course of treatment depending on the constitution of the patient. Thus the need for yin-nourishing herbs not only to nourish blood but also to cool and detoxify.

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