The Three Treasures Newsletters
SUMMER 2005
CHEMOTHERAPY AND CHEMO-SUPPORT
This issue is dedicated to the discussion of chemotherapy for cancer
and the application of the remedy Chemo-Support
designed to lessen the side-effects of this treatment. Chemo-Support
is gaining recognition as an effective remedy to lessen the side-effects
and toxicity of chemotherapeutic agents and, for this reason, its
application is presented here with a more detailed explanation of
its protocol and dosage.
The purpose of treating cancer cells with chemotherapy is to prevent
them from dividing, invading and metastasizing. Most chemotherapeutic
agents exert their effect on cell multiplication: obviously, since
multiplication is a characteristic of many normal cells, chemotherapeutic
agents will inevitably affect also normal cells and especially those
with a rapid rate of multiplication and turnover such as those of
the hair, intestinal mucosa, blood and bone marrow. This explains
the common toxic effect of chemotherapy on the hair (hair loss),
the intestines (vomiting and diarrhoea), the blood (affecting blood
counts) and bone marrow (affecting the immune system).
Inhibition of cell multiplication can take place at several levels
within the cell:
| • |
Macromolecular synthesis and function |
| • |
Cytoplasmic organization |
| • |
Cell membrane synthesis function |
| • |
Environment of cancer cell growth |
Most agents have their primary effect on either macromolecular synthesis
or function. They interfere with the synthesis of DNA, RNA or proteins
or with the appropriate functioning of the molecule. When interference
with macromolecular synthesis or function of the neoplastic cells
is sufficiently great, a proportion of the cells die. Because only
a proportion of the cells die as a result of a given treatment,
repeated doses of chemotherapy must be used to continue to reduce
their number.
Neoplastic cell death may not take place at the time of exposure
to the chemotherapeutic agent. Often the cell must undergo several
divisions before the lethal event that took place earlier results
in death of the cell. This means that the effect of chemotherapy
may last for several weeks after the end of the treatment: likewise
with its toxic effects on normal cells. This has important implication
for our protocols with Chemo-Support as it means that we need to
continue tonifying Qi and Blood for some time after the end of the
treatment (see below).
TOXICITY
The toxicity of chemotherapeutic agents (and also of other drugs)
is not a fixed entity but it varies according to several factors:
| • |
Toxicity of specific agent |
| • |
Dose |
| • |
Schedule of administration |
| • |
Route of administration |
| • |
Predisposing factors of the patient which may be known or
unknown before the start of the treatment |
| • |
Sex (women tend to develop toxicity at a lower dose than
men) |
COMMON TOXICITIES
Some toxicities are relatively common among chemotherapeutic agents.
Common acute toxicities include:
| • |
Myelo-suppression with leukopenia, thrombocytopenia
and anaemia |
| • |
Nausea and vomiting |
| • |
Mucous membrane ulceration |
| • |
Alopecia |
Apart from nausea and vomiting, these toxicities occur because of
the cytotoxic effect of chemotherapy on rapidly-dividing normal
cells in the bone marrow, mucous membranes and hair.
The side-effects of chemotherapy vary greatly according to the agent
used. Agents may be broadly classified into four groups:
| • |
Alkylating
agents damage the programs that control growth in the
chromosomes of the tumour cells. Example: busulfan, carboplatin,
carmustine, chlorambucil, cisplatin, cyclophosphamide, dacarbazine,
doxorubicin, estramustine, ifosfamide, lomustine, mechlorethamine,
melphalan, semustine, thiotepa. |
| • |
Antimetabolites
interfere with the manufacture of nucleotides, the substances
that make up the DNA. Example: azacitidine, capecitabin, cladribine,
floxuridine, fludarabine, 5-fluorouracil, gemcitabine, mercaptopurine,
methotrexate, pentostatin, raltitrexed, thioguanine, trimetrexate. |
| • |
Natural products
interfere with cell structure and cell division. Example:
asparaginase, bleomycin, dactinomycin, daunorubicin, docetaxel,
doxorubicin, epirubicin, etoposide, idarubicin, irinotecan,
plicamycin, mitomycin, mitoxantrone, taxol, teniposide, topotecan,
vincristine, vinblastine. |
| • |
Hormones
block the effect of oestrogen by acting on the oestrogen-receptors.
Example: aminoglutethimide, anastrozole, bicalutamide, dexamethasone,
diethylstilbestrol, fluoxymesterone, flutamide, goserelin,
leuprolide, letrezole, nilutamide, raloxifen, tamoxifen, torenufen. |
| • |
Miscellaneous agents:
altretamine, amifostine, amsacrine, dexrazoxane, hydroxyurea,
mitotane, pamidronate, porfimer, procarbazine. |
| • |
Biologic
agents
Monoclonal antibodies:
rituximab, trastuzumab.
Interferons:
interferon-á2a and interferon-á2b.
Interleukins: aldesleukin, oprelvekin.
Myeloid- and erythroid-stimulating factors:
erythropoietin, filgrastim, sargramostim. |
SHORT-TERM SIDE-EFFECTS OF CYTOTOXIC DRUGS
Short-term side-effects of cytotoxic drugs include:
| • |
Loss of appetite |
| • |
Nausea |
| • |
Vomiting |
| • |
Stomatitis |
| • |
Malaise |
|
|
| • |
Flu-like feeling, fever |
| • |
Cystitis |
| • |
Haematuria |
| • |
Constipation |
| • |
Diarrhoea |
|
LONG-TERM SIDE-EFFECTS OF CYTOTOXIC DRUGS
Long-term side-effects of cytotoxic drugs include:
| • |
Cardiac toxicity (usually
from high doses of doxorubicin or daunorubicin). Doxorubicin
is widely used for breast carcinoma. If radiation is administered
to the chest, the cardiac toxicity (in the form of congestive
cardiac failure) may occur at lower doses. This particular
long-term side-effect may occur even several years after the
administration of chemotherapy. |
| • |
Pulmonary toxicity (pulmonary
fibrosis) is associated with high doses of bleomycin but also
with alkylating agents and methotrexate. |
| • |
Haematologic impairment. Alkylating
agents may cause cytopenia. |
| • |
Immunologic impairment
and myelo-suppression. Fludarabine, cladribine and pentostatin
cause profound suppression of CD4 and CD8 lymphocytes and
render patients treated susceptible to opportunistic infections.
There may be a fall in white blood cells and platelets counts. |
| • |
Skin reactions (rash, inflammation,
pigmentation, photosensitivity) |
| • |
Liver toxicity. |
| • |
Nephrotoxicity. This is typically caused
by cisplatin, oxaliplatin, methotrexate and nitrosoureas).
This toxicity may be acute or chronic and in severe cases
it may require haemodialysis. |
| • |
Neurotoxicity (peripheral
neuropathy) is typically caused by vinca alkaloids, cisplatin,
oxaliplatin, epipodophyllotoxins and paclitaxel. |
| • |
CNS toxicity (lethargy, fatigue, depression,
headaches, poor memory and concentration) |
| • |
Premature menopause may
occur in women who have received certain chemotherapeutic
agents such as alkylating agents or procarbazine. |
SIDE-EFFECTS OF INDIVIDUAL CYTOTOXIC DRUGS
| Adriamycin |
Heart muscle damage, haematuria,
hair loss, nausea, vomiting, mouth ulcers. |
| Anthracyclines |
Cardiomyopathy. |
| Asparaginase |
Anaphylaxis (allergic reaction), fever,
malaise. |
| Bleomycin (or Blenoxane) |
Alopecia, stomatitis,
fever, skin reactions, nail ridging, pulmonary toxicity. |
| Carboplatin (or Paraplatin) |
Nausea, vomiting, bone-marrow suppression,
nephrotoxicity, liver function abnormalities, diarrhoea. |
| Chlorambucil |
Myelo-suppression, amenorrhoea,
azoospermia, CNS effects at high doses. |
| Cisplatin |
Nausea, vomiting, diarrhoea, bone-marrow
suppression, renal toxicity, neurotoxicity, ototoxicity, severe
electrolyte abnormalities (hyponatremia, hypomagnesemia, hypocalcemia,
hypokalemia), peripheral neuropathy. |
| Cladribine |
May cause profound suppression
of CD4 and CD8 lymphocytes, nausea, skin rash, fever, headache,
myalgia, arthralgia. |
| Cyclophosphamide |
Bone-marrow suppression, hair loss,
nausea, vomiting, cystitis, haematuria. |
| Dacarbazine |
Severe nausea and vomiting,
flu-like feeling, malaise, diarrhoea, bone-marrow suppression. |
| Daunorubicin |
Myelo-suppression, cardiac toxicity,
nausea, vomiting, alopecia. |
| Doxorubicin |
Nausea, vomiting, stomatitis,
hair loss, bone-marrow suppression. |
| Epipodophyllotoxins |
Neuro-toxicity (peripheral neuropathy). |
| Etoposide |
Nausea, vomiting, hair
loss, bone-marrow suppression. |
| Fludarabine |
May cause profound suppression of CD4
and CD8 lymphocytes, nausea, vomiting. |
| 5-Fluorouracil |
Diarrhoea, mild nausea,
stomatitis, bone-marrow suppression, painful, erythematous
desquamation and fissures of palms and soles. |
| Ifosfamide |
Bone-marrow suppression, nausea, vomiting,
cystitis, renal toxicity. |
| Melphalan |
Renal toxicity, nausea,
vomiting, diarrhoea, hair loss, stomatitis, bone-marrow suppression,
depression. |
| Methotrexate |
Bone-marrow suppression, nausea, stomatitis,
skin reactions. |
| Methotrexate
(high dose) |
Mouth ulcers, stomach
ulcers, nausea, vomiting, bone-marrow suppression, renal toxicity. |
| Mitomycin-C |
Nephrotoxicity, bone-marrow suppression. |
| Mitoxantrone |
Mild nausea and vomiting,
loss of appetite, mild hair loss, bone-marrow suppression. |
| Paclitaxel |
Neuro-toxicity (peripheral neuropathy),
myelo-suppression, nausea, vomiting, alopecia. |
| Pentostatin |
May cause profound suppression
of CD4 and CD8 lymphocytes. |
| Procarbazine |
Food and drug interactions (it has
a MAOI activity and patient should avoid beer, wine, fermented
cheese, chocolate, fava beans and yeast extracts), myelo-suppression,
nausea, vomiting, rash, hives, photosensitivity. |
| Taxol |
Bone-marrow suppression,
allergic reaction, neurological damage, nausea, vomiting,
diarrhoea. |
| Thiotepa |
Fatigue, nausea, vomiting, cystitis,
dizziness. |
| Vincristine |
Constipation, numbness,
tingling, paraesthesia of hands and feet. |
CHEMOTHERAPY SIDE-EFFECTS FROM THE POINT OF
VIEW OF CHINESE MEDICINE
If we analyze the above side-effects, there are important differences
between various cytotoxic drugs and one could conceivably formulate
an individual Chinese herbal formula for each. However, one can
identify common characteristics among the above side-effects. We
can attempt to group the side-effects according to the Chinese pathological
pattern induced by the various cytotoxic drugs. Looking at the side-effects
of each drug, four patterns in particular stand out:
| • |
DEFICIENCY
OF QI, BLOOD AND YIN
Hair loss, diarrhoea, nail ridging, bone-marrow suppression,
malaise, fatigue, depression, loss of appetite, neurological
damage, dizziness, constipation, numbness, tingling, paraesthesia
of hands and feet. |
| • |
ST-QI
REBELLING UPWARDS
Nausea, vomiting. |
| • |
STOMACH HEAT
Mouth ulcers, stomatitis, stomach ulcers. |
| • |
BLOOD
HEAT
Haematuria, fever, skin reactions, cystitis. |
Thus, we can deduce from the analysis of the above patterns that
cytotoxic drugs cause the following:
| • |
Qi, Blood
and Yin deficiency (of Stomach, Lungs, Liver and Kidneys) |
| • |
Stomach-Qi rebelling upwards |
| • |
Stomach Heat |
| • |
Blood Heat. |
The treatment principles to adopt are therefore (the herbs used
are indicated in brackets):
| • |
Tonify
Qi, Blood and Yin (Huang Qi Radix
Astragali, Ren Shen Radix
Ginseng, Ling Zhi Ganoderma,
Xi Yang Shen Radix Panacis
quinquefolii, Mai Men Dong Radix
Ophiopogonis, Dang Gui Radix
Angelicae sinensis, Nu Zhen Zi Fructus
Ligustri lucidi, Huang Jing Rhizoma
Polygonati) |
| • |
Subdue
rebellious Stomach-Qi (Lu Gen Rhizoma
Phragmitis, Ban Xia Rhizoma
Pinelliae preparatum, Sha Ren Fructus
Amomi) |
| • |
Clear
Stomach Heat (Lu Gen Rhizoma
Phragmitis, Zhi Mu Radix
Anemarrhenae) |
| • |
Cool
Blood (Mu Dan Pi Cortex
Moutan) |
ANALYSIS OF INDIVIDUAL HERBS IN CHEMO-SUPPORT
| Huang
Qi Radix Astragali:
tonify Qi and raise immune response. |
| Ren
Shen Radix Ginseng:
tonify Qi. |
| Ling
Zhi Ganoderma:
tonify Qi and Blood and raise the immune response. |
| Xi
Yang Shen Radix Panacis
quinquefolii: tonify Qi and Yin. |
| Mu
Dan Pi Cortex Moutan:
cool Blood. |
| Zhi
Mu Radix Anemarrhenae:
clear Heat. |
| Fu
Ling Poria:
resolve Dampness. |
| Chen
Pi Pericarpium Citri
reticulatae: resolve Dampness, stop nausea. |
| Mai
Men Dong Radix Ophiopogonis
: nourish Yin. |
| Dang
Gui Radix Angelicae
sinensis: nourish Blood |
| Ban
Xia Rhizoma Pinelliae
preparatum: resolve Phlegm, subdue rebellious Stomach-Qi,
stop nausea and vomiting. |
| Lu
Gen Rhizoma Phragmitis:
clear Stomach-Heat, stop vomiting. |
| Nu
Zhen Zi Fructus Ligustri
lucidi |
| Sha
Ren Fructus Amomi:
move Qi, resolve Dampness, stop nausea. |
| Huang
Jing Rhizoma Polygonati:
tonify Qi, nourish Yin and Jing. |
| Gan
Cao Radix Glycyrrhizae
uralensis: harmonize. |
PHARMACOLOGY OF CHEMO-SUPPORT INGREDIENTS
I shall report only the pharmacology of the above plants that is
relevant to chemotherapy, immune function, inflammation, digestion
or carcinoma. Thus, for each plant, there are many other pharmacological
actions not reported below. These data are not available for all
of Chemo-Support's ingredients.
It should also be noted that such data are reported for reference
only as they reflect a reductionist view of the action of herbs
that is at variance with the Chinese medicine view. Some of the
research studies reported present a doubly-reductionist view: firstly,
they use single herbs and secondly, many of them use single constituents
of a herb. By contrast, Chinese medicine uses only formulae composed
of several herbs. It is a well-know fact that first of all, the
action of a herb is more than the sum-total of the actions of its
individual constituents and secondly, the synergistic action of
the herbs within a formula is more than the sum-total of its individual
herbs.
Furthermore, many of the studies reported are based on animal experiments
which could be criticized on ethical grounds.
HUANG QI Radix
Astragali
Constituents
2'4'-dihydroxy-5,6-dimethoxyisoflavone, kumatakenin, choline, betaine,
polysaccharides, glucoronic acid, folic acid.
Pharmacology
| • |
Enhancement
of immune function
The decoction given to mice increased the phagocytic activity
of the reticuloendothelial system. Oral administration or
nasal spray of Huang Qi offered protection against the common
cold. Intraperitoneal administration of the polysaccharides
from the root of Astragalus membranaceus antagonized the atrophy
of immune tissues such as spleen, thymus and intestinal lymph
nodes as well as leukopenia caused by immunosuppressant prednisolone
in mice. Intraperitoneal administration of the homogeneous
fraction of the polysaccharides astragalan I and II increased
the weight and cell number of mouse spleen. Two months of
oral treatment with the herb in subjects susceptible to common
cold greatly increased the levels of IgA and IgG in the nasal
secretion. |
| • |
Antibacterial
effect
In vitro, Huang Qi was effective against Shigella
shigae, Bacillum anthracis, Streptococcus hemolyticus, Corynebacterium
diphtheriae, Diplococcus pneumoniae, Staphyloccus aureus. |
| • |
Prevention
of renal toxicity in chemotherapy
A double-blind trial of 49 patients undergoing chemotherapy
showed that the decoction of Huang Qi Radix
Astragali and Fu Ling Poriae
markedly reduced the incidence of renal toxicity. Rats with
experimentally-induced glomerulonephritis, when treated with
Huang Qi had significantly less proteinuria than control groups
as well as milder pathological tissue changes. |
| • |
Effect
on endurance
Decoction of Huang Qi given to mice significantly increased
their endurance in swimming tests. |
| • |
Endocrine
effect in patients undergoing radiotherapy
In a randomized clinical trial, the plasma hydrocortisone
level in stage II carcinoma of the cervix was observed. The
average level in 18 patients before and after irradiation
were 8.0 and 6.1 Fg/100ml, whereas the before and after levels
were 9.5 and 9.1 Fg/100ml in patients who received a decoction
of Huang Qi Radix Astragali
and Nu Zhen Zi Fructus Ligustri
lucidi for two months. |
| • |
Anti-inflammatory
effect
Intravenous dose of 5 mg/Kg or oral dose of 50 mg/Kg of astramembranin
I inhibited the increase in vascular permeability induced
by serotonin or histamine in rats. |
| • |
Hepatoprotective
effect
Intravenous administration of 10 mg/Kg of astramembranin I
induced accumulation of cAMP in rabbit plasma. |
REN SHEN Radix
Ginseng
Constituents
Triterpene saponins, aglycone protopanaxadiol, aglycone protopanaxytriol,
aglycone oleanolic acid, water-soluble polysaccharides, polyynes.
Pharmacology
| • |
Endocrine
effect
Animal tests proved that ginseng stimulates the pituitary
gland to increase the secretion of ACTH, which in turn stimulates
the adrenal gland. |
| • |
Effect
on endurance
Mice administered a single extract of ginseng recorded a 132%
increase in duration of swimming compared with a 179% increase
in mice given the extract for 7 days. |
| • |
Immunologic
effect
Ginseng increases the function of the reticuloendothelial
system. Administration to guinea pigs promoted antibody production
against leptospira and influenza virus. The percentage of
tumour-bearing mice and weight of the tumour decreased in
mice bearing sarcoma S 180 and ARS following dosages of ginseng.
Ginseng may also increase the activity and and reduce the
toxicity of other anti-tumour agents. |
| • |
Haematologic
effect
Ginseng extract demonstrated protective and stimulant actions
on bone marrow, increasing red and white blood cell numbers,
and also hemoglobin in normal and anemic animals. |
| • |
Effects
on the nervous system
An intraperitoneal injection of 50mg/kg of Ren Shen for 5
days has a stimulating effect as it increases the amounts
of dopamine and norepinephrine in the brain stem. However,
Ren Shen solution 40% taken orally reacts as a sedative. Therefore,
due to its dual effective nature, Ren Shen provides an adaptogenic
effect for the body suffering various stresses. |
LING ZHI Ganoderma
Constituents
Ergosterol, lysozyme, acid protease, amino-acids, polypeptides,
saccharides, sterols, lactones, alkaloids and polysaccharides.
Pharmacology
| • |
Cardiotonic
action
The tincture had a significant cardiotonic action on the isolated
frog heart. |
| • |
Action
on coronary circulation
Injection of an extract given to dogs rapidly increased the
coronary flow by 44%. |
| • |
Regulation
of immune function and inhibition of allergic reaction
Ling Zhi accelerated the clearance of I-labelled protein in
the blood of albino mice, indicating its ability to enhance
the phagocytic action of the reticuloendothelial system. The
polysaccharide fraction of Ling Zhi markedly increased the
phagocytic ability of abdominal macrophages of mice against
chicken erythrocytes. These facts suggest that the polysaccharides
can increase non-specific immunologic function of the body. |
MU DAN PI Cortex Moutan
Constituents
Paenol, paenoside, pasenolide, paeniflorin, volatile oil and phytoesterol.
Pharmacology
| • |
Antimicrobial
action
The decoction of the root showed strong antibacterial action
in vitro against, Bacillus subtilis, Escherichia coli, Salmonella
typhi, Salmonella paratyphi, Proteus vulgaris, Staphylococcus
aureus, Streptococcus haemolyticus, Doplococcus pneumonia
and Vibrio cholerae. |
| • |
Anti-inflammatory
action
Paenol given intragastrically inhibited swelling of rat paws
induced by dextran. Paenol inhibited the increase of intra-abdominal
capillary permeability of mice and cutaneous capillary permeability
of guinea pigs caused by acetic acid. The methanolic extract,
the glycosidic fraction and paenol inhibited blood platelet
aggregation. |
| • |
Hypotensive
effect
The blood pressure of dogs with essential or renal hypertension
was significantly reduced after oral administration of 5 g/Kg
of the decoction of the root bark for 5 days and 10 g/Kg for
two more days. |
| • |
CNS
effects
Intraperitoneal or oral administration of paenol decreased
the spontaneous activity of mice, antagonized caffeine-induced
hyperactivity and prolonged cyclobarbital-induced sleep. |
FU LING Poria
Constituents
Paenol, paenoside, pasenolide, paeniflorin, volatile oil and phytoesterol.
Pharmacology
| • |
Antineoplastic
effect
Pachymaran produced an inhibition rate of 96.88% against sarcoma
in rats. Topical application of the methanolic extract of
the herb (2 mg/100 ìl) significantly reduced the percentage
of tumour-bearing mice and the number of tumours per mouse
induced by DMBA plus TPA. |
| • |
Effect
on immune function
Oral administration increased phytohemagglutinin-induced lymphocyte
transformation rate and increased serum IgG. |
| • |
Effect
of digestive system
The herb inhibited gastric ulcer provoked by pylorus-ligation
and decreased gastric secretion and free acidity in rats.
The herbs also protected rats against CCl4-induced hepatotoxicity,
reducing GPT activity and preventing necrosis of hepatocytes. |
CHEN PI Pericarpium Citri reticulatae
Constituents
Dlimonene, citral, hesperidin, neohesperidin, tangeretin, nobiletin,
citromitin, 5-O-desmethylcitromitin, inositol, vitamin B1.
Pharmacology
| • |
Actions
on the gastro-intestinal smooth muscles
The herb decoction inhibited the motility of the isolated
small intestines of mice and rabbits. |
| • |
Action
against gastric ulcers
Daily injections of methylhesperidin for 6 days markedly reduced
the incidence of ulcers and inhibited gastric secretions. |
| • |
Anti-inflammatory
action
Both hesperidin and methylhesperidin had vitamin P-like actions.
Hesperidin inhibited the inflammatory reaction of croton oil
granulation in rats. Intraperitoneal dose of 10 mg/Kg of hesperidin
inhibited increased permeability caused by histamine in mice. |
MAI MEN DONG Radix Ophiopogonis
Constituents
Ophiopogonins A, B, C, and D (steroid saponins), beta-sitosterol,
amino-acids.
Pharmacology
| • |
Antibacterial
action
The herb inhibits Staphylococcus albus, Bacilus subtilis,
Escherichia coli and Salmonella typhi. |
| • |
Immunologic
effect
Intraperitoneal administration of 12.5 g/Kg of the herb to
mice significantly increased the weight of the spleen and
phagocytosis of the macrophages; it also counteracted the
reduction in white cells due to cyclophosphamide. |
| • |
Effects
on blood glucose
Intramuscular administration of 1 ml/Kg of the 50% decoction
of the herb increased blood glucose level in rabbits. |
DANG GUI Radix Angelicae sinensis
Constituents
Ligustilide, n-butylidene phthalide, palmitic acid, beta-sitosterol,
beta-sitosteryl palmitate, sucrose, vitamin B12, nicotinic acid,
folic acid, folinic acid, biotin, vitamin A and E.
Pharmacology
| • |
Effect
on coronary flow
Perfusion of the 2% fluid extract into the isolated heart
of guinea pigs significantly dilated the coronary vessels
and increased coronary flow. |
| • |
Effect
on platelet aggregation
The aqueous extract of the root and its ingredient ferulic
acid inhibited rat platelet aggregation and serotonin release. |
| • |
Effect
on immune system
The herb enhanced the phagocytic function of abdominal macrophages
of animals. |
| • |
Anti-inflammatory
effect
The aqueous extract of the root decreased vascular permeability.
The inhibitory activity in mice by oral administration was
comparable to that of aspirin; like aspirin, it also inhibited
the release of 5-HT and other inflammatory substances. |
BAN XIA Rhizoma Pinelliae preparatum
Constituents
Methionine, glycine, beta- and gamma-aminobutyric acids, alkaloids
1-ephedrine and trigonelline, phytosterol, glucoronic acid.
Pharmacology
| • |
Anti-emetic
action
The stir-fried tuber had an anti-emetic action in emesis induced
by morphine or digitalis. The decoction of the herb prevented
early vomiting caused by deslanoside as well as emesis caused
by orally-administered copper sulfate. |
| • |
Anti-neoplastic
action
The aqueous extract had a marked inhibitory action on animal
tumours such as sarcoma, liver carcinoma and cervical carcinoma.
|
| • |
Anti-inflammatory
action
The tuber has a PAF-antagonism effect due to the lignans. |
SHA REN Fructus Amomi
Constituents
Essential oils, saponins, zinc, copper, iron.
Pharmacology
| • |
Gastrointestinal
effect
A low-level decoction of Sha Ren has been proved to stimulate
the intestines of rats and rabbits. Sha Ren helps to relieve
bloating, spasms and pains, and diarrhea |
| • |
Effect
on nausea
11 patients suffering from nausea were given 2 grams of powdered
Sha Ren orally 3 times a day with good results.
Patients appetites have also been improved with Sha Ren |
LU GEN Rhizoma
Phragmitis
Constituents
Coixol, tricin, asparamide, D-xylose, L-arabinose, D-glucose, D-galactose,
vitamins B1, B2 and C.
Pharmacology
| • |
Antibiotic
effect
Decoctions of Lu Gen have shown an in
vitro antimicrobial effect against beta-hemolytic Streptococcus. |
ZHI MU Radix Anemarrhenae
Constituents
Timosaponin, mangiferin, sarsasapogenin, markogenin, neogitogenin,
anemarns.
Pharmacology
| • |
Antipyretic
effect
Subcutaneous injection of the aqueous extract of the rhizone
(4g/kg) decreased the body temperature of rabbits inoculated
with Escherichia coli. |
ZHI MU Radix
Anemarrhenae
Constituents
Timosaponin, mangiferin, sarsasapogenin, markogenin, neogitogenin,
anemarns.
Pharmacology
| • |
Incremental
effect on white blood cells
The fruit increased white blood cells in leukopoenia due to
chemotherapy or radiotherapy in mice. |
| • |
Effect
on immune function
The fruit promoted lymphoblast transformation and increased
the number of cells with haemolytic plaques. The in vitro
restorative effect of the aqueous extract of the herb was
studied in cancer patients and in normal healthy donors. Using
the local graft versus host (GvH) reaction as a test assay
for T-cell function, the extract affected an immune restoration
in 9 of 13 cancer patients with an increase in local GvH reaction
from 32.3 / 36.1 mm3 to 118/ 104.9 mm3; these results suggest
the herb contains powerful immune stimulants. |
| • |
Antineoplastic
action
The extract given by intragastric administration to mice gave
a 49% inhibition rate against cervical cancer. The extract
of the herb has been found to reverse tumour-associated macrophage
suppression; these data suggest that the herb has cancer chemopreventive
properties. |
| • |
Effect
on leukopenia
The injection of an extract of the fruit given once or twice
daily could be used in cancer patients to prevent and treat
leukopenia caused by chemotherapy. |
| • |
Anti-inflammatory
effect
Paw oedema in rats was inhibited by oral administration of
12.5 or 25 g/Kg of the decoction of the herb for 5 days. |
HUANG JING Rhizoma Polygonati
Constituents
Flavonoid glycosides, cardiac glycosides, alkaloids, amino-acids,
resin.
Pharmacology
| • |
Antibacterial
effect
The decoction inhibited Staphylococcus
aureus in vitro. |
| • |
Effect
on blood glucose
Oral administration of the extract of the herb to rabbits
gradually increased blood glucose level but decreased it afterwards. |
GAN CAO Radix
Glycyrrhizae uralensis
Constituents
Triterpenes glycyrrhizin, flavonoids berniarin, umbelliferone, ferulic
acid, sinapic acid, amino-acids, biotin, beta-sitosterol.
Pharmacology
| • |
Glucocorticoid-like
action
Injection of glycyrrhizin in healthy subjects increased free
cortisol levels in the blood. Intraperitoneal administration
of a low dose of glycyrrhizin to rats caused atrophy of the
thymus gland and increased weight of the adrenal gland suggesting
a cortico-tropin-like action; in patients with mild Addison=s
disease requiring daily intramuscular injection of 12.5 mg
of cortisone, concurrent daily intramuscular dose of glycyrrhizin
increased urinary free 17-hydroxycorticosterone and decreased
the conjugated 17-hydroxycorticosterone. |
| • |
Mineralocorticoid-like
action
The extract reduced the urinary volume and sodium excretion
and increased potassium excretion in various animal species. |
| • |
Anti-inflammatory
action
The anti-inflammatory effect of the herb resembles that of
butazone or hydrocortisone; cotton pledget-induced granulation,
formaldehyde-induced paw swelling and subcutaneous granulomatous
inflammation in rats were all inhibited by glycyrrhetic acid. |
| • |
Effect
on the immune system
Glycyrrhizin inhibited egg-white-induced allergic reaction
in guinea pigs. Glycyrrhizin inhibited the degranulation of
mast cells elicited by the histamine liberation agent, Compound
48/80, so that it suppressed the release of the allergy mediators. |
| • |
Anti-ulcer
action
Injection of the herb extract produced significant inhibition
of ulcers in albino rats, together with marked reduction in
gastric juice and free acid. In many clinical studies on the
use of Gan Cao for ulcers, the effectiveness was usually around
90%. |
| • |
Anti-neoplastic
action
Glycyrrhetinic acid inhibited the transplanted Oberling-Guerin
myeloma in rats. |
| • |
Effect
on lipid metabolism
In rats with atherosclerosis, Gan Cao lowered cholesterol
levels and stopped the progression of the lesions. |
| • |
Antihepatotoxic
effect
Oral administration of the extract of the herb showed hepatoprotective
effects against carbon tetrachloride-induced cytotoxicity
in rats; it markedly abated hepatic degeneration and necrosis,
promoted the recovery of hepatocellular glycogen and ribonucleic
acid and also lowered serum glutamic pyruvic transaminase.
Glycyrrhizin and glycyrrhetic acid are able to prevent the
development of cirrhosis. |
DOSAGE AND PROTOCOL
Chemo-Support works better if it is started some time before the
beginning of chemotherapy and continued for about two weeks after
the end. It is important to note that "during the treatment"
means during the course of treatment, i.e. also in the days of break
from the treatment. The dosage is as follows:
| • |
Two weeks
before start of treatment: 2 tablets a day |
| • |
Four days before the start
of treatment: 2 tablets twice a day |
| • |
During the treatment:
3 tablets three times a day |
| • |
After the end of the treatment
for about 4 weeks: 2 tablets twice a day |
It is best to take the tablets away from meals, i.e. about 1 hour
before or after a meal, swallowed with hot water. The tablets should
also be taken separately from other medication, at least 1 hour
away. If the patient feels very nauseous and finds it difficult
to swallow the tablets, these could be crushed and powdered, immersed
in a small amount of hot water with three slices of fresh ginger
and the water sipped slowly.
The dosage during treatment indicated above should be adjusted according
to the severity of the side-effects and the above dosage could be
reduced or increased.
If the patient is receiving both chemo- and radio-therapy and is
taking both Chemo-Support
and Radio-Support, the dosage
of each should be reduced. Adjustments can be made according to
the patient's side-effects and timing of therapies in this situation
by using a higher ratio of Chemo-Support
during the days surrounding chemotherapy or when its side-effects
are heightened. Similarly, the dosage of Radio-Support
can be increased if the side-effects experienced from radiotherapy
are more severe, or during the days surrounding the administration
of radiotherapy.
Chemo-Support should be
discontinued approximately four weeks after the end of the treatment
when the condition should be reassessed and a different formula
given. By contrast, Radio-Support
should be continued for at least 6 weeks after the end of radiotherapy.
ACUPUNCTURE TREATMENT OF CHEMOTHERAPY SIDE EFFECTS
Acupuncture can be used to great effect, in conjunction with Chemo-Support
to reduce the side-effects of chemotherapy. Indeed, acupuncture
can complement the use of Chemo-Support by tailoring the treatment
to the specific side-effects suffered by the patient. The following
are suggested point combinations for specific symptoms and signs.
| Fatigue |
Ren-12 Zhongwan, ST-36
Zusanli, SP-6 Sanyinjiao, BL-20 Pishu, BL-21 Weishu. |
| Nausea, vomiting |
Ren-13 Shangwan, P-6 Neiguan,
ST-34 Liangqiu, ST-36 Zusanli. In addition to acupuncture,
the following massage technique is very effective to combat
nausea and vomiting: apply a massage oil liberally to the
lower legs, make a loose fist with your hands, starting from
ST-36, massage downwards along the Stomach channel using the
knuckles of the index fingers all the way down to the ankle
and then massage upwards along the Spleen channel using your
thumbs. This technique harmonizes the ascending and descending
of Stomach- and Spleen-Qi, stimulating Stomach-Qi to descend
and Spleen-Qi to ascend.. |
| Alopecia |
BL-17 Geshu (with direct moxa cones),
ST-36 Zusanli, SP-6 Sanyinjiao, LIV-8 Ququan, BL-20 Pishu,
BL-23 Shenshu. Add Shou Wu Pian or Glorious
Sea to Chemo-Support. |
| Myelo-suppression |
BL-17 Geshu (with direct
moxa cones), BL-11 Dashu (with direct moxa cones), BL-20 Pishu,
BL-23 Shenshu. |
| Stomatitis, mouth ulcers |
ST-44 Neiting, L.I.-4 Hegu, L.I.-11
Quchi. |
| Cystitis |
Ren-3 Zhongji, BL-63 Jinmen,
BL-28 Pangguangshu, BL-32 Ciliao, SP-9 Yinlingquan. |
| Fever |
L.I.-11 Quchi, KI-2 Rangu, Du-14 Dazhui. |
| Skin rash |
L.I.-11 Quchi, SP-10 Xuehai. |
| Diarrhoea |
ST-25 Tianshu, ST-37 Shangjuxu. |
BIBLIOGRAPHY
1) Perry M, Anderson C, Dorr V, Wilkes J, The Chemotherapy Sourcebook,
Williams & Wilkins, Baltimore, Maryland, 1999.
2) Skeel R, Handbook of Cancer Chemotherapy, Williams & Wilkins,
Baltimore, Maryland, 1999.
3) Zhu YP, Chinese Materia Medica, Harwood Academic Publishers,
Amsterdam, 1998.
4) Bensky D and Gamble A, Chinese Herbal Medicine Materia Medica,
Eastland Press, Seattle, 1993.
5) Chang H.M. and But P.P.Hay, Pharmacology and Applications of
Chinese Materia Medica, World Scientific, Hong Kong, Vol. I, 1986.
6) Chen J K, Chen T T, Chinese Medical Herbology, Art of Medicine
Press, City of Industry, CA, USA 2004.
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