An article on the Chinese Herbal Experience for AA - Pt 1
I am posting this to the forum as the article was seemingly "lost" within a very long report on ITP which appeared as an appendix in Aplastic Central.
Aplastic Anemia and Thrombocytopenia
....... ( truncated to keep within stipulated length of this forum )...
In China, aplastic anemia is frequently treated by herbal therapies. There seems to be little agreement on the best formulations to use, as the number of published formulas that differ markedly from one to the next is large, but most of the prescriptions rely heavily on tonic therapies, as might seem appropriate to this disease characterized by a blood deficiency. From the traditional Chinese perspective, the blood is stored in the liver, and there are a group of “liver blood” tonics that are thought to promote the accumulation of blood; the spleen is the source of blood nutrients, so qi tonics are usually deemed important to producing more blood; and the kidney system, which includes the bone marrow, is the ultimate source of blood and is stimulated by a combination of yang tonics to invigorate its activity and yin nourishing herbs to provide essential substance. It is common for the herbal prescriptions recommended to patients with aplastic anemia to be large, incorporating three or four herbs from each of the tonic categories: qi, blood, yin, and yang.
Anemias are often accompanied by fever, and the traditional description is that the blood deficiency, a type of yin weakness, gives rise to a deficiency heat (the heat is not adequately controlled). Thus, some formulas for treatment of aplastic anemia include heat clearing herbs, with a focus on those that clear heat from the blood. Some anemias are accompanied by reduced production of platelets, a condition that can lead to spontaneous bleeding; therefore, some cases of aplastic anemia are treated with herbs that inhibit bleeding.
It has been proposed that as a focus of treatment, for red blood cell deficiency focus on tonifying qi and blood; for platelet deficiency tonify yin; and for leukocyte deficiency tonify yang. Integrated Chinese and Western medicine is sometimes applied, using androgens, such as testosterone or stanazolol, or stem cell growth factors (i.e., erythropoeiten: EPO).
Gelatins from tortoise, turtle, antler, or donkey skin are prescribed in some formulas for the treatment of aplastic anemia. One example is an evaluation that involved 300 patients recruited during a 27-year period and treated with Chinese herb formulas (35). There were four formulas administered, but all contained donkey skin gelatin, rehmannia, and licorice; in the case of hyperactivity of yang and deficiency of yin as a traditional diagnosis, the patients were also treated with tortoise shell, turtle shell, stellaria, picrorrhiza, and lycium bark. While the cure rates were relatively low (except for patients with simple yang deficiency diagnosis), the improvement rates were said to be high; in the case of yin deficiency and yang hyperactivity, 77% of patients were reported to respond to this treatment method.
Another example is the use of Buxue Tang (Blood Nourishing Decoction) plus Buxue San (Blood Nourishing Powder) used in a study of treatment for aplastic anemia (25). The decoction included turtle shell and tortoise shell, the blood cooling and nourishing group of raw rehmannia, moutan, peony; the qi tonics astragalus, atractylodes, dioscorea, and codonopsis; the blood nourishing ho-shou-wu and lycium; and the astringents schizandra, cirsium, and rubia. The powder contained donkey skin gelatin and deer antler, plus ginseng, eucommia, sanqi, and gallus. The decoction and powder were taken twice daily. Of 25 patients so treated, it was reported that 17 were essentially cured, 5 were in remission, and only 3 did not respond after a course of therapy lasting one month. These formulas, rich in gelatins from four animals, mainly focus on the traditional categories of tonifying qi and blood.
A version of this protocol, using Bushen Shengxue Yihao (Tonify Kidney, Generate Blood No. 1), has the main ingredients tortoise gelatin, donkey hide gelatin, rehmannia, and astragalus. This was tested in laboratory animals (32) and shown to increase plasma testosterone levels, an effect that has also been claimed for deer antler and its gelatin. Testosterone is sometimes given along with Chinese herbs to treat aplastic anemia; in one study (42), patients with chronic aplastic anemia were given large doses of testosterone by injection and a decoction of Chinese herbs according to constitution. For patients classified as having yin deficiency, the formula incorporated tortoise shell, tortoise shell gelatin, antler gelatin, lycium, eclipta, ligustrum, and ho-shou-wu. Among 13 of 22 patients who had good response to the combined therapy, 9 had no relapse for at least a year.