Use Of Traditional Chinese Medicinal Herbs Biology Essay

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Urinary tract infections are considered to be the most common bacterial infection. It can be defined as the presence of pathogenic microorganisms in the urine, urethra, bladder, or prostate. In most cases the threshold of bacteria ≥10⁴ colony forming units per millilitre (cfu/ml). (1) Usually classified by the site of infection, it includes cystitis, pyelonephritis, and urine bacteriuria. The epidemiology of infection varies with sex, age, and presence of associated genitourinary abnormalities.(2)

Women are significantly more likely to experience a UTI than men. Nearly 1 in 3 women will have had at least one episode of UTI by the age of 24 and almost half of all women will experience one UTI during their lifetime.(3) In the USA, every year over 11 million women reported having UTI accounting for $ 1.6 billion in medical costs.(4) in Europe, there are no good data concerning the prevalence of various types of UTIs and their impact on the quality of life of the affected population.(5)

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UTIs are caused by a variety of types of bacteria, including Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, and Klebsiella pneumonie. Signs and symptoms of UTIs are typically cloudy urine, dysuria, haematuria, urinary frequency lower abdominal pain and low back pain. Furthermore infection is accompanied by inflammation.(6)The term acute UTI refers mainly to acute symptomatic cystitis.(7) Recurrent UTI refers to attacks of cystitis, but some have frequent recurrences (e.g. more than twice/yr). (8)

When the body's normal immune cannot eradicate pathogen it is often treated with chemotherapeutic agents such as antibiotics. Antibiotics have reduced bacterial infectious diseases but inappropriate prescriptions to patients have contributed to drug resistance. (9)Alternative methods are needed in the treatment against those infections. Despite the modernity of Western medicine, (10) it cannot be denied that Chinese medicinal treatments date back as early as 700 B.C. and the Taoists were the first to develop what is known as Traditional Chinese Medicine (TCM)(11).Chinese medicine has been successful in establishing a position as a complementary and alternative therapy in the West, especially UK and USA. The herbal site of Chinese medicine came comparably late to the UK in contrast with acupuncture.(12).These complementary therapies are potentially rich sources of compounds to combat pathogenic bacteria.

Chinese herbal theory is based on the theory of Yin-Yang, the Five Phases (fire, earth, metal wood, and water), Internal Organs, and meridians, which are the foundation of Traditional Chinese Medicine. The meridians regulate the Yin-Yang balance in the body and also provide and protect the body against external causes of disease.(13) There are certain points along the meridians where Qi is thought to or concentrate or collect. These points are used in Chinese medicine for acupuncture treatment as well as diagnosis. The Yin Yang represents a state of good health, in which, health exists when the body is balanced and its energy is freely flowing. The term "energy" refers to Qi, the life energy that is said to activate or circulate throughout the body and determines the person's basic level of vitality. The term "balance" refers to the Yin and Yang. This in accordance with vitalist philosophy of health as appear to be reductant philosophy not Biomedicines has evolved from.

Any form of life depends on substance and activity. Substance is Yin; it is the material our bodies are made of: bones, muscles,blood, fluid and so on. Activity is Yang; it is movement or transformation including the transformation required to repair and build body tissue. Yin and Yang are opposites and continually interact to produce constant changes in the universe .(14)

The way to preserve health and achieve longevity is to maintain a harmony of Yin and Yang. This means creating a balance between substance and activity that will maximize Qi which is necessary for all life functions. In an ideal state, Yin and Yang in all their forms are perfectly balanced in every part of the body.(15*)If the Yin is in excess relative to the Yang and vice versa the Qi will be compromised leading to dysfunction and disease and therefore disharmony. A body in disharmony may be vulnerable to External or Internal factors of disease, these, factors can affect this balance, and therefore cause disease. One example of External causes in terms of TCM is exposure to Climatic factors, Damp, Heat, Dryness /Cold environment. For example, wanding in cold water or not changing a bathing suit after swimming, could lead to a so-cold invension of wind cold. Sitting on damp grass, living in a damp environment or a damp house, being exposed to early morning dampness while jogging and sweating, dampness during menstrual period or after child birth can lead to invension of external Damp. Heat stroke through long hours of sun exposure, is believed to cause temperature deregulation.Refered to as summer Heat in TCM.(15) Examples of Internal causes of disease, relate to the emotional sphere.eg. long standing anxiety and repressed anger joy, worry, pensiveness, sadness, fear, fright, grief, stress could all lead to Heat/Fire. This, may be transmitted to the Small Intestine to which the Heart is interiorly-exteriorly related. Because the connection between the small intestine and Bladder channels, Fire is transmitted to the Bladder causing pain. These emotional factors cause Liver Qi stagnation which may cause Qi painful urination. Dietary habits such as excessive consumption of sweets, sugar dairy and greasy foods leads to the formation of intense Dampness which, if settles in the urinary system, causes painful urination. (16-)Excessive consumption of spicy foods and alcohol may generate Heat which combines with Dampness cause Damp-Heat in the lower burner or pelvic region. Imbalances of work, rest and excessive sexual activity weaken the Kidney energy and lead to either cloudy urination or painful urination; these causes of disease are classified as miscellaneous. In contrast to conventional medicine, TCM recognises Internal causes as being significant whereas they not necessary acknowledge by western medicine. (16)

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Chinese medical diagnosis and treatment involves identifying the factors that are out of balance and attempting to bring them back into harmony. Diagnosis is carried out by means of "listening" to the pulse (in other words, taking the pulse with extraordinary care and sensitivity), observing and palpating various parts of the body, and asking a long series of questions.(17) The information gained and used to form a diagnosis base of the patterns of disharmony for UTIs.These patterns are classified under the title of "stranguria syndromes and the two common patterns are Dam-Heat pattern and Kidney-Spleen deficiency pattern.(18)

In TCM an acute UTI is described as Damp-Heat of the urinary Bladder and recurrent UTI, is a disharmony due to the development of repeated attacks of Damp Heat in the urinary bladder, and it looks at women's vulnerability to UTI. Prescriptions for traditional Chinese herbal medicines (TCHC) are formulated to correct excesses or deficiencies of Yin-Yang, blockages or incorrect direction in the flow of Qi, disorders located in a specific organ, and the emotional problems that accompany physical illness(20*) Chinese medicine does not distinguish between psychiatric and general medical conditions in contrast to western medicine. TCM has a long history of using plants-based drugs for treatment of diseases and its purpose is the restoration of health through correction of body imbalance.TCHM differs from current western herbal medicine in several ways. Chinese herbal medicine, unlike western herbal medicine, is based on ancient formulas. Western practitioners select herbs based on a symptom description by each patient. (28*)Also, most western herbal practitioners use one herb (called simpling) or occasionally, a combination of herbs again differing from the Chinese system based on developed formulas. Chinese herbal medicine uses water for the extraction of its base herb. Currently, many western companies, even when manufacturing Chinese formulas, use alcohol or glycerine extraction. In China, the two most common methods of applying herb therapies are to make a decoction (a strong tea )that must be simmered for about an hour or more in boiling water.

CMH have used clinically to treat both acute an recurrent UTIs.As discusses above, there are in the form of herbal formulas consisting of herbs into different therapeutic actions. Thus, some herbs will aim to ''clear Damp'' others will be 'cooling' and counveract ` Heat ' and others will aim to strength the Qi of the patient and rebalance Ying and Yang. Table 1. shows two typical formulae for the treatment of acute and recurrent UTI.

Acute

Recurrent

Pin Yin Name

Pharmaceutical name

Pin Yin Name

Pharmaceutical name

Tu Fu Ling

Smilacis glabrae Rhz.

Tu Fu Ling

Smilacis glabrae Rhz.

Bai Jiang Cao

Patriniane Herba

Bai Jiang Cao

Patriniane Herba

Zao Xiu

Paridis Rhizoma

Ku shen

Sophorae flavescentis Rx

Huang Bai

Phellodrendi Cortex

Zei Xei

Alismatis Rhizoma

Ku Shen

Sophorae flavescentis Rx

Tong Cao

Trespanacis Medulla

Shi Wei

Pyrrosiae Sheareri Fol.

Tu Si Zi

Cuscutae Semen

Che Quian Cao

Plantagis Folium

Yin Yan Hou

Epididimii Herba

Ze Xie

Alismatis Rhizoma

Bai Zhu

Atrctylodes mac.Rhz.

Tong Cao

Tetrapanacies Medulla

Cang Zhu

Atractylodes Rihizoma

Yi Mu Cao

Le Herbaounuri

Huang Qi

Astraglus memb Radix

Cuan Lian Zi

Toosedan Fructus

Ling Zhi

Ganoderma lucidum

Wu Yao

Lindarae Randix

Yi Mu Cao

Lenurus hetero phyllus

Gan Cao

Glycyrrhiza urealis

Wu Yao

Lindarae Randix

Pu Gong Ying

Taraxaci Herba

Xiang Fu

Cyperus rotunds Rhz

Gan Cao

Glycyrrhiza urealis

Table 1. Typical TCM Herbal formulae for treaty UTIs.

The formula have been developed base on the TCM therapeutic of the hersbs.Table 2, 3, 4,5,6 summarises the properties for some of the constituent herbs, however the mode of action from Biomedical action remains unclear, and this knowledge will be required for the integration of those herbs preparations into marisian medicine. The proposed study aims to generate a better understanding of the mechanism of these herbs. From a medical perspective and how they produce the observed therapeutic benefits.

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Proposed program of study

Hypotesis:

TCM herbal formulae produce their clinical benefit via a measurable specific mode of action.

Aims:

To evaluate the effects of two TCM herbal Formulae and the viability of the bladder urothelial cell monolayer.

To evaluate the effects of two TCM herbal Formulae and the viability of the bladder urothelial cell in spheroid form.

To evaluate the antibacterial effects of two TCM herbal formulae commonly used to treat UTIs.

Ethics:

No ethical approved is required as the work will be involved establish cell line. Selected bacterial cell cultures.

No primary tissue /cells will be used on clinical samples.

Culture of Bladder urothelial cell lines.

R7112 will be manhanded in RPM1 media suplementated with 10% foetal bovine serum and sheponiyan/ penecilium/L-glutamine at 37°C in 5 % CO2. To produce spheroils,R7112 cells will be cultivated as above222222222222222222

Herbal decoction.

The herbal decoction will be obtain from the Avicenna Centre of Chinese medicine; Hove Sussex. Prior to use in cell culture assays, particulate mattess will be removed by centritrifugatia of the asuty deo supplements futer shemerized using 0.2 µm filters . Decotion will be diluted in tissue culture median. 0.5 ml samples of decotion using in each except pobu will be place into pre-weighted glass vails, frozen and the lyaphibed. This will allow for estimate the concentrate or extract.

3.Assesment of viability.

The effect of serial dilutions of the TCM on R7112 monolayers and spheroids will be evaluated using the M77 assay according to establish protocols (ref).Cell will be incubated with lwlwiheat extracts for 12, 24 and72h. It is anticipated heat the herbal decoction will demonstrate an effect of manhi cell viability

4.Evaluation of anti-microbial activity

Herbal dilution of the herbal decoction will be evaluate for their activity against Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonie and Proteus mirabilis bacteria sp.

This will be achieved using well and dise-diffusion techniques From the zones of xxx generated the minimum inhibitory concentration (MIC) of each herb will be determined. This will xxx xxx of selected antibiotics.

Data analysis

Cell xxxability experiment will be analysed by calculating the mean percentage residue biomassxxxxxx significant differences in cell-biomass will be assessed using non parametric two way ANOVA.

For the anti-microbial experiments The MIC for each decoction will be determined, comparisons will be made to know antibiotics

Pharmaceutical name:

Glycyrrhiza uralensis

English / Chinese name:

Lincorise root (Gan Cao)

Part Used:

Dried root, it is collected in spring and autumn sliced and dried in sunlight, and used unprepared or stir-baked with honey.

Flavour and properties

Sweet, peculiarly sweet in taste. It is about five hundred times the sweetness of cane sugar.

Distribution:

It is mainly produced in the Shanxi, Gansu and Xinjiang regions of China.

Channel tropism:

Acts mainly on the Heart, Lung, and Spleen.

Energetic effects

Tonifies (Spleen), enhances Qi, clears Heat.

Moistens the Lung to stop cough.

Relieves spasm and pain.

Moderates the properties of other herbs.

Effects on digestive system: anti ulcer.

Promotes secretion of insulin, and protects liver from toxin.

Anti inflammation properties

Anti allergy

Table 2. Properties of Glycyrrhiza uralensis

Pharmaceutical name:

Toosendan Fructus

English / Chinese name:

Chuan Lie Zi

Flavour and properties

Bitter, cold slightly toxic.

Distribution:

Guizhou, Hubei provinces of China

Channel tropism:

Acts on Bladder, Liver, small Intestine, Stomach

Energetic effects

Promote Qi flow, 

Rid of dampness-heat, clear Liver Fire.

Rid of pain, promote urination.

Regulates Qi, kills parasites.

Also used externally for fungus infections of Scalp.

Table 3. Properties Toosendan Fructus

Pharmaceutical name:

Phellodendri Cortex

English / Chinese name:

Huang Bai

Part Used:

Dried bark

Flavour and properties

Bitt,acts on the Kidney, Bladder, and Large Intestine channels.

Distribution:

Produced in Liaoning, Jilin, Hebe

Channel tropism:

kidney﹐ bladder

Energetic effects

Clears Damp Heat especially in

Removes toxins, relieves consumptive fever.

 

Table 4. Properties Phellodendri Cortex

Pharmaceutical name:

Alismatis Rhizoma

English / Chinese name:

Alisma / Ze xie

Part Used:

Flavour and properties

Sweet, bland, cold

Distribution:

It is mainly produced in Fu Jian provinces of China.

Channel tropism:

Kidney and Bladder

Energetic effects

General tonic, anti oxidant, anti cancer.

For edema, painful and difficult urination.

Diarrhea , leucorrhagia, caused by damp heat in the lower burner.

Table5. Properties Alismatis Rhizoma

Pharmaceutical name:

Semen Cuscutae Chinensis

English / Chinese name:

Cuscuta / Tu Si ZI

Part Used:

Flavour and properties

Acrid, sweet, neutral

Distribution:

Produced in Shandong, Henan provinces of China.

Channel tropism:

kidney, Liver

Energetic effects

Tonifies kidneys, Liver and Spleen.

Table 6Properties of Semen Cuscutae Chinensis

Pharmaceutical name:

Epidimdii Herba

English / Chinese name:

Epimedium / Yin Yang Huo

Part Used:

Flavour and properties

Acrid, sweet, warm

Distribution:

Shaanxi, Liaoning, Shanxi, Hubei, Sichuan.

Channel tropism:

kidney, Liver

Energetic effects

Tonifies the Kidneys and fortifies the yang.

 Patterns with such symptoms as impotence, spermatorrhea, frequent urination , forgetfulness, withdrawal, and painful cold lower back and knees.

Expels wind-damp-cold: for wind-damp-cold painful obstruction with such symptoms as spasms or cramps in the hands and feet, joint pain, and numbness in the extremities due to bad circulation.

Tonifies the yin and yang and harnesses liver yang ascending, for lower back pain.

Dizziness, and menstrual irregularity from deficiency of Liver and Kidney.

Table7. Properties of Epidimdii Herba