Clinical Application of Radix Notoginseng and Its Homology of Medicine and Food

Hao HUANG, Xiumei MA, Zujie QIN, Hong LEI, Wen ZHONG

International Zhuang Medical Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning 530201, China

Abstract Clinical application of Radix Notoginseng in the last ten years is summarized, such as Radix Notoginseng powder, compatibility of Radix Notoginseng with other traditional Chinese medicines, and related preparations of Radix Notoginseng, as well as application of Radix Notoginseng in homology of medicine and food, such as preventing and controlling gynecological diseases, rheumatoid arthritis, hypertension, gastric cancer, arthritis, and anemia.

Key words Radix Notoginseng, Clinical application, Homology of medicine and food

1 Introduction

Traditional Chinese medicine Radix Notoginseng is dry roots and rhizomes ofPanaxnotoginseng(Burk.) F. H. Chen[1], which is mainly produced in Guangxi and Yunnan. Radix Notoginseng is known as a miracle medicine for hemostasis, and belongs to the class of stasis removing and hemostatic drugs in traditional Chinese medicine. Its nature is sweet and warm, and its taste is slightly bitter. It belongs to the liver and stomach meridians, and can remove blood stasis, stanch bleeding, reduce swelling and pain. Moreover, it has the characteristics of hemostasis without leaving blood stasis and removing blood stasis without harming health[2]. Radix Notoginseng is also a traditional Chinese medicine with the same origin of medicine and food. In theCompendiumofMateriaMedica, it was firstly recorded that "Radix Notoginseng could stop bleeding, disperse blood and calm pain". Seen from the ancients’ cognition of Radix Notoginseng, the appellation "Jinbuhuan" really conforms to Radix Notoginseng. In ancient times, hemostatic drugs were the most valuable in order to improve the survival rate when injuries and bleeding or war broke out. Through years of cognition of Radix Notoginseng, it is found that Radix Notoginseng is not only used in clinical medicine, but also appears in people’s kitchens.

2 Clinical application

2.1 Radix Notoginseng powderCoronary heart disease belongs to the category of thoracic obstruction in traditional Chinese medicine. The heart pulse is blocked, and the blood flow is not smooth. Arrhythmia belongs to the category of palpitation in traditional Chinese medicine, which will block blood flow and obstruct the heart pulse. In patients with hypertension, too much calcium ions entering the blood vessels will lead to blood stasis and poor operation. Radix Notoginseng can effectively block the inflow of calcium ions. For hyperlipidemia, Radix Notoginseng can increase the activity of peroxidase to inhibit lipid peroxidation and reduce the incidence of cardiovascular disease caused by hyperlipidemia. Using the characteristics of activating blood circulation, dispersing blood stasis and removing blood stasis without harming health, Radix Notoginseng can treat this kind of disease in clinic. The curative effect could be achieved by expanding blood vessels, increasing blood flow and dredging blood vessel congestion.

100 patients with cardiovascular disease were selected clinically for study[3]. Radix Notoginseng turbid liquid (1 g∶10 mL) was used once a day, 2 mL once a time, for two weeks. The statistical results showed that there were significant differences in the test indicators, indicating that the hemostatic effect of taking Radix Notoginseng alone was still obvious. There was also good effect when Yao Yabin[4]used Radix Notoginseng to treat cardiovascular disease and gastrointestinal bleeding. Due to powerful hemostatic function, Radix Notoginseng was applied to hemorrhagic disease in ancient times. The easiest use way was to apply Radix Notoginseng directly to the bleeding place, and swallow it for internal injury. Later, doctors found that Radix Notoginseng can be effectively used in the treatment of other diseases in the compatibility with other traditional Chinese medicine, and the scope of Radix Notoginseng was gradually expanded.

In the process of medical practice, Xu Qiongfang[5]treated the patient by Radix Notoginseng powder once a day, 3 g once a time. A patient with vasculitis (with knee and elbow ulceration for three years) took Notoginseng Radix powder under normal treatment. One month later, the ulcerated part began to heal. He insisted on taking Notoginseng Radix powder for a long time, and was not hospitalized due to skin ulceration for one year. For a female patient with melasma for half a year, after oral administration of Notoginseng Radix powder for 1 month, she felt that melasma became slightly milder but not larger. After half a year, the melasma on the left side of the face shrank and faded, and it was no longer obvious after 1 year.

When treating cardiovascular diseases, Zhang Haiyan[6]gave the patient Radix Notoginseng suspension (ratio of Radix Notoginseng powder to water was 1 g∶10 mL) once a day, 2 mL once a time, for two weeks. The condition of patients with coronary heart disease, hypertension, hyperlipidemia and arrhythmia has been improved accordingly, indicating that Radix Notoginseng still has a good therapeutic effect on cardiovascular diseases. Ding Peidong took Radix Notoginseng powder orally to the patient 3 d before the operation. The study found that it could prevent intraoperative and postoperative bleeding during the posterior operation of thoracolumbar fracture. Patients who did not take Radix Notoginseng powder orally lost more blood after operation[7]. In the clinical treatment of hemorrhagic stroke, Zhang Yunling[8]added Radix Notoginseng powder to the patients during routine treatment, once a day, 5 g once a time, for three consecutive weeks, and the treatment result was significantly higher than that of the control group. After intracerebral hemorrhage, there will be blood stasis residue. Radix Notoginseng could be used to remove blood stasis, stop bleeding, and reduce swelling and pain, thereby reducing intracranial blood stasis and intracranial pressure (blood stasis will lead to increased intracranial pressure), and dissipating brain edema. In the treatment of massive hemoptysis caused by pulmonary tuberculosis and cerebral infarction, Zhu Lixia[9]used Radix Notoginseng powder and pituitrin, which can achieve better clinical treatment effect, with less adverse reactions. It can be seen that Radix Notoginseng has a powerful hemostatic function.

2.2 Compatibility of Radix Notoginseng with other traditional Chinese medicinesIn clinical treatment, Liu Yunsheng[10]used Radix Notoginseng in combination with other traditional Chinese medicines, and satisfactory curative effects have also been achieved in some diseases. For angina pectoris of coronary heart disease, qi deficiency leads to qi stagnation and blood stasis, and Radix Notoginseng in combination with Astmgali Radix, Codonopsis Radix (both replenishing qi), Cattail Pollen, Chuanxiong Rhizoma (removing blood stasis, activating blood circulation and qi circulation, belonging to pericardial meridian), Allii Macrostemonis Bulbus (essential medicine for thoracic obstruction), Fructus Aurantii (both promoting the circulation of qi) could be used. In terms of upper gastrointestinal ulcer, there will be blood in stool, hematemesis, epigastric pain and other manifestations. Radix Notoginseng plus stamen Bletillae Rhizoma powder, and then compatible with Cyperus Rotundus and Astmgali Radix (soothing the liver, relieving depression, regulating qi, replenishing qi, invigorating qi and relieving pain) could be used. In treating upper gastrointestinal bleeding, Wang Guanzhi[11]used 9 g Bletillae Rhizoma, 5 g Radix Notoginseng, and 3 g Rhei Radix Et Rhizoma (stir fried charcoal), 3 times a day for 5 d. It was found that the curative effect was significantly higher than that of western medicine group, and the curative effect between groups was also statistically significant. Moreover, the recurrence rate after one year was significantly lower than that of the control group (western medicine).

2.3 Radix Notoginseng related preparationsGuiqi Sanqi Oral Liquid[12]can reduce the degree of liver damage caused by TACE treatment of liver cancer and prevent the deterioration of liver function. In the replantation of severed fingers, Sanqi Huoxue Jiegu Capsule[13]has good anti-inflammatory, analgesic, anticoagulant and detumescence effects. In the clinical treatment of atrophic gastritis, Bai Yumei[14]used Sanqi Shengwei Pill to treat 94 patients, and the total effective rate was 80.85%, without adverse reactions. In clinical practice of 120 patients with nonalcoholic fatty liver disease complicated with hyperlipidemia, Yanghuo Sanqi Capsule[15]can also obtain good curative effect. Radix Notoginseng saponins[16]can reduce pain and improve lung function in patients with exacerbation of chronic pulmonary obstruction. Sanqi Tongshu Capsule[17-18]is a safe and effective drug that can treat various types of vertigo.

3 Homology of medicine and food

Medicinal diet and dietotherapy are part of traditional Chinese medicine. In addition to medical treatment, the ancient people also used food therapy to treat human diseases. Many medicinal materials are also food in people’s kitchens, such as mung beans, honey, lotus seeds, lilies,etc.Radix Notoginseng is a medicinal material with the same origin as food, and it is also deeply loved by ethnic minority compatriots in southwest China. Radix Notoginseng could match with ordinary ingredients, and the cooked dishes also have the effect of tonifying the body. Radix Notoginseng can be used for both raw and cooked, and its efficacy can be differentiated into "raw beating and cooked tonifying". The so-called "raw beating" refers to that raw Radix Notoginseng can cure traumatic injuries, reduce swelling and pain, promote blood circulation and remove blood stasis. "Cooked tonifying" means that the cooked Radix Notoginseng can tonify and strengthen the body, replenish blood and regulate blood, and improve the body’s immunity[19]. The processing method of cooked Radix Notoginseng: generally, Radix Notoginseng and rapeseed oil or chicken oil are heated with slow fire until Radix Notoginseng turns yellow, and then it is powdered or crushed[20].

3.1 Treating gynecological diseases(i) Angelicae Sinensis Radix and brown sugar are decocted together, and sweet wine (wine brewing) and 2 eggs are added after Angelicae Sinensis Radix is cooked. After eggs are cooked, the cooked Radix Notoginseng powder is added[21]. (ii) Radix Notoginseng egg soup[21]: 3 g Radix Notoginseng powder, 15 g Salviae Miltiorrhizae, 1 egg. Method: First, Salvia miltiorrhiza is first decocted in water for 20 min, and then the broken egg flower is poured in. Radix Notoginseng powder is added to continue to cook for 2 min, once a day. This soup can promote blood circulation and replenish blood, and can be used to treat irregular menstruation caused by qi stagnation and blood stasis. (iii) Antler gum or turtle horn gum is boiled, and then Radix Notoginseng powder is added, three times a day. Three steamed red dates should be eaten together each time.

3.2 Treating rheumatoid15-30 gP.notoginsengfibrous root, 50 g Poria, 10 g Citrus Reticulata Blanco, 3 slices of ginger. Method: they aredecocted with water untilP.notoginsengfibrous roots are cooked, twice a day. Function: dispel wind, dredge collaterals, activate blood and tonify[22]. It is suitable for patients with phlegm stasis and arthralgia.

3.3 Treating hypertension(i)P.notoginsengflower tea[23]: 5 gP.notoginsengflower is used for brewing, and an appropriate amount of chrysanthemum and rock sugar is added as needed, once a day. (ii) 10 gP.notoginsengflower, 10 g white chrysanthemum, 10 g sophora flower, 10 g cassia seed, and they are put in several times to guarantee persistence of efficacy. (iii)P.notoginsengcoriander porridge: 10 gP.notoginsengflower, 50 g fresh coriander, 50 g polished round-grained rice. Method: the porridge is first boiled until it is almost cooked, and thenP.notoginsengflower and coriander are chop into the porridge. It is boiled over a slow fire, and an appropriate amount of brown sugar is added[24].

3.4 Preventing and treating gastric cancerRadix Notoginseng and Poria hoof tendon: 6 g raw Radix Notoginseng, 15 g Poria, 50 g pig hoof tendon. Raw Radix Notoginseng and Poria are powdered. The swollen pig hoof tendon is boiled with high heat, then a little cooking wine is added, and pig hoof tendon is stewed with slow fire. The medicine powder is added, and then it is stirred evenly, once a day. It is suitable for people with hematemesis of gastric cancer and bloody stool[25].

3.5 Helping treat osteoarthritis(i) 10-15 g Radix Notoginseng, 15-20 g Salviae Miltiorrhizae, 30 g Spatholobi Caulis. The medicinal materials are decocted with water until thick juice. Then the porridge is boiled until it is almost cooked, and the medicine juice is added, and it is heated for a while, once a day. It is suitable for joint pain with blood stasis, internal obstruction and unfavorable meridians[26]. (ii) 6 g Radix Notoginseng, 10 g Astmgali Radix, 1 male black fowl. The medicinal materials are put into the chicken belly, and an appropriate amount of yellow rice wine is added, and it is steamed through water, once every other day. It is suitable for patients with knee arthritis due to lack of yang[26].

3.6 Treating anemiaStewed chicken with Radix Notoginseng[27-28]: 5-10 g Radix Notoginseng is softened with water, and then it is sliced. It is put it into the stomach of the chicken, and an appropriate amount of yellow rice wine is added, and then it is steamed through water. It is suitable for people with moderate anemia or weak qi and blood.

3.7 Treating coronary heart diseaseStewed rabbit with Radix Notoginseng and Codonopsis Radix[29]: 10 g Radix Notoginseng, 10 g Codonopsis Radix, 1 rabbit, 2 corianders, pepper, green onion, ginger and garlic. First, the medicinal materials and pepper are boiled with high heat, then the rabbit meat, onion, ginger and garlic are add to continue to boil and stew over slow fire for 40 min. After removing the medicinal materials, pepper, onion, ginger and garlic, coriander is added finally. This diet can regulate both qi and blood, and is helpful for treating chest tightness and palpitation.