Huang Qi (pronounced like huang chi; Chinese as 黄芪, or 黄耆; English as Astragalus, Fig. 1), is a genus name of perennial leguminous herbs. The main medicine sources are from the roots of Astragalus membranaceus (Fisch.) bge. and A. membranaceus (Fisch.) bge.var.mongpholicus (bge.) Hsiao.  The medicinal history of Huang Qi has been 2000 years. According to legend, in ancient times, there was a nice old man, whose name was Daishan. He was good at acupuncture therapy and always being ready to help others. His body was thin and his face yellowish. People called him “黄耆” (Huang Qi, meaning yellow old man) with respect. He died in the act of saving a child falling off a cliff. There was a sweet herb grown by his tomb with the effects of invigorating spleen-stomach, replenishing qi, consolidating superficies for arresting sweating, inducing diuresis for removing edema, promoting pus discharge and tissue regeneration. It was used to cure many patients and was widely circulated. In order to commemorate the old, people call the herb as “黄芪”(Huang Qi, meaning a yellow herb with deep roots) [[1]].

 

 

The modern pharmacology has testified Huang Qi with following pharmacological effects [1]:

1. Increasing oxygen consumptions.

2. Strengthening the contraction of a normal heart and the heart with function failure.

3. Dilating the tubular blood vessels, renal blood vessels, and peripheral blood vessels; promoting the skin blood circulation and declining the blood pressure.

4. Intermediate diuretic effect.

5. Experimental inhibitory effect on nephritis

6. Calming effect on mice for several hours.

7. Decreasing blood glucose.

8. Shrinking effect on the rat uterus in vitro.

9. Immunopotentiating and anti-inflammatory effects [[2]]

9. Bacteriostatic test in vitro: inhibiting effects on Shigella dysenteriae, Bacillus anthracis, hemolytic streptococcus, Streptococcus, Corynebacterium diphtheriae, diphtheroid bacillus, Streptococcus pneumoniae, Staphylococcus aureus, Staphylococcus citreus, Bacillus subtilis, etc.

10. Regulating many cytokines and endocrine molecules to reach the homeostasis of metabolisms, such as PAI-1/t-PA and MMPs/TIMP-1 systems [[3]], rBD-2 and NF-κB [[4]], IL-1b, IL-6 and TNF-a [[5]], HIF-1α, VEGF and PI3K/AKT [[6]], IL-1β, PGE2 and cortisol [[7]], Th1/Th2 cytokines [[8]], etc. It is these regulations that make Huang Qi showed broad medical effects.

 

In general health care or treatment, raw, sliced and dried Huang Qi (sometimes called Sheng Huang Qi, 生黄芪) is used. Some doctors use honey processed Huang Qi for patients with Qi shortage of middle-jiao and organ prolapse (Table-1). Hang Qi is a well known herb in folks. People often use it to cook soup tonic. From the perspective of Traditional Chinese Medicine (TCM), Huang Qi is a good medicine. It is powerful and unique. The pulse will immediately respond it after tens of grams of clinical use and the mental and physical energy will be improved [[9]]. It is widely used in various diseases (Table-2). For example, since Huang Qi strengthens cardiac muscle, dilates blood vessels, promotes circulation and diuresis, it is used in the coronary artery disease, angina, arrhythmia and hypertension. Due to its promotion of skin blood circulation, inhibition of microorganisms, immune regulations and anti-inflammatory, Huang Qi is used for dermatitis.

Huang Qi has very low toxicity. Its LD50 in mice for intraperitoneal injection is approximately 40 g/kg. The maximum dosage of Huang Qi in clinical use is 120 grams [[10]]. However, from the constitutional diagnose, Huang Qi is the most suitable for the person with Qi deficiency and spleen-damp, who has a puffiness body, weak muscle, especially in the abdominal. It is not suitable for the person whose body is very strong and thin. Huang Qi used for the patient who has kidney disease with Yin deficiency, dampness-heat and toxic heat flourishing may often cause side effects. It should be forbidden to use because Huang Qi is sweet and slightly warm in properties, it will progress the heat and hurt Yin and blood easily to the patient with Yin deficiency; and it will stagnate the Evil and aggravate the illness easily to the patient with dampness-heat and toxic heat flourishing. In these situations, Huang Qi must be combined with other herbs if it has to be used [1].  

 

Table-1. Comparison of Huang Qi and Zhi Huang Qi.

 

Huang Qi (黄芪, 生黄芪)

Zhi Huang Qi (炙黄芪)

English name

Astragali Radix

Astragali Praeparata Cum Melle Radix

Preparation

Dried, sliced root of the raw plant.

Honey stir fried or baked root [[11]]

TCM characteristics (taste, nature and channels)

Sweet in taste; slightly warm in nature; attribute to liver, spleen, lung and kidney channels. [1]

Sweet in taste; warm in nature; attribute to spleen and lung channels [11].

TCM indications

Invigorating Qi (vital energy) and consolidating the exterior, arresting sweating and relieving depletion, promoting pus discharge and generating flesh, promoting diuresis and relieving edema. [1]

Strengthening middle Jiao to nourish Qi [10]. Zhi Huang Qi has an enhanced ability to treat imbalances of the interior, such as Spleen and Lung Qi deficiencies and yang deficiency [10].

 

 

Table-2. Formulas with Huang Qi for various diseases.

Disease

Huang Qi or its formula

Comments

Angina

Huang Qi (黄芪) 30g,Tai Zi Shen (太子参)30g,Dan Seng (丹参)20g,Dang Gui (当归)15g,Tao Ren (桃仁)10g,Chuan Qiong (川芎)12g,Gua Lou (瓜蒌)15g,Xie Bai (薤白) 15g, decoction.

Angina total effective rate: 88.3%. Electrocardiogram effective rate 78.3%. Increase coronary blood flow, reduce blood fat, improve myocardial ischemia and hypoxia, improve the abnormal changes of ST-T on ECG [[12]].

Arrhythmia

Huang Qi (黄芪) 50g,Dang Shen (党参)、Dan Shen (丹参) 30g respectively,Mai Dong (麦冬)、Dang Gui (当归)、Fu Zi (附子) 10g respectively,Wu Wei Zi (五味子)、Hong Hua (红花)、Sheng Jiang (生姜)5g respectively,Da Zao (大枣) 20 individuals, Decoction, q.d.

Out of 56 patients, 34 cured, 17 effective, 5 ineffective. Total effective rate 91% [[13]]

Atopic dermatitis

Huang Qi (黄芪)、Dang Gui (当归)、Shen Di Huang (生地黄)、Xuang Shen (玄参)、Di Fu Zi (地肤子)、Jiang Can (僵蚕)、Chi Bai Shao (赤白芍), p.o.; Qing Dai (青黛)、Bing Pian (冰片)、She Chuang Zi (蛇床子), powder in sesame oil, external.

Out of 110 patients, the effective rate is 100% [[14]]

Cerebral arteriosclerosis

Huang Qi (生黄芪) 25g,Fu Ling (茯苓)、Hai Zao (海藻)、Fa Xia (法夏) 10g respectively,Shou Wu (首乌)、Mai Dong (麦冬)15g respectively,Shui Zhi (水蛭) 6g,Chao Xing Ren (炒杏仁) 3g, Decoction divided, t.i.d.

Out of 48 patients, 17 cured, 30 effective, 1 ineffective [13].

Cerebral infarction

Huang Qi (生黄芪) 60g,Tian Ma (天麻)、Chuan Qiong (川芎)、Tao Ren (桃仁)、Niu Xi (牛膝)、E Zhu (莪术) 10g respectively,Sheng Dang Gui (生当归)、Sheng Dan Shen (生丹参) 20g respectively,Gou Teng (钩藤) 15g, Decoction divided, b.i.d.

Out of 63 patients, 17 cured (to normal language and activity functions), 39 effective (to basic functions in daily life). Total effective rate 88.8% [13].

Colds and influenza

Huang Qi (黄芪) alone 5g pills, t.i.d or 15g decoction, q.o.d for 20 days with 5 days of rest in between.

Used for prevention, lowered risk of infection, and a shortened duration of infection [10].

Coronary artery disease

Huang Qi (黄芪) 10-30g, Tai Zi Shen (太子参) 12-20g, Gui Zhi (桂枝) 9g, Xue Fu Zhu Yu Tang (血府逐淤汤), decoction, q.d.

24/32 patient effective significantly, 7/32 effective and 1/32 ineffective; better than the control group of isosorbide dinitrate+aspirin, or Dan Shen dripping pills [[15]].

Diabetes

Huang Qi (生黄芪) 15g,Huai Shan Yao (淮山药) 12g,Huang Jing (黄精) 12g,Bai Sha Shen (北沙参) 12g,Xuan Shen (玄参) 12g,Cang Zhu (苍术) 10g,Sheng Di (生地) 15g,Tian Hua Fen (天花粉) 12g,Nu Zhen Zi (女贞子) 12g, addition or subtraction according to symptons.

Control group: gliclazide tablets, 1#, b.i.d; Treatment group: gliclazide plus the formula. Results: the total effective rate of treatment group was 94.44%, while control group was 65.71%. There was a significant difference (p<0.05) [[16]].

Hypertension

Fang Ji Huang Qi Tang with Ge Gen (防己黄芪汤加葛根). Huang Qi (黄芪) 30克、Bai Zhu (白术) 12克、Fang Ji (防己) 12克、Gan Cao (甘草) 3克、 Sheng Jiang (生姜) 3片、Hong Zao (红枣) 10粒,often remove Gan Cao and add Ge Gen (葛根)30克

Especially for the treatment of hypertension in the elderly with edema in lower extremity. Showed the effect of eliminating edema and lowering hypertension [1].

Immune disorder

Fresh Huang Qi (黄芪) 30g, Ren Shen (人参) 15g, and 20 pieces of Da Zao (大枣), decoction.

Showed marked improvement in 14 patients with low white blood cell counts [10].

Infection of pulmonary tract

Huang Qi (黄芪) 15g, Da Zao (大枣) 10g, b.i.d.

For prevention of pulmonary tract infection in  patients with past histories of chronic bronchitis, bronchial asthma, and allergic rhinitis [10].

Lung cancer (non-small cell)

Huang Qi (黄芪)、Bei Sha Sheng (北沙参)、Tian Men Tong (天门冬)、Nu Zhen Zi (女贞子)、Shi Shang Bai (石上柏)、Chong Lou (重楼).

Out of 127 patients, survival rates of 1, 3, 5 years were 73. 21 %、13. 93 % and 11. 17 %; in comparison with Chemo groups (MAP 64 patients, PR 7 patients, NC 39 patients) in the same period: 40. 54 %, 11. 06 % and 5. 53 % [[17]].

Nephritis

Huang Qi (黄芪) 100g, decoction divided, b.i.d. for 15-90 days.

7/20 showed significant improvement; 9/20 showed marked improvement; 4/20 showed no improvement [10].

Nephropathy

Huang Qi (黄芪) in large doses

Used to treat chronic nephritis in human clinical trials. It increases the volume of urine, and the excretion of chloride and ammonia [10].

Peptic ulcer disease

Huang Qi (黄芪) 12g, Bai Shao (白芍) 12g, Gan Cao (甘草) 5g, Gui Zhi (桂枝) 10g, Sheng Jiang (生姜) 3g, Da Zao (大枣) 5 pieces, and Yi Tang (饴糖) 30g. Decoction divided, b.i.d., 25-53 days.

Out of 43 patients, 22 reported significant improvement, 17 reported moderate improvement, and 4 showed no improvement. The rate of effectiveness was 90.7% [10].

Prostatic hypertrophy

Fresh Huang Qi (黄芪) 100g, Hua Shi ( 滑石) 30g, Hu Po (琥珀) 3g, decoction taken on an empty stomach.

35/52 patients reported complete remission of symptoms, 13/52 improved in flow rate and reduction in size of the prostate, and 1 had no improvement [10].

Psoriasis

Huang Qi (黄芪) as powder, decoction, injection or topical cream

Out of 204 patients, 42 reported marked improvement, 62 reported moderate improvement, 91 reported slight improvement, and 9 reported no improvement [10].

Pulseless disease (Takayasu’s disease)

Huang Qi (黄芪) 60g in Bu Yang Huan Wu Tang (补阳还五汤)

Out of 6 patients, 3 were significantly improved; 3 moderately and 1 lightly improved [10].

Rectal prolapse

Fresh Huang Qi (黄芪), 30-50g,

Dan Shen (丹参) 15g, Shan Zha (山楂) 10g, Fang Feng (防风) 3g, and Sheng Ma (生麻) 3g, decoction q.d.

Showed marked effectiveness for treatment of rectal prolapse [10].

 

Xiaolong Meng

 

References:

 

 

 


[2] Steven Sinclair: Chinese Herbs: A Clinical Review of Astragalus, Ligusticum, and Schizandrae. Alternative Medicine Review. Volume 3, Number 5, 1998

 

 

[3] Liqiang Meng et al: A COMBINATION OF CHINESE HERBS, ASTRAGALUS MEMBRANACEUS VAR. MONGHOLICUS AND ANGELICA SINENSIS, ENHANCES INTERSTITIAL EXTRACELLULAR MATRIX DEGENERATION IN OBSTRUCTIVE NEPROPATHY. http://ckj.oxfordjournals.org/content/2/suppl_2/ii1867.abstract?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&andorexacttitle=and&andorexacttitleabs=and&fulltext=Astragalus+cytokine&andorexactfulltext=and&searchid=1&FIRSTINDEX=10&tdate=6/30/2013&resourcetype=HWCIT

 

 

[4] L. Chen et al: Cigarette smoke enhances β-defensin 2 expression in rat airways via nuclear factor-κB activation. Eur. Respir. J., Sep 2010; 36: 638 – 645.

 

 

[5] H-D Xu et al: Effects of Astragalus Polysaccharides and Astragalosides on the Phagocytosis of Mycobacterium tuberculosis by Macrophages. Journal of International Medical Research, Jan 2007; 35: 84 – 90.

 

 

[6] Ling Zhang et al: Astragaloside IV Stimulates Angiogenesis and Increases Hypoxia-Inducible Factor-1α Accumulation via Phosphatidylinositol 3-Kinase/Akt Pathway. J. Pharmacol. Exp. Ther., Aug 2011; 338: 485 – 491.

 

 

[7] X. F. Mao et al: Effects of ß-glucan obtained from the Chinese herb Astragalus membranaceus and lipopolysaccharide challenge on performance, immunological, adrenal, and somatotropic responses of weanling pigs. J Anim Sci, Dec 2005; 83: 2775 – 2782.

 

 

[8] Mao SP et al: [Modulatory effect of Astragalus membranaceus on Th1/Th2 cytokine in patients with herpes simplex keratitis]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004 Feb;24(2):121-3.

 

 

[9] Huang Qi clinical use: http://health.people.com.cn/GB/11202469.html

 

 

[11] Zhi Huang Qi, Baidu: http://baike.baidu.com/view/281556.htm

 

 

[15] Dong, Dequan: Effect of Chinese medicine on treatment of stable angina pectoris by coronary artery disease. Chinese J. Traditional & Western Medicine. 7 (18):1657, 2006.