Analysis of research status of anti fatigue medicine and food homologous traditional Chinese Medicine

YaozhicuiLuobinXieyingDuhongzhenWanglijiaoLizhengning

Department of clinical nutrition, the first hospital of Hebei Medical University

1.1  Cognition of Western Medicine

In the 1980s, CFS was discovered and named by the Centers for Disease Control and Prevention (CDC) of the United States. Subsequently, many countries have carried out a large number of studies on CFS. . CFS usually presents with complex symptoms weeks or months after an acute viral infection or stress period.

1.1.1  Viral infection:

. Before the acute phase, most patients had a suspicious history of infection. Therefore, many studies believe that the occurrence of this disease may be related to viral infections, such as Epstein Barr virus, enterovirus, Borna virus, cytomegalovirus, influenza virus, human herpesvirus infection, etc[4,5]However, at present, the theoretical basis of CFS caused by viral infection is not sufficient, and the pathogenesis is not completely clear, which still needs further study.

1.1.2  Genetic susceptibility:

Studies have shown that the onset of CFS may be related to genetic factors[6]In 2006, CDC in the United States carried out a large-scale study on CFS. The study carried out a detailed clinical evaluation and comprehensive blood sample tests on 227 patients with CFS (including the evaluation of the heritability and activity of 20000 genes). The results showed that some genes contained in CFS patients were related to the regulation of stress response activities by the brain, and showed different gene activities from ordinary people, indicating that specific genes and gene activities were associated with the disease. Smith et al[7]Reported that compared with children of healthy mothers, children born to mothers with CFS were more likely to suffer from CFS. Kerr et al[8]By analyzing the differential expression genes of 55 patients with cfs/ myalgia encephalomyelitis (me) and 75 healthy blood donors, 88 genes were confirmed to be differentially expressed, of which 85 were up-regulated and 3 were down regulated. In addition, twin studies have shown that the fatigue consistency of monozygotic twins is higher than that of dizygotic twins[9,10,11]. in 2016, schlauch et al[12]More than 906600 known DNA single nucleotide polymorphism chips were used to analyze the DNA of cfs/me subjects and healthy controls, and 442 of them were found to be possibly associated with CFS. This study also provides support for the genetic susceptibility of CFS.

1.1.3  Abnormal immune function:

CFS is a chronic multisystem disease. Many scholars believe that the production of CFS may be related to the immune dysfunction of the body, showing a variety of characteristics of autoimmune diseases[13,14,15,16]For example, the levels of immunoglobulin A, immunoglobulin G and immunoglobulin M are disordered, the levels of cytokines are abnormal, the number or activity of natural killer cells (NK cells) is reduced, the proportion of T cell subsets is changed, the function of effector T cells, phagocytosis of monocytes and lymphocyte proliferation are decreased, and the immune complexes in blood are increased. Although the above index changes are not unique to CFS patients, they can reflect the effect of clinical treatment under certain circumstances. The change mechanism of immune cells and factors in patients with CFS still needs a lot of in-depth research, in order to further provide a scientific and reliable basis for clinical treatment.

1.1.4  Psychological factors:

Heavy workload and high mental pressure are very important reasons for fatigue. Multivariate statistical results showed that people with introverted personality and poor interpersonal environment were more likely to suffer from CFS[17]These people often have poor interpersonal environment, are dissatisfied with their work, and lack appropriate psychological adjustment ability. Their bad emotions cannot be vented in time, and they are prone to psychological confusion or discomfort. Psychological fatigue will form after a long time. If they are overloaded for a long time, their physiological functions will be affected, and more serious fatigue symptoms will appear, which will lead to CFS. Therefore, stress or emotional trauma are often considered as risk factors for unexplained fatigue diseases[18,19]。

1.1.5 

Dizziness, insomnia, palpitations, memory loss and other symptoms associated with some CFS patients may be related to neuroendocrine disorders. Through comprehensive analysis of the neuroendocrine system of CFS patients, researchers found that the patients' cortisol secretion increased, thyroid function decreased, anabolism weakened, resulting in decreased body recovery and increased fatigue[20]Studies have shown that lower norepinephrine levels are associated with higher fatigue[21]However, the etiology and pathogenesis of this disease have not been clearly determined in modern medicine. The treatment mainly includes antiviral, immunosuppression, nutritional support and psychological counseling, but it can only alleviate some clinical symptoms of patients, and the long-term curative effect is still not ideal.

1.2  TCM cognition

There is no record of the disease name of CFS in traditional Chinese medicine, but there is an earlier understanding of fatigue. . According to traditional Chinese medicine, the health of human body depends on the balance of yin and Yang, the coordination of viscera, and the filling of Qi and blood. Fatigue is related to "asthenia" and "asthenia syndrome"[22], which involves the following aspects.

1.2.1  Spleen injury due to fatigue:

The spleen and stomach have a great relationship with the digestion and nutrient absorption of human diet. If the spleen and stomach are strong, the nutrient absorption is good, and the body can be provided with enough energy. On the contrary, if you are too tired and damage the spleen function, it will affect the body's energy production and further aggravate fatigue.

1.2.2  Fatigue injury HP:

The heart governs the blood and the mind; The lung governs Qi, propaganda and suppression. Between Qi and blood, "Qi is the beauty of blood, and blood is the mother of Qi". The two are mutually metaplastic, and the disease is very easy to be related to each other, and they cause and damage each other, thus aggravating the disease. For example, long-term Qi deficiency will lead to blood deficiency, Qi deficiency, visceral dysfunction, and blood metabolism disorders; The deficiency of blood in the camp will lead to the loss of nourishment of the viscera and the loss of the source of Yang Qi, which will further aggravate the original deficiency of Qi. The more serious the deficiency of Qi, the more serious the deficiency of blood in the camp.

1.2.3  Excessive strain:

The liver governs tendons and hides blood. It is recorded in the canon of internal medicine that "the liver is the root and the residence of the liver; its beauty lies in the claw and its filling in the tendon to generate blood...". It is believed that the liver governs tendons and plays an important role in exercise, which is the fundamental of motor function. The physiological and pathological characteristics of the liver and spleen are closely related to CFS. The liver is the "base of striking the extreme". It is the main muscle. If the muscle strength is not healthy and the exercise is unfavorable, it is prone to fatigue. The spleen is the foundation of the day after tomorrow. It is mainly used to transport and transform the body and muscles. Various reasons lead to the loss of healthy movement of the spleen and the lack of Qi and blood, causing the patient to feel sleepy and weak in the limbs. . Therefore, eating disorders, overwork, emotional disorders, etc. will lead to the imbalance of human viscera, blood, yin and Yang, the disorder of body function, and then the manifestations of fatigue, joint pain, muscle soreness, insomnia, anxiety, depression, etc. In ancient times, there were records of using traditional Chinese medicine to treat fatigue. For example, Shennong herbal classic, the earliest herbal monograph in China, recorded the drugs of "Beili" and "yiqili".

"Medicine and food are of the same origin" refers to many foods, namely drugs. Food and drugs can prevent and treat diseases as well, and there is no absolute boundary between the two. Ancient medical experts believed that each kind of food had "four properties" and "five tastes", and the idea that "medicine and food have the same origin" was reflected in the Tang Dynasty "Huang Di Nei Jing Tai Su": "fasting food is food, and patients eat medicine". In the "list of items that are both food and medicine" published by the former Ministry of health in 2002, 87 substances were included: clove, fresh reed root, concanavalis, cumin, coix seed, laminaria, hawthorn, white bean flower, purslane, fresh Imperata root, papaya, Torreya, hemp seed, polygonatum odoratum, cassia seed, liquorice, yam, plum kernel, gardenia, nutmeg, Angelica dahurica, thistle, ginkgo, almond, Zaocys, black plum, white lentil, longan meat, cinnamon, Phyllanthus emblica, bergamot, seabuckthorn, pepper, red bean, chicken nux, malt, daidaidaihua, Siraitia grosvenorii, star anise, honeysuckle, Houttuynia cordata, Euryale ferox, ginger, peach kernel, green fruit, Fructus aurantii, jujube, Amomum villosum, fat sea, Poria cocos, citron, mulberry, Allium macrostemon, Elsholtzia chinensis, donkey hide gelatin, mulberry leaves, tangerine, Lycium barbarum, Platycodon grandiflorum, chicory, Alpinia oxyphylla, lotus leaf, Raphani Lotus seed, light bamboo leaf, chrysanthemum, lily, perilla seed, Pueraria lobata, black sesame, raspberry, Sophora japonica, black pepper, light Douchi, Sophora japonica, galangal Semen ziphi Spinosae, polygonatum, dandelion, Perilla frutescens, honey, Agkistrodon halys, orange peel, patchouli, yellow mustard, mint, etc. In 2014, 14 substances were added: pine pollen, saffron, honeysuckle, rose, Pueraria lobata, Prunella vulgaris, Angelica sinensis, rag leaves, Kaempferia, Tsaoko, coriander, turmeric, ginseng and Piper longum. In November, 2019, the National Health Commission and the State Administration of market supervision jointly issued the notice on carrying out the pilot work of substance management for nine substances including Codonopsis pilosula, which are both food and traditional Chinese medicine according to tradition. The nine substances are Gastrodia elata, Eucommia ulmoides leaves, American ginseng, Codonopsis pilosula, Dendrobium officinale, Astragalus membranaceus, Cornus officinalis, Cistanche deserticola and Ganoderma lucidum.

3.1  Literature statistics of drug food homology / drug food dual use anti fatigue

3.2  Literature analysis of anti fatigue medicine and food homologous traditional Chinese Medicine

4.1  ginseng

4.2  Polygonatum

4.3  licorice

4.4  Yam