Research progress of Astragalus and Angelica

Huan-Le Fang ， Hui Zhang , Yan-Yan Tao ， Yan-Bin Chen

1.Medical College of Xi 'an Peihua University, Xi’an,Shaanxi 710125, China

2.Shanxi Buchang Pharmaceutical, Xi’an,Shaanxi 710075, China

3.Department of Pharmacology, Xi’an Jiaotong University Health Science Center, Xi’an, Shaanxi 710061, China

Keywords:Astragalus Angelica Pharmacological study Clinical application

ABSTRACT Astragalus angelica is a famous pair of Qi tonifying and blood enriching drugs. After compatibility, it can achieve the same effect, complement each other and promote each other. It can enhance human immunity, improve blood circulation, promote hematopoiesis, protect cardiovascular and cerebrovascular vessels, anti fibrosis, protect kidney, assist in the treatment of kidney syndrome, diabetes, children's cough, dizziness, improve cancer and other functions. In this paper, Astragalus Angelica pairs were systematically elaborated from its efficacy and material basis, pharmacological research and clinical application, and its further research was prospected, providing basis for the development of Astragalus Angelica pairs.✉Corresponding author: Chen Yanbin, male, deputy director pharmacist.

Compound Chinese medicine is a hot research topic in recentyears, which has complex components and numerous targets. The drug pair is the important core and the best entry point of the compound. Astragalus Angelica medicine is a member of this family. It is recorded in the volume of the theory of differentiation of internal and external injuries that Danggui Buxue Decoction is composed of Danggui and Huangqi in a certain proportion. It has the effect of supplementing blood and Qi, and it can treat the syndrome of deficiency of both qi and blood and fever. It is called one of the representative prescriptions of "double supplement of Qi and blood"

[1]. Astragalus and angelica, as the core drugs of Invigorating Qi and promoting blood circulation, have important compatibility significance in clinical treatment.

The combination of Astragalus and Angelica can not only replenish qi and generate blood, but also not hinder the spleen and stomach. According to pharmacological research, the active ingredients of Astragalus and Angelica can resist radiation, antioxidant, antiinflammatory and other pharmacological effects [2], and can treat diabetic nephropathy [3], children cough [4], vertigo and other clinical diseases [5]. It can be seen that both of them can achieve synergistic effect through synergistic effect. Therefore, a review of the material basis, efficacy, pharmacological research and clinical application of Astragalus Angelica drug pair can lay a solid foundation for the rational development and scientific utilization of this drug pair.

1. Efficacy and material basis

Modern pharmacological research has shown that the main components of Astragalus membranaceus, such as saccharides, various amino acids, proteins, choline, etc., have the effects of regulating patients' immunity and antiviral [6]; Angelica sinensis mainly contains volatile oil, organic acids, polysaccharides and amino acids, which have the functions of enhancing human immunity, antioxidation, promoting cardiovascular function, improving blood circulation system [7]. It can be seen that Astragalus membranaceus and Angelica have different activities, but they have complementary effects, which is helpful for the treatment of pathological changes in some diseases.

2. Pharmacological research

2.1 Protection of kidney

Research shows that Astragalus and Angelica are the core drug pairs of early diabetic nephropathy, which can improve renal function by activating Nrf2 pathway, antioxidant stress and other ways [8]. Wei Sheng et al. Studied the renal protective effects of Compound Huangqi Danggui Decoction on metabolic syndrome (MS) rats. At the same time, some studies have shown that Huangqi Danggui Buxue Decoction has also played a very good role in the effective prevention and inhibition of acute glomerular atherosclerosis and vascular interstitial cell fibrosis [10]. Meng Liqiang [11] et al. Studied that Astragalus and angelica mixture can improve the imbalance of PAS / pais and MMPs / TIMPs system in renal tissue, reduce the accumulation of extracellular matrix, improve renal fibrosis and protect renal tissue.

2.2 Protection of the immune system

The activation of the immune system has a good protective effect on the body. Long term immune dysfunction can easily lead to aggravation of the disease, leading to premature aging and death of patients [12]. Li Zongshan et al. [13] showed that Astragalus decoction can also inhibit the proliferation of spleen lymphocytes and the production of IL-2 in mice. Song Jie et al. [14] believed that Astragalus had protective effect on immune system in anti X-ray. Hongyan et al. [15] showed that angelica polysaccharide can significantly improve the peripheral blood picture of irradiated mice, inhibit the immune adherence of red blood cells, and promote the hematopoietic function of cells. Qin Qianhua et al. [16] Astragalus Angelica 10:1, 1:1 compatibility has significant effect on improving the immunity of mice. Therefore, Astragalus and Angelica compatibility can better protect the immune system.

2.3 Effect on blood vessels of rats

The results of Peng Xiwei et al [17-19] showed that Astragalus Angelica (1:1) could inhibit intimal hyperplasia by reducing the expression of type I collagen (CoL-I), fibronectin (FN) and matrix metalloproteinase-9 (MMP-9). Other studies have shown that [20] Astragalus Angelica 1:1 combination can inhibit VSMCs phenotype transformation and VSMCs proliferation after vascular endothelial damage. In recent years, it has been found that Astragalus Angelica 1:5 combined decoction can significantly promote angiogenesis of chorioallantoic membrane of chicken embryo [21]. Yan Huifang et al [22] showed that Astragalus and Angelica compatibility may have inhibitory effect on intimal hyperplasia after vascular endothelial damage by activating PI3K / Akt signal pathway.

2.4 Effect on hematopoietic function of bone marrow

Problems in the hematopoietic system can lead to infection, anemia, bleeding and other complications. Chen Lingbo et al. [23] showed that Astragalus Angelica 1:1 has a better effect on inhibiting the proliferation and differentiation of hematopoietic progenitor cells in the bone marrow of mouse model, and inhibiting the function of hematopoietic cells in the bone marrow. Huang Xiaoping [24] et al. Showed that Astragalus Angelica 1:1, 1:2.5, 1:5 ratio of compatibility can be very good against cyclophosphamide induced hematopoietic function of bone marrow showed a better role in promoting hematopoiesis. Xu Hao et al. Showed that qiguiyao can promote and enhance the hematopoiesis through five active ingredients: ferulic acid, mangpropionate, astragaloside a, maorui isoflavone and maorui isoflavone [25].

2.5 Anti-atherosclerosis and improvement of platelet aggregation

Tengjialin etal [26] showed that Astragalus angelica, which can benefit Qi and activate blood, can significantly inhibit the platelet aggregation rate of rats with acute "blood stasis" at 5:1. Guo Liangqing (27) etal. Carried out the experiment, the results suggested that Qi GUI medicine might play a role in protecting vascular endothelium by improving the level of NOS and no in 3:2 group. Zhi Yujuan et al. [28] carried out an experimental study to show that Astragalus and Angelica 5:1 can reduce or eliminate atherosclerotic plaques by inhibiting macrophages phagocytosis of OX-LDL to form foam cells and reducing foam cell formation. Huang Shuiqing

[29] reviewed the research on improving blood lipid of Astragalus angelica, which indicated that Astragalus Angelica has the effect of regulating blood lipid and anti atherosclerosis.

2.6 Improvement of pulmonary and renal fibrosis

Pulmonary fibrosis is a hot topic in the study of respiratory system. Li Lijun [30] and other studies show that Astragalus Angelica 5:1 group can significantly improve the content of Hyp in mice with pulmonary fibrosis and improve the alveolar structure of pulmonary fibrosis.

Renal fibrosis is the end stage of the development of various kidney diseases. Ye Taisheng et al. [31] found that Astragalus and Angelica can significantly reduce the blood urea nitrogen, creatinine, proteinuria, and the expression of TGF-β 1 mRNA and CTGF mRNA in renal tissue. It can resist renal fibrosis and protect kidney.

2.7 Protective effect of Astragalus and Angelica on cerebral ischemia injury

Chen Gang [32], et al Compared with the model group, the apoptotic rate of the treatment group was significantly reduced, which indicated that Astragalus angelica mixture could reduce the apoptosis of nerve cells in a certain degree, alleviate the stress of endoplasmic reticulum against cerebral ischemia injury.

3. Clinical application

At present, Astragalus Angelica has been widely used in clinical research and treatment of kidney function damage, asthenia labor, diabetic disease, children's cough, vertigo, cancer adverse reactions, cardiovascular disease and other diseases.

3.1 Nephrotic syndrome

Shangweiqing [33] Clinical Observation of nephrotic syndrome patients showed that on the basis of conventional treatment combined with Astragalus angelica mixture treatment, medication for 6 months. Before and after treatment, the level of renal function indexes and inflammatory factors were significantly lower than that of the conventional treatment group. Xiao Qiong [34] was divided into the routine group and the observation group. The results showed that the renal function of the observation group was significantly improved. Wang Yuanzhen et al. [35] divided the treatment of refractory nephrotic syndrome into the control group and tacrolimus and symptomatic treatment. The treatment group was treated with Astragalus Angelica Mixture on the basis of the control group for 6 months. The results showed that the clinical efficacy of Astragalus Angelica Mixture Combined with tacrolimus in the treatment of refractory nephrotic syndrome was better than that of tacrolimus alone, and the safety was high.

3.2 Diabetic lesions

Zhao Xiaomei [36] compared the therapeutic effect of 86 diabetic patients. Compared with the normal treatment group, the observation group with Astragalus and angelica mixture had significant improvement in urinary protein and lipid metabolism. It can obviously improve the therapeutic effect of clinical diabetes patients. The study also showed that Astragalus and Angelica compatibility can improve the complications of diabetes. Zhao Xian [37] observed that Astragalus Angelica Decoction combined treatment of diabetic peripheral neuropathy patients, control group control diet injection of insulin while using mecobalamin injection, observation group on the basis of the control group plus self-made Astragalus Angelica Decoction combined treatment, the results showed that the observation group can effectively improve diabetic peripheral neuropathy to protect nerves, clinical effect is good. Han Xiaobing et al. [38] showed that Astragalus and angelica mixture can improve diabetic nephropathy, and its effect is similar to that of benazepril.

3.3 Treatment of children's cough

Traditional Chinese medicine considers that the pathogenesis of cough is exogenous six evils, internal injury of viscera, damage of lung collaterals, endogenesis of phlegm and Yin, loss of lung qi, and the pathological location is mainly in the lung, followed by a long course of cough in children with kidney and spleen. It is common in cough with deficiency of Qi and blood stasis, which is a kind of chronic cough. The addition and subtraction of Astragalus Angelica Decoction has a very good effect in treating this disease, not only invigorating qi and Promoting Yang, promoting water and eliminating swelling, but also invigorating blood and activating blood[39]. It can be seen that the combination of Astragalus and Angelica can improve the clinical symptoms of children, and the drug safety is high.

3.4 Treatment of menopausal vertigo

Professor Kong Li [40] found that perimenopausal vertigo was mainly seen in deficiency of both qi and blood. According to the principle of treating diseases and seeking the root, the method of supplementing both qi and blood was adopted. In clinic, it is based on Invigorating Qi and promoting blood circulation. It uses large dose of Astragalus to invigorate Qi and strengthen the surface, regulate Qi mechanism, and then mix with a certain dose of Angelica to invigorate blood and promote blood circulation and regulate blood deficiency. It can be seen that the compatibility of the two for women, especially perimenopausal women, often lack of Qi and blood, when invigorating qi and blood to treat the root, expectoration to treat the symptoms, both specimens.

3.5 Improvement of lung cancer and its adverse reactions

Han Wei [41] studied the clinical use of Astragalus Angelica Decoction to improve the adverse reactions of chemotherapy in 42 patients with advanced lung cancer. The results showed that the total effective rate and the incidence of adverse reactions of the patients in the routine treatment plus Astragalus Angelica Decoction were higher than those in the control group. The quality of life of patients was significantly improved.

4. Summary and prospect

Astragalus angelica is one of the most important drugs in many famous prescriptions for nourishing qi and nourishing blood. Both of them contain alkaloids, polysaccharides, organic acids, proteins and other components. They have pharmacological effects in protecting kidney, improving blood circulation system, strengthening human immunity, promoting cardio cerebral vascular recovery, anti fibrosis and so on. Especially in improving kidney disease and diabetes In the treatment of peripheral vascular diseases, Astragalus Angelica has obvious advantages, and also has significant effects on children's cough, dizziness and cancer, which provide a strong basis for the compatibility of the two drugs. To sum up, it can be seen that Astragalus and Angelica should be used in combination.

After the combination of Astragalus and angelica, the effect and classic proportion of Astragalus and Angelica have been confirmed through experiments and clinical research. However, the mechanism of its action is still unclear. In the later stage, we can use network pharmacology, metabonomics, proteomics and other technologies to discover the regularity and mechanism of the compatibility of Astragalus and angelica. For the research of this drug pair, we can further build the basic chemical substance database of Astragalus and Angelica through literature exploration and chemical analysis technology. According to the existing data, we can build the disease and target network model, and then build the components of Astragalus and angelica- Target disease network, to analyze its network pharmacology mechanism, and finally through the overall animal pharmacodynamics evaluation and molecular mechanism to explore and verify its role, the in-depth study of Astragalus angelica for the clinical treatment of great significance.