Dong Quai, Chinese Angelica : Scientific and Traditional Uses

by MedlinePlus

Dong Quai ( Angelica sinensis ), also known as Chinese Angelica, has been used for thousands of years in traditional Chinese, Korean, and Japanese medicine. It remains one of the most popular plants in Chinese medicine, and is used primarily for health conditions in women. Dong Quai has been called "female ginseng," based on its use for gynecologic disorders such as painful menstruation (dysmenorrhea) or pelvic pain, recovery from childbirth or illness, and fatigue/low vitality. It is also given for strengthening xue (loosely translated as "the blood"), for cardiovascular conditions/high blood pressure, inflammation, headache, infections, and neuropathic (nerve) pain.

In the late 1800s, an extract of Dong Quai called Eumenol became popular in Europe as a treatment for gynecologic complaints. Recently, interest in Dong Quai has resurged due to its proposed weak estrogen-like properties. However, it remains unclear if Dong Quai has the same effects on the body as estrogens, blocks the activity of estrogens, or has no significant hormonal effects. Results of animal studies are conflicting, and one human trial found no short-term estrogen-like effects on the body (1). Additional research is necessary in this area before a firm conclusion can be drawn.

In Chinese medicine, Dong Quai is most often used in combination with other herbs. Within the Chinese medical framework, Dong Quai is used as a component of formulas for liver qi stasis and spleen deficiency. It is believed to work best in patients with a yin profile, and is considered to be a mildly warming herb. Dong Quai is thought to return the body to proper order by nourishing the blood and harmonizing vital energy. The name Dong Quai translates as "return to order" based on its alleged restorative properties.

The part of the plant most often cultivated for medicinal use is the root, which is divided into three parts (head, body, tail). Each section is thought to have different actions within the body. For example, the tail is proposed to be best for promoting blood circulation, while the head is thought to be the worst.

Although Dong Quai has many historical and theoretical uses based on animal studies, there is little human evidence supporting the effects of Dong Quai for any condition. Few clinical studies have been done, most of which have been either poorly designed or reported insignificant results. Most have examined combination formulas containing multiple ingredients in addition to Dong Quai, making it difficult to determine which ingredient may cause certain effects.

Uses based on scientific evidence

Amenorrhea (lack of menstrual period)

There is limited poor-quality study of Dong Quai as a part of herbal combinations given for amenorrhea. It is unclear from laboratory studies if Dong Quai has the same effects on the body as estrogens or blocks the activity of estrogens (or neither), and how this might affect women with amenorrhea. One human study suggests that Dong Quai may not have significant short-term estrogen-like effects on the body. Additional research is necessary before a firm conclusion can be drawn.

Angina pectoris / coronary artery disease

There is insufficient evidence to support the use of Dong Quai for the treatment of heart disease.

Arthritis

Dong Quai is traditionally used in the treatment of arthritis. However, there is insufficient reliable human evidence to recommend the use of Dong Quai alone or in combination with other herbs for osteoarthritis or rheumatoid arthritis.

Dysmenorrhea (painful menstruation)

There are unclear results of preliminary, poor-quality human research of Dong Quai in combination with other herbs for dysmenorrhea. Animal studies report conflicting results, with either relaxing or stimulatory effects of Dong Quai on the uterus. Reliable scientific evidence for Dong Quai alone in humans with dysmenorrhea is not available.It is traditionally believed that therapy should begin on day 14 of the cycle and continue until menstruation has ceased.

Glomerulonephritis

There is insufficient evidence to support the use of Dong Quai as a treatment for kidney diseases such as glomerulonephritis. Preliminary poor-quality research of Dong Quai in combination with other herbs reports unclear results.

Idiopathic thrombocytopenic purpura (ITP)

A poor-quality study reports benefits of Dong Quai in patients diagnosed with idiopathic thrombocytopenic purpura (ITP). However, these patients were not compared to individuals who were not receiving Dong Quai, and therefore the results can only be considered preliminary.

Menstrual migraine headache

One small study reports a reduced average number of menstrual-associated migraine attacks during prophylactic treatment with a daily combination of 60mg soy isoflavones, 100mg Dong Quai, and 50mg black cohosh, with each component standardized to its primary alkaloid. Patients received study medication for 24 weeks. The effects of Dong Quai alone for this condition are not clear, and further research is necessary before a clear conclusion can be reached.

Nerve pain

There is insufficient evidence to support the use of Dong Quai as a treatment for neuropathic pain. High-quality human research is lacking.

Pulmonary hypertension

A preliminary controlled trial reports that the combination of Dong Quai with the drug nifedipine may be better than either agent alone to improve pulmonary hypertension in individuals with chronic obstructive pulmonary disease (COPD) (2). A second study of Dong Quai alone also noted benefits (3). These studies were small and not well reported, and cannot be considered conclusive. It remains unclear if Dong Quai is beneficial for other causes of pulmonary hypertension. Further research is needed before a recommendation can be made.

Menopausal symptoms

Dong Quai is used in traditional Chinese formulas for menopausal symptoms. It has been proposed that Dong Quai may contain "phytoestrogens" (chemicals with estrogen-like effects in the body). However, it remains unclear from laboratory studies if Dong Quai has the same effects on the body as estrogens, blocks the activity of estrogens, or has no significant effect on estrogens.A well-designed 24-week human trial compared the effects of Dong Quai to a placebo in 71 women with menopausal symptoms (1). This study found no differences in hot flashes or in the Kupperman Index (a commonly used measure of menopausal symptoms) between Dong Quai and placebo groups. No changes occurred in blood estrogen levels, thickness of the uterus lining, or vaginal dryness. This study suggests that Dong Quai may not have short-term estrogen-like effects on the body. However, there may have been too few patients enrolled in the study to accurately measure effects. In addition, the Dong Quai extract used, prepared by East Earth herbs, Inc. (4.5 milligrams per day, standardized to 0.5 milligrams per kilogram of ferulic acid), may not be manufactured in the same way as other Dong Quai products, and may yield different results. Additional research is necessary before a strong recommendation can be made.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Abdominal pain, abnormal fetal movement, abnormal heart rhythms, abscesses, age-related nerve damage, allergy, anemia, anorexia nervosa, antibacterial, anti-aging, antifungal, antiseptic, antispasmodic, anti-tumor, antiviral, anxiety, aortitis, asthma, atherosclerosis, back pain, bleeding hemorrhoids, bleomycin-induced lung damage, blood clots, blood flow disorders, blood purifier, blood stagnation, blood vessel disorders, blurred vision, body pain, boils, bone growth, breast enlargement, bronchitis, Buerger's disease, cancer, central nervous system disorders, cervicitis, chilblains, chronic hepatitis, chronic obstructive pulmonary disease (COPD), chronic rhinitis, cholagogue, cirrhosis, colchicine-induced learning impairment, congestive heart failure (CHF), constipation, cough, cramps, diabetes, digestion disorders, diuretic (increasing urination), dysentery, eczema, emotional instability, endometritis, expectorant, fatigue, fibrocystic breast disease, fibroids, flatulence (gas), fluid retention, gastric ulcer, glaucoma, hay fever, headache, heartburn, hematopoiesis (stimulation of blood cell production), hemolytic disease of the newborn, hernia, high blood pressure, high cholesterol, hormonal abnormalities, immune cytopenias, immune suppressant, infections, infertility, irritable bowel syndrome, joint pain, kidney disease, labor aid, laxative, leukorrhea (vaginal discharge), liver protection, lung disease, malaria, menorrhagia (heavy menstrual bleeding), menstrual cramping, migraine, miscarriage prevention, morning sickness, muscle relaxant, dermatitis, osteoporosis, ovulation abnormalities, pain, pain from bruises, palpitations, pelvic congestion syndrome, pelvic inflammatory disease, peritoneal dialysis, pleurisy, post-partum weakness, pregnancy support, premenstrual syndrome (PMS), psoriasis, prolapsed uterus, pulmonary fibrosis, Raynaud's disease, reperfusion injury, respiratory tract infection, retained placenta, Rhesus (Rh) factor incompatibility, rheumatic diseases, sciatica, sedative, sepsis, shingles (herpes zoster), skin pigmentation disorders, skin ulcers, stiffness, stroke, stomach cancer, stress, tinnitus (ringing in the ear), toothache, vaginal atrophy, vitamin E deficiency, wound healing.

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