Tokishakuyakusan (Angelica sinensis + Paeonia formula): Benefits, Dosage, Safety & Evidence

Questions fréquentes

How does Tokishakuyakusan work for women's health?

Tokishakuyakusan works by improving blood circulation and modulating hormonal balance, specifically through estrogenic activity. Active compounds like ligustilide and paeoniflorin are believed to relax smooth muscle tissue and improve microcirculation in the pelvic region. In Kampo theory, the formula addresses 'blood deficiency' and 'cold constitution,' making it effective for menstrual irregularities. Research on its mechanism is limited but suggests influence on ovarian function and blood viscosity (Evidence Level: C).

Can I take Tokishakuyakusan with blood thinners like warfarin?

You should not take Tokishakuyakusan if you are on anticoagulant medications. The formula contains Angelica sinensis (Dang Gui), which possesses blood-thinning properties that can potentiate the effects of drugs like warfarin or aspirin. This interaction increases the risk of bleeding complications. Because of the potential for serious drug interactions, individuals on blood thinners should avoid this formula unless strictly supervised by a physician.

Is Tokishakuyakusan safe during pregnancy?

Tokishakuyakusan is contraindicated and considered unsafe during pregnancy. The formula contains herbs with emmenagogue properties, meaning they can stimulate blood flow in the pelvic region and uterus. This action may stimulate uterine contractions, potentially leading to miscarriage or premature labor. Women who are pregnant or suspect they may be pregnant should avoid this herbal formula entirely to ensure fetal safety.

What is the standard dosage for Tokishakuyakusan?

The standard adult dosage for Tokishakuyakusan typically involves taking standardized Kampo granule extracts as directed on the specific product label. In clinical practice, this is often administered in divided doses, usually 2 to 3 times daily before or between meals. Dosage may vary based on the individual's age, constitution, and specific symptoms. It is essential to follow a qualified practitioner's guidance rather than self-prescribing to ensure appropriate use.

What is Tokishakuyakusan used to treat?

Tokishakuyakusan is widely prescribed in Japanese gynecology to treat 'blood deficiency' and 'cold constitution' in women. It is primarily used for menstrual irregularities, dysmenorrhea (painful periods), and infertility related to poor circulation. Practitioners often recommend it for women experiencing fatigue, cold hands and feet, and a pale complexion alongside menstrual issues. While traditionally used for these purposes, current clinical evidence is rated as Level C.

Fiche d'information compilée à partir de PubMed

Cette fiche a été compilée à partir de résumés PubMed (NIH) avec l'assistance d'une IA. Chaque affirmation factuelle est citée par un article PubMed réel (voir la liste des sources). Elle n'a pas encore été révisée par un humain — confirmez auprès d'un professionnel de santé avant utilisation.

Compilé à partir de 30 articles PubMed · modèle : gemma4:31b

Résumé

Tokishakuyakusan (TSS) is a Japanese Kampo herbal formula used for various gynecological and neurological conditions [PMID:27493835, PMID:1336588].

Contexte

Tokishakuyakusan, also known as Danggui-Shaoyao-San (DSS) or TJ-23, is a traditional herbal formula consisting of a mixture of herbal medicines [PMID:27493835, PMID:26344429].

Usages traditionnels

It has been widely used in oriental countries for the treatment of various gynecological diseases [PMID:27493835] and gynecological symptoms in aged women [PMID:1336588].

Composés actifs

The formula is composed of six herbal plants: Angelica sinensis (Toki), Paeonia lactiflora (Shakuyaku), Ligusticum chuanxiong (Senkyu), Poria cocos (Bukuryo), Alisma orientale (Takusha), and Atractylodes macrocephala/lancea (Sojutsu) [PMID:27493835, PMID:8874673].

Mécanisme d'action

TSS exhibits immunomodulatory and anti-inflammatory effects by reducing inflammatory mediators such as IL-1β, IL-2, TGF-β, RAGE, and TLR2, and down-regulating endoplasmic reticulum stress and apoptotic signaling [PMID:26344429]. It also demonstrates antioxidant activities, reduces cell apoptosis in the hippocampus, and modulates central monoamine neurotransmitter systems, including the cholinergic, dopaminergic, adrenergic, and serotonergic systems [PMID:27493835]. In the brain, it may increase acetylcholine (ACh) and blood flow in the dorsal hippocampus [PMID:17160971] and suppress the decrease of choline acetyltransferase (ChAT) activity in the cerebral cortex and dorsal hippocampus [PMID:10904156].

Preuves cliniques

Preuve CDysmenorrhea

There is some evidence of benefit with the use of the Japanese herbal remedy toki-shakuyaku-san [PMID:15686299].

Preuve BLeukorrhagia

Administration normalized irregular menstrual cycle, healed cervical pseudo-erosion, and reduced leukorrhagia in young women with insufficient luteal function [PMID:8874673].

Preuve BHypochromic anemia (uterine myoma)

No significant improvement in blood counts or laboratory parameters of anemia was noted compared to oral iron, although some improvement in signs and symptoms was observed [PMID:14513774].

Preuve DMild Cognitive Impairment (MCI) and Alzheimer's Disease (AD)

Treatment (7.5g/day for 8 weeks) significantly increased regional cerebral blood flow in the posterior cingulate and tended to improve MMSE orientation scores [PMID:22454658].

Preuve DHeadaches and Depression

Used in middle-aged women to investigate effects on headache and concomitant depression [PMID:24648849].

Preuve B

Sécurité et effets indésirables

In a study of patients with MCI and AD, no adverse events occurred during the study period [PMID:22454658].

Grossesse et allaitement

Studies in pregnant rats suggest it may inhibit L-NAME-induced hypertension and abrogate fetal growth retardation [PMID:14971720]. A study in women found that Tokishakuyakusan treatment had no significant effect on plasma or amniotic fluid endothelin-1 levels during the menstrual cycle, gestation, or post-partum period [PMID:2270848].

Synthèse des preuves

Evidence is mixed, consisting primarily of animal models (mice/rats) and small-scale clinical observations or trials. There is some clinical evidence for gynecological use and ocular blood flow, but high-level evidence (meta-analyses) for primary efficacy is lacking in the provided set.

Sources PubMed

1.PMID: 15686299 (2005) — Dysmenorrhea. · American family physician
2.PMID: 26344429 (2015) — Toki-shakuyaku-san, a Japanese kampo medicine, reduces colon inflammation in a mouse model of acute colitis. · International immunopharmacology
3.PMID: 27493835 (2016) — Danggui-Shaoyao-San: New Hope for Alzheimer's Disease. · Aging and disease
4.PMID: 1336588 (1992) — Effects of toki-shakuyaku-san (Tsumura TJ-23) on electrical activity in neuroblastoma cells and frog neuromuscular junctions. · Neuroscience research
5.PMID: 14513774 (2003) — A comparative study of the usefulness of toki-shakuyaku-san and an oral iron preparation in the treatment of hypochromic anemia in cases of uterine myoma. · Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan

Tokishakuyakusan

Sources et citations

Calculer une dose sûre de Tokishakuyakusan

Anemone pulsatilla

Si Wu Tang Patent

Rheum officinale

Questions fréquentes

Résumé

Contexte

Usages traditionnels

Composés actifs

Mécanisme d'action

Preuves cliniques

Sécurité et effets indésirables

Grossesse et allaitement

Synthèse des preuves

Sources PubMed

Sources gouvernementales

Tokishakuyakusan

Sources et citations

Calculer une dose sûre de Tokishakuyakusan

Plantes associées

Anemone pulsatilla

Si Wu Tang Patent

Rheum officinale

Questions fréquentes

Résumé

Contexte

Usages traditionnels

Composés actifs

Mécanisme d'action

Preuves cliniques

Sécurité et effets indésirables

Grossesse et allaitement

Synthèse des preuves

Sources PubMed

Sources gouvernementales