Astragalus Membranaceous & White Blood Cell Function
Patricia Wolf B.Sc. N.D.

Introduction

Traditional Chinese medicine as practised today had its
theoretical and philosophical tenets first outlined in the Yellow
Emperor's Inner Classic, written between 200 and 100 BC. The
Inner Classic promotes the use of herbs, acupuncture, dietary
management and exercise as therapeutic modalities (Bensky,
Gamble).

Centuries of careful observation and empirical study have
resulted in an extremely detailed and refined system of herbal
use according to traditional Chinese medical theory (TCM).
However, very little is known about the mechanism of action or
the physiological effects of most Chinese herbs in terms of
modern Western medical thought. Recently, research has been
conducted, mostly in China, in an attempt to elucidate these
areas.

Radix Astragali, the root of Astragalus membranaceous (Huang
Ch'i), is a popular tonic herb first described in the Divine
Husbandman's Classic of the Materia Medica, a text reconstructed
and edited from several earlier works by Tao Hong-Jing in the
6th. Century A.D.(Bensky et al). According to TCM, Radix
Astragali affects the Spleen, Lung and Triple Warmer meridians.
It specifically tonifies the exterior, or protective energy (Wei
Chi), which is understood to be the body's first defence against
the external disease factors (ie., Wind, Cold, Damp, Heat,
Dryness). Huang Ch'i also tonifies Chi, especially the Yang Chi
of the Spleen and Stomach. It tonifies Blood and regulated fluid
metabolism (Bensky et al; Teeguarden).

Modern research has revealed several effects of Radix Astragali.
Of primary interest to the author is the herbs's reputed
stimulatory effect on the immune system. Teeguarden reports on
Chinese studies which have shown Astragalus to have in vitro
anti-bacterial effects, as well as an inhibitory effect on T-
suppressor cells. He also cites clinical trials on cancer
patients which suggest that Astragalus enhances bone marrow
activity and adrenal cortical function which had been depleted by
chemotherapy and/or radiation treatment. (The original papers
were not available for perusal.)

One study found that Radix Astragali significantly enhanced
interferon production in mice, in human cell cultures and in
vitro leucocyte samples (Hou, Ma, Wu, Li, Li). These workers also
describe a clinical trial showing that a combination of human
interferon and Astragalus was more effective in preventing common
cold symptoms than either interferon alone or a flu vaccine. In
one of the few Western studies conducted, Astragalus was found to
restore T-cell function in cancer patients with an impaired
immune response, and to augment T-cell function in normal donors
(Sun, Hersh, Talpaz, Lee, Wong, Loo, Mavligit).

This paper will report on the effect of Radix Astragali on white
blood cell (WBC) status in human volunteers as reflected by WBC
differential count and by "Liv Cell" analysis.


Abstract
The effect of a decoction of the Chinese tonic herb Astragalus
membranaceous on certain aspects of white blood cell (WBC) status
was studied in seven healthy volunteers. After a one week course
of treatment with Astragalus decoction at a dosage equivalent to
1.5g of dried root t.i.d. per os, the relative number of
leucocytes was significantly increased (p s 0.01). Furthermore,
this effect was sustained (p s 0.05) one week after treatment had
been discontinued. A WBC differential count showed significant
changes in the proportions of individual categories of leucocytes
(p s 0.05), such that high or low percentages of leucocytes were
brought into normal range, with the exception of basophils, which
remained high. This effect was also sustained one week after
treatment had been discontinued (p s 0.05). A `Liv Cell' analysis
did not yield significant (p s 0.05), but this may have been a
function of the criteria chosen to measure WBC status. This study
suggests that Astragalus membranaceous may have a regulatory
effect on WBC status and therefore may be a useful treatment in
conditions of bo the deficient and excess (or disproportionate)
WBC levels.


Materials and Methods

Herbal Preparation:
454 grams of grade `A' quality dried Astragalus root was obtained
from Nam Pek Hong, a reputable Chinese herb store in Toronto's
Chinatown. The root was placed in 9.09 l. distilled water,
brought to a boil, and then simmered to half the original volume
of water, The extractive was poured off and saved. An additional
6.82 l. distilled water was added to the herb, brought to the
boil and similarly simmered to half the original volume. This
extractive was added to the first and white vinegar was also
added to 4.5% of the final solution as a preservative. The final
decoction yielded unit doses of 42.6 ml., equivalent to 1.5 g. of
dried root.

The placebo solution was prepared by boiling potato with onion
skins in distilled water to obtain the required colour, and
adding white vinegar in 4.5% of the final solution.

Subjects:
Twelve healthy volunteers were recruited and randomly divided
into two groups of eight and four subjects, treatment and placebo
groups respectively. Subjects were asked to refrain from using
any other treatment modalities or making any dietary or lifestyle
changes during the test period.

Experimental Design and Procedure:
A double blind format was used. Blood samples were obtained by
finger prick on days 1, 8, and 15. The herbal decoction or
placebo was taken for 6 days, from day 2 to 8 inclusive. The
dosage was 42.6 ml. three times a day. A WBC differential count
and `Liv Cell' analysis (product information) were performed on
the blood samples by a technician blind to the experimental
conditions.

For the `Liv Cell' analysis, 25 WBC's were examined for each
subject. Five categories were used to indicate WBC status,
namely, the number of WBC's showing:

1. phagocytized material
2. streaming of cytoplasm/chemotaxis
3. irregular borders
4. spilling of contents/degeneration
5. no apparent activity

Categories 1 and 2 were considered indicative of positive WBC
function and given a score of +1 for each cell in either of these
categories. Categories 3, 4 and 5 were chosen as negative
parameters of WBC status and cells appearing in them were given a
score of -1 each. Overlap between categories was allowed; thus a
cell showing characteristics of more than one category would be
entered under each. Therefore the maximum score possible for
optimal WBC function would by 50 (ie. 25 in each of categories 1
and 2, and 0 in categories 3, 4 and 5). The final score was used
as an index of WBC status and comparisons were made between all
possible pairs of scores.

Statistical Analysis:
The number of fields examined to yield a count of 100 WBC's was
taken as an indication of the relative numbers of WBC's per
sample. Statistical analysis of the changes in the number of
fields between pretreatment with Astragalus and post treatment
samples taken at one and two weeks respectively, was performed
using a right-tailed Student's t-test for paired data at p s 0.05
level of significance. Similarly, the same test was used to
analyze the change in the proportion of individual types of
leucocytes, except that a two tailed test was used. Student's t-
test (right-tailed) was also used to analyze the difference
between the WBC index score obtained from the `Liv Cell'
analysis.

Results
All but one treatment subject showed a decrease in the number of
fields needed to locate 100 WBC's in the differential count,
indicative of a relative increase in the total number of WBC's
after treatment with Astragalus. The one subject who showed a
slight increase in the number of fields had the lowest number of
fields initially (100 as compared to the mean of 410 fields). The
mean difference in numbers of fields studied was 183.9 and the
difference was significant at p s 0.01. Furthermore, the change
was maintained in sample number 3 taken one week after
discontinuing the Astragalus (p s 0.05).

Each of the five types of leucocytes showed a significant change
in their proportions of the total count immediately after
treatment at p s 0.05 level of significance. The changes appeared
to be regulatory, such that relatively low proportions were
increased while high proportions were decreased.
In most cases, except for the basophils, the differential count
was brought more in line with the expected normal frequencies for
adults (ie. neutrophils, 50 - 70%; lymphocytes, 20 - 40%;
monocytes, 2 - 10%; eosinophils, 1 - 4%; basophils s 0.5%).

The "immune index" scores obtained using `Liv Cell' analysis did
not show an effect at the p s 0.05 level of significance.
However, the mean difference (4.71) was only 0.40 units below the
upper limit of acceptance for the null hypothesis (5.11).
Furthermore, a significant negative change in the immune index
score was shown by only one subject, and if this subject is
omitted from the statistical analysis of results, the mean change
in scores increases significantly at the p s 0.05 level.

It was not possible to statistically compare the treatment group
with the placebo group, as only one subject in the placebo group
completed the study.

Discussion
Radix Astragali has long been used in traditional Chinese
medicine as an important tonic herb. More recently, it has come
under scrutiny regarding its physiological actions as understood
in Western Medical theory. Among these is the herb's reputed
positive effect on the immune system. This study has attempted to
determine the effect of Astragalus decoction on certain
parameters of WBC activity.

Astragalus was seen to have a stimulatory effect on the relative
numbers of leucocytes at the p s 0.01 level of significance. The
relative proportions of individual categories of
leucocytes were also significantly affected by treatment with
Astragalus (p s 0.05), such that high proportions were lowered
and low proportions were raised. This effect applied to both the
variance between sample means and the variance within samples.
Specifically, four subjects had above normal baseline proportions
of monocytes &/or eosinophils, while three subjects had below
normal proportions. In each case, treatment with Astragalus
brought the proportions within normal ranges. Thus
Astragalus appears to have a regulatory or amphoteric effect on
individual classes of leucocytes in the WBC differential count.
Furthermore, these effects seem to be sustained over time as the
results obtained one week after discontinuing treatment indicate.
This finding corroborates observations made by Hou et al.


In addition to the WBC differential, a `Liv Cell' analysis was
used in an attempt to support findings. The Liv Cell technique
allows observation of living, unstained blood corpuscles and
their activity. However, criteria for standard assessment is not
well established for this method. An attempt was made to choose
and weight parameters visible by Liv Cell analysis which would
provide a measure of immune status. The parameters chosen yielded
results that were just below the p s 0.05 level of significance
and that lend support to the findings obtained using the WBC
differential, namely, that Astragalus appears to have an
enhancing effect on leucocyte function. The Liv Cell affords
valuable and unique information about the dynamic state of the
blood, but more work needs to be done in setting definite
criteria for both quantitative and qualitative analysis.

Although the sample size in this study was small, the results
would seem to warrant further investigation into the area of
enhancement of the immune system by Astragalus. Specifically, a
larger sample size with a placebo control group would be in
order. In addition to WBC differential count, a total WBC count
should be performed. It would also be interesting to screen
subjects to recruit those with both high and low baseline
differentials for specific categories of leucocytes to test the
hypothesized regulatory effect of Astragalus suggested by this
study. Furthermore, a longer treatment time with follow-up
samples taken over several months (see Hou et al) would provide
more information about the long term effects.

If Astragalus is consistently found to regulate leucocyte
activity, it may be a valuable adjunct in the treatment of both
immune deficient conditions and conditions of aberrant
leucocytosis, such as leukaemia.

References
Bensky, D., Gamble, A. (compiled & translated by). Chinese Herbal
Medicine Materia Medica. Eastland Press Inc., P.O. Box 12689,
Seattle, Washington 9811; 1986. p.3
Ibid. p.5, p.457
Ibid. pp. 457 - 9

Hou, Y., Ma, G., Wu, S., Li, Y., Li, H. "Effect of Radix
Astragali seu Hedysari on the Interferon System". Chinese Medical
Journal, 94(1): 35 - 40, 1981.

Sun, Y., Hersh, E.M., Talpaz, M., Lee, S-L., Wong, W., Loo, T.L.,

Mavligit, G.M. "Immune Restoration and/or Augmentation of Local
Graft Versus Host Reaction by Traditional Chinese Medicinal
Herbs". Cancer 52:70 - 73, 1983.

Teeguarden, R. Chinese Tonic Herbs. Japan Publications Inc., New
York 1984. pp. 98 - 101.


This Article is taken from The Herbalist, newsletter of the
Canadian Herbal Research Society. COPYRIGHT June 1988.

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