Chinese herbal recommendations for cataracts

Posted on April 14, 2010

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In the English-Chinese Encyclopedia of Practical Traditional Chinese Medicine (2), there is a chapter on diseases of the lens. Three basic formulations (well-known traditional prescriptions) are recommended for senile cataract on the basis of differential diagnosis of syndromes, as follows (the number of grams used for a daily dose of decoction is indicated in parentheses after the common names of the herbs):

Liver/Kidney Deficiency Spleen Qi Deficiency Yin Deficiency and Damp Heat
Qi Ju Dihuang Tang Yiqi Congming Tang Ganlu Yin
Rehmannia (24)
Cornus (12)
Dioscorea (12)
Alisma (9)
Hoelen (9)
Moutan (9)
Lycium (9)
Chrysanthemum (9)
Vitex (12)
Phellodendron (9)
Peony (9)
Astragalus (6)
Ginseng (6)
Baked Licorice (3)
Pueraria (3)
Eriobotrya (24)
Asparagus (12)
Ophiopogon (12)
Rehmannia (9)
Rehmannia, raw (9)
Dendrobium (9)
Scute (9)
Ching-hao (9)
Licorice (6)

According to the text: “Medication [referring to these herb therapies] may be effective in the incipient stage [of cataract]; when there is notable opacity of the lens, medication will not work, and so surgical treatment should be considered.” In the book Traditional Chinese Treatment for Senile Diseases (3), the etiology of cataracts is described as based in deficiency, leading to inadequate nourishment of the eyes. It is evident from the wording of the text that its contents are derived primarily from the same sources as that used for the above-mentioned Encyclopedia. The three formulas described above are listed (with slight variation on the dosage of individual ingredients), along with two other formulas for additional diagnostic categories:

Liver/Kidney Yin Deficiency Liver Deficiency and Spleen Damp
Buyin Bushen Tang Siwu Tang + Erchen Tang
Rehmannia (24)
Black sesame (12)
Cassia seed (12)
Morus fruit (12)
Lycium (12)
Tang-kuei (10)
Dioscorea (10)
Alisma (10)
Hoelen (10)
Moutan (10)
Schizandra (10)
Rehmannia (18)
Tang-kuei (10)
Peony (10)
Cnidium (10)
Citrus (10)
Pinellia (10)
Plantago (10)
Licorice (10)

Both texts also mention the use of eye drops, two items being listed are Phacolysin and Catalin. Catalin is a brand name for the drug pirenoxine sodium (see illustration and explanation below), which is probably the most widely-used eye drop for early stage cataracts, with more than 50 years of use and distribution in 40 countries. It is produced by 20 manufacturers in China; the brand Catalin is made in Japan. Phacolysin (also called Phacolin) is a complex anti-oxidant (see structure diagram left); it has been used both topically and internally as a therapy for eye disorders.

In Japan, Rehmannia Eight Formula (Bawei Dihuang Wan, also called Jingui Shenqi Wan) is recommended for treatment of several disorders of aging, including diabetes and cataracts. The modified version, Achyranthes, Plantago, and Rehmannia Formula (Rehmannia Eight Formula with achyranthes, niuxi, and plantago seed, cheqian, added, called Niu Che Shenqi Wan; in Japan, called Goshajinkigan) is especially used for complications of diabetes, such as diabetic neuropathy and cataracts. The formula appears to be effective for reducing corneal sensitivity in diabetes patients, indicating an influence on the eye (4).

A CASE OF SUCCESSFUL CATARACT TREATMENT IN A DIABETIC WOMAN

In an article from Japan, published in the American Journal of Chinese Medicine (5), three physicians report on a successful case of cataract treatment with a traditional herb formula. This involved a 68-year-old woman with diabetes having a cataract in one eye. The cataract had been present for more than four years at the time of treatment with the herb formula. She was given Achyranthes, Plantago, and Rehmannia Formula. She had been taking Catalin eye drops and Tathion eye drops (glutathione eye drops, another antioxidant strategy), with only slight effect, but when she began taking the herb formula, her vision began to rapidly improve within 10 days, and continued to improve over three months of therapy. The affected eye then remained in improved condition thereafter, with continued use of the herbs (dried extract granules, 7.5 grams per day).

ILLUSTRATIONS OF TOPICAL PREPARATIONS FOR CATARACT

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Sample of pirenoxine eyedrops (a modified phenoxazine carboxylic acid, see structure diagram, right) for cataract; this is labeled Catalin (in Japan); it is also sold as Clarvisan, Clarvisor, and under other names; a Chinese version is called Baineiting.

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N-acetylcarnosine, is an antioxidant provided as an eye drop; the pictured product is called Can-C; carnosine is also sold as Bright Eyes and NuEyes, and under other names. Carnosine is a dipeptide (alanine-histidine) researched mainly in Russia as a treatment for cataracts. In one study (6), it was claimed that after 6 months, 89% of all eyes treated with the drops had an improvement of glare sensitivity; 41% had improvement of the transmissivity of the lens, and 90% of the eyes showed improvement in visual acuity. The improvements were said to be retained during two years of follow-up with continued use of the eye drops. Carnosine may specifically inhibit glycosylation of the lens proteins.

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A Swiss product called Quinax (dihydroazapentacen or azapentacene polysulfonate) is used as a treatment for cataracts. According to one research report from Poland (7): “An observation of (on average) 5 years duration showed that systematic application of the drug prevents the development of early senile cataract and distiin nctly slows down the progress of the condition in the group of patients without the risk factors. Non systematic application of the compound also slows down the progress of the condition in the group of early cataract. The drug was ineffective patients with an advanced diabetic cataract.”

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