Background introduction
Angelica sinensis is also known as Chinese angelica. It belongs to the same plant family as parsley, celery, carrots, and poison hemlock. Angelica sinensis has been used for thousands of years in traditional Chinese, Korean, and Japanese medicine. It is one of the most popular plants in Chinese medicine. Angelica sinensis has been called “female ginseng” because it is commonly used for health conditions in women. The plant has been used for menstrual cramps, anemia associated with menstruation, pregnancy, premenstrual syndrome (PMS), pelvic pain, recovery from childbirth or illness, and fatigue or low energy. Angelica sinensis is used in both men and women for heart conditions, high blood pressure, inflammation, headache, infections, and nerve pain. It has been suggested that Angelica sinensis has weak estrogen-like effects. However, it remains unclear whether Angelica sinensis has the same effects as estrogens, blocks estrogen activity, or lacks significant hormonal effects. Angelica sinensis is often used in combination with other herbs for liver and spleen problems. It is thought to work best in people who have a calm, reserved profile, and is thought to be a mildly warming herb. Angelica sinensis is believed to help nourish the blood and balance energy. There is little human evidence to support the medical use of Angelica sinensis. Angelica sinensis has been studied for many conditions, including absent menstrual periods, arthritis, blood circulation, brain disorders, heart disease, immune problems, and sexual dysfunction. More high-quality research is needed to confirm the use of Angelica sinensis for any condition.

Chemical composition
The chemistry of Angelica sinensis is distinct from that of other species in the genus. While coumarins have been reported from this species, a recent comparative study of commercial Angelica sinensis products and related species found coumarins to be lacking, while the lactone Z -ligustilide was a major constituent. In this study, Angelica sinensis more closely resembled Levisticum officinale in chemical composition than other species of Angelica . Thus, there is justification for terming the latter plant European Angelica sinensis. Several other lactones related to ligustilide have been found in Angelica sinensis. Ferulic acid and its esters were also found in Angelica sinensis. A capillary electrophoresis method for measuring ferulic acid in Angelica sinensis has been published.
In contrast, the roots of A. dahurica were found to contain an abundance of coumarins. Imperatorin and isoimperatorin are the major constituents, with many other related compounds (eg, bergapten, phellopterin, scopoletin) reported. Ferulic acid was also detected in this species. The root of A. pubescens contains coumarins, but with some differences from A. dahurica. The simple prenylcoumarin, osthole, and the linear furocoumarins, columbianadin and columbianetin acetate, are the major constituents, while the coumarins, angelols A-H, are characteristic of the species. The common polyacetylene falcarindiol has been isolated from various species of Angelica. Polysaccharides have been isolated from different species of Angelica; however, they have not been characterized sufficiently to permit comparison. Simple plant sterols and lipids have also been found.

Indications in Traditional Chinese Medicine
1.Insufficiency of blood
It is an essential herb to tonify blood and indicated for all kinds of blood deficiency syndromes, especially for blood deficiency with blood stasis because it is skilled in tonifying blood. For sallow complexion, vertigo and palpitation caused by blood deficiency, it is combined with other blood-tonifying and symptoms-suiting herbs, for instance, it is used with Shu Di Huang, Chuan Xiong, and Bai Shao in the formula Si Wu Tang from Tai Ping Hui Min He Ji Ju Fang. For palpitation, insomnia, dream-disturbed sleep, amnesia, and other symptoms caused by insufficiency of heart due to blood deficiency, it is combined with other heart-nourishing and tranquilizing herbs, for instance, it is used with Suan Zao Ren and Bai Zi Ren in the formula Tian Wang Bu Xin Dan from She Sheng Mi Pou. For blood deficiency with qi deficiency, it is combined with other qi tonics, for instance, it is used with Huang Qi in the formula Dang Gui Bu Xue Tang from Nei Wai Shang Bian Huo Lun.

2.Pain syndromes due to blood deficiency, blood stasis and congealing cold
It is indicated for all kinds of pain syndromes caused by blood deficiency, blood stasis and congealing cold with blood stasis because it can tonify blood, activate blood, dispel cold and alleviate pain. The combinations are variously based on different pain causes, for abdomen pain due to blood deficiency with cold pathogen, it is combined with interior-warming ancl cold-dispelling herbs, for instance, it is used with Sheng Jiang, and Yang Rou in the formula Dang Gui Sheng Jiang Yang Rou Tang from Jin Kui Yao Lue. For pain arthralgia due to congealing cold and obstruction of blood vessels, it is combined with other cold-dispelling and blood-vessel-smoothing herbs, for instance, it is used with Gui Zhi and Chuan Mu Tong in the formula Dang Gui Si Ni Tang from Shang Han Lun. For hematoma, swelling and pain due to falling, hitting, and other injuries, it is combined with other blood-activating, pain-alleviating and injury-curing herbs, for instance, it is used with Ru Xiang, Su Mu and Tu Bie Chong in the formula Huo Xue Zhi Tong Tang from Shang Ke Da Cheng (Complete Book of Traumatology).

3.Irregular menstruation, amenorrhea and dysmenorrheal
It is an essential herb in gynecology and indicated for irregular menstruation, amenorrhea and dysmenorrhea because it can tonify blood, activate blood, regulate menstruation and alleviate pain. It is especial in these symptoms due to blood deficiency, blood stasis and cold congealment. For delayed menstruation, little quantity in pale color, it is combined with herbs, such as Shu Di Huang, and Bai Shao in the formula Si Wu Tang which is skilled in tonifying blood and regulating menstruation. For menstrual diseases due to blood deficiency, blood stasis and congealing cold, it is combined with other meridians-warming and cold-dispersing herbs, for instance, it is used with Wu Zhu Yu and Gui Zhi in the formula Wen Jing Tang from Jin Kui Yao Lue. For menstrual diseases due to liver depression, qi stagnation, blood stasis, it is combined with other liver-soothing ancl qi-regulating herbs, for instance, it is usecl with Chai Hu in the formula Xiao Yao San from Tai Ping Hui Min He Ji Ju Fang. Besides regulating menstruation, it is also indicated for all kinds of syndromes due to blood deficiency and blood .stasis Lefore or after delwery.

4.Ulcers and sores
It is indicated for ulcers, especially for ulcer without burst of pus or uncured ulcers due to blood deficiency, because it can promote blood circulation, remove swelling, alleviate pain, tonify blood, improve tissue generation, and it is warm in property but skilled in tonifying blood and healthy qi. It is combined with corresponding herbs in clinic. For ulcers and sores without burst of pus, it is combined with herbs of tonifying qi, expelling toxin and pus, and activating blood, for instance, it is used with Huang Qi, and Zao Jiao Ci in the formula Tou Nong San from Wai Ke Zheng Zong. For uncured ulcers and sores, it is combined with qi and blood tonics, for instance, it is used with Ren Shen, and Shu Di Huang in the formula Shi Quan Da Bu Tang from He Ji Ju Fang. For ulcers and sores due to excessive heat-toxin and manifested as red, swelling, hot, and pain, it should be applied in combinations. It is combined with herbs of clearing heat-toxin, removing swelling, and eliminating ulcer, for instance, it is used with Jin Yin Hua and Tian Hua Fen in the formula Xian Fang Huo Ming Yin from Jiao Zhu Fu Ren Liang Fang.

5.Constipation due to intestinal fluid consumption
It is indicated for constipation due to blood deficiency with intestinal dryness, because it can tonify blood and moisten dryness, nourish intestines to smooth stool. It is combined with blood-nourishing, dryness-moistening and stool-smoothing herbs, for instance, it is used with raw He Shou Wu and Huo Ma Ren. Besides, it is also indicated for cough and dyspnea because it can relieve dyspnea.

Benefits and Usage in Modern Researches
1.Invigorates and harmonizes the Blood
The root is also called dang gui and is valuable in anemia and menstrual pain, or as a general tonic after childbirth. It clears liver stagnation (of both energy and toxins) and can relieve constipation, especially in the elderly.
This herb tonifies the Blood and regulates the menses and it can be used for deficient blood patterns with such symptoms as a pale ashen face, tinnitus, blurred vision, and palpitations but also for Deficient Blood patterns with menstrual problems such as irregular menstruation, amenorrhea, dysmenorrhea, and other women’s conditions.

Angelica sinensis invigorates and harmonizes the blood, so Angelica sinensis is an important herb used to stop pain from congealed blood. Commonly used for abdominal pain, traumatic injuries, and carbuncles from congealed blood. Used also in the treatment of deficient blood with chronic wind damp painful obstruction. Drinking Angelica sinensis also moistens the intestines and moves stool so it is advised to use it for dry intestines from deficient blood.

Angelica Sinensis contains vitamins E, A and B12 and researchers have isolated at least six coumarin derivatives that exert antispasmodic and vasodilatory effects. Antispasmodics are a remedy for menstrual cramps. The essential oil in Angelica sinensis contains ligustilide, butylphthalide and numerous other minor components as ferulic acid and various polysaccharides, and all these elements can prevent spasms, reduce blood clotting and relax peripheral blood vessels. Research has shown that Angelica sinensis produces a balancing effect on estrogen activity.

Modern treatments prescribe the herb to combat PMS and to help women resume normal menstruation after using birth control pills for years.
The plant has also been used as a blood purifier, to promote blood circulation and nourish the blood in both sexes. It is high in iron content and may help to prevent iron deficiency and anemia. Studies show that Angelica sinensis can be helpful in regulating blood sugar and in lowering blood pressure.

Angelica Sinensis has a mild sedative effect which can relieve stress and calms the nerves. It has also be used to stimulate the uterus during childbirth, treat insomnia, alleviate constipation and for migraine headaches.

2. Dysmenorrhea
In vivo animal studies suggest that the basis for Angelica sinensis use in dysmenorrhea lies in its action of increasing excitability of the uterus; the rhythm of contraction changed from fast, weak, and irregular to slow, strong, and more regular. It has been postulated that the antispasmodic effects of Angelica sinensis are related to the volatile oil constituents ligustilide, butylidenephthalide, and butylphthalide, while the uterine-stimulating effect is due to the water-soluble components. Clinical trials are lacking.

3.Menstrual migraine
Among women with either menstrual migraine or simple migraine without aura, a combination preparation of soy isoflavones, black cohosh, and Angelica sinensis taken daily for 24 weeks decreased the frequency and severity of attacks. Angelica sinensis has not been investigated alone for its effect in this indication.

4.Menopausal vasomotor symptoms
Randomized, double-blind, placebo-controlled trials of Angelica sinensis as a single agent and in combination found no difference for Angelica sinensis over placebo for menopausal vasomotor symptoms. No effect on endometrial thickness or on the level of estradiol or estrone was found in a trial of Angelica sinensis alone. The study material was standardized for ferulic acid content. In addition, Chinese traditional medicine does not recommend the use of Angelica sinensis alone, but rather in combination with other plant extracts. The North American Menopause Society concludes that Angelica sinensis is no more effective than placebo and that data on estrogenic activity are inconclusive.

Despite evidence that Angelica sinensis does not bind to estrogen receptors, experiments have demonstrated the ability of Angelica sinensis extracts to stimulate breast cancer cells lines (MCF-7 and BT-20). Considering the lack of evidence for effect on menopausal vasomotor symptoms, Angelica sinensis should not be used by menopausal women with breast cancer.

5.Angiogenesis
In vitro and in vivo animal experiments suggest that Angelica sinensis possesses angiogenic activity. Experiments on human periodontal and bone tissue have been conducted. The clinical relevance of these findings has yet to be confirmed.

6.Antiallergy
An aqueous extract of Angelica sinensis inhibited IgE-antibody production in a mouse model of atopic allergy. The extract was active orally and the activity was retained on dialysis, indicating that it was caused by high molecular weight components of the extract. The simple lactone ligustilide is thought to be a major bioactive principle of Angelica sinensis. Its antiasthmatic action was studied in guinea pigs.
7.Anti-inflammatory effects
Chemical constituents from related species have demonstrated anti-inflammatory effects in vitro and in animal experiments. Histamine antagonism and analgesic properties have also been demonstrated.

8.Antioxidant
An in vitro study demonstrated a protective effect of Angelica sinensis on hydrogen peroxide-induced endothelial cell damage.

9.Antispasmodic
Ligustilide and the related butylidenephthalide and butylphthalide were found to have antispasmodic activity against rat uterine contractions and other smooth muscle systems. The compounds were characterized as nonspecific antispasmodics with a mechanism different from that of papaverine.

10.Cancer
In in vitro experiments, Angelica sinensis extracts have induced apoptosism activity against cervical and hepatocellular carcinoma and leukemia cell lines, and inhibitory actions against a number of tumors.

11.CNS
The furocoumarin phellopterin has been characterized as a competitive partial agonist of central benzodiazepine receptors by gamma-aminobutyic acid (GABA) and TBPS shift assays, and to bind with high affinity to benzodiazepine receptors in vitro; however, other closely related furocoumarins were weaker or inactive. The ligustilide and butylidenephthalide constituents of Japanese angelica root may exert central noradrenergic or GABA activity.

12.Renal
Nephrotic syndrome has been traditionally treated with A. senensis and Astragalus mongholicus by Chinese practitioners. Animal models demonstrated an efficacy with these plant extracts similar to that of enalapril in preventing renal fibrosis and limiting the deterioration of renal function.