Brief Introduction
Cistanche Tubulosa (Schenk) R. Wight is a plant that parasitizes the roots of Tamarix. Since it has no root or chloroplast, it cannot photosynthesize. Therefore, it grows by absorbing the nutrition out of plants it parasitizes. In China, Cistanche Tubulosa is known as a rare Panax ginseng found in deserts and used as a pharmaceutical agent to cure Alzheimer’s disease. In Japan, Cistanche Tubulosa has been categorized as a food after its food/pharmaceutical classification was revised by the Health, Labor and Welfare Ministry in 2005. It belongs to Cistanche, Orobanchaceae, same as the parasitic plant Cistanche salsa used in Chinese herbal medicine. According to the Chinese Comprehensive Pharmaceutical Dictionary, it supplements renal function, aphrodisiac, and smoothes the intestines. The dictionary stated that it treats impotence, infertility, menstrual disorder, and psychroalgia of the back and knees. Cistanche salsa has been widely used clinically as a prescribed drug for supplementing renal function and nutritional fortification in China. However, collecting the valuable crude drug Cistanche salsa has become difficult recently. Therefore, there is a growing awareness about Cistanche Tubulosa which belongs to the same family and has been reported to have similar effects and functions as Cistanche salsa.

Cistanche Tubulosa grows in the TaklaMakanDesert in Xinjiang Uygur Autonomous Region, China. It has a very strong vital energy to flower and fruit under severe desert conditions. Its host tamarix grows to 6 meters tall and has small, dark pink flowers. This plant is used to protect against wind and sand (prevents the spread of yellow sand) in desert regions. Cistanche Tubulosa is nowconsidered to be the key to greenification of deserts and prevention of global warming and the Chinese government recommends the plantation of Cistanche Tubulosa to stimulate local industries.

Chemical Analysis
The main effective ingredients of Cistanche Tubulosa extract are phenylethanoid glycosides, especially echinacoside and acteoside. Although echinacoside is known as the main component of the herb Echinacea, Cistanche Tubulosa contains a higher amount of echinacoside than any other plant. Acteoside (a type of polyphenols) has an extremely strong antioxidative property which is reported to be 15 times stronger than resveratrol (polyphenols contained in grapes) and 5 times stronger than vitamin C. In recent study, new compounds (kankanoside and others) have been isolated and vasorelaxing activity has been reported as a pharmacological action of the new compounds, echinacoside, and acteoside. Active constituents in extracts of Cistanche salsa and Cistanche Tubulosa that belong to the same family, were compared and it was clarified that Cistanche Tubulosa has more active constituents.

Indications of Cistanche Tubulosa in TCM(Traditional Chinese Medicine)
1.Deficiency of kidney yang, insufficiency of essence and blood
It is indicated for impotence, premature ejaculation, sterility due to cold in womb, soreness and pain of lumbar and knees and atrophy-flaccidity caused by kidney yang deficiency because it can tonify kidney yang, supplement essence and blood, and it is warm, moist and sweet without dryness in properties. It also can be used for dizziness and dizzy vision, tinnitus and deafness, early white of beard and hair which caused by kidney yang deficiency and insufficiency of blood and essence. For it is mild in actions wirhout quick effect, it is combined with other herbs to tonify kidney yang, supplement essence and blood, for instance, it is used with Du Zhong, Gui Zhi, Shu Di Huang and Zi He Che etc.

2.Constipation due to intestinal fluid consumption
It is very suitable for senile constipation due to blood deficiency and fluid consumption with intestinal dryness or kidney yin deficiency, because it can tonify kidney yang, supplement essence and blood, and moisten intestines to smooth stool. For dry stool and constipation due to yin deficiency, it is combined withSuo Yang in mutual reinforcement, such as in the formula Cong Rong Suo Yang Zhou, these two herbs are made with rice into gruel, from Chi Shui Xuan Zhu (Black Pearl in Red River). It is also combined with blood and yin-nourishing and stool-smoothing herbs, for instance, it is used in Dang Gui, and Zhi Qiao in the formula Ji Chuan Jian from Jing Yue Quan Shu.

Pharmacological Actions of Cistanche Tubulosa
1. Aphrodisiac effect
1). Effects of the constituents of Cistanchis herba on sex behavior in stressed mice (in vivo).
Phenylethanoid glycosides-rich fraction of Cistanche salsa extract and its bioactive components, echinacoside and acteoside have been reported to improve sexual ability(Sato T., et al., Pharmacological studies on Cistanchis Herba. I. Effects of the constituents of Cistanchis Herbaon sex and learning behavior in chronic stressed mice (1), Yakugaku Zasshi, 105(12), 1131-1144, 1985.). The effect of Cistanche salsa extract and its bioactive components, echinacoside and acteoside on stress-induced reduced libido was evaluated for 15 consecutive days. Ten female mice and one male mouse were placed together for ten minutes and the number of mice that experienced mounting or intromission, the number of such behavior, and also the time spent for mounting were measured. Groups and the number of days with significant difference observed were described below. In group of mice receiving Cistanche salsa extract, mounting and intromission observed on day-3 and day-5 respectively while the time spent for mounting and intromission observed on day-4. In group of mice receiving echinacoside and acteoside, sexually active mice were observed on day-4 and day-5 respectively while mounting and intromission observed on day-3 to day-6. Also, time spent for mounting and intromission was observed on day-4 to day-6 respectively. Results indicated that Cistanche salsa extract (phenylethanoid glycosides-rich fraction),  achinacoside and acteoside improved condition of stress-induced reduced libido in mice. Similarly, belonging to the same family as Cistanche sals, Cistanche Tubulosa with higher content ofbioactive components is believed to be aphrodisiac on stressed mice.

2). The Effect Cistanche Tubulosa Extract on testosterone production in Leydig cells.
Method: Leydig cells (R2C) derived from testicular cancer of rat were cultured in a 24-hole plate (2.5×10000 cells/500 uL) and incubated for 24 hours. After addition of test samples, the cells continue to be incubated for four hours, and the supernatant was separated to measure the level of testosterone. Leydig cell exists in the testis and produces testosterone. Using Leydig cell line (R2C), the effect of Cistanche Tubulosa Extract on testosterone production was evaluated. As shown in below figure, Cistanche Tubulosa Extract and its bioactive components, echinacoside and acteoside, increased the production of testosterone in Leydig cells.

2. Immune boosting effect
The effect of Cistanche Tubulosa extract on mouse lymphatic cells (in vivo).
Cistanche salsa extract (phenylethanoid glycosides-rich fraction) has been reported to enhance immune function(Xiaowen W., et al., Morphological changes of peripheral blood corpuscles of radiated mice feeded with Cistanche. ACTA Academiae Medicinae Xinjiang, 18(2), 83-86, 1995.). Cobalt 60 was radiated on mice to lower the immune function. Each test sample was orally administered to the mice for 15 days consecutively. At the end of the experiment, blood was collected from mice and specimen slides were prepared. The diameter of lymphocytes (cells that defend the host from attack from bacteria and viruses), was measured under microscope to evaluate the effect of Cistanche salsa extract. As shown in below figure, size of lymphocytes was significantly enlarged in group of mice receiving Cistanche salsa extract as result of antigen stimulation (cobalt 60) and it is suggestive that Cistanche Tubulosa Extract may exert similar effect as it belongs to the samefamily as Cistanche salsa while containing higher level of bioactive components.

In addition, Cistanche Tubulosa extract has been reported to activate lymphoid cells and increase the killing rate on cancer cells(Dawen S., et al., The effects of traditional Chinese medicine Cistanchespecies on the immune function and lipid peroxidation. Acta Academiae Medicinae Shanghai, 22(4), 306-308, 1995.). Therefore it is further convinced that Cistanche Tubulosa extract enhances immune function.