Over the years, several components at the heart of the complex makeup of Foshou San (FSS), a traditional Chinese formula, have been isolated and identified, and today they appear to be linked to a range of pharmacological activities. Among these is a potential efficacy in treating cognitive decline associated with Alzheimer’s disease (AD) and in gynecological conditions such as endometriosis (EM). This is what emerges from a Chinese review published in Drug Design, Development and Therapy.
The Potential of FSS
The potentially therapeutic effects appear to be linked to specific chemical constituents that make up the FSS formula and to particular pharmacological and pharmacokinetic properties.
In particular, the current study seems to suggest, through a comprehensive analysis of the regulation of apoptosis, oxidative stress and inflammation, ferroptosis, bile acids, and the gut microbiota, the feasibility and benefits of applying FSS in the treatment of AD and EM. These properties could depend on the action of FSS, also known as Guixiong Tang (GXT), which is capable of promoting blood circulation and removing blood stasis.
The formula consists of Angelica sinensis (AS) [Apiaceae; root of Angelica sinensis] and Ligusticum chuanxiong (CX) [Apiaceae; rhizome of Ligusticum chuanxiong] in a 2:1 ratio.
As a traditional Chinese medicine, FSS is already widely used in traditional medicine for gynecological and obstetric disorders such as fetal restlessness, postpartum lochia, abdominal pain, dysmenorrhea, but also other issues such as dizziness and muscle pains caused by blood deficiency and blood stasis, in regulating qi and blood.
Recent Evidence
The most recent studies seem to support potential efficacy also in EM management: in particular, AS, warm, sweet, and acrid, would nourish and activate the blood, regulate menstruation, and relieve pain; whereas CX, with a pungent and warm nature, would promote blood circulation, remove blood stasis, support the circulation of qi, and alleviate pain.
These properties would lead to considering FSS as a qi-within-the-blood medicine, encouraging the use of both drugs/constituents in approaches to enrich the blood and promote blood circulation within traditional Chinese medicine (TCM).
On the AD front, according to TCM theory, this is attributed to liver qi stagnation and blood stasis. At the base of the two conditions, depending on the context, there are various pathogenic factors: hormonal synthesis, inflammatory immune response, angiogenesis, invasion and metastasis, apoptosis, all deemed important. This leads TCM to hold that “blood is unfavorable when it generates water” and that the phenomenon is caused by blood stasis obstructing the circulation of qi and blood, thus suggesting that AD and EM share common symptoms such as “blood stasis” and “qi stagnation.” A common denominator allowing for treatment of both conditions with FSS. This underscores the multi-component, multi-target, and multi-therapeutic nature of TCM.
Approaches in AD
Emerging experimental studies appear to indicate that the combination of AS and CX in FSS may have synergistic effects in preventing and treating neurological disorders; in particular, administering an FSS decoction to rats would show improvements in neurobehavioral deficits, reduced severity of cerebral edema, and smaller infarct volumes in models of cerebral ischemia. Meanwhile, other studies show an effect of FSS in promoting blood circulation and removing blood stasis, with potential applications in treating AD as well as hemorrhagic aspects more typical of EM.
For example, studies validated through animal experiments and network pharmacology would also suggest that a new Chinese medicine formula, “Enhanced FSS,” derived from FSS, could contribute to treating hemorrhagic metastases by reducing angiogenesis, inhibiting invasion and metastasis, and modulating immunity.
Conclusion
The review seems to help clarify some therapeutic mechanisms of FSS through its modulation of critical biological processes, including regulation of cellular apoptosis, mitigation of oxidative stress, anti-inflammatory action, inhibition of iron deposition, optimization of bile acid metabolism, and modulation of the gut microbiota. These results would suggest that FSS may exert therapeutic effects through multi-target and multi-pathway interventions, with particular emphasis on disease progression via regulation of the gut microbiome, offering innovative perspectives for studying disorders of the gut–brain–uterine axis.
Source
Yu Y, Sun T, Zhang J et al. Homeopathy for heteropathy: FSS and its components for the treatment of Alzheimer’s Disease and endometriosis. Drug Design, Development and Therapy, 2025, 19 5009–5032
Abbonati a Karla Miller
