Artemisia annua is the dry above-ground part of Artemisia anaua L., an annual herbaceous plant of the Asteraceae family. It has a special aroma. This medicine was first recorded in the "Shen Nong's Materia Medica", which listed it as a low-grade product, saying that it "mainly treats scabies, scabs and itching, malignant sores, kills fleas, retains heat in the joints, and improves eyesight [1]". Artemisinin is a new generation of antimalarial drug containing sesquiterpene lactones extracted from Artemisia annua. Since its inception, it has been recognized worldwide for its high efficiency, rapid effect, and low toxicity of antimalarial activity, and has been widely used in on-site malaria treatment. treatment. According to the records of clinical use of Artemisia annua by doctors of past dynasties, with the continuous deepening of research on artemisinin and its derivatives, modern research has revealed that artemisinin also has anti-tumor, lupus erythematosus, other parasitic diseases, anti-endotoxin and treatment Skin diseases and other effects. This article explores the relationship between the ancient and modern traditional applications of Artemisia annua and the modern research direction of artemisinin.

1 Treatment of Malaria

Malaria is an ancient infectious disease that has seriously endangered human health since ancient times. Our country has relevant records as early as in the "Nei Jing". Starting from the use of Changshan, Sichuan lacquer, etc. to treat malaria, doctors of all generations have gradually realized the anti-malarial effect of Artemisia annua in clinical treatment practice. The earliest record of the use of Artemisia annua to treat malaria is Ge Hong's "Emergency Prescription" of the Eastern Jin Dynasty: "Take a handful of Artemisia annua, soak it in two liters of water, wring out the juice and drink it to treat malaria caused by cold and heat." Li Shizhen's "Compendium of Materia Medica" of the Ming Dynasty clearly stated that Artemisia annua can cure "malaria, cold and heat". "Qinghao Decoction" is listed in the Song Dynasty's "Shengji Zonglu", "Qinghao Decoction" is listed in the Yuan Dynasty's "Danxi Heart Method", and "Qinghao Powder" and "Qinghao Shenying Pills" are listed in the Ming Dynasty's "Puji Fang". " and so on, all use the compound recipe of Artemisia annua to treat malaria [2]. The treatment experience of doctors of past generations has provided rich clinical basis for modern artemisinin anti-malarial research, which directly led to the major invention of artemisinin anti-malarial in the 1970s. This is a major contribution of Chinese scientists to mankind.

Clinical studies have proven that artemisinin and its derivatives are particularly effective against cerebral malaria and chloroquine-resistant falciparum malaria, without obvious toxic or side effects. It can eliminate more than 95% of protozoa in 24 hours, and the cure rate of artemisinin derivatives using a 7-day course of treatment on site can reach more than 95%, and it has an inhibitory effect on P. falciparum gametocytes. A variety of derivatives and various dosage forms have been developed. Due to the spread of multi-drug-resistant malaria around the world, artemisinin drugs have irreplaceable advantages such as high efficiency, rapid effect and low toxicity that cannot be replaced by other antimalarial drugs. They have been widely used in malaria-endemic areas and have become the first-line drugs for antimalarial treatment. . However, due to the short half-life of artemisinin drugs, WHO and experts advocate the use of artemisinin in combination with other antimalarial drugs to delay the development of resistance.

2 Treatment of febrile diseases

Artemisia annua is a traditional heat-clearing medicine, and doctors of all ages have highly praised its antipyretic effect. For example, the "New Compilation of Materia Medica" says that it "relieves summer heat." "Yilin Compendium" says that it can "clear dampness and heat in the blood, and treat jaundice and stagnation of fire." "Illustrated Materia Medica": "Qinghao, cures The ancient prescription for bone steaming and hot flashes is more comprehensive. "Artemisia annua is used to treat night heat and early coolness in the late stage of febrile disease, fever with no sweating, or yin deficiency and fever." , such as bone steaming hot flashes, midday hot flashes, or persistent low-grade fever of unknown origin, combined with syndrome differentiation and medication, often have unexpected effects [3] "For example, it is used to treat Artemisia annua and turtles that are damaged by evil spirits and have Yin components left behind. Prescriptions such as Jia Decoction, Qinggu Powder for yin deficiency, fever, bone steaming and hot flashes, and Haoqin Qingdan Decoction for Shaoyang evil and liver meridian dampness and heat are common prescriptions using Artemisia annua as the main drug to treat various febrile diseases.

Modern medicine believes that in addition to infections caused by pathogens such as bacteria and viruses, malignant tumors, immune diseases and certain parasitic diseases such as schistosomiasis also account for a large proportion of febrile diseases. Fever is a common symptom of these diseases. The fever is generally not high but relapses. In addition to symptomatic and hormonal treatment, there is currently no better clinical treatment method. Some progress has been made in using Artemisia annua to treat various febrile diseases.

2.1 Cancer-related fever Cancer-related fever is a common symptom in patients with intermediate and advanced cancer. Traditional Chinese medicine believes that it is mostly due to long-term illness that consumes Qi and Yin, resulting in deficiency of both Qi and Yin, resulting in an imbalance of Yin and Yang in the body. Clinical treatment is mostly based on nourishing yin and clearing away heat. Qinghao Biejia Decoction, which uses artemisia annua as the main medicine, has the effect of nourishing yin and clearing heat. The artemisia annua nourishes yin, clears heat and penetrates meridians, which can lead evil out. Bian Ronghua used this prescription to treat 19 cases of cancerous fever based on syndrome differentiation. The total effective rate was 75%, and the effect was long-lasting and had no toxic or side effects [4]. Experiments by woerdenbag h.j and others have shown that artemisinin and its derivatives show strong cytotoxic activity against Ehrlich ascites cancer cells [5]. Yang Xiaoping's in vivo anti-tumor experiments using artemisinate sodium also proved that it has an in vitro killing effect on human hela human cervical cancer cells and human sune-1 and cne-1 [6]. Chen Zhengtu and others used artemisinin to mediate apoptosis in the liver cancer cell line hepg2. As a result, the destruction rate of hepg2 cells reached 51.67%, and the cell apoptosis rate was 19.19% [7]. The newly synthesized artemisinin derivative (c-10-carba trioxane dimmer3) by Posner gh and others has a strong inhibitory effect on the growth of human tumor cells without cytotoxicity [8]. Scholars believe that artemisinin and its derivatives have the potential to become simple, effective and economical anti-tumor drugs.

2.2 Fever caused by systemic lupus erythematosus Systemic lupus erythematosus is an immune disease, fever is one of its main symptoms, and its syndrome differentiation is mostly based on yin deficiency. Zhuang Guokang and others reported the use of Artemisia annua to treat discoid lupus erythematosus in the early 1980s [9]. As a result, many scholars have conducted extensive research on the relationship between artemisinin and immune function. Some scholars believe that it has an immunosuppressive effect, while others believe that it can enhance immune function [10]. Gao Chunfang and others believe that this may be closely related to the dosage. Small doses have an immune-enhancing effect, while large doses have an immunosuppressive effect. Experiments have shown that artesunate acts on systemic lupus erythematosus-like mice and can significantly inhibit Disease development [11]. Yu Qibin [12] and Zhong Jiaxi [13] respectively used artesunate to treat systemic lupus erythematosus, and both achieved certain results.

2.3 Anti-endotoxins Endotoxins are the main pyrogens that cause fever in the human body, mainly caused by endotoxemia caused by virus or bacterial invasion. "Chongqingtang Essays" says that "Qinghao specializes in relieving dampness and heat, and its aroma is fragrant, so it is an important medicine for damp-heat diseases." Can Qinghao, as a traditional medicine for treating various warm diseases, be explained by modern medical theories? It also attracted people's attention. Tan Yuqing [14], Liu Yunhai [15] and others have shown through relevant animal experiments that Artemisia annua can reduce the mortality of endotoxin mice, prolong the average survival time of mice, and also has a certain protective effect on the morphology of liver and lung tissue. Experiments by Wang Jucun [16] and others have shown that Artemisia annua has a significant inhibitory effect on the increase in serum NO concentration in endotoxemia mice, and has certain significance in preventing and treating multiple organ dysfunction syndrome and multiple organ failure caused by endotoxemia.

2.4 Treatment of schistosomiasis In the early 1980s, artemisinin was found to have anti-schistosomiasis effects [17]. Since then, Chinese scholars have conducted a large number of studies and confirmed that artemisinin and its various derivatives have anti-schistosomiasis effects, which mainly work by killing worms in the host. Compared with praziquantel, artemisinin drugs are reliable, stable, convenient and have fewer side effects [18]. In recent years, experiments in flood-fighting areas in various places have also confirmed the anti-schistosomiasis effect of artemisinin drugs. For example, Hu Shuiyin et al. [19] used artesunate to prevent schistosomiasis infection in people exposed to epidemic water. The results were 17,031 people. No acute schistosomiasis occurred in the whole group after treatment. It is believed that it is used to prevent and treat schistosomiasis and has the advantages of high efficiency, safety and convenience. Zhang Shaoji et al. [20] used artesunate and praziquantel to treat schistosomiasis patients in schistosomiasis endemic areas in Jiangxi, Anhui, and Hubei. The results showed that artesunate had mild side effects and significant therapeutic effects.

3 Treatment of skin diseases

"Shen Nong's Materia Medica" first recorded that Artemisia annua "maintains scabies, itching, scabs, malignant sores, and kills fleas." "Therapeutic Materia Medica" of the Tang Dynasty stated that "Artemisia annua... burnt ashes and juice, decoction with lime, can treat malignant sores and dimples." Modern experimental research shows that artemisia annua decoction has an effect on Staphylococcus epidermidis, catarrhalis, etc. Strong antibacterial effect. It has a certain inhibitory effect on Staphylococcus aureus, Pseudomonas aeruginosa, etc. Artemisia annua volatile oil has a bacteriostatic effect on all dermatophytes at a concentration of 0.25%, and has a bactericidal effect on all dermatophytes at a concentration of 1% [21]. Xu Hongwei et al. [22] clinically used Artemisia annua to treat tinea manuum and pedis, and the efficacy was satisfactory. They believed that it had good killing and inhibiting effects on a variety of pathogenic bacteria and had no toxic side effects. Jiang Haiyan [23] and Chen Hua [24] used artemisinin and its extracts to treat neurodermatitis, eczema-dermatitis and photosensitive skin diseases, and also received satisfactory results.

4 Outlook

With the development of science and technology, people’s understanding of traditional Chinese medicine is also deepening. The traditional Chinese medicine Artemisia annua has a history of more than 2,000 years as a traditional heat-clearing medicine. It has been used by doctors throughout the ages to treat various febrile diseases including malaria. Chinese medical scientists conducted research on the basis of previous theories and clinical experience and invented artemisinin, which is used to treat various types of malaria, especially cerebral malaria and severe malaria, and has been recognized by the world. At the same time, artemisinin has also been studied and achieved certain results in its anti-tumor, anti-lupus erythematosus, anti-endotoxin, treatment of other parasitic diseases and other fever-related diseases and pathologies. However, its specific mechanism for treating these diseases requires further research.

In addition, there are reports on the use of artemisinin and its derivatives in treating trauma, experimental silicosis, promoting hair growth and anti-arrhythmia. In the 2003 integrated traditional Chinese and Western medicine treatment plan for SARS, Qinghao, a commonly used traditional Chinese medicine in the treatment of SARS, played a certain role in improving the efficacy of SARS and reducing the mortality rate. These modern research and applications of artemisinin can be based on the historical records and clinical experience of traditional applications of artemisinin. Further exploration and research of the ancient and modern traditional applications of artemisinin will provide ideas for broadening research on artemisinin and artemisinin. It is of great significance, such as the research on other active ingredients of Artemisia annua and the expansion of the research scope of therapeutic application of artemisinin.