Clinical Trials
There have been numerous clinical studies researching the benefits of acupuncture and Chinese herbal medicine. Here are just a few of them. Select the trials you wish to read about.
Chinese herbal medicine in the treatment of 58 cases of acne
58 patients with acne (15 men, and 43 women with age ranging between 16 – 38, average age being 27) were all given a standard water decoction based on the Chinese herbal formula Qing fei yi rou tang, but adjusted according to the morphology of the lesions and the constitution of the patient.
Results: After a variable time of treatment ranging from 2-6 months the following results were recorded.
46 cases were classified as clinically cured (all papules, pustules, nodules and cysts cleared, with no reoccurrence). 10 cases were classified as improved (reduction in all lesions, but mild reoccurrence on stopping the herbs) 2 cases no change.
(Xinzhongyi. New Journal of Chinese medicine 2001.4 – 33-4 Author: Zhouxin zhong)
Treatment of severe atopic eczema with Chinese herbal medicine
A report in the British Journal of Dermatology (1) reveals that Traditional Chinese Herbal Medicine has been shown to be extremely effective in the treatment of severe cases of atopic eczema. A controlled study carried out at the Department of Dermatology, Great Ormond Street Hospital for Sick Children, U.K. proves what has been know for a long time by practitioners of Chinese medicine: Chinese herbal medicine has a major role to play in treating moderate and severe cases of atopic eczema (the most common form of eczema to afflict children and adults). The researchers acknowledged that severe and widespread atopic eczema often fails to respond adequately to conventional treatments and, after observing substantial benefit in patients receiving daily decoctions of traditional Chinese medicinal plants, they decided to undertake a placebo-controlled double-blind trial. A specific prescription of Chinese herbs was specially formulated for widespread non-exudative atopic eczema. Forty seven children were randomly selected to receive the Chinese herbal formula or a placebo (medicine that has no effect on the disease) for 8 weeks, with an intervening 4-week wash-out period. Thirty-seven children completed the treatment. The response to the treatment was significantly greater than the response to placebo, and was judged by the researchers to be clinically valuable. There was no evidence of haematological, renal or hepatic toxicity in any of the children who participated in the study and the researchers predicted that there would be considerable therapeutic potential for traditional Chinese medicinal plants, not only in the treatment of eczema, but also for other skin diseases. The same researchers were so impressed with the results of the 8 week study that they went on to do a longer term investigation, analysing the results of 37 children who were suffering from severe atopic eczema. This study conducted over a one year period found that 49% of the children experienced at least 90% reduction in the severity of their eczema. These studies demonstrated that Chinese medicine is a valid therapeutic option available in the treatment of childhood and adult eczema. But until earlier this year, researchers were still unsure how or why the treatment worked. Scientists at the Department of Immunology, UCL Medical School, London discovered that selected Chinese herbs have a significant effect on the production of white blood cells and thereby affect the immune system, reducing allergic responses and alleviating inflammation.
1.British Journal of Dermatology (1992) 126 179-184 2.The Lancet Vol 340: July, 1992.
A new study demonstrates the effectiveness and safety of herbs in eczema
It is reported in an article published in the August, 2007 issue of the British Journal of Dermatology, that doctors at the Chinese University of Hong Kong conducted a double blind placebo controlled trial to established whether Chinese medicine has a beneficial effect in treating atopic eczema. Between February 2004 and July 2005, 85 children suffering with moderate to severe forms of this common childhood eczema where recruited for the trial. 42 children were given a mixture of five traditional Chinese herbs, which have long been used to treat eczema. According to Chinese medicine these herbs, when combined in exact proportions have the effect of “clearing heat, draining dampness and resolving fire toxin” (a metaphorical but precise description for reducing inflammation, alleviating itching and controlling allergic response). The herbs where administered twice daily for 12 weeks. To ascertain their effectiveness, the remaining 43 children were given placebos (ingredients that have no medicinal effect, but are used as a control to establish if the active herbs do indeed make a difference) for the same duration of time. Despite the shortcomings of the trial (according to Chinese medicine typically a specific and varied group of herbs are prescribed individually to suit the characteristics of each patient, rather than one fixed formula that is used for all cases), by the end of the study, the conditions of the children who were given the herbs “significantly improved” and their use of corticosteroid creams and ointments was also “significantly reduced by one third”. “Adverse events, tolerability, haematological and biochemical parameters were monitored during the study, and no serious adverse effects were observed between the groups”.
Acupuncture and IVF treatment for infertility
Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. A recent meta-analysis reported in the prestigious British Medical Journal of 7 clinical trials involving 1366 women who underwent IVF treatment for infertility has found that acupuncture, administered within a day of embryo transfer, led to significantly increased rates of pregnancy and live births when compared to either sham (pretend) acupuncture or no acupuncture at all. Women who received acupuncture were around 65% more likely to become pregnant and 91% more likely to have a live birth. The authors of the study conclude: “Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilization”. This is a significant endorsement for the use of acupuncture as part of the standard care programme during IVF treatment.
www.bmj.com/cgi/content/full/bmj.39471.430451.BEv1
Acupuncture instead of drugs for migraine
Women who opt for acupuncture instead of a drug to prevent migraines report feeling fewer symptoms, fewer attacks, and less side effects from the treatment, new study findings report. The study, carried out at the Woman’s Headache Centre at the University of Turin, Italy, compared the effect of acupuncture with oral flunarizine in preventing non-aura migraine over a 6-month period. The 160 women enrolled in the study had experienced headaches at least twice a month in the year prior to the study and had had no previous experience of acupuncture. Acupuncture was given once a week for the first 2 months and then once a month for the next 4 months. The flunarizine group received the drug daily for the first 2 months and then for 20 days per month for the next 4 months. The frequency of headaches and the use of symptomatic drugs significantly decreased during treatment in both groups, however the number of attacks after 2 and 4 months of treatment was significantly lower in the acupuncture group, as was analgesic consumption after 2 months of treatment. At six months however, no such differences existed between the two treatment groups. Pain intensity was significantly reduced only by acupuncture treatment and side effects were significantly less frequent in the acupuncture group – overall, women taking flunarizine were more likely than those receiving acupuncture to drop out of the study, for reasons that included depression, weight gain and sleepiness. (Headache 2002, Vol. 42(9) p.855-861).
Acupuncture and Urinary Tract Infections
Researchers from the University of Bergen in Norway have investigated the benefits of acupuncture in a group of 94 women, all of whom had experienced at least 3 urinary tract infections during the previous 12 months. Sixty-seven of the women received acupuncture 2 times per week for 4 weeks. 73% of the women who received acupuncture remained infection-free during the 6 months after treatment, relative to only 52% of those who did not receive acupuncture. They also measured the amount of residual urine left in bladders after urination, which is thought to be a risk factor in recurrent urinary problems, and found this was halved in those receiving acupuncture. (American Journal of Public Health 2002;92:1609-1611).
Acupuncture and the Overactive Bladder
Eleven patients (9 males and 2 females) with overactive bladders were treated by acupuncture. The age range was from 51 to 82 years (mean 71 years). Nine patients complained of urge incontinence and 2 patients of urgency. Uninhibited contraction was observed in all patients before the acupuncture. Acupuncture was given at bilateral Zhongliao BL-33 and the needles rotated for 10 minutes manually. After an average of 7 treatments, urge incontinence was controlled completely in 5 and partially in 2 of the 9 patients. In 2 patients who complained of urgency, complete response was obtained after the
treatment. Uninhibited contraction disappeared in 6 patients after the treatment. Acupuncture also significantly induced an increase of maximum bladder capacity and bladder compliance. (Japanese Journal of Urology. 1995; 86(10):1514-9).
Research into Chinese herbal medicine and ovarian dysfunction
(1) The effectiveness of a Chinese formula called ‘Tian gui fang’ in comparison with metformin was tested on patients with polycystic ovarian syndrome [PCOS]. The patients were divided into two groups and either Tian gui fang or metformin was administered for three months. After treatment, 4 out of the 8 patients on metformin had restoration of menstrual cyclicity, and two of them had a double phase BBT. The testosterone levels had decreased. No other measures changed. In the group that received the Chinese medicine, 6 patients out of 8 had a restored cycle as well as a double phase BBT. Testosterone and the body mass index (BMI) decreased significantly. The authors conclude that both therapies can induce ovulation but that Chinese herbal medicine has a higher efficacy in restoring ovulation and normal BBT measures.
Hou J, Yu J, Wei M. ‘[Study on treatment of hyperandrogenism and hyperinsulinism in polycystic ovary syndrome with chinese herbal formula ‘tian gui fang]’. Zhongguo Zhong Xi Jie he Za Zhi. 2000; 20 (8):589.
(2) The effectiveness of a Chinese herbal formulary was tested on patients with high LH levels due to polycystic ovary syndrome. Eight weeks of treatment with Chinese herbal medicine significantly reduced plasma LH.
Ushiroyama T, Ikeda A, Sakai M, Hosotani T, Suzuki Y, Tsubokura S, Ueki M. ‘Effects of unkei-to, an herbal medicine, on endocrine function and ovulation in women with high basal levels of luteinizing hormone secretion.’ J Reprod Med. 2001 May; 46(5):451-6.
(3) In Japan, a Chinese herbal formulary was tested on patients with polycystic ovarian disease [PCOD] to find an effective treatment without side effects that could be used instead of clomiphene citrate or gonadotropin therapy. After a course of treatment, the FSH/ LH ratio had significantly decreased, and the ovulatory rate was 70.6%. Serum testosterone did not change during treatment. The authors conclude that the Chinese formula may be useful for the treatment of anovulation in PCOS patients.
Sakai A, Kondo Z, Kamei K, Izumi S, Sumi K. ‘Induction of ovulation by Sairei-to for polycystic ovary syndrome patients.’ Endocr J. 1999 Feb; 46(1):217-20.
(4) A case study from Taiwan discusses the effective treatment of premature ovarian failure using Chinese herbal medicine. Clomiphene citrate therapy over 8 months had not changed the FSH and LH levels from the post menopausal range. A course of 4 months treatment with Chinese herbal medicine based on Zuo gui wan induced an ovulation, and the patient fell pregnant. The authors conclude that Chinese herbal medicine can restore ovarian function effectively and promptly and offers another option for treating infertility in patients with premature ovarian failure.
Chao SL, Huang LW, Yen HR. ‘Pregnancy in premature ovarianfailure after therapy using Chinese herbal medicine. A case study.’Chang Gung Medical Journal 2003 Jun; 26(6): 449-52.
(5) At Shanghai medical university, the effectiveness of Chinese medical herbs from the category of yin supplementing weretested on 35 patients with polycystic anovulation. The patients were treated for three months, and a variety of tests were carried out before and after the course of treatment. Testosterone levels lowered significantly. In 59.7% of patients and a regular cycle was restablished. 41.2% of women became pregnant. The authors conclude that Kidney Yin nourishing herbs could provide a good microcircumstance for ovarian follicular growth, which results in ovulation and pregnancy.
Zhou LR, Yu J. [Clinical observation on treatment of hyperinsulinemia and hyperandrogenism anovulatory patient with replenishing kidney-yin drugs] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1996Sep; 16(9): 515-8.
(6) Hachimijiogan, a Chinese herbal formulary (Liu wei dihuang wan + rou gui, yin yang huo, huang qi), was shown in one study to benefit female infertility due to pituitary dysfunction. Two infertile women (one with and one without a pituitary adenoma) who were resistant to medical treatment, were given Hachimijiogan which subsequently reduced the serum prolactin level, and resulted in a normal ovulatory cycle and pregnancy, without side effects.
Usuki S; Kubota S; Usuki Y. Treatment with hachimijiogan, anon-ergot Chinese herbal medicine, in two hyperprolactinemic infertilewomen’. Acta Obstet Gynecol Scand 1989, 68 (5) p475-8.
(7) In another study looking at pituitary dysfunction causinginfertility, 27 women were given the same formulae as discussed above.6 of the women had amenorrhea. In 15 patients, the prolactin levelsdropped to a healthy range, and remained low 6 months after the courseof treatment. Four patients with amenorrhea ovulated. Eleven patientsconceived and delivered a healthy baby. In three women, the prolactinlevel did not lower. The authors conclude that a modification of Liuwei di huang wan can be a safe and effective treatment for hyperprolactinemic women.
Usuki S, Usuki Y. ‘Hachimijiogan treatment is effective in themanagement of infertile women with hyperprolactaemia orbromocriptine-resistant hyperprolactaemia.’ American Journal of Chinese Medicine 1989; 17 (3-4):225-41.
Research into endometriosis and Chinese herbal medicine
(1) A study from Beijing compared three treatment methods to find the most effective treatment for endometrial ovarian cysts. 152 patients with endometrial ovarian cysts were divided into three groups: an integrated laparoscopy and Chinese herbal medicine (combination group), a Chinese herbal medicine group, and a Danazol group. The clinical efficacy, side-effects and reproductive hormones were compared. The shrinking rate and disappearance rate of the cysts were highest in the combination group as was the pregnancy rate. Few side effects were noticed in the combination and Chinese herbal medicine group. The authors conclude that combining laparoscopy with Chinese herbal medicine is an effective treatment for endometrial ovarian cysts with minimal side effects and a maximal preservation of the reproductive function.
Wu Y, Hua L, Jin Y [Clinical study on endometrial ovarian cyst treated by integrated laparoscopy and Chinese herbal medicine] Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000 Mar; 20 (3):183-6.
(2) A study was carried out in Shanghai to explore the mechanism of treating endometriosis by tonifying Kidney and removing blood stasis with Neiyixiao Recipe (NYXR). METHODS: One hundred and three patients with endometriosis were divided randomly into the NYXR group (58 cases, treated with NYXR) and the control group (45 cases, treated with danazol) and were reviewed for the improvement of clinical symptoms, serum level of FSH, LH, PRL, E2, P and T, humoral and cellular immunity (C3, C4, CD3, CD4, CD8), and plasma prostaglandin after treatment. RESULTS: There was no significant difference in effect between the NYXR group and the control group in relief of dysmenorrhea and degradation of elevated plasma prostaglandin (chi 2 = 0.71, P > 0.05). But there was significant difference between the two groups in curing infertility (chi 2 = 14.77, P < 0.01), and the effect of NYXR in regulating endocrine and immunity was significantly better than that of danazol. The authors conclude that by tonifying Kidney and removing blood stasis, Chinese herbal medicine is an effective method for the treatment of endometriosis, simultaneously maintaining and improving fertility.
Liu J, Li X, Hu X. [Clinical observations on treatment of endometriosis by tonifying kidney and removing blood stasis] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1998 Mar;18 (3):145-7.
(3) A study in Shanghai tested the therapeutic mechanism of endometriosis by the treatment of Yiqi Huoxue Huayu Tongfu Principle (YQHXHYTFP, tonifying Qi and promoting blood circulation to remove stasis and purgation therapy) with Neiyi 1+ pill. METHODS: Forty-five cases with endometriosis were divided randomly into TCM group (30 cases, treated with Neiyi 1+ pill) and the control group (15 cases, treated with tamoxifen). The activity of natural killer cell of peripheral blood, T lymphocyte subsets, secreting interleukin-II and the EmAb were determined. RESULTS: Endometriosis is associated with immunologic disturbance. After treatment, the activity of NK cells and the count of T-suppressor cells were significantly increased (P < 0.01), the count of T-helper cells, the secretion of interleukin-II and TH/TS ratio were significantly reduced (P < 0.01). Over 50% of the cases whose EmAb was positive eventually turned to negative. The effective rate of this therapy was 90%. There was no significant difference between TCM group and the control group. CONCLUSION: Chinese herbal medicine could modulate the immunologic disturbance in women with endometriosis, and could clearly improve clinical symptoms and signs.
Li J, Zheng J, Wang D. [Clinical observation on treatment of endometriosis by tonifying qi and promoting blood circulation to remove stasis and purgation principle] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Sep; 19 (9):533-5.
(4) A study in Kunmin aimed to find a medicine that treats endometriosis effectively with less side-effects. METHODS: A Chinese herbal prescription [Dan’e mixture] (DEM, consists of Radix Salviae Miltiorrhizae and Rhizoma Zedoariae) was used to treat 189 cases of endometriosis and the change of symptom and sign, the B ultrasonograph, the anti-endometrium antibody and endometriosis quantitative diagnostic index were observed. Another 160 cases were treated with Danazol as control. RESULTS: One hundred and eighty-nine cases were treated for 9 months. According to National Standards, 39 cases (20.6%) were cured, 67 cases (35.4%) were markedly effective, 67 cases (35.4%) were effective, and 16 cases (8.4%) were ineffective. Compared with 160 cases treated with Danazol for 9 months, the total effective rates were 95% and 91.5% respectively, the difference between them was insignificant. Animal experiments showed similar results to the clinical ones. CONCLUSION: The authors conclude that the Chinese herbal prescription is as effective as Danazol for the treatment of endometriosis, without observed side effects. It is particularly helpful for diagnosis, treatment and prevention of endometriosis in the early stage.
Cai L, Shu Y, Xie H. [Clinical and experimental study on the treatment of endometriosis with dan’e mixture] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Mar;19 (3):159-61.Research into Acupuncture and abnormality of sperm.
(1) Idiopathic infertility A study carried out in Brazil observed the effect of acupuncture and moxibustion on sperm abnormalities. 19 patients with idiopathic infertility were divided into a study and into a control group. The study group was treated twice a week for 10 weeks (25 min acupuncture, 20 min moxa). Sperm analysis was carried out before and after the treatment course. The patients in the study group showed a significant increase in the percentage of normal-form sperm. The authors conclude that acupuncture and moxa treatments seem to favourably modify normal-form sperm counting.’
Gurfinkel E, Cedenho AP, Yamamura Y, Srougi M.Effects of acupuncture and moxa treatment in patients with semen abnormalities. Asian J Androl. 2003 Dec; 5(4):345-8.
(2) Low sperm count (Oligospermia) A study carried out in Tel Aviv observed the effect of acupuncture on males with very low sperm count. 15 of the males were azoospermic patients, two were pseudoazoospermic and three had severe oligoteratoasthenozoospermia (OTA). After a course of acupuncture, the OTA had only a slight increase in sperm count. 67% of azoospermic patients showed a definite increase in sperm count, seven of them significantly. Males with genital tract inflammation exhibited the most remarkable improvement in sperm density. Two pregnancies were achieved in conjunction with IVF-ICSI. The authors conclude that acupuncture might be a useful treatment for males with very poor sperm count, especially those with a history of genital tract inflammation.
Siterman S, Eltes F, Wolfson V, Lederman H, Bartoov B. Does acupuncture treatment affect sperm density in males with very low sperm count? A pilot study. Andrologia. 2000 Jan; 32(1):31-9.
(3) Spem motility In a study from Israel, 16 patients with subfertility related to sperm impairment were treated with acupuncture twice a week for 5 weeks and compared to a control group. The sperm motility and intactness of the axonema were greatly increased in the study group.
Siterman S, Eltes F, Wolfson V, Zabludovsky N, Bartoov B.Effect of acupuncture on sperm parameters of males suffering from subfertility related to low sperm quality. Arch Androl. 1997 Sep-Oct; 39(2):155-61.
(4) Spem morphology A study in treating subfertility by acupuncture was carried out in Germany on 28 men. Each patient received a total of 10 treatments for a period of three weeks. The spermiograms and hormone levels were checked before and after acupuncture. Total count, concentration and motility were evaluated and in all cases the researchers observed a statistically significant improvement of sperm quality. The authors conclude that acupuncture therapy at the time of ovulation might increase the chances of a pregnancy.
Fischl F, Riegler R, Bieglmayer C, Nasr F, Neumark J. [Modification of semen quality by acupuncture in subfertile males] Geburtshilfe Frauenheilkd. 1984 Aug;44 (8):510-2.
(5) A Chinese study was carried out on 54 males with impaired fertility. 1-3 months of acupuncture therapy was given, and sperm analysis carried out before and after treatment. 55.5% of patients impregnated their partners in that period of time, and 24% showed a significant improvement in sperm parameters. 20% of patients, previously diagnosed with azoospermia and immune disturbance, did not improve. The best improvement was seen in patients with abnormal sperm.
Qian, Z [Clinical observation of 54 cases of male infertility treated by acupuncture and moxibustion] Journal of Chinese Medicine, 1996 Sep; 52.
(6) A Chinese study was carried out on 248 males who suffered from sperm abnormities, absence of ejaculation and impotence. Treatment of acupuncture was given every other day. 20 treatments comprised one course. 2 courses were given (approx 2 months). About half of the patients with abnormal sperm achieved good sperm count and motility. (20-60mill/ml with 20-60% motility and less than 20% deformity). 52 % of patients with abnormal sperm failed to respond, a large percentage of those (40%) who were diagnosed with azoospermia, failed to respond at all.
Zhang J [The Acupuncture treatment of 248 cases of male infertility], Chinese Acupuncture and Moxibustion, Vol 7, 1987.
Chinese herbal medicine better than drugs for dysmenorrhoea (painful periods)
The evidence supporting the use of Chinese herbal medicine (CHM) for primary dysmenorrhoea is promising, but better quality research on the subject is still required. These are the conclusions of a systematic review by Australian researchers, which included 39 RCTs involving a total of 3475 women. CHM was found to result in significant improvements in pain relief, overall symptoms and use of additional medication when compared with use of pharmaceutical drugs. CHM also resulted in better pain relief than either acupuncture or heat compression in the studies analysed. There were no indications that CHM caused any adverse events. (Chinese herbal medicine for primary dysmenorrhoea. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD005288).
Research into Recurrent Miscarriage & Chinese Herbal Medicine
(1) The effect of Chinese herbal medicine in threatened miscarriage was observed in a study at Shanghai Gynaecology & Obstetrics Department of Shanghai Medical University. In 40 women with threatened abortion and a history of miscarriage, blood test showed threatened abortion (TA), compared to the blood test of normal pregnant women (The plasma beta-EP level in TA was significantly higher than that in normal pregnant women, P < 0.01. On the contrary, plasma GnRH, HCG and P4 were obviously lower in TA as compared with those of the normal cases, P < 0.01.) After treatment with Chinese herbal medicine that supported reproduction and blood circulation and protected the foetus, 36 of the 40 patients continued their pregnancy without symptoms of TA, and the above-mentioned four criteria measured at 10-12th week of gestation were similar to those of normal cases, P > 0.05. The authors concluded that Chinese herbal Medicine can regulate plasma beta-EP and placental endocrine function in threatened abortion in women with a history of recurrent miscarriage.
Sun F, Yu J. [Effect of TCM on plasma beta-endorphin and placental endocrine in threatened abortion] Zhongguo Zhong Xi Yi Jie He Za Zhi. 1999 Feb; 19 (2):87-9.
(2) A study in Japan showed that recurrent miscarriages with an immunological component (rejection of the foetus as foreign) benefit positively to the treatment with Chinese herbal medicine. Twelve patients with recurrent abortion who had shown positive anti-phospholipid antibodies were treated through the administration of a Japanese modified traditional Chinese herbal medicine Sairei-To (Cai ling Tang). The patients had experienced a total of 27 spontaneous abortions in their previous pregnancies and had no other pregnancy history except for one patient. The patients were treated with 9.0 g of Sairei-To per day before their next pregnancy. The positive value of antiphospholipid antibodies returned to negative in 9 patients out of 12 patients through the treatment. Out of 12 patients, 10 patients continued their new pregnancy uneventfully, and they delivered an offspring (Success rate: 83.3%). Thus, the current treatment was considered to be an effective therapy for patients with recurrent abortion whose miscarriage is immune related (positive anti-phospholipid antibodies).
Takakuwa K, Yasuda M, Hataya I, Sekizuka N, Tamura M, Arakawa M, Higashino M, Hasegawa I, Tanaka K. Treatment for patients with recurrent abortion with positive antiphospholipid antibodies using a traditional Chinese herbal medicine. J Med. 1996; 24(5):489-94.
Chinese herbs & Irritable Bowel Syndrome (IBS)
A team of researchers led by Alan Bensoussan of the University of Western Sydney Macarthur in Australia has confirmed that Chinese herbal medicine can ease the symptoms of patients with irritable bowel syndrome. It is estimated that about 10% to 20% of adults suffer from irritable bowel syndrome. The Australian research placed 116 patients with irritable bowel syndrome on one of three treatment regimens: i. individually tailored Chinese herbal therapy; ii. a standard Chinese herbal formulation; or iii. a placebo. Patients were not informed as to which of the three formulations they were receiving. The authors report that after four months of treatment, standard or individualised herbal therapies were associated with “significant improvement in bowel symptom scores”. 76% of patients on standard herbal therapy and 64% of those on individualised therapy reported symptom improvement, compared with just 33% of patients in the placebo group. The researchers found little difference in initial improvement rates between those patients receiving either individualised or standard Chinese herbal therapies. But Bensoussan and colleagues suggest that individual therapies may work better over the long-term. At 14 weeks after the end of treatment “patients in the individualised treatment group … maintained more substantial improvement” than patients in the other two groups, they report. (The Journal of the American Medical Association 1998;280:1585-1589. 2)
Psoriasis and Chinese herbal medicine
A clinical trial at the famous Beijing Guan Anmen hospital, Department of Dermatology by professor Zhu Renkang enrolled 108 patients with widespread plaque psoriasis to investigate the efficacy of Chinese herbal medicine in treating this stubborn disease. The patient group were assigned to one of two groups – either “Hot blood type”, or “Dry blood type” of psoriasis (in accordance to principles of Chinese medicine where the morphology of the lesions and other symptoms and signs, including the appearance of the tongue, is taken into account). The administration of Chinese herbs continued for up to 24 weeks (average was 18 weeks). The following results were recorded:
“Hot blood” group (54 patients)
72.2% had total clearing of skin; 11.1% had significant improvement (over 80% improvement); 11.1% had some improvement (between 30-80% improvement); 3% had no change.
“Dry blood” group (54 patients)
59.2% had total clearing of skin; 16.7% had significant improvement (over 80% improvement); 18.5% had some improvement (between 30-80% improvement); 6% had no change.
The patients from both groups who had total clearing were followed up for 12-32 months and assessed for the condition of their skin. 63.6% remained stable, 5% had mild relapse, whilst 25% had total relapse. (Reported in the Zhongyi Zazhi (The Journal of Traditional Chinese medicine) 1981. 4. P22-24 Author Zhuren Kang).
Chinese Herbs Effective for Allergic Rhinitis
An Australian study has demonstrated the benefits of a Chinese herbal preparation (Biminne) in the treatment of allergic rhinitis (AR) Hay fever. In a randomised, double-blind, placebo-controlled clinical trial, 58 patients received 5 capsules of either Biminne or placebo, twice a day for 12 weeks. Outcomes were assessed by changes in symptom diaries, quality of life scores, patients’ evaluations of improvement on visual analog scores, physicians’ overall evaluation, and total serum immunoglobulin E levels. A statistically significant improvement was found in the symptoms of AR, whereas others exhibited a positive trend that did not reach statistical significance. Total serum immunoglobulin E was reduced after the herbal treatment. A follow-up one year after completion of the trial suggested that benefit of the treatment persisted. (Annals Allergy Asthma Immunol 2002 May;88(5):478-87).
Chinese Medicine and Hayfever
In a randomised blinded trial, 52 patients suffering from seasonal allergic rhinitis (hay fever) were assigned to an active treatment group or a control group. The active group received a semi-standardised acupuncture treatment, once a week, and an appropriate Chinese herbal formula, taken as a decoction three times daily for six weeks. The control group received acupuncture applied to non-points and a “non-specific herbal formula”. 85% of patients in the active group experienced improvement in the Global Assessment of Change scale compared to 40% of the control group. (Allergy. 2004 Sep;59(9):953-60).
Chinese Herbs and the Treatment of Allergic Asthma
An oral combination of Chinese herbs could be as effective as conventional medicines at alleviating asthma symptoms but without such severe side effects, report American and Chinese researchers. The researchers, from the world famous Mount Sinai School of Medicine in New York along with Weifang Asthma Hospital and Weifang School of Medicine in China, sought to investigate alternatives to corticosteroids, the “cornerstone” of Western asthma treatment. Since corticosteroids can cause side effects, such as greater susceptibility to infections due to immune suppression and reduced growth velocity, they said that there is a need for additional effective treatments with fewer side effects. In China, traditional medicine is part of mainstream practice, and has been used for centuries for treating a wide range of disease, however relatively little clinical research has been carried out into traditional Chinese medicine for asthma, say the researchers. For the double-blind placebo-controlled study published in the September issue of the Journal of Allergy and Clinical Immunology (vol. 116, issue 3), they investigated the effects of a combination of Chinese herbal extracts (dubbed ASHMI – antiasthma herbal medicine intervention). The trial involved 91 subjects with moderate to severe persistent asthma. They were admitted to hospital for the four-week duration. Forty-six patients were randomly assigned to receive ASHMI as well as placebo tablets similar in appearance to prednisone, an oral administration of the hormone cortisone. The 46 patients in the placebo group received 20mg of prednisone per day, plus placebo resembling ASHMI.
The researchers measured participants’ lung function, side effects and serum cortisol, cytokine and igE levels before and after treatment. The effects of prednisone and ASHMI on lung function were “slightly but significantly greater” with prednisone. However unlike prednisone, ASHMI was seen to have no adverse effects on adrenal function, and had a beneficial effect on TH1 and TH2 cytokine levels.
In addition, fewer patients receiving ASHMI experienced gastric discomfort compared to those receiving prednisone, and the prednisone patients showed significant weight gain after four weeks of treatment. “Taken together, the findings of this study show that ASHMI is effective and well-tolerated in nonsteroid-dependent patients with moderate-severe persistent asthma,” wrote the researchers. They said that the mechanisms underlying its “remarkable” effects are largely unknown but that they are likely to be the result of synergistic or additive effects of the complex nature of its constituents.
Cancer and Chinese herbal medicine
Wang B, Liu X, Wu Z. [Effect of qi replenishing and blood circulation activating drugs in treatment of middle-advanced pancreatic cancer with radio- and chemotherapy] [Article in Chinese] Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000;20(10):736-8.
OBJECTIVE: To study the effect of Qi replenishing and blood circulation activating drugs (QRBCAD) in treatment of middle-advanced pancreatic cancer with radio- and chemotherapy. METHODS: Patients were divided randomly into two groups, 28 patients treated with radiotherapy and intervention treatment as Group A and 30 patients treated with the same therapy but with additional QRBCAD medication as the Group B, and the effects in the two groups were compared. RESULTS: The short-term effective rate in Group A and B was 53.6% and 67.6% respectively (P < 0.05). The remission rates of jaundice and abdominal pain in Group A were 57.1% and 50.0% respectively, while in Group B, 83.3% and 76.7% respectively, there was significant difference between the two groups, P < 0.05. The gastroenteric reaction occurred in Group B was significantly lesser than that in Group A, P < 0.05. The 1- and 2-year survival rate in Group A were 50% and 21.4%, and in Group B, 80.0% and 46.6% respectively, significant difference (P < 0.05) showed in comparison of the two groups. CONCLUSION: QRBCAD could alleviate the gastroenteric reaction caused by radio- and chemotherapy, raise the clinical symptomatic effective rate of treatment, and prolong the 1- and 2-year survival rate of patients.
Anti-cancer medicine
A study by European researchers has discovered why a Chinese herbal prescription can inhibit some forms of cancer. The study has shown how indirubin, an active ingredient in the traditional prescription Danggui Longhui Wan, works to halt enzymes that promote cell growth. A type of enzyme or protein known as cyclin-dependent kinases (CDK) triggers
cell divisions, and indirubin inhibits CDK. Clinical trials on indirubin in mainland China have found that 26 per cent of 314 chronic myelocytic leukaemia patients showed complete remission and 33 per cent partial remission. Toxicity {of indirubin} was low and side effects were limited to mild abdominal pain, diarrhoea, nausea and vomiting.Studies are ongoing to further investigate the molecular basis of the efficacies of traditional Chinese medicines as well as their use as potential therapeutic agents in the treatment of cancer. (Nature Cell Biology, May 1999).
Chinese anti-cancer herb
(1) Ban Zhi Lian (Herba Scutellariae Barbatae): has been used in recent years in China in the treatment of cancer. Now researchers at Salford University in the UK have found in laboratory trials that the herb destroys the blood vessels supplying tumours. Conventional anti-cancer drugs attack cancer cells themselves but have the side effect of harming healthy cells, leading to side effects. The effect of Ban Zhi Lian appears to be very specific and the “very exciting” findings will be tested in live trials within 18 months and human trials within 3 years, subject to funding. (http://news.scotsman.com/latest.cfm?id=3165619).
(2) Ginger and turmeric fight cancer: Ginger: turmeric and other members of the Zingiberaceae family of rhizomes have a long history of use in traditional Chinese medicine. Ginger, for example, is widely used in the treatment of stomach problems, nausea, vomiting, epilepsy, sore throat, cough, bruises, wounds, childbirth, sore eyes, liver complaints, rheumatism, asthma, and many other disorders. Researchers at the Forest Research Institute of Malaysia now report that several members of the Zingiberaceae family effectively block the promotion of cancerous tumors. They tested 11 different species and found that seven of them had strong anti-tumor properties. Their test involved a short term assay of the inhibitory effect of extracts of the rhizomes (roots) on human cancer cells. They found that turmeric (Curcuma domestica) extracts (turmeric root extracted with petroleum ether, chloroform or ethanol) completely inhibited further growth of the cancer cells. Ginger (Zingiber officinale) extracts, especially the chloroform extract, also inhibited further growth, but the concentration of extract was more critical than for the turmeric extracts. The researchers conclude that turmeric, ginger and other Zingiberaceae rhizomes may be useful in preventing the promotion of cancer and that populations with high risks of cancer should be encouraged to include them in their diet. Further work is now underway to isolate the active components in the plants.?Vimala, S., et al. Anti-tumour promoter activity in Malaysian ginger rhizobia used in traditional medicine. British Journal of Cancer, Vol. 80, No. 1/2, April 1999, pp. 110-16.
Acupuncture for gastrointestinal disorders (Irritable Bowel Syndrome)
Researchers from Hong Kong suggest that electro-acupuncture can alter the activation of neural pathways for pain perception in irritable bowel syndrome (IBS) patients, who are characterised by abnormal brain activation in response to pain signals from the gut. Thirty IBS-diarrhoea patients were randomised to true electro-acupuncture (TA) or sham acupuncture (SA) at Zusanli ST-36 ,Shangjuxu ST-37 and Sanyinjiao SP-6. Functional MRI (fMRI) was performed to evaluate brain activation while patients underwent rectal distension (RD), before, during and after acupuncture or sham. The results showed significant fMRI differences between the TA and SA groups, which the authors suggest reflect the interaction in the central nervous system between the sensation evoked by acupuncture and the noxious sensation evoked by RD. They postulate that the effect of acupuncture on pain involves modulation of the serotonin pathway at the insula and modulation of mood and affect in higher cortical centres. (Does acupuncture therapy alter activation of neural pathway for pain perception in irritable bowel syndrome?: a comparative study of true and sham acupuncture using functional magnetic resonance imaging. J Neurogastroenterol Motil. 2012 Jul;18(3):305-16).
In an experimental study, American scientists have found that acupuncture at Zusanli ST-36 was able to improve upper and lower abdominal symptoms and impaired gastric peristalsis induced by rectal distention (RD), possibly mediated via the vagal nerve pathway. In a study involving 20 healthy volunteers acupuncture, but not sham-acupuncture or no-acupuncture, reduced both upper and lower abdominal symptoms which had been induced by RD. While RD was found to decrease the percentage of normal gastric slow waves, acupuncture performed during RD improved gastric slow waves. In addition, vagal activity during RD plus acupuncture was significantly higher than that during RD alone. Neither sham-acupuncture nor no-acupuncture showed any effects on vagal activity. (Effects and possible mechanisms of acupuncture at ST36 on upper and lower abdominal symptoms induced by rectal distension in healthy volunteers. Am J Physiol Regul Integr Comp Physiol. 2012 Jul;303(2):R209-17).
Acupuncture has anti-inflammatory effects in allergic asthma
A team of Chinese investigators has shown that acupuncture has regulatory effects on mucosal and cellular immunity in patients with allergic asthma. One hundred patients with allergic asthma and 74 patients with chronic bronchitis received manual acupuncture three times per week, for five weeks at acupuncture points specific for asthma, based on traditional Chinese medicine theory (Dazhui DU-14, Fengmen BL-12 and Feishu BL-13). Clinical results showed that the total efficacy of acupuncture in patients with allergic asthma at the end of one course of treatment was 85 percent. After acupuncture treatment, concentrations of immunoglobulins (sIgA and total IgA) in the in the saliva and nasal secretions of patients with allergic asthma were found to be significantly decreased. IgE levels in sera, as well as numbers of activated T-cells and eosinophils in the peripheral blood were also significantly decreased following acupuncture. Although there were no significant changes in patients with chronic bronchitis treated with acupuncture, some trends indicating a benefit of treatment were observed. (Considerations for Use of Acupuncture as Supplemental Therapy for Patients with Allergic Asthma. Clin Rev Allergy Immunol. 2012 Jun 3. [Epub ahead of print]).
Meanwhile an experimental study carried out in a mouse hypersensitivity model that simulates human allergic asthma has demonstrated that electro-acupuncture at Zusanli ST-36 exerts an anti-inflammatory response. Korean researchers used histopathology to examine the effects of electro-acupuncture on tissues affected by the allergic inflammatory process. It was discovered that electro-acupuncture significantly decreased the excessive pathological accumulation of inflammatory T cells in peribronchal and perivascular tissues, by enhancing the function of regulatory Treg cells. (Electroacupuncture Attenuates Ovalbumin-Induced Allergic Asthma via Modulating CD4(+)CD25(+) Regulatory T Cells. Evid Based Complement Alternat Med. 2012;2012:647308. Epub 2012 May 10).
Acupuncture benefits brain after both ischaemic and haemorrhagic stroke
Chinese researchers have found electro-acupuncture at points on the head to be helpful for increasing neuroplasticity in cerebral motor regions following ischaemic stroke. The scientists used PET to observe the cerebral function of six patients who had suffered a stroke. The patients received EA treatment at Baihui DU-20 and right Qubin GB-7. The results showed that, following EA, brain activity changed significantly in structures related to motor function (primary motor area, premotor cortex, superior parietal lobule, supplementary motor area, insula, putamen, and cerebellum) in both hemispheres of the brain. (Effects of Electroacupuncture at Head Points on the Function of Cerebral Motor Areas in Stroke Patients: A PET Study. Evid Based Complement Alternat Med. 2012;2012:902413. Epub 2012 Aug 22).
Another Chinese experimental study using PET-CT has found that true acupuncture at Waiguan SJ-5 had a regulating effect on cerebral function in 43 patients who had suffered an ischaemic stroke. The authors suggest that these effects of acupuncture may contribute to its impact on the recovery of post-stroke patients. (Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients – a PET-CT cerebral functional imaging study. BMC Neurosci. 2012 Jun 27;13(1):75).
An examination of the effect of acupuncture therapy on patients who had had a recent cerebral infarction has revealed that it is effective for protecting neurons and facilitating motor recovery. Twenty patients with recent cerebral infarction were divided randomly into an acupuncture group and a control group by a Chinese research team. Both groups of patients underwent serial scans using diffusion tensor imaging (DTI, a form of MRI) to examine how their brains changed in the post-stroke recovery period. The results showed that there was a significant difference between acupuncture and control groups in respect of several measures of ischaemia in the areas of the brain damaged by the infarct. Fractional anisotropy (FA, a measure of the micro-structural tissue integrity) was higher in the acupuncture group than the control group, indicating a positive effect of acupuncture on the structure of the damaged tissue. The authors suggest that these positive changes might correlate with patient’s recovery of motor function. (Effect of Acupuncture Therapy for Postponing Wallerian Degeneration of Cerebral Infarction as Shown by Diffusion Tensor Imaging. J Altern Complement Med. 2012 Sep 5. [Epub ahead of print]).
Acupuncture inhibits excitable brain’s motor system…and activates areas associated with Parkinson’s disease
Acupuncture needling at Yanglingquan GB-34, traditionally classified as an influential point for muscles and tendons, results in a subtle but specific inhibitory effect on the excitability of the brain’s motor system – the network of brain regions involved in activating muscles to produce body movements. In a German study, twenty healthy volunteers received both verum and sham (non-penetrating) acupuncture applied at right Yanglingquan GB-34, using a crossover design. Compared with sham, verum acupuncture significantly increased resting motor threshold, indicating that acupuncture at Yanglingquan GB-34 had an inhibitory effect on motor system excitability. (Effects of acupuncture needle penetration on motor system excitability. Neurophysiol Clin. 2012 Jun;42(4):225-30).
Korean scientists used fMRI to examine the neural responses of 12 patients with Parkinson’s disease (PD) and 12 healthy participants before and after acupuncture stimulation at Yanglingquan GB-34. Acupuncture stimulation increased neural responses in regions which are impaired by PD (substantia nigra, caudate, thalamus and putamen). (Acupuncture Stimulation on GB34 Activates Neural Responses Associated with Parkinson’s Disease. CNS Neurosci Ther. 2012 Sep;18(9):781-90).
Acupuncture Helpful for Chronic Pain: A Meta-Analysis
A recent NCCAM-funded study, employing individual patient data meta-analyses and published in theArchives of Internal Medicine, provides the most rigorous evidence to date that acupuncture may be helpful for chronic pain. In addition, results from the study provide robust evidence that the effects of acupuncture on pain are attributable to two components. The larger component includes factors such as the patient’s belief that treatment will be effective, as well as placebo and other context effects. A smaller acupuncture-specific component involves such issues as the locations of specific needling points or depth of needling.
Although millions of Americans use acupuncture each year, often for chronic pain, there has been considerable controversy surrounding its value as a therapy and whether it is anything more than an elaborate placebo. Research exploring a number of possible mechanisms for acupuncture’s pain-relieving effects is ongoing.
Researchers from the Acupuncture Trialists’ Collaboration, a group that was established to synthesize data from high-quality randomized trials on acupuncture for chronic pain, conducted an analysis of individual patient data from 29 high-quality randomized controlled trials, including a total of 17,922 people. These trials investigated the use of acupuncture for back and neck pain, osteoarthritis, shoulder pain, or chronic headache.
For all pain types studied, the researchers found modest but statistically significant differences between acupuncture versus simulated acupuncture approaches (i.e., specific effects), and larger differences between acupuncture versus a no-acupuncture controls (i.e., non-specific effects). (In traditional acupuncture, needles are inserted at specific points on the body. Simulated acupuncture includes a variety of approaches which mimic this procedure; some approaches do not pierce the skin or use specific points on the body.) The sizes of the effects were generally similar across all pain conditions studied.
The authors noted that these findings suggest that the total effects of acupuncture, as experienced by patients in clinical practice, are clinically relevant. They also noted that their study provides the most robust evidence to date that acupuncture is more than just placebo and a reasonable referral option for patients with chronic pain.
Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for chronic pain: individual patient data meta-analysis. Archives of Internal Medicine. September 10, 2012; Epub ahead of print.
