How Cupping Works: from Practice to Mechanism

Tiejun Tang

Cupping therapy is a traditional healing practice that has gained significant attention in recent years due to its purported health benefits. Rooted in ancient medical traditions, cupping is used in various cultures to treat a range of ailments. This article explores the history, clinical indications, contraindications, and scientific mechanisms underlying cupping therapy.

History of Cupping Therapy

Cupping therapy dates back thousands of years and has been used in different forms across many civilizations. The earliest recorded use of cupping can be traced to ancient Egyptian, Chinese, and Middle Eastern cultures. Egyptian medical texts, such as the Ebers Papyrus (circa 1550 BC), mention cupping as a method to remove toxins from the body. In Traditional Chinese Medicine (TCM), cupping is associated with promoting the flow of Qi (vital energy) and blood circulation. Islamic medicine, as documented by renowned scholars like Avicenna, also advocated for cupping as a therapeutic intervention for various diseases. The tools for cupping have evolved from animal horns used in ancient times to bamboo, pottery, glass, etc.

Clinical Indications of Cupping Therapy

Cupping is commonly used for a variety of conditions, including:

• Musculoskeletal pain: It is frequently applied to alleviate conditions such as back pain, neck pain, and arthritis.
• Respiratory issues: Cupping has been traditionally employed to relieve symptoms of colds, asthma, and bronchitis.
• Stress and anxiety: The relaxing effect of cupping may help in reducing mental stress and tension.
• Digestive disorders: Some practitioners use cupping to aid digestion and treat gastrointestinal conditions.
• Sports recovery: Many athletes incorporate cupping to reduce muscle soreness and improve recovery time.

Contraindications of Cupping Therapy

While cupping is generally considered safe, it is contraindicated in certain conditions, including:

• Skin infections or open wounds: Cupping over compromised skin can lead to infections.
• Bleeding disorders: Individuals with hemophilia or those on anticoagulant therapy should avoid cupping due to the risk of excessive bruising.
• Pregnancy: Cupping should be avoided over the abdomen and lower back in pregnant women.
• Severe cardiovascular conditions: Those with uncontrolled hypertension or cardiac disease should seek medical advice before undergoing cupping therapy.

Scientific Explanation of the Mechanism of Cupping

Cupping is believed to promote healing by enhancing blood flow, reducing pain, and removing toxins. Modern research suggests that cupping therapy exerts its effects through multiple physiological mechanisms:

1.    Pain Modulation via Diffuse Noxious Inhibitory Controls (DNICs):

Cupping may activate the body's DNIC system, where the introduction of a new noxious stimulus (the suction) can diminish the perception of pre-existing pain. This "pain inhibits pain" phenomenon suggests that the discomfort from cupping can trigger the body's pain-relief mechanisms.^[1] ​

2.    Enhanced Blood Circulation and Nitric Oxide Release:

The suction effect of cupping causes localized vasodilation, increasing blood flow to the treated area.^[2] This process may involve the release of nitric oxide, a molecule that regulates blood pressure and promotes vascular health. Improved circulation can facilitate the removal of toxins and supply oxygen-rich blood to tissues, aiding in healing and reducing muscle tension.^[3] ​

3.    Reflex Zone Stimulation:

According to reflex zone theory, stimulating specific skin areas through cupping can influence corresponding internal organs and tissues. This suggests a neurobiological connection where cupping affects deeper structures via skin receptors, potentially improving organ function and alleviating discomfort.^[1]  ​

4.    Activation of Endogenous Analgesic Systems:

The mechanical action of cupping may stimulate mechanosensitive nerve fibers (Aδ and C fibers), leading to the release of endorphins—natural pain-relieving chemicals. This mechanism is similar to that proposed for acupuncture, where physical stimulation results in analgesia.^[2] ​

5.    Hemorphin Release from Hemoglobin Degradation:

Cupping can cause minor bleeding under the skin, leading to the breakdown of hemoglobin. This process may release hemorphins, peptides with analgesic properties, contributing to pain relief experienced after cupping sessions.^[2] ​

The above studies provide scientific evidence for the mechanism of cupping therapy, and further scientific research is needed to fully reveal the mystery of cupping therapy.

Conclusion

Cupping therapy remains a widely practiced and valued treatment in both traditional and contemporary medicine. While scientific evidence continues to evolve, many individuals report significant relief from various ailments. However, it is crucial to consult a qualified healthcare provider before undergoing cupping therapy, especially for those with underlying health conditions.

As interest in alternative medicine continues to grow, further research will help clarify the full range of benefits and mechanisms behind this ancient therapeutic practice.

  Reference:

1.    Abdullah MN Al-Bedah .The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med. 2018 Apr 30;9(2):90–97

2.    Changzheng Song. Hemorphin-Based Analgesia: A Mechanism of Cupping Technique? J Pain Res. 2023 May 29;16:1751–1754.

3.    Dominador Perido. How does cupping work? Mechanisms of action explained. Massage Magazine 2022; Dec. 12.

How to treat Hair Loss with Chinese Medicine

 Tiejun Tang

Hair loss is a common condition affecting millions of people worldwide. In the UK, approximately 50% of men over the age of 50 and 50% of women over the age of 65 experience hair loss.^[1] Androgenetic alopecia, alopecia areata, and telogen effluvium are the most common types of hair loss. This condition can lead to significant psychological distress and social anxiety. According to the NHS, hair loss is often underreported, and many individuals seek treatment only after the condition has progressed significantly.^[2]

Western Medicine Approaches to Hair Loss

Western medicine offers several treatments for hair loss, but their effectiveness is often limited:

1.     Minoxidil: A topical solution that stimulates hair growth by increasing blood flow to the scalp. It requires continuous use to maintain results; stopping treatment leads to hair loss recurrence. It is only effective for a subset of patients, with studies showing significant regrowth in about 30-40% of users. Side effects include scalp irritation, itching, and unwanted facial hair growth in some cases.

2.     Finasteride: An oral medication that inhibits the hormone dihydrotestosterone (DHT), which is responsible for androgenetic alopecia. It is primarily effective for male pattern baldness and is not suitable for women. Side effects include sexual dysfunction, which can persist even after discontinuation (post-finasteride syndrome).

3.     Hair Transplant Surgery: A surgical option for advanced hair loss. This therapy is costly and invasive, carrying risks such as scarring, infection, and unnatural-looking results if not performed well. Additionally, it does not prevent further hair loss in non-transplanted areas.

The Chinese Medicine Approach to Hair Loss

Traditional Chinese Medicine (TCM) views hair loss as a manifestation of internal imbalances, particularly involving the kidneys, liver, and blood. According to TCM, healthy hair growth depends on the abundance of Qi (vital energy) and blood, as well as the proper functioning of the kidneys, which are believed to govern hair health. Common TCM treatments for hair loss include:

Herbal Remedies

 Heshouwu (Polygonum multiflorum):  A popular herb known for its hair-nourishing properties. Studies suggest it promotes hair growth by improving blood circulation and reducing oxidative stress. Research has shown that Heshouwu extract supports hair growth by prolonging the anagen phase and counteracting the effects of androgens in cultured human dermal papilla cells.^[3]

Ginseng: Enhances Qi and blood circulation, supporting hair follicle health. Treatment with Red Ginseng Oil (RGO) and its main components has been found to upregulate the expression of hair growth-related proteins, inhibit inflammation and apoptosis, and induce cytoprotective mechanisms, thereby preventing or treating hair loss and protecting the skin from UV radiation.^[4]

 Danggui (Angelica sinensis)：A commonly used herb for  nourishing blood, it containing glycoside active ingredients mainly promote hair follicle cells to enter the growth phase earlier or inhibit hair follicle cell apoptosis.^[5]

 BeauTop (BT): A traditional Chinese medicine compound composed of Ginseng, Angelica, and Astragalus. It has been shown to promote hair growth by increasing the expression of vascular endothelial growth factor (VEGF), which is a key mediator in the angiogenesis process involved in hair growth and development.^[6]

 Yangxue Shengfa Capsule (YSC): Clinically used for many years to improve androgenetic alopecia (AGA). Studies have demonstrated that five of its compounds significantly promote cell proliferation in cultured immortalized human dermal papilla cells. Ferulic acid and rhamnolide have shown promising pharmacological properties against AGA.^[7]

Acupuncture

Acupuncture stimulates specific points on the scalp to improve blood flow and balance Qi. Research has shown that acupuncture can be effective in treating alopecia areata.^[8]

Conclusion

Hair loss is a multifaceted condition with significant psychological and social impacts. While Western medicine provides effective treatments, these often come with limitations, including suboptimal results for some patients, side effects, and high costs.

Traditional Chinese Medicine, on the other hand, aims to address the root causes of hair loss by harmonizing Qi and blood, regulating internal organ function, and taking a multi-target approach. This holistic strategy results in a stable and lasting therapeutic effect.

References

1.     https://www.alopecia.org.uk/androgenetic-alopecia-pattern-hair-loss

2.     Hunt, N., & McHale, S.  The psychological impact of alopecia. British Medical Journal. 2005; 331(7522), 951-953.

3.     Shin, J.Y.  Polygonum multiflorum extract supports hair growth by elongating the anagen phase and counteracting the effects of androgens in cultured human dermal papilla cells. BMC Complement Med Ther. 2020; 20(1), 144.

4.     Van-Long Truong.  Red ginseng oil promotes hair growth and protects skin against UVC radiation. J Ginseng Res. 2021; 45(4), 498-509.

5.     Jinjin Dou. Exploring the effects of Chinese herbal ingredients on the signaling pathway of alopecia and the screening of effective Chinese herbal compounds. Journal of Ethnopharmacology. 2022; Volume 294, 115320.

6.     Chien-Ying Lee.  Observation of the expression of vascular endothelial growth factor and the potential effect of promoting hair growth treated with Chinese herbal BeauTop. Evid Based Complement Alternat Med, 2021, 6667011.

7.     Justin J.Y Tan. Bioactives in Chinese Proprietary Medicine modulate 5α-reductase activity and gene expression associated with androgenetic alopecia. Front Pharmacol. 2017; 8, 194.

8.     Andraia R. Li.  Efficacy of acupuncture and moxibustion in alopecia: A narrative review. Front Med (Lausanne, 9), 2022; 868079.

How to Treat Osteoarthritis with Chinese Medicine

 Tiejun Tang

Osteoarthritis (OA) is the most prevalent form of arthritis globally, affecting approximately 7.6% of the population—equivalent to around 595 million people as of 2020. The knee is the most commonly affected joint, followed by the hip and hand.^[1] In the United Kingdom, OA is a significant health concern, with an estimated 10 million people living with the condition. Among these, 5.4 million are affected by knee OA and 3.2 million by hip OA. Notably, approximately 18% of individuals over 45 in England have been diagnosed with knee OA.^[2]

Western medicine primarily focuses on managing OA symptoms rather than curing the disease. Common treatments include:

1.    Pharmacological Interventions: Nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and corticosteroids are commonly prescribed to reduce pain and inflammation. However, long-term use of NSAIDs can lead to gastrointestinal, cardiovascular, and renal complications.

2.    Physical Therapy: Exercise and physical therapy are recommended to improve joint function and strengthen surrounding muscles. While effective, these methods require consistent effort and may not be suitable for all patients.

3.    Surgical Interventions: In severe cases, joint replacement surgery may be necessary. Although surgery can provide significant relief, it is invasive, costly, and carries risks such as infection and prolonged recovery.

4.    Lifestyle Modifications: Weight management and activity adjustments are often advised to reduce stress on joints. However, these measures are not always sufficient to control symptoms.

          Despite these options, many patients continue to experience pain and disability, highlighting the need for alternative or complementary therapies.

Traditional Chinese Medicine Approach to Osteoarthritis

Traditional Chinese Medicine (TCM) views OA as a manifestation of imbalances in the body, particularly involving the deficiency of liver, kidneys, and spleen. According to TCM theory, OA is often associated with "Bi syndrome" (obstruction syndrome), which arises when wind, cold, and dampness invade the body, blocking the flow of Qi (vital energy) and blood in the meridians. This blockage leads to pain, stiffness, and reduced mobility.

TCM treatments for OA aim to restore balance and promote the free flow of Qi and blood. Common approaches include:

1. Chinese Herbal Medicine

Duhuo Jisheng Decoction (DHJSD): This ancient prescription, attributed to Sun Simiao (581–682 AD) of the Tang Dynasty, is widely used in China to treat early-stage knee OA. Recent studies have shown that DHJSD: Increases the synthesis of chondrocyte autophagosomes and the expression of autophagic proteins (LC3 and Beclin-1).Reduces the phosphorylation levels of Akt and mTOR, as well as the levels of zinc, MMP-13, Bax, and Bcl-2.Inhibits the Akt/mTOR signaling pathway, promotes chondrocyte autophagy, and has a protective effect on cartilage.^[3]

Additionally, DHJSD has been found to antagonize the production of proinflammatory cytokines in human nucleus pulposus cells (hNPCs) induced by SDF-1. This suggests that DHJSD may inhibit inflammation by targeting multiple molecules in the SDF-1/CXCR4/NF-κB pathway.^[4]

The latest research in 2025 confirmed that DHJSD can repair cartilage damage in rabbits and reverse the level of inflammatory factors in joint fluid. Its therapeutic mechanism is related to the activation of TGF-β/Smad signaling pathway. This provides a reliable basis for the application of DHJSD in the treatment of cartilage damage after knee osteoarthritis.^[5]

2. Acupuncture

Acupuncture is a well-studied TCM modality for OA. A clinical study involving 442 patients with knee OA compared electroacupuncture (EA), manual acupuncture (MA), and sham acupuncture (SA). The results showed that the remission rates in the EA and MA groups were significantly higher than in the SA group.^[6]

3. Moxibustion

Moxibustion, a therapy that involves burning mugwort near the skin, has also shown promise for OA. A meta-analysis of 57 randomized controlled trials (RCTs) involving 5,149 subjects found that moxibustion and combined moxibustion therapies improved the overall effectiveness of knee OA treatment.^[7]

4. Tuina (Therapeutic Massage)

Tuina, a traditional Chinese therapeutic massage, has been reported to: Reduce knee OA cartilage tissue damage.Decrease inflammatory response and chondrocyte apoptosis.Activate the PI3K/AKT/mTOR signaling pathway, which may contribute to its therapeutic effects.^[8]

Conclusion

Osteoarthritis is a widespread and debilitating condition that poses significant challenges to patients and healthcare systems worldwide. While Western medicine provides valuable tools for managing OA, it has limitations and potential side effects. TCM offers a promising complementary approach, with mechanisms of efficacy increasingly supported by scientific research. By combining the strengths of Western and Traditional Chinese Medicine, we can provide more comprehensive and effective treatment options for osteoarthritis patients globally.

References

1.  GBD 2021 Osteoarthritis Collaborators. Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023 Aug 21;5(9):e508-e522 .

2.  Versus Arthritis. Data and Statistics. Available at: https://versusarthritis.org/about-arthritis/data-and-statistics.

3.  Ye-Hui Wang. Duhuo Jisheng Decoction regulates intracellular zinc homeostasis by enhancing autophagy via PTEN/Akt/mTOR pathway to improve knee cartilage degeneration. PLoS One. 2024 Jan 2;19(1):e0290925 .

4.  Zong-Chao Liu. Duhuo Jisheng Decoction inhibits SDF-1-induced inflammation and matrix degradation in human degenerative nucleus pulposus cells in vitro through the CXCR4/NF-κB pathway. Acta Pharmacol Sin. 2018 Jun;39(6):912-922.

5.  Zhao Ye. Duhuo Jisheng Decoction in reduction of inflammatory response via Transforming growth factor-β/Smad signaling pathway for repairing rabbit articular cartilage Injury: A Randomized Controlled Trial. International Immunopharmacology. Volume 144, 10 January 2025, 113646

6.  Jian-Feng Tu. Efficacy of Intensive Acupuncture Versus Sham Acupuncture in Knee Osteoarthritis: A Randomized Controlled Trial. Arthritis Rheumatol. 2021 Mar;73(3):448-458.

7.  Shao Yin. An Overview of Systematic Reviews of Moxibustion for Knee Osteoarthritis. Front Physiol. 2022 Feb 3:13:822953.

8.  Zhen Wang. Traditional Chinese Manual Therapy (Tuina) Improves Knee Osteoarthritis by Regulating Chondrocyte Autophagy and Apoptosis via the PI3K/AKT/mTOR Pathway: An in vivo Rat Experiment and Machine Learning Study. J Inflamm Res. 2024 Sep 17:17:6501-6519.

Chinese Medicine for Eczema: A Holistic Approach to Skin Health

 Tiejun Tang

Eczema, a chronic inflammatory skin condition characterized by dry, itchy, and inflamed skin, is a growing concern in the UK. According to the National Eczema Society, over 15 million people in the UK suffer from eczema, with 1 in 5 children and 1 in 10 adults affected.^[1] The condition not only impacts physical health but also significantly affects mental well-being and quality of life. While Western medicine offers various treatments, many patients seek alternative therapies, such as Chinese medicine, to manage their symptoms effectively and holistically.

Western Medicine for Eczema: Challenges and Limitations

Western medicine primarily treats eczema with topical corticosteroids, emollients, and antihistamines to reduce inflammation, moisturize the skin, and relieve itching. In severe cases, systemic immunosuppressants or biologics may be prescribed. While these treatments can be effective, they often come with limitations and side effects. Prolonged use of topical steroids, for example, can lead to skin thinning, discoloration, and tolerance, while systemic treatments may carry risks of immune suppression or organ toxicity.^[2] These challenges have led many patients to explore complementary and alternative therapies, especially traditional Chinese medicine (TCM).

Chinese Medicine’s Understanding of Eczema

In Chinese medicine, eczema is often attributed to an imbalance in the body’s internal environment, particularly involving the Lung, Spleen, and Liver systems. According to TCM theory, eczema is caused by a combination of factors, including:

• Wind, Heat, and Dampness: External pathogens like wind and heat, combined with internal dampness, are believed to contribute to skin inflammation and itching.
• Blood Deficiency: Chronic eczema is often linked to blood deficiency, which leads to dry skin and poor nourishment of the skin.
• Emotional Factors: Stress and emotional imbalances are thought to exacerbate symptoms by disrupting the flow of Qi (vital energy) and blood.

Chinese Medicine Treatment Methods

Chinese medicine employs a holistic approach to treat eczema, focusing on addressing the root cause of the imbalance rather than just alleviating symptoms. Common treatment modalities include:

1. Herbal Medicine: Customized herbal formulas are prescribed based on the patient’s specific pattern of imbalance. For example:
• Wind-Heat Pattern: Herbs like Jin Yin Hua (Honeysuckle) and Lian Qiao (Forsythia) are used to clear heat and expel wind.
• Damp-Heat Pattern: Herbs such as Huang Qin (Scutellaria) and Fu Ling (Poria) help resolve dampness and heat.
• Blood Deficiency Pattern: Herbs like Dang Gui (Angelica Sinensis) and Shu Di Huang (Rehmannia) nourish the blood and moisten the skin.

Commonly used formulas include Xiao Feng San (Wind-Dispelling Powder) for acute eczema and Si Wu Tang (Four Substances Decoction) for chronic cases.

2. Acupuncture: Acupuncture is used to regulate Qi and blood flow, reduce inflammation, and relieve itching. Specific points, such as LI11 (Quchi) and SP10 (Xuehai), are often targeted for skin conditions.
3. Dietary Therapy: TCM emphasizes the role of diet in managing eczema. Patients are advised to avoid damp-producing foods like dairy and sugar while incorporating nourishing foods such as leafy greens and lean proteins.
4. Topical Herbal Applications: Herbal creams or washes made from ingredients like Ku Shen (Sophora) and Huang Bai (Phellodendron) can soothe itching and reduce inflammation.

Efficacy of Chinese Medicine for Eczema

A Clinical study showed that Xiaofeng San can reduce in total lesion scores in the treatment group of eczema patients. It was significantly better than that in the placebo group at 8 weeks. There were also statistically significant differences between the treatment group and the placebo group in terms of erythema, skin surface damage, itching, and sleep scores. Patients reported no side effects of the treatment.^[3]

A meta-analysis study included a total of 662 patients with eczema were included (322 in the experimental group and 340 in the control group). The area and severity index and the remission rate of the treatment group were better than those of the placebo group. The atopic dermatitis score, surface damage score, and sleep score of the treatment group were all improved.^[4]

Modern Pharmacological Research on Chinese Medicine

Modern research has begun to validate the mechanisms behind TCM’s efficacy. For example:

• Huang Qin (Scutellaria) has been found to contain baicalein, a compound with anti-inflammatory and antioxidant properties.^[5]
• Ku Shen (Sophora) contains matrine, which has been shown to inhibit histamine release and reduce itching.^[6]
• Dang Gui (Angelica Sinensis) promotes blood circulation and skin repair through its active compounds, such as ferulic acid.^[7]

These findings bridge the gap between traditional knowledge and modern science, providing a scientific basis for the use of Chinese medicine in eczema treatment.

Conclusion

Eczema is a complex condition that requires a multifaceted approach to management. While Western medicine provides effective symptom relief, its limitations and side effects have led many patients to explore Chinese medicine as a complementary or alternative therapy. With its holistic approach, personalized treatments, and growing body of scientific evidence, Chinese medicine offers a promising option for those seeking to manage eczema naturally and effectively.

References:

1. National Eczema Society. (2023). Eczema Facts and Figures. Retrieved from www.eczema.org
2. Muhammad Yasir. Corticosteroid Adverse Effects. StatPearls Publishing; 2025 Jan-.
3. Hui-Man Cheng. The efficacy and safety of a Chinese herbal product (Xiao-Feng-San) for the treatment of refractory atopic dermatitis: a randomized, double-blind, placebo-controlled trial. Int Arch Allergy Immunol . 2011;155(2):141-8.
4. Xiaoce Cai. Efficacy and safety of Chinese herbal medicine for atopic dermatitis: Evidence from eight high-quality randomized placebo-controlled trials. Front Pharmacol. 2022 Sep 27:13:927304.
5. Yongqiang Wen. The Pharmacological Efficacy of Baicalin in Inflammatory Diseases. Int J Mol Sci. 2023 May 26;24(11):9317
6. Zhe Zhang. Oxymatrine screened from Sophora flavescens by cell membrane immobilized chromatography relieves histamine-independent itch. J Pharm Pharmacol. 2021 Dec 7;73(12):1617-1629
7. Kamila Zduńska .Antioxidant Properties of Ferulic Acid and Its Possible Application. Skin Pharmacol Physiol. 2018;31(6):332-336.
   

Don't Ignore Colds and Flu

 Tiejun Tang

Recently, there has been a significant increase in cold and flu cases, with the UK Health and Safety Agency (UKHSA) reporting a drop in flu positivity rates to 17.5% in week 3, up from 21.1% the week before, as of 22 January 2025. However, among children aged 5 to 14, positivity rates rose to 30.7% from 26.8% in week 2^.[1] In Scotland, the flu outbreak has been particularly severe, with 168 flu-related deaths reported last week, the highest weekly toll since records began in 2000.

While some may view these illnesses as minor inconveniences, it is vital to understand the potential harm they can cause, especially if left untreated.

Why you shouldn’t ignore a cold

The common cold may seem harmless, but neglecting treatment can lead to complications. For most healthy people, symptoms may resolve on their own. However, for older people and those with chronic conditions such as diabetes, heart disease or respiratory problems, a cold can escalate into more serious problems such as bronchitis or pneumonia. If left untreated, these complications can be life-threatening.

Flu, on the other hand, is more aggressive. Viruses weaken the immune system, making the body more susceptible to bacterial infections. In severe cases, untreated flu can lead to hospitalization or even death from complications such as sepsis or organ failure.

Risks for Vulnerable Populations

Older adults and those with chronic medical conditions are particularly vulnerable to infection. Their immune systems are often weaker, making it harder for them to fight off infection. A simple cold can quickly exacerbate existing health problems, leading to hospitalization or long-term health effects.

For example:                          

Respiratory complications: Symptoms may worsen in people with chronic obstructive pulmonary disease (COPD) or asthma.

Heart strain: Infections increase the workload on the heart, leading to complications in people with heart disease.

Reduced immunity: People with diabetes may have a harder time controlling their blood sugar levels during illness, increasing their risk of further complications.

Role of TCM in Flu Treatment

Traditional Chinese Medicine (TCM) is widely recognized for its holistic approach to treating illnesses, including flu. TCM focuses on restoring balance in the body and boosting the immune system, which can be especially beneficial during flu season.

Some of the advantages of TCM in treating flu include:

Herbal remedies: Herbal formulas such as Lianhua Qingwen^[2] and single herb Banlangen^[3] can be used to relieve symptoms such as fever, cough and sore throat. These remedies often have antiviral and anti-inflammatory effects.

Personalized treatment: TCM practitioners tailor treatment plans to each patient's specific needs, targeting both symptoms and underlying imbalances.

Supporting recovery: Techniques such as acupuncture and cupping can improve circulation and enhance the body's natural healing process.

Fewer side effects: TCM generally has fewer side effects than some drug treatments and is suitable for people who are sensitive to traditional medicines.

By combining TCM with modern medical practices, individuals can benefit from a more comprehensive approach to flu prevention and treatment.

Self-protection measures

See a doctor promptly: Do not ignore long-term symptoms or worsening of the condition.

Vaccinations: Annual flu and pneumococcal vaccinations can reduce the risk of severe illness.

Maintain good hygiene habits: Wash your hands frequently, avoid crowded places during peak flu season, and wear a mask when necessary.

Boost your immune system: Eat a healthy diet, stay hydrated, and get plenty of rest.

 Conclusion

Colds and flu should not be underestimated, especially for vulnerable populations such as the elderly and those with chronic illnesses. Early treatment and preventive measures can significantly reduce the risks and complications associated with these illnesses. In addition, considering the benefits of TCM may provide an alternative or complementary approach to managing symptoms and enhancing overall health.

References：

1.Weekly flu and COVID-19 surveillance graphs 2025 week 3. UK Health and Safety Agency.

2. Li Runfeng. Lianhuaqingwen exerts anti-viral and anti-inflammatory activity against novel coronavirus (SARS-CoV-2). Pharmacol Res. 2020 Jun:156:104761.

3. Bin Yu. Network pharmacology study on the mechanism of the Chinese medicine Radix Isatidis (Banlangen) for COVID-19. Medicine (Baltimore). 2021 Aug 13;100(32):e26881.

Comments on Chinese Medicine Research Papers Published in The Lancet

 Tiejun Tang    

A recent research paper published in the internationally renowned medical journal The Lancet titled "Traditional Chinese Medicine FYTF-919 (Zhongfeng Xingnao Oral Prescription) for the Treatment of Acute Cerebral Hemorrhage: A Multicenter, Randomized, Placebo-Controlled, Double-Blind Clinical Trial" ^[1] concluded that the efficacy of the traditional Chinese medicine (TCM) prescription, Zhongfeng Xingnao Oral Prescription, was no different from that of a placebo, and it could not improve the functional prognosis, survival rate, or quality of life of patients with cerebral hemorrhage. This conclusion could easily mislead readers into thinking that traditional Chinese medicine is ineffective in treating cerebral hemorrhage, causing a negative impact on the reputation of TCM and provoking strong responses from the TCM community both domestically and internationally.

But is it really true that traditional Chinese medicine is ineffective in treating cerebral hemorrhage? No! The conclusions of this study only show that the specific prescription used in the trial is ineffective, and they cannot be generalized to all traditional Chinese medicines. The main issue with the negative research results lies in the selection of the prescription.

Zhongfeng Xingnao Oral Prescription contains four ingredients: Hongshen, Sanqi, Chuanxiong, and Dahuang. My opinion is using Chuanxiong in the treatment of acute cerebral hemorrhage is fundamentally incorrect.

The Chinese Pharmacopoeia records that Chuanxiong is pungent, warm, and acts on the liver, gallbladder, and pericardium meridians. It is known for promoting blood circulation, dispelling wind, and relieving pain. It is typically used for irregular menstruation, dysmenorrhea, abdominal pain due to lumps, stabbing chest and rib pain, swelling and pain from injuries, and headaches. In clinical practice, Chuanxiong is recognized for its ability to promote blood circulation and remove blood stasis, making it an important medicine for treating headaches. Modern pharmacological studies have confirmed that the main active ingredient of Chuanxiong is ligustrazine. The pharmacological effects of Chuanxiong and ligustrazine have been hotly researched, with over 1,000 articles available on PubMed when searching for "Chuanxiong" or "ligustrazine" (1022 and 1608 papers, respectively). In 2024 lone, there were 96 and 115 studies published on the topic.

Recent studies on Chuanxiong’s effect on coagulation and blood rheology reveal some concerning findings:

1. One study using network pharmacology found that Chuanxiong can inhibit TF (tissue factor) procoagulant activity and reduce TF mRNA and protein expression in EA.hy926 cells in a dose-dependent manner via the PI3K/Akt/NF-κB signaling pathway ^[2].
2. Another study using affinity ultrafiltration mass spectrometry (AUF-MS) identified 21 active components from Chuanxiong, with ferulic acid, chlorogenic acid, and isochlorogenic acid A being potential antithrombin agents. The conclusion was that Chuanxiong is a Chinese herbal medicine with good anticoagulant effects ^[3].
3. A third study using a microfluidic chip model of normal and stenotic arteries showed that ligustrazine inhibits platelet aggregation and activation by reducing the binding of von Willebrand factor (vWF) to the GPIb/IX/V complex, partly inhibiting platelet aggregation through the P2Y12-ADP receptor pathway ^[4].

Ligustrazine has effects such as inhibiting platelet aggregation, dilating blood vessels, reducing blood viscosity, and anticoagulation. It is mainly used in the treatment of ischemic stroke and can be employed for rehabilitation in hemorrhagic stroke. However, it is obviously unsuitable for use in the acute stage of cerebral hemorrhage, as its anticoagulant properties could worsen bleeding.

In contrast, Western medicine uses hemostatic drugs such as aprotinin, 6-aminocaproic acid, and tranexamic acid in treating acute cerebral hemorrhage to correct coagulation dysfunction and prevent the expansion of the bleeding area. Although the clinical effect of hemostatic drugs is not ideal, they remain one of the routine treatments for acute cerebral hemorrhage. The effect of ligustrazine on coagulation is completely opposite to that of hemostatic agents.

Traditional Chinese medicine (TCM) holds that "blood that leaves the vessel is stagnant," and there are indeed reports of using blood-activating and blood-stasis-removing methods to treat cerebral hemorrhage. However, this is generally applied in the recovery period, not in the acute phase. TCM often uses Sanqi (Panax notoginseng), which has both blood-activating and hemostatic effects, in such treatments. The two ingredients, Chuanxiong and Dahuang, in this particular prescription both promote blood circulation, which does not align with the TCM principles of syndrome differentiation and treatment. This discrepancy likely led to the negative research results in the study.

For treating acute cerebral hemorrhage, TCM must follow the principle of syndrome differentiation. For example:

• Angong Niuhuang Wan clears heat, resolves phlegm, and opens the orifices, suitable for phlegm-heat blocking type stroke.
• Shenfu Tang is used for yang qi exhaustion syndrome.
• Shengmai San is used for qi and yin deficiency syndrome.

There is no single prescription that can effectively treat all types of strokes.

Furthermore, scientific research on TCM must respect the inherent principles of TCM. It cannot simply replicate the Western medical research model, as this approach would lead to biased conclusions.

References:

1. Jianwen Guo. Traditional Chinese Medicine FYTF-919 (Zhongfeng Xingnao Oral Prescription) for the Treatment of Acute Intracerebral Hemorrhage: A Multicenter, Randomized, Placebo-Controlled, Double-Blind Clinical Trial. The Lancet, 2024 Nov; Volume 404, Issue 10468, Pages 2187-2196.
2. Shasha He. "Exploring the Mechanism of Chuanxiong Rhizoma Against Thrombosis Based on Network Pharmacology, Molecular Docking and Experimental Verification." Molecules, 2023 Sep 19; 28(18): 6702.
3. Chencun Huang. "Screening of Anti-Thrombin Active Components from Ligusticum Chuanxiong by Affinity-Ultrafiltration Coupled with HPLC-Q-Orbitrap-MS." Phytochemical Analysis, 2023 Jun; 34(4): 443-452.
4. Tiancong Zhang. "Application of Microfluidic Chip Technology to Study the Inhibitory Effect of Tetramethylpyrazine on Platelet Aggregation, Activation, and Phosphatidylserine Exposure Mediated by Pathological High Shear Rate." Blood Coagul Fibrinolysis, 2023 Jan 1; 34(1): 47-60.