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Traditional Chinese medicine (TCM) has thousands years history. It has unique basic theories and diagnostic methods. It is a very effective therapy in treating many chronic diseases and some acute diseases. If you are interested in TCM, welcome to pop in to this TCM forum, let's discuss on any topic about Chinese herbal medicine and acupuncture. If you have any health problem, you are welcome to visit my clinic Knowhow Acupuncture at No.1 Harley street, London. If you are far away from London, you can pop in my online clinic to get some help. If you like this blog please share it to your friends.

Thursday, 5 March 2020

Systematic Review of Modified Yupingfeng San and its Potential Effects on Covid 19

Tiejun Tang

Yupingfeng San (YPF) is the most commonly used formula for prevent disease in the history of traditional Chinese medicine. It consists of three ingredients. They are Huangqi (Astmgali Radix), Baizhu ( Largehead Atractylodes Rh) and Fangfeng (Divaricate Saposhniovia Root.). It has been widely used in China since the Yuan dynasty (1217 AD). According to traditional Chinese medicine philosophy, this formula can build up healthy Qi and to prevent invasion of external evils. In Chinese “Yupingfeng mean jade screen and San mean powder. Is it possible to use YPF to prevent and treat Covid 19? Is there any scientific research evidence to support the clinical application of this classical formula? This paper aimed to answer these questions by systematic review.

Methods

Database includes PubMed, MEDLINE, CNKI, CSCD. Use Yupingfeng as key word.

Search time limit is from 2000-2020. All the Included articles were published in English.

Results

1.    Immunoregulatory and anti-inflammatory function

Inflammatory cytokine storm is very important pathological change of Covid 19.

To observe the Immunoregulatory and anti-inflammatory effects of YPF, Song J. applied YPF to treat a rat chronic bronchitis model. The results showed that the inflammation in the pulmonary tissue and the bronchus of rats was significantly reduced in the treatment groups.  In serum samples collected at different times from rats after administration of YPF, the result showed increased proliferation of splenic lymphocytes area. They use serum samples of YPF group to treat alveolar macrophages. The result found interleukin-8 (IL-8) in the cell culture media has been inhibited [1].

IL-8 plays an important role in the pathogenesis of bronchitis and cystic fibrosis. It also is a very important pathological factor in the cytokine storm of Covid 19 [2]. To investigate the immunomodulating mechanism of YPF, Sun H applied YPF polysaccharides to treat mice lymphocytes and macrophages. The results showed YPF polysaccharides effectively enhanced the proliferation of lymphocytes and promoted mRNA expression of inducible nitric oxide synthase (iNOS), IL-6, TNF-α, INF-γ, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and TLR-4 in lymphocytes and macrophages. Moreover, it can effectively normalized cell proliferation and down regulated mRNA expression levels of pro-inflammatory cytokines, NF-κB, TLR-4, and iNOs in chronic inflammation cells [3]. These cytokine factors all play important role in the chain reaction of Covid 19 cytokine storm [2].

2.    Anti-virus effect function

Coronavirus is the pathogen of Covid 19. The anti-virus effect of YPF was approved by some laboratory researches. To investigate the antivirus effect of YPF, Liu Q. applied real-time RT-PCR and western blotting technique to detect influenza virus (IFV) and the human respiratory syncytial virus (HRSV). The result showed YPF extract inhibited both IFV and HRSV in a dose-dependent manner when given before, during and after a viral infection. YPF was effective in blocking the entry of the virus. Furthermore, pre-treatment with YPF reduced the susceptibility of cells to the invasion of HRSV by inhibiting the expression of ICAM-1. YPF extract increased the survival rate of lethal influenza-infected mice, prolonged the survival time and alleviated the virus-induced lung lesions, which is comparable with the effects of ribavirin treatment [4]. To enhance the anti coronavirus function of YPF, I added Lizhihe (Litchi core) in my modified YPF formula, because of it can significantly inhibit protease activity of SARS coronavirus 3CL [5].

3.    Anti-asthma function

Difficulty breathing is one of the common symptoms of Covid 19. Previous studies showed YPF has a good function of anti-asthma.  Wang Z. reported that YPF could alleviate the inflammation in the lung tissue of mice, decrease the proportion of Th17 cells, and increase the proportion of Treg cells in bronchoalveolar lavage fluid, it could decrease IL-4 and TNF-α level and increase TGF-β level in blood [6]. Liu X applied network pharmacology to explore potential mechanism of YPF on asthma. In vitro experiments showed that YPF significantly decreased the production of TNF-α and IL-6, as well as both mRNA and protein levels of IL-1β, NLRP3, Caspase-1 and ASC. In vivo experiment showed YPF treatment not only reduce the clinical symptoms, but also reduced inflammatory cell infiltration, mucus secretion in lung of asthmatic mice. Moreover, YPF treatment remarkably decreased the mRNA and protein levels of IL-1β, NLRP3, Caspase-1 and ASC in lung of asthmatic mice [7].

4.    Anti pulmonary fibrosis

Pulmonary fibrosis is a major pathological change in Covid 19 patients. YPF showed an anti pulmonary fibrosis function in the previous studies. Li L applied total extract of YPF to treat bleomycin-induced pulmonary fibrosis in rats. The result showed YPF treatment can reduce the alveolitis and fibrosis, reduced the loss of body weight and increase of lung coefficient. YPF also significantly decreased the levels of hydroxyproline and type I collagen, and reduced the over-expression of high-mobility group box 1 (HMGB1), transforming growth factor-beta 1 (TGF-β1), Col-I and α-smooth muscle actin (α-SMA) .It can improve lung fibrosis by alleviating HMGB1 activity and TGF-β1 activation [8].

Cui W applied the total glycoside of Yupingfeng (YPF-G) to treat pulmonary fibrosis, the result found that both dose of YPF-G significantly reduced bleomycin-induced alveolitis and pulmonary fibrosis in rats. The levels of HMGB1, laminin, hyaluronic acid, and hydroxyproline were effectively reduced. The increased protein expression of HMGB1 was dramatically inhibited after YPF-G treatment [9].

5.    Clinical randomized controlled trials

Except laboratory research YPF also showed some good effects on clinical trials of some related diseases include SARS. A meta-analysis aimed to evaluate the immunomodulating function of YPF in children with recurrent respiratory tract infections. Twelve trials with 1236 patients were identified. YPF significantly increased serum levels of IgA, IgG, IgM and CD3 (+) T-lymphocytes. It also reduced the frequency of recurrent respiratory tract infections and increased total effective rates of symptom improvement [10]. A randomized, double-blind, parallel, placebo-controlled study analysed 240 patients from eight centres in China. Participants were eligible if they had mild to severe chronic obstructive pulmonary disease. They were randomly assigned to receive YPF or placebo. The result showed YPF group had a significantly lower exacerbation rate than placebo group and a significantly reduced risk of second exacerbation. The mean change in the COPD assessment test score in the YPF group were signifacantly lower than placebo group [11].

During the epidemic period of SARS in Hong Kong there were 2,601 medical staff administered with Kandu Bufei  Decoction which is a modified YPF It was confirmed that 1,063 people had taken it for a successive two weeks. They were regarded as the treatment groupThe control group consisted of 15,374 subjects who didn’t take Chinese herbal medicineThe result showed: No one in the herbal treatment group contracted the SARS infection while in the control group, 64(0.4%) were infected [12].

Discussion

The pandemic of Covid 19 is gradually getting under control in China. Chinese herbal medicine played a very important role in this battle against Covid 19 in China. More than 85% of patients received herbal medicine treatment. Because the involvement of Chinese herbal medicine the cure rate was significantly increased and mortality rate significantly decreased.

YPF is a natural immune enhancer. Its immunoregulatory function can prevent viral infection. The anti-inflammatory and antivirus function can block the cytokine storm reaction of Covid 19. The anti-asthma effect can release the shortness of breath. The anti pulmonary fibrosis effect can reduce the pulmonary fibrosis in the severe stages and recover stages.

Conclusions

Based on above research evidence we have reason to conclude YPF probably has the effects on prevention and treatment of Covid 19.

Reference

  1.  Song J. Anti-inflammatory and immunoregulatory effects of Yupingfeng powder on chronic bronchitis rats. Chin J Integr Med. 2013; 19(5):353-9.
  2.  Xuetao Cao. COVID-19: immunopathology and its implications for therapy. Nature Reviews Immunology . 2020; 20, 269-270.
  3.  Sun H. Bidirectional immunomodulating activity of fermented polysaccharides from Yupingfeng. Res Vet Sci. 2017; 110:22-28.
  4.  Liu Q. Jiawei-Yupingfeng-Tang, a Chinese herbal formula, inhibits respiratory viral infections in vitro and in vivo. J Ethnopharmacol. 2013; 150 (2):521-8.
  5. Shouji Gong.  A study on anti-SARS. CoV 3CL protein of flavonoids from litchichinem  sonn core. Chinese Pharmacological Bulletin 200824 (5): 699700.
  6. Wang Z. Yupingfeng Pulvis Regulates the Balance of T Cell Subsets in Asthma Mice. Evid Based Complement Alternat Med. 2016; 6916353.
  7.  Liu X. Yupingfeng San Inhibits NLRP3 Inflammasome to Attenuate the Inflammatory Response in Asthma Mice. Front Pharmacol. 2017; 8, 1-12.
  8.   Li L. Total extract of Yupingfeng attenuates bleomycin-induced pulmonary fibrosis in rats.Phytomedicine. 2015; 22 (1):111-9.
  9.  Cui W. Total glycosides of Yupingfeng protects against bleomycin-induced pulmonary fibrosis in rats associated with reduced high mobility group box 1 activation and epithelial-mesenchymal transition.Inflamm Res. 2015; 64(12):953-61.
  10. Song T. Adjuvant Treatment with Yupingfeng Formula for Recurrent Respiratory Tract Infections in Children: A Meta-analysis of Randomized Controlled Trials.Phytother Res. 2016; 30 (7):1095-103.
  11.  Ma J. Effects of YuPingFeng granules on acute exacerbations of COPD: a randomized, placebo-controlled study.Int J Chron Obstruct Pulmon Dis. 2018; 13, 3107-3114.
  12. Liu Dehui. Clinical Observation on the Preventive Effect of KangduBufei Decoction on AcuteSevere Respiratory Syndrome. Chinese Journal of Integrated Traditional and Western Medicine. 2004; 24(8): 685-688.

Tuesday, 4 February 2020

My ten year blogger journey

Tiejun Tang

Ten years ago, I opened my TCM blog Chinese Medicine Forum, during which I published over 80 posts. All the posts are related to Chinese medicine and acupuncture, and the topics range from clinical treatment to theoretical discussionand research review. I never expected this small blog could attract so many readers from all over the world. My readers include patients, TCM students & practitioners, doctors and researchers. Many readers received practical suggestion about their disease or health issues.
The pageviews of my blog have reached 318,253. 

The readers came from over 30 different countries.The top 10 countries are:



The following shows the posts concerning clinic treatment which received more pageviews.



The readers left 157 comments on my blog. Here are a few comments:

Williams wrote on Can acupuncture treat Parkinson’s disease?  "I wanted to thank you for this great Information and knowledge, I definitely loved every little bit of it. I have you bookmarked your web site to check out the latest stuff you post. Your blog is eye-catching. I get pleasure from it."

Alex wrote on How to treat Raynaud's Phenomenon with Chinese Medicine?  "It’s really nice and meanful. It’s really cool blog. Linking is very useful thing, you have really helped lots of people who visit blog and provide them useful information."

Leslie wrote on How to treat rheumatoid arthritis with Chinese medicine? I am really a big fan of Chinese medicine and I have been self studying about it. This article is very helpful. It gives total insight to the viewers when it comes to RA. It gives comparison and guide on how to deal with RA. "

Davy wrote on Acupuncture Pain Clinic in Whittington Hospital:  "Nice post. I read your article and found useful information regarding Acupuncture Pain Clinic. I would like to say thanks for sharing this. Keep sharing."

Anonymous wrote on Acupuncture Pain Clinic in Whittington Hospital: "This is a great posting of blog and thanks sharing, It was an one of the great treatment in acupuncture therapies, its useful for relaxation and infertility acupuncture etc."

Savannah wrote on Acupuncture Pain Clinic in Whittington Hospital:  "I have to say that the information here was the most complete that I found anywhere. I am definitely bookmarking this to come back and read later. Really impressed! "

Mendes wrote on Glandular fever and its TCM treatment: "This is a great article thanks for sharing this informative information. I will visit your blog regularly for some latest post. "

Williams wrote on How to treat urinary tract infection with Chinese herbal medicine?  "I have being researching about urinary tract infection and reading your blog, I found your post very helpful."

Greenjjade wrote on Hashimoto’s disease and its TCM treatment: "Hi Dr Tang, As a non-Chinese speaking student of TCM, I just wanted to express a very big thank you for freely sharing your clinical knowledge and expertise and writing about such interesting topics."

I am really appreciated all the comments.  Your feedback has encouraged me to keep on posting for the past 10years. I have been dedicated to TCM for more than 40 years, and deeply believe that Traditional Chinese medicine is a precious resource. The aim of this blog is to share my TCM knowledge and experience to English readers of the whole World. I will continue to post new articles in 2020, and readers are very welcome to leave their comments or share this blog with their friends. If this blog can make you and your family healthier, that is my best hope.

Thursday, 23 January 2020

How to prevent coronavirus infection?

Tiejun Tang


We are all aware of the new Coronavirus spreading from Wuhan across China and beyond.. This disease is very similar to the Severe Acute Respiratory Syndrome (SARS) epidemic of 2003 which originated in China and spread to 37 countries with 8098 cases and 774 fatalities. The pathogens are from a different subtype of coronavirus; Its incubation period is longer than SARS and its symptoms are slightly different.

SARS initially spread from Guangzhou in Southern China, and I was working in that city when SARS started to spread. Our hospital is one of the leading hospitals in Guangzhou, so we accepted and treated many patients. When patients were diagnosed with SARS they were isolated and treated with modern medicine. My PhD tutor, Professor Deng Tietao suggested to central government to use traditional Chinese medicine and after the Chinese herbal medicine was involved the mortality rate significantly reduced.
Chinese herbal medicine was widely used to prevent SARS infection. Many people took herbal decoction of Banlangen (Radix isatidis) which has proven to have an antiviral function.’[1] During the epidemic period of SARS in Hong Kong there were 2,601 medical staff administered with Kandu Bufei  DecoctionIt was confirmed that 1,063 people had taken it for a successive two weeks according to the request and had returned the questionnaire monitoring effectiveness They were regarded as the treatment groupThe control group consisted of 15,374 subjects who didn’t take Chinese herbal medicineResults: No one in the herbal treatment group contracted the SARS infection while in the control group, 64(0.4%) were infected.[2]
Extensive pharmacological research has shown that many Chinese herbal medicines have very good antiviral effects in their different ways.[3] Chinese herbal medicine could prevent the occurrence of coronavirus infection. It is possibly improving symptoms through enhancing the immunity of body. The ingredients of Kandu Bufei Decoction were based on the classical formula of Yupingfeng San, which is recorded from Yuan Dynasty in 1345 AD. Yupingfeng in Chinese means jade screen.  It means that like a jade screen this medicine can protect people from wind evils.  Modern research has shown that a modified Yupingfeng San formula can inhibit respiratory viral infections in vitro and in vivo.[4]
Coronavirus infection is preventable. Wearing a mask, washing hands and drinking plenty of water can help to prevent infection but the best way to prevent coronavirus infection is to take some Chinese herbal decoction. You can access your local Chinese herb clinic to get your jade screen. It will help you to stay safe from the risk of coronavirus.
Reference:
1. Zhou W Research progress of Chinese herbal medicineRadix isatidis (banlangen).
      Am J Chin Med. 2013;41(4):743-64.
2. Liu Dehui. Clinical Observation on the Preventive Effect of KangduBufei Decoction on AcuteSevere Respiratory Syndrome. Chinese Journal of Integrated Traditional and Western Medicine. 2004; 24(8): 685-688.
3.  Jun Huang. Antiviral Herbs -Present and Future. Infectious Disorders – Drug Targets, 2014, 14, 61-73.

Sunday, 10 November 2019

Five kind of magical seeds

Tiejun Tang


Wuzi Yanzong Wan (WZYZW) is a kind of traditional Chinese medicine patent pill. It originated from Tang Dynasty. It has been used as the first choice for male infertility treatment for more the one thousand years. In Chinese “Wuzi” has two means. It means five seeds and also means five sons. “Yanzong” means reproduction and “Wan” means pill. The ingredients and function of this pill all showed in its name.

The 5 ingredients of WZYZW are 5 kinds of seeds. They are Tusizi, Gouqizi, Fupenzi, Wuweizi, Cheqianzi. In recent few decades it has been found that this pill not only used to treat male infertility bur also can be used to treat female reproductive system diseases. It can regulate many hormone levels which related to fertility function. It can increase the success rate of IVF treatment and regulate women's menopausal symptoms.


Why these five kinds of seeds have so magical effect on fertility treatment? Some researchers did a lot of scientific researches to find out the mysteries behind.
Zou D use Ultra-Performance LC coupled with ESI-linear ion trap-Orbitrap tandem mass spectrometry technique analysed chemical constituents of WZYZW. 106 compounds were found in these 5 seeds, including organic acids, flavonoids, phenylpropanoids, alkaloids and terpenoids. [1]

Ji HJ reported oral administration of WZYZW for 3 weeks, it can significantly increased testes weight, sperm quantity and motility, and reduce testicular damage. Meanwhile, WZYZW treatment significantly reversed the reduction of serum testosterone, and decreased testes malondialdehyde and oxidative stress index relative to the radiated mice.  It also effectively prevented the down regulation of proliferating cell nuclear antigen (PCNA) expression in testes induced by x-ray irradiation.[2]

Xu YP use WZYZW on the spermatogenesis and specific secretory functions of sertoli cells in rat model and to investigate the underlying mechanism. Serum levels of follicle-stimulating hormone inhibit B and testosterone was evaluated using enzyme-linked immunosorbent assay. Androgen-binding protein gene expression and transferrin protein expression in testis tissue specimens of all rats were determined using RT-PCR and Western blotting analysis, respectively. Histopathological alterations in the testis were determined using Johnsen's score. The research found WZYZW can increase the specific secretory functions of sertoli cells. Furthermore, serum testosterone level and Johnsen's score of the testis increased greatly compared with the model group. [3]

Yang Z applied molecular biology technique to detect WZYZW. The results showed this pill can restore testicular structure and significantly increased the histology score in the oligoasthenozoo spermic rats. In addition, it also significantly increased the serum levels of gonadotropin release hormone, luteinizing hormone, estradiol, and testosterone and decreased that of follicle-stimulating hormone. [4]

A latest research use WZYZW to treat non-obstructive oligoasthenozoospermia (NOA). In this study, both plasma and urine metabolomics profiling was first analysed to explore the therapeutic mechanisms of WZYZW on NOA rats induced by removal of the unilateral testicle. Then, 106 identified compounds comprising WZYZW, for which putative targets were discovered using systems pharmacology, were systematically analysed via mRNA microarrays to validate their putative targets. The results suggested that WZYZW plays key roles in modulating the concentrations of 18 metabolites in the metabolism of amino acids, lipids and so on, normalizing the metabolic phenotype and regulating metabolic disorders. Moreover, 27 targets of WZYZW (23 compounds) against NOA were validated, and metabolomics-tested metabolites were also found to be significantly related to these identified targets. [5]

Above research reports provide a strong scientific evidence of WZYZW. This magic pill should be a good choice for the infertility treatment of male and female. 
Reference: 
  1. Zou D.  Analysis of Chemical Constituents in Wuzi-Yanzong-Wan by UPLC-ESI-LTQ-Orbitrap-MS. Molecules. 2015; 20 (12):21373-404.
  2. Ji HJ. Wuzi Yanzong pill, a Chinese polyherbal formula, alleviates testicular damage in mice induced by ionizing radiation. BMC Complement Altern Med. 2016; 16(1):509.
  3. Xu YP. A Chinese herbal formula, Wuzi Yanzong pill, improves spermatogenesis by modulating the secretory function of Sertoli cells. Chin J Integr Med. 2014; 20(3):194-9.
  4. Yang Z. Effect of Wuzi Yanzong on Reproductive Hormones and TGF-β1/Smads Signal Pathway in Rats with Oligoasthenozoospermia. Evid Based Complement Alternat Med. 2019 Apr 16;2019:7628125.
  5. Zou D. Analysis of pharmacological mechanisms and targets mining of Wuzi-Yanzong-Wan for treating non-obstructive oligoasthenospermia. Biomed Pharmacother. 2019 Jul;115:108898. doi: 10.1016/j.biopha.2019.108898.

Thursday, 11 April 2019

Can acupuncture treat Parkinson’s disease?

Tiejun Tang
Today is World Parkinson's Day. This week is Parkinson’s disease awareness week of UK. Parkinson’s disease (PD) is the second most common age-related neurodegenerative disorder after Alzheimer’s disease. An estimated seven to 10 million people worldwide have PD. There are an estimated 127,000 people in the UK living with PD.

There's currently no cure for Parkinson's disease. Physiotherapy can relieve muscle stiffness and joint pain through manipulation and exercise. Language therapy can help to improve speaking. Levodopa usually used to improves movement problems, but it often causes a lot of side effects. Long-term use of levodopa is also linked to problems such as uncontrollable, jerky muscle movements (dyskinesias) and "on-off" effects, where the person rapidly switches between being able to move (on) and being immobile (off).

Acupuncture is widely used to treat PD in many countries. Many clinical trials and laboratory research reports were published in the past two decades. These reports showed us two facts: 
1. Acupuncture is effective in PD treatment:
Shulman LM [1] used acupuncture to treat 20 cases of PD. On the patient questionnaire, 85% of patients reported subjective improvement of individual symptoms including tremor, walking, handwriting, slowness, pain, sleep, depression, and anxiety; Ren XM [2] used acupuncture combined with madopar to treat 50 cases of PD. A total effective rate of 92% was achieved with obvious alleviation of motor disorder in the treatment group, which was significantly higher than that in the madopar control group. The result indicates acupuncture can enhance therapeutic effects of western medicine and lessen the dose of the medicine needed; Arankalle DV[3]  used electro-acupuncture to treat a case of PD. Assessments were based on the Berg Balance Scale (BBS) and Parkinson's Disease Questionnaire-39 items. The patient  improvement on the BBS, his quality of life showed improvement particularly on the 'activities of daily living', 'cognition' and 'communication' dimensions;  Iseki C [4] reported acupuncture can alleviate the nonmotor symptoms of PD including pain, depression, and autonomic Symptoms; Fukuda S [5] reported acupuncture have an immediately effects on tongue pressure including swallowing reflex latency in PD;  Lee SH [6] reviewed 25 randomized controlled trials (RCTs) on the topic of acupuncture treat PD. The results showed acupuncture was effective in relieving PD symptoms compared with no treatment and conventional treatment alone, and acupuncture plus conventional treatment had a more significant effect than conventional treatment alone; Yeo S [7] used electro-acupuncture to treat 10 patients in the hospital. The acupoints GB34 and LR3 were selected. After 8 weeks treatment the Unified Parkinson's Disease Rating Scale (UPDRS) sub-scores and the depression scores for the patients had statistically decreased compared to the scores before acupuncture treatment; moreover, 8 weeks later, these scores remained stable. A positive correlation was found between the UPDRS and the mean magnetic resonance signal change for the thalamus.
2.    These effects were supported by many scientific research reports:
Wang L [8] reported 29 PD patients were under the auditory evoked brain stem potential (ABP) examination, the latent period of V wave and the intermittent periods of III-V peak and I-V peak were significantly shortened after acupuncture treatment. The difference of cumulative scores in Webster's scale was also decreased in correlation analysis; My ex colleague Huang Y[9] used positron emission tomography (PET) and the 18-flourodeoxyglucose tracer to study cerebral effects of acupuncture in PD. Five patients received scalp-acupuncture and Madopa, while the other five had Madopa only. PET scans before and after acupuncture show increased glucose metabolisms in parietal, temporal, occipital lobes, the thalamus, and the cerebellum in the light-diseased hemisphere, and in parietal and occipital lobes of the severe-diseased hemisphere. No changes were observed in the Madopa-only group. This indicated acupuncture in combination with Madopa may improve cerebral glucose metabolism in PD; in the other report [10] she used single photon emission computed tomography (SPECT) measures of 99mT-ECD and 99mTc-TRODAT-4, before and after scalp acupuncture treatment. Patients who received levodopa and complementary acupuncture had increased regional cerebral blood flow (rCBF) in the frontal lobe, the occipital lobe, the basal ganglion; Yang JL[11] investigated the role of acupuncture in neurotoxin-induced PD mice. The mice were evaluated for behavioral changes, in terms of time of landing, after acupuncture treatment. The animals were sacrificed and their brains assayed for dopamine and its metabolites and tyrosine hydroxylase (TH) expression by using HPLC and immunohistochemistry/Western blotting. The results showed that the time of landing of the three groups with treatment was significant longer than normal group. Nonetheless, the acupuncture group had a shorter time of landing than sham acupuncture group. The number of TH (+) neurons and the expression of TH proteins were significantly higher in the acupuncture group than in the sham acupuncture group. These results conclude that acupuncture possibly attenuates neuronal damage in MPTP-induced PD mice, which suggests acupuncture may be useful as a complementary strategy when treating human PD; Yeo S[12] investigated the reported association between acupuncture point GB34 and PD. They use fMRI methods examined the neural responses of 12 patients with PD and 12 healthy participants before and after acupuncture stimulation. The results showed acupuncture stimulation increased neural responses in regions including the substantia nigra, caudate, thalamus, and putamen, which are impaired caused by PD; Wang S[13] investigated the effect of electro-acupuncture at Fengfu (GV16) and Taichong (LR3) acupoints in rat models of PD. Reverse transcription-PCR demonstrated that brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor mRNA expression was significantly increased in the substantia nigra of rat models of PD, and that abnormal behavior of rats was significantly improved following electro-acupuncture treatment. These results indicated that electro-acupuncture treatment up-regulated brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor mRNA expression in the substantia nigra of rat models of PD;  Wattanathorn J[14] aimed to determine the effect of laser acupuncture at HT7 on memory impairment, oxidative stress status, and the functions of both cholinergic and dopaminergic systems in hippocampus of animal model of PD. The results showed that laser acupuncture at HT7 enhanced memory and neuron density in CA3 and dentate gyrus. The decreased AChE, MAO-B, and MDA together with increased GSH-Px in hippocampus of a 6-OHDA lesion rats were also observed; Park JY[15] reported that p53 signalling mediates the protective effects of acupuncture treatment in a mouse model of PD. They found that the acupuncture treatment in the mouse PD model results in significant recovery to the normal in the context of behaviour and molecular signatures. The gene network associated with p53 signalling is closely involved in the protective effects of acupuncture treatment in PD. These data suggest that p53 signalling mediates the protective effects of acupuncture treatment in PD.

Traditional Chinese medicine believes PD is mostly due to liver & kidney yin deficiency this lead to liver yang excess. In some conditions it might combined with blood stasis and/or phlegm heat. Bases on these TCM philosophy acupuncturists select different acupoints in different conditions. Body acupuncture, scalp acupuncture and electro- acupuncture can be selected. If Chinese herbal medicine were added it will obtained a better treatment effect.
World Parkinson’s Day, be aware of PD !

 Reference:
  1. Shulman LM. Acupuncture therapy for the symptoms of Parkinson's disease. Mov  Disord. 2002; 17(4):799-802.
  2. Ren XM. Fifty cases of Parkinson's disease treated by acupuncture combined with madopar. J Tradit Chin Med. 2008; 28(4):255-7.
  3. Arankalle DV. Effect of electroacupuncture on function and quality of life in Parkinson's disease: a case report. Acupunct Med. 2013; 31(2):235-8.
  4. Iseki C. Acupuncture Alleviated the Nonmotor Symptoms of Parkinson's Disease including Pain, Depression, and Autonomic Symptoms. Case Rep Neurol Med. 2014;2014:953109.
  5. Fukuda S. Immediate effects of acupuncture on tongue pressure including swallowing reflex latency in Parkinson's disease. Acupunct Med. 2016; 34(1):59-61.
  6. Lee SH. Clinical effectiveness of acupuncture on Parkinson disease: A PRISMA-compliant systematic review and meta-analysis. Medicine (Baltimore). 2017; 96(3):e5836.
  7. Yeo S. A study of the effects of 8-week acupuncture treatment on patients with Parkinson's disease. Medicine (Baltimore). 2018; 97 (50):e13434.
  8. Wang L. Effect of acupuncture on the auditory evoked brain stem potential in Parkinson's disease. J Tradit Chin Med. 2002
  9. Huang Y. Complementary acupuncture treatment increases cerebral metabolism in patients with Parkinson's disease. Int J Neurosci. 2009; 119(8):1190-7.
  10. Huang Y.  Complementary acupuncture in Parkinson's disease: a spect study. Int J Neurosci. 2010; 120(2):150-4.
  11. Yang JL. Neuroprotection effects of retained acupuncture in neurotoxin-induced Parkinson's disease mice. Brain Behav Immun. 2011; 25(7):1452-9.
  12. Yeo S. Acupuncture stimulation on GB34 activates neural responses associated with Parkinson's disease. CNS Neurosci Ther. 2012; 18(9):781-90.
  13. Wang S. Electroacupuncture-regulated neurotrophic factor mRNA expression in the substantia nigra of Parkinson's disease rats. Neural Regen Res. 2013; 25; 8(6):540-9.
  14. Wattanathorn J. Laser Acupuncture at HT7 Acupoint Improves Cognitive Deficit, Neuronal Loss, Oxidative Stress, and Functions of Cholinergic and Dopaminergic Systems in Animal Model of Parkinson's Disease. Evid Based Complement Alternat Med. 2014:937601. doi: 10.1155/2014/937601.
  15. Park JY. p53 signalling mediates acupuncture-induced neuroprotection in Parkinson's disease. Biochem Biophys Res Commun. 2015; 460(3):772-9.