Metabolic Syndrome and its TCM Food Therapy

Tiejun Tang
Last month I delivered two lectures, one for TCM Student Society of Middlesex University, the other for the annual general meeting of ATCM. In these two lectures I talked a same topic -- Metabolic Syndrome and its TCM Food Therapy. The audiences are very interested in my talk. Many people ask me for handout, somebody suggest me to publish this paper in ATCM journal. I prefer to put this article in my blog first, to share my knowledge to more readers all over the world.

Metabolic syndrome (MS) is a group of common diseases. It became more and more popular due to the life- style of modern society. Chinese medicine herbs have a good effect in the treatment and prevention of MS. Patients often need a long term treatment. Most of patients don’t like to take the herb decoction for too long time, many treatment have to be terminated for this reason. If we use herbs as a daily food therapy, that will be much more acceptable for most of the patients. In this paper I will introduce some TCM food therapy methods on the treatment of MS.
The definition of metabolic syndromeAlthough the conception of metabolic syndrome originated in late 1950s, but it used to have a different definition. Until Reaven (G.M Reaven 1988) noticed that hyperlipidaemia, hypertension and insulin resistance often cluster together, he put forward the conception of X-syndrome, nine years later Zimmet (P.Z. Zimmet 1997) suggested to use the conception of metabolic syndrome. In 1999 WHO gives the work definition of metabolic syndrome it refers to a clustering of cardiovascular disease risk factors, including type 2 diabetes, hyperlipidaemia, hypertension and obesity.
The diagnostic criteriaThe diagnostic criteria of MS are various in different countries. NCEP (National Cholesterol Education Program) criteria and IDF & AHA (International Diabetes Federation & America Heart Association) criteria are applied in America. EGIR (European Group for the study of Insulin Resistance) criteria are applied in most of the European countries. The WHO criteria (1999) is following:
Require presence of one of:

•  Diabetes mellitus
•  Impaired glucose tolerance
•  Impaired fasting glucose or
•  Insulin resistance

AND two of the following:

•  BP: ≥ 140/90 mmHg
•  Dyslipidemia:TG: ≥ 1.695 mmol/L & HDL-C ≤ 0.9 mmol/L (male), ≤ 1.0 mmol/L (female)
•  Central obesity: waist:hip ratio > 0.90 (male); > 0.85 (female),
• or body mass index > 30 kg/m2
•  Microalbuminuria: urinary albumin excretion ratio ≥20 µg/min
• or albumin:creatinine ratio ≥ 30 mg/g

The prevalence of MSThe prevalence of the MS varies with country, race and the definition used. One study in the USA found a prevalence of 44% in the over-60s. A study in the Shanghai found a prevalence of 17.14% (1/6) in the age of 20-74 (Lei Chen. 2003). A report showed that the prevalence of metabolic syndrome in western London is various in different races. South Asians have higher prevalence than African-Caribbeans and Europeans (T.Tillin.2005).
Traditional Chinese medicine’s philosophy about MSAccording to Chinese medicine’s theory MS falls within the category of Xiaoke (消渴) and Xuanyun (眩晕). The etiology of MS is due to: a) Improper diet causing by over eating fat and sweet food; b) Emotional disorder causing by stress work and depression ; c) Spleen deficiency due to many chronic disease; d) Kidney and liver deficiency due to ageing; e) Yin-Yang loose balance and phlegm obstruction; f) Sluggish qi and blood circulation due to lack of exercise; Commonly used treatment principle should be: a) Expel dampness and phlegm; b) Remove the qi stagnation; c) Activate qi and blood circulation; d) Invigorating the spleen; e) Tonify kidney.
Food therapy formulas:

1. Gouqi Juhua Tea
Ingredients: Gouqizi (Fructus Lycii) 10g add 500ml water, boil 2 minute, add Juhua (Chrysanthemum) 10g, green tea 5g，Covered and soak for 30min. Drink once or twice daily.
Clinical application: hypertension, arteriosclerosis, coronary heart disease, diabetes, hyperlipemia, dry eyes and blurred vision.
2. Shanzha Jueming Tang
Ingredients: Shanzha (Hawthorn Fruit) 20g, Juemingzi (Semen Cassiae) 10, Prepare method : add 500ml water, boil for 30 min, drink once a day.
Clinical application: hyperlipemia, cholesterol or triglyceride, hypertension, arteriosclerosis, coronary heart disease, constipation, food retention.
3. Yumixu Tang
Ingredients: Yumixu (Corn Stigma) washed and soaked with boiled water for 5 min, or boil with water for 5 minute, drink once a day.
Clinical application: diabetes, hypertension, cholecystitis, hepatitis, nephritis.
4. Sanqi Shanyao Zhou
Ingredients: Sanqi (Radix Notoginseng）5g, Shanyao (Rhizoma dioscoreae) 60g, Jingmi (rice) 60g. Prepare method: above ingredients add water 500 ml, boiled for 1 hour，drinking the porridge.
Clinical application: diabetes, hypertension, anaemia, irregular menstruation, scanty menstruation.
5. Gegen Fen Zhou
Ingredients: Gegenfen (Radix Puerariae) 30g, Jingmi (rice) 50g; Prepare method ：add water 500 ml, boiled for 1 hour, drinking the porridge.
Clinical application: diabetes, hypertension, coronary heart disease, hyperlipoidemia.
6. Shanzha Shouwu Tang
Ingredients: Shanzha (Hawthorn Fruit) 30g, Heshouwu (Radix polygoni multiflori) 18g, Zexie (Rhizome of Oriental Waterplantain) 12g; Prepare method：Above ingredients add water 600 ml, boiled for 1 hour. Drink the decoction twice a day.
Clinical application:　hyperlipemia, Diabetes hypertension, coronary heart disease．
7. Ju Huai Cha
Ingredients: Juhua (Chrysanthemum) 3g, Huaihua (Flower of Japanese Pagodatree) 3g, Green tea 3g; Prepare method ：Put above ingredients in a cup, add boiled water, soaked 5 minute, drink the tea once daily.
Clinical application:　Hypertension，Headache，Dizzness．
8. Xiakucao Jiangya Cha
Ingredients: Xiagucao (Spike Prunella) 10g, Cheqiancao (Herba plantaginis) 12g; Prepare method: above ingredients washed, and put them in a cup, add boiled water, covered and soaked for 5 minute, drink the tea once a day.
Clinical application：Hypertension，Headache，Dizzness．
9. Danshen lucha Yin
Danshen (Rdix salviae miltiorrhizae) 9g, Green tea 3g; Prepare method： Put Danshen power and green tea in a cup, add boiled water, covered and soaked 5 minute, drink the tea once or twice daily.
Clinical application：Coronary heart disease，Angina，Hyperlipoidemia．　
DiscussionWestern medicine is effective in treating MS but it has to use many tablets at the same time. Patient has to take one table for blood sugar, one for cholesterol, and one or two tablets for control blood pressure. Usually these medicines are quite effective to control sugar, cholesterol and blood pressure, but each medicine will cause some side effects if used long term. These side effects will lead to some new troubles, such as liver function damage, low libido, edema, dry cough, headache, and even heart failure. That is the biggest trouble of west medicine.

Pharmacological research showed the ingredients of Yumixu contains flavone, glycoside, trace element, organic acid, glucide, multi-vitamin. It showed a better effect than 2.5mg Glibenclamide in diabetic patients. There are many effective ingredients in these herbs like tanshinone in Danshen; flavone in Juhua; phytomelin in Huaihua; Notoginseng leaf saponins and flavone in Sanqi; lycium barbarum polysaccharide and Carotene in Gouqizi etc.

Shanzha, Juemingzi and Heshouwu can reduce blood lipid; Juhua, Xiakucao and Gouqizi are good for high blood pressure; Danshen, Sanqi and Gegen can improve coronary circulation and benefit heart. In clinical practice, according to patient’s diagnosis we can select one or two from the nine formulas above. Patients can take the tea or porridge every day or every other day. MS can be get control by daily food therapy. Some MS cases didn’t show a lot of symptoms, many patients didn’t paid enough attention to this disease, but MS put the patients in a high risk of heart attack or stroke. Taking action to reduce the potential risk is better than to wait until the attack has occurred. This is a very important treatment principle of traditional Chinese medicine.

Reference:

1. Lei Chen. (2003). Prevalence of metabolic syndrome among Shanghai adults in China. Chinese Journal of Cardiology. 31(12): 909-912.
2. Reaven GM.(1988). Role of insulin resistance in human disease. Diabetes. 37(12):1595-607.
3. Tillin. T. (2005). Metabolic syndrome and coronary heart disease in South Asians, African-Caribbeans and white Europeans: a UK population-based cross-sectional study
4. Diabetologia 48(4): 649-656.
5. Zimmet PZ et al. (1997). The global epidemiology of non-insulin-dependent diabetes mellitus and the metabolic syndrome. Journal of Diabetes and its Complications. 11(2): 60-68.

Deng’s Herbal Tea

Tiejun Tang
Drinking herbal tea is a very popular for keeping healthy in the southern China. People often drink some herbal tea for clearing heat and detoxification. It is called Liang Cha in Cantonese, mean cold tea. Drinking Liang Cha can keep you away from flu and many other unwell during the hot summer. Deng’s Herbal Tea is a new form of Liang Cha, which was invented by my tutor professor Deng Tietao. Due to its good prescription and excellent pharmaceutical technology, it became one of the most popular healthy products in China.

Deng’s herbal tea is composed of six natural herbs. They are Jinyinhua, Baimaogen, Juhua, Sangye, Pugongying and Gancao. It has heat clearing and detoxification function, so it can be used to treat and prevent common cold and flu which is due to wind-heat. It also has a function of benefiting liver and cooling blood, it can reduce the harm of alcohol and smoking, it is good for heavy drinker and smoker. Because it is good at clearing the heat from lung and stomach, Deng’s herbal tea also can clean acne for any age groups. The modern pharmacology research shows it has an antivirus, immune enhance and diuresis functions.

Deng’s herbal tea has different formulations. Pop can is easier to dink at anytime and any condition. Granule is suitable for family and office worker. Lozenge is easier to carry and taken. Syrup is good for release constipation and moisten lung because it is prepared with honey. There is a no sugar granule special for diabetic population.

The weather of UK is not as hot as southern China. Is it necessary to drink Liang Cha? My answer is yes. For the most British their heat is not from the weather, it is from their life style. According to Chinese medicine’s theory, mutton, lamb, any baked food, chocolate, alcohol and smoking are easy to produce heat or damp-heat. If any one of the above mentioned is your favourite, you probably will have more heat in constitution. You need Liang Cha to expel these pathological fires. Deng’s Herbal Tea is a right choice.

Infertility and its TCM treatment

Tiejun Tang
First of all, I need to identify the concepts of the three key words in this topic.

Infertility: The infertility diagnosis standard of World Health Organization (WHO) is that couples who failed to conceive after 12 months of contraceptive-free intercourse if the female is under the age of 34, or 6 months of intercourse if the female is over the age of 35. Couples who have never been able to conceive are classified as primary infertility, whilst others are called secondary infertility.
TCM: traditional Chinese medicine, which includes Chinese herbal medicine, acupuncture, moxibustion, and electric acupuncture in some conditions.

Treatment: I am very cautious in using the word “treatment” here. A new advertising code had been announced by The Advertising Standards Authority (ASA) in March 2011. The code lays down strict restrictions to advertisements of complementary medicine practices. Wordings such as “cure”, “treatment” are prohibited from the advertisement of our leaflet or clinic website. Some practitioners use wordings like “management” or “help” instead. I never use the word “cure” in my leaflet, because in medicine, it can never be 100% sure that any disease could be cured. I think “treatment” just means the process of a therapy. It doesn’t indicate whether the result will be positive or negative. Why are we not allowed to use the word “treatment” in advertisement? What is the difference amongst “treatment”, “management” and “help”? What a strange code! The code also declared that objective claims must be backed by evidence. Substantiation will be assessed on the basis of the available scientific knowledge. I have two reasons why I used “treatment” here and also in my other blog articles. Firstly, this blog is not a clinic website, hence it is not an advertisement. Secondly, I always show some scientific evidence to support my opinion

The causes of infertility can be due to either the female or male or both parties. In some cases, the cause can be unexplained. In UK the statistic data of 2009 is shown below.

In female infertility the common reasons are shown below.

In a clinical study from Germany (Paulus, 2002), 160 patients who were undergoing assisted reproduction therapy were divided into two groups randomly: embryo transfer with acupuncture (n=80) and embryo transfer without acupuncture (n=80). Acupuncture was performed at 25 minutes before and after embryo transfer. In the control group, embryos were transferred without any supportive therapy. The results showed clinical pregnancies were documented in 34 out of 80 patients (42.5%) in the acupuncture group, whereas pregnancy rate was only 26.3% (21 out of 80 patients) in the control group.

Another report is from Denmark (Lars G. 2006). Patients treated with IVF/ICSI (intracytoplasmic sperm injection) were divided into three groups. Group 1 received acupuncture on the day of embryo transfer (ET), group 2 on ET day and again 2 days later, and both groups were compared with a control group that did not receive acupuncture. Results showed clinical pregnancy rates were significantly higher in group 1 as compared with controls (37 of 95 [39%] vs. 21 of 87 [26%]) and ongoing pregnancy rates were also higher in group 1 as compared with controls (34 of 95 [36%] vs. 19 of 87 [22%]). The clinical and ongoing pregnancy rates in the group 2 (36% and 26%) were higher than in controls, but the difference did not reach statistical difference. Conclusion can be drawn that acupuncture on the day of ET significantly improves the reproductive outcome of IVF/ICSI, as compared with no acupuncture.

Acupuncture also has good effect in treating male infertility. In a prospective controlled study, statistical evaluation of the transmission electron microscopy data showed a significant increase after acupuncture in the percentage and number of sperms without ultrastructural defects in the semen. A statistically significant improvement was also detected in acrosome position and shape, nuclear shape, axonemal pattern and shape, and accessory fibers of sperm organelles. (J. Pie. 2005)

In addition to acupuncture, Chinese herbs can also greatly increase the chances of pregnancy. There is an experimental study which showed that Erzhi Tiangui Decoction could significant raise the quality of oocyte in mice (F. Lian 2004). A clinical track study showed Wenshen Antai Decoction can also increase the pregnancy rate after re-transplant of IVF (D. Li. 2009).

Fertility problems affect one in seven couples in the UK. Many couples choose IVF or IUI, but they have to be prepared for the low success rate and the high cost. Much evidence showed that acupuncture and Chinese herbs can treat infertility for both male and female. Only a few reports amongst many were mentioned above. TCM treatment can help get natural pregnancy, prevent miscarriage and increase the success rate of IVF, although the success rate would vary with different treatment plans and different causes of infertility.

Reference:Lian Fang, Sun Zhen-gao, Zhang Jian-wei, et al.(2004). Experimental Study on Effect of Erzhi Tiangui Recipe on Quality of Oocyte in Mice. Chinese Journal of Integrated Traditional and Western Medicine. 24(7):625-7.

Li Dong (2009). Increase of pregnancy rate by Wenshen'antai Decoction combined with assisted reproductive technology in patients with embryo transplant failure. Journal of Beijing University of Traditional Chinese Medicine. 32(2):

Pei J, Strehler E, Noss U. et al. (2005). Quantitative evaluation of spermatozoa ultrastructure after acupuncture treatment for idiopathic male infertility. Fertility and sterility, 84 (1): 141-147

Paulus WE, Zhang M, Strehler E, et al. (2002). Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil and Steril. 77 (4): 721–4.

Westergaard LG, Q Mao, M Krogslund. et al (2006) Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertility and sterility, 85(5): 1341-1346.

Decoction is the best formulation

Tiejun Tang
There are several different formulations in Chinese herbal medicine. Pills, tablets, powders, capsules are commonly used patent remedies. In addition to these formulations, there is another commonly used formulation – decoction. It means several different raw herbs mixed together, soaked in the water for a period of time and then boiled over fire for about an hour, filtrate them and drink the liquid. It is the most traditional method in Chinese herbal medicine and in my opinion, it is the best formulation. The reasons are below.

Firstly, decoction can give a patient an individual treatment. The treatment principle of Chinese medicine is based on syndrome differentiation diagnosis. In the clinical practice each individual case might need different herbs. Even the same disease with different patient, it may need different prescription because their symptoms are not exactly the same. For example, if two people catch cold at same time. Mr. A has a sore throat, headache, and high temperature; but Mr. B suffers sneezing, blocked and runny nose, with normal temperature. If we treat using a decoction, we will select different herbs according to patient’s clinical manifestation. A good prescription will suit the individual patient only, just like a tailor made suit for an individual person according to their measurements.

Secondly, decoctions have good adaptability. The patient’s symptoms might change during the treatment process. At different stages of the same disease, the patient might need different herbs. We can amend the prescription by changing some herbs or adjusting the dosage of some herbs. It’s better to amend the prescription once a week according to symptoms. Let’s take irritable bowel syndrome (IBS) as an example. Patients suffering from IBS often alternate between diarrhoea and constipation. When diarrhoea happens we need to use Baizhu, Yiyiren, Huoxiang, Peilan etc to tonify the spleen and expel dampness. When constipation happens we need to remove Yiyiren, Huoxiang, Peilan and add Maziren, Juemingzi to moisten the intestine and release constipation. This adjustment can be used more often in some acute diseases and less often in stabile chronic disease.

Thirdly, decoction is more easily absorbed by the patient. After drinking into the stomach, the effective substances in the decoction will be absorbed through the gastrointestinal system and into the blood within half to one hour. The result is much quicker than other formulations.

The disadvantage of decoction is that it requires a little preparation time. The patient needs to spend some time boiling the herbs every day. The other disadvantage sometimes is its taste which is usually quite bitter. You can add some sugar or honey before drinking it. Many people gradually get used to the bitter taste after taking them for a period of time. Some even start to like the "magic coffee", because they get a lot of benefits from the herbal decoction.

Decoction is the best formulation, but a good treatment depends on correct diagnosis. Nevertheless, if disease is misdiagnosed, no formulation will work. However, if you get it right, you are sure to hit the target spot on!

Glandular fever and its TCM treatment

Tiejun Tang

Glandular fever is an infectious disease caused by the Epstein-Barr virus. Some TCM practitioners who were trained in China might not be familiar with this, but its formal name -- infectious mononucleosis, will be more familiar.

The diagnosis of this disease is not difficult. The main points of diagnosis are included in the names of the disease. The clinical manifestations are fever with swollen glands, sore throat, headache, fatigue and muscle ache. These symptoms are similar to flu, except that the patient will have a unique blood test result with monocytes count significantly increased. There may be swollen lymph nodes, enlarged liver and spleen, widespread red skin rash without itchiness.

This disease can occur in any age groups but young people between 10 and 25 years are most vulnerable to this infection. The incubation period from infection to when the symptoms first appear is between 30 and 50 days.

Western medicine does not have any efficient treatment for infections caused by virus. Usually patients will be prescribed medicine such as paracetamol or ibuprofen to ease the symptoms. Antibiotics may be used if the patient developed a secondary bacterial infection of the throat. Steroids may also be prescribed in severe swelling of tonsils.

Chinese medicine diagnosed this disease as Wenbing (温病, epidemic febrile). It is due to wind-heat or wind-cold invading the superficies. The exogenous evils produce heat and toxin. These heat-toxin spread to the blood, it consumes qi and body fluid, then causing qi and yin deficiency at a later stage.

Chinese medicine treats glandular fever with different treatment principles at different stages. In the early stage the diagnosis is due to wind-heat invading the lung, we can use modified Yinqiao San to clear and detoxify wind-heat.  In the middle stage where the heat develops from Wei stage to Qi stage, we need to use modified Baihu Tang to purge the internal fire. In the later stage the heat develops to Ying stage, we select Qingying Tang to clear heat and cool the blood. At the recovery stage, patients usually have qi and yin deficiency symptoms, we should then select modified Zhuye Shigao Tang to clear the remaining fever and tonify qi and yin.

Some Chinese herbs have a good function of inhibiting virus which can be applied to treat glandular fever.  These are Banlangen (Radix Isatidis), Daqingye (Folium Isatidis), Lianqiao (Fructus Forsythiae), Jinyinhua (Lonicera japonica Thunb), Guanzhong (Cyrtomium Rhizome), Huangqin (Radix Scutellariae). If the patient has red skin rash appearing, I would like to add Chishao (Red Peony Root), Mudanpi (Tree Peony Bark), Zicao (Radix Lithospermi), Qiancao (Radix Rubiae), Xuanshen (Radix Scrophulariae) to cool blood. If the patient has qi and yin deficiency, Maimendong (Dwarf Lilyturf Tuber), Zhuye (Folium Phyllostach Lophatheri), Zhimu (Rhizoma Anemarrhenae), Taizishen (Radix Pseudostellariae) can be added.

In addition to Chinese herbal medicine, acupuncture can also be used to treat glandular fever. The commonly used points are Hegu (LI4), Quchi (LI11), Waiguan (SJ5), Dazhui (Du14), Fengmeng (BL12), Feishu (BL13), Xuehai (SP10).  A reducing manipulation can be applied. In some severe cases with high temperature, bloodletting cupping at Dazhui (DU14) is necessary.

Glandular fever usually takes 2-4 weeks to resolve without complications. In about 3 per cent of the cases, it might develop into complications such as pneumonia, anaemia, thrombocytopenia, meningitis or encephalitis. Three percent is a very low chance, but if it happened to an individual person that mean a hundred percent to him/her. Glandular fever should not be ignored.  If a patient has got this disease, he should have plenty of rest, drink plenty of water, and access to a Chinese medicine practitioner. I am sure Chinese herbal medicine and acupuncture can give more help than chemical drugs.

Welcome the right decision from Department of Health

Tiejun Tang

On 16th February the Health Secretary of UK government had announced to Parliament that herbal medicine practitioners will be regulated from April 2012. The four UK health departments have agreed that the Health Professions Council (HPC) should hold a statutory register of practitioners who supply unlicensed herbal medicines to people to enable the supply of herbal medicines to continue after 30 April 2011.

This decision is very good news for all of herbal medicine practitioners including our TCM practitioners. It is also good news for the public because practitioner regulation will be underpinned by medicine legislation which will provide further safeguards to protect public health. Let’s welcome this right decision made by UK government.

The regulatory status of TCM is our hope and dream. Some of colleagues at ATCM had struggled for this target for many years. As a council member of ATCM, I feel very happy to see the good result of regulation. Traditional Chinese Medicine has received great development in the last two decades in UK. There are more than three thousand clinics all over the UK. Chinese medicine became more and more popular in this country. However, some practitioners do not have good qualification. Because there is no status regulation, anybody can practise Chinese medicine here. Many clinics run like a business with the sole purpose of making profits. Some patients enter a Chinese herbal shop irrationally just as they are choosing a Chinese restaurant because they simply do not know where to find advice or recommendation even if they believe in TCM. Many medical mishaps occurred just because of unqualified practice. After April 2012, this condition will not happen again and the public will get better protection, as a register of all qualified practitioners will be kept and made available to the public.

Traditional Chinese Medicine is an Undiscovered Science. This is the title of one of my blog paper last year. TCM origin is from China but it is a common treasure of human beings. It had been widely accepted by almost every country of the world. There is no international border for science, the same for TCM. Chinese medicine is very effective in treating many diseases. For some disease it always works if you get the correct diagnosis and have selected the correct treatment principles. In China the practice of TCM has been strictly regulated by law. All the practitioners must have received at least 5 years training. After they are qualified from university they still need to pass a practice licence examination, any unlicensed practice is illegal. I think TCM practice should be regulated by law in any country for the public’s safety. I would like to say the UK government has made a wise decision this time.

Cold winter is gone, spring is coming. In the UK, TCM’s spring will come very soon.

How to treat Raynaud's Phenomenon with Chinese Medicine?

Tiejun Tang
This winter is extremity cold; many people have very cold hands and feet in such weather. Some people’s cold extremities come by episodic attacks. When the attack occurs, the skin colour changes from white to blue and red. The hands and feet become cold and numb. Some patients describe the sensation as tingling, or painful "pins and needles". The attack is usually triggered by exposure to cold or emotional stress. This phenomenon is called Raynaud’s phenomenon in western medicine. This phenomenon can be subdivided into primary and secondary conditions. The primary form is known as Raynaud’s disease, whereas the secondary form is known as Raynaud’s syndrome.

Raynaud's phenomenon is a disorder that affects the blood vessels in the fingers and toes. This disorder causes vasospastic attacks where the blood vessels in the fingers and toes constrict thus causing a loss of circulation. This phenomenon can affect between 5 to 10 percent of the general population. Women are more susceptible to have the disorder in comparison to men, and it appears to be more prevalent in the winter season of colder climate areas.

In Western medicine the treatment of Raynaud's syndrome is carried out with calcium-channel blockers. These cause the smooth muscle to relax and consequently dilate the small blood vessels. In some patients, doctors use alpha blockers that counteract the actions of norepinephrine. These medicines can often cause some side effects, in which case many patients have to stop using them. These medications may also have a detrimental affect on a growing foetus; therefore women who are pregnant or are trying to have a baby should avoid taking these medications. Unfortunately Raynaud’s is more likely to occur in women of childbearing age.

In Chinese medicine Raynaud’s phenomenon falls within the category of Hanjue (寒厥). It means cold extremities. The interior pathology of this disease is Qi and blood deficiency and Yang deficiency, whereas the exterior pathology would relate to cold invasion within the meridian. The treatment principle should be to nourish the qi and blood, whilst expelling the cold and to warm the yang. This theory can be carry out through the use of herbs, acupuncture and moxibustion.
A herbal prescription suitable for this condition is; Danggui Sini Tang. This would be used as the first choice for this disease, as it is a traditional formula which originates from Shanhanlun, a classic text of TCM, written by Zhang Zhongjing about 1700 years ago. The ingredients include; Danggui (Angelica sinensis), Guizhi (Ramulus Cinnamomi), Baishao (Radix Paeoniae Alba), Xixin (Manchurian Wildginger), Tongcao (Tetrapanax papyriferus), Dazhao（Fructus Jujubae）, Zhigancao (Radix Glycyrrhizae Preparata). If patient have more qi deficiency symptoms, add Huangqi (Radix Astragali) and Baizhu (Rhizoma Atractylodis Macrocephalae). If there is more of a blood deficiency, Jixueteng (Millettia dielsiana) and Heshouwu (Fallopia multiflora) can be add, and if there is more of a yang deficiency, Rougui (Cortex Cinnamomi) and Ganjiang (Dried Ginger) can be included.

With regards to the Acupuncture and moxibustion, these can be very helpful in the treatment of Raynaud’s disease. The acupuncture point selection would include; Mingmen (DU4), Shenshu (BL23), Guanyuan (RN4), Qihai (RN6), Xuehai (SP10), Zusanli (ST36), Baxie (EX-UE9), Bafeng (EX-LE10). Reinforcing manipulation can also be applied. The specific point selection for Moxibustion application should be Guanyuan (RN4) and Shenque (RN8).

I have a student who has been diagnosed with Raynaud’s disease. She often has Raynaud’s attacks during the winter period, but has cold hands and feet all year. She came to see me with regards to this problem last summer, and after few treatment sessions her hands and feet felt a lot warmer. Her Raynaud’s attack did not occur this winter.

Chinese medicine therapy is effective in treating both primary and secondary Raynaud’s phenomenon. It never causes any side effects, and is safe for pregnant women. If you often have cold limbs you need to nourish your qi and blood and warming your meridian pathways at any time during the year, you should not wait until winter. Generally it is better to start your treatment before the attack happens. A good treatment can give you a warmer and more comfortable winter.