How can we help urinary disorders?

Tiejun Tang
Urinary disorder is not a single disease. It includes many common diseases.  Urinary tract infections (UTI) are more common in women than in men. It's estimated that half of all women in the UK will have a UTI at least once in their life. Men are not luckier than women, because prostate diseases became the other group of common urinary disorders including prostatitis, benign prostatic hyperplasia (BPH) and prostate cancer. The prevalence of prostatitis is 2.2-9.7% of adult men. For men by age 60, over one-half have BPH; by age 85, the number climbs to 90%, according to the American Urological Association. Prostate cancer is the most common cancer in men in the UK, accounting for 25% of all new cases of cancer in males.

Different urinary disorder diseases show different clinical symptoms:

Ø  UTI:  frequent, urgent and painful urine; a burning sensation when urinating; urine colour appears darker or cloudy.

Ø  Prostatitis:  discomfort, pain or aching in testicles, or the area between testicles and perineum, or the tip of penis; discomfort, pain or aching in the lower abdomen; urinate frequently or urgently; pain or stinging during or after urinating; lack of libido.

Ø  Prostatic hyperplasia: age over 60; trouble getting a urine stream started and completely stopped; often feeling like need to urinate; a weak urine stream; a sense that the bladder is not completely empty after urination.

Ø  Urinary tract stone: lower back orlower abdominal pain, which can often be severe; pain or difficulty when urinating, frequent urination, and at night; cloudy or blood in the urine.

Ø  Bladder prolapse: discomfort or pain in the pelvis; tissue protruding from the vagina; difficulty urinating; feeling that the bladder is not empty immediately after urinating; urine leakage during sneezing or coughing; painful intercourse.

The main reasons of UTI and prostatitis are bacterial infections or any other infections of sexually transmitted diseases (STD). Prostatic hyperplasia and cancer often result from long term prostatitis. Bladder prolapse is related to excessive sex and multiple labours.

TCM Perspective

Traditional Chinese medicine believes that the kidneys dominate the water metabolism. All the problems of bladder, ureter and prostate are related to the kidneys. The symptoms of UTI and prostatitis are due to bladder dampness and heat. The treatment principle is to expel dampness and clean away the heat. Prostatic hyperplasia is due to kidney deficiency arising from the aging process. Invigorating the kidney will benefit the urination. Bladder prolapse and other pelvic organ prolapse (POP) are due to sinking of the Qi in the spleen and stomach. The treatment principle is lifting qi of middle jiao.

Many acupuncture points have a very good function of regulating urinary disorder. Taixi(KI3), Sanyinjiao(SP6), Zhonngji(RN3) and Shuidao(ST28) just to name a few. A randomized controlled clinical trial suggest that women who received 4 weekly bladder specific acupuncture treatments had significant improvements in bladder capacity, urgency, frequency, and quality-of-life scores as compared with women who received placebo acupuncture treatments^[1].

Bazheng San is a very effective traditional formula for cleaning bladder damp-heat. It is widely applied to treat UTI and prostatitis when antibiotics don’t work. Some randomized controlled trials suggest that Chinese herbal medicine was superior to western medication in improving quality of life and reducing prostate volume^[2].

 

No matter what kind of urinary disorder, TCM always can find a right method to solve the problem or relive the symptoms. Some treatment mechanisms have been proved by modern science, some still undiscovered. If you have any of the above urinary disorder, contact your TCM practitioner. 

Reference

1. Emmons SL. Acupuncture for overactive bladder: a randomized controlled trial.Obstet Gynecol. 2005; 106(1):138-43
2. Ma CH. Efficacy and safety of Chinese herbal medicine for benign prostatic hyperplasia: systematic review of randomized controlled trials.Asian J Androl. 2013;15(4):471-82. 

How can we help stroke sequelae & rehabilitation?

Tiejun Tang

In the UK, strokes are a major health problem. Every year, around 110,000 people have a stroke in England and it is the third largest cause of death^[1]. The treatment of and productivity loss arising from stroke results in total societal costs of £8.9 billion a year, with treatment costs accounting for approximately 5% of total UK NHS costs^[2]. More than half of the costs are incurred on rehabilitation of following strokes.

After survival from the acute stage, stroke patients usually will be discharged from hospital. Patients still have hemiplegia, numbness in one side of the body, distortion of the face and tongue, slurred speech or dysphasia. A long term rehabilitation care and treatment is very necessary. Good treatment can greatly improve the symptoms of stroke sequelae, in many cases patients can return completely back to normal. If there is no treatment or inappropriate treatment in sequelae stage, patients will have a high risk of a second and even worse stroke.   

There are two main causes of stroke:  The ischemic cerebrovascular disease accounts for 85% of all cases, others are hemorrhagic cerebrovascular disease. Some risk factors are main reasons of these two acute cerebrovascular attacks. Include: high blood pressure, high cholesterol, diabetes, obesity, smoking, drinking excessive alcohol, lack of exercise and emotional stimulation which may cause a temporary rise in blood pressure.

TCM Perspective

Stroke in TCM is called Zhong Feng. It means attacked by wind. It is an internal wind, which is caused by liver yang excess and/or kidney yin deficiency. In some cases healthy qi deficiency and blood stasis or wind phlegm obstruction can became the main reasons.

Acupuncture especially electric acupuncture and scalp acupuncture can help to reduce muscular atrophy and improve the myodynamia. A randomized controlled clinical trial showed acupuncture can significantly increase cerebral blood flow velocity of post stroke patients^[3]. Another 3 clinical studies also suggest that acupuncture increases quality of life and improves mobility and activities of daily living ^[4].

Buyang Huanwu Decoction is a famous traditional Chinese medicine formula, and has been used extensively in the treatment of stroke for centuries. Many clinical trial and experimental studies suggest this decoction can benefit strike sequelae through many molecular mechanisms^[5].

In the acute stage of stroke, western medicine must be the first choice, but in the sequelae stage Chinese medicine should be a better choice. The effect of acupuncture and herbs can enhance each other.  Chinese Tuina massage or acupressure also can help a lot in the rehabilitation of hemiplegia.

Reference:

1.      http://www.nhs.uk/conditions/Stroke/Pages/Introduction.aspx

2.      Omer Saka. Cost of stroke in the United Kingdom. Age Ageing (2009) 38 (1): 27-32.

3.      Ratmansky M. The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial. J Altern Complement Med. 2015 Nov 16

4.      Farmer C. Bringing holistic treatments to the attention of medicine: acupuncture as an effective poststroke rehabilitation J Evid Based Complementary Altern Med. 2015; 20 (2):120-5

5.      Guo Q.  A Systems Biology Perspective on the Molecular Mechanisms Underlying the Therapeutic Effects of Buyang Huanwu Decoction on Ischemic Stroke. Rejuvenation Res. 2015; 18(4):313-25. 

Stress, Depression, Anxiety and TCM treatment

Tiejun Tang

Stress, depression and anxiety are three different mental health disorders.

Stress is the most common condition, nearly everyone experiences stress at one time or another. According to the findings from the Office for National Statistics (ONS), nearly one-fifth of adults in the UK experience anxiety or depression.

The clinical manifestations of these three emotional disorders are different;

Stress is the feeling of being under too much mental or emotional pressure. It can cause a lot of physical symptoms including: low energy, headaches, stomach upset, diarrhoea, constipation and nausea, aches, pains, and tense muscles, chest pain and rapid heartbeat, insomnia and low libido.

Depression is a mood disorder that causes a persistent feeling of helplessness, hopelessness and sadness and loss of interest in daily activities, anger or irritability, appetite or weight changes, sleep changes, loss of energy, self-loathing and reckless behaviour.

Anxiety is a feeling of unease, such as worry or fear. The clinical symptoms vary depending on the type of anxiety disorder, but generally include: Feelings of panic, fear, and uneasiness, sleeping disorder, cold or sweaty hands and/or feet, shortness of breath, palpitations, restlessness, dry mouth, numbness or tingling in the hands or feet.

Living in modern society everybody has to face a stressful life of working or studying. Long term stress often causes depression and anxiety.  Many other reasons also can lead to depression and anxiety, including marital or relationship problems, unemployment, alcohol or drug abuse, early childhood trauma or abuse, health problems or chronic pain and family history.

TCM Perspective

Traditional Chinese medicine believes these diseases are caused by seven emotions disorder. In ancient classic text these conditions have been diagnosed as Yu Zheng. In TCM most of depression and irritable moods are due to liver qi stagnation; most of sleeping problems and palpitation are due to heart shen disturbance or heart qi deficiency; some symptoms of the digestive system are due to spleen and stomach disharmony.

Acupuncture can regulate the function of these internal organs by 

stimulating certain points on certain meridians. A systematic review and meta-analysis study suggests that acupuncture combined with antidepressant medication is effective, has an early onset of action, safe and well-tolerated over the first 6-week treatment period ^[1]. In depression treatment, a cost-effectiveness analysis study from UK suggests that acupuncture is cost-effective compared with counselling or usual care alone ^[2].

Chinese herbs also can have good effect in relieving depression and anxiety symptoms. Some antidepressant-like effects were obtained from ethanolic extract of Chinese herb Suanzaoren and Hehuan^[3]. These antidepressant-like extracts come from natural herbs; they don’t have any side effects unlike synthetic antidepressants.

Generally speaking TCM can be very helpful in the treatment of stress, depression and anxiety and is therefore a better alternative option.

Reference:

1. Chan YY. The benefit of combined acupuncture and antidepressant medication for depression: A systematic review and meta-analysis. J Affect Disord. 2015 May 1;176:106-17.
2. Spackman E. Cost-effectiveness analysis of acupuncture, counselling and usual care in treating patients with depression: the results of the ACUDep trial. PLoS One. 2014 Nov 26;9(11):e113726.
3. Liu J. Antidepressant-like effect of the ethanolic extract from Suanzaoren & Hehuan Formula in mice models of depression. J Ethnopharmacol. 2012 May 7;141(1):257-64

An Historic breakthrough - Chinese herb research awarded the Nobel Prize!

Tiejun Tang    

On 5^th October 2015, the Chinese pharmacologist Youyou Tu was awarded the 2015 Nobel Prize in Physiology or Medicine for her discovery of artemisinin. As a traditional Chinese medicine practitioner, I am very proud of this great achievement. It is an historic breakthrough in at least three aspects: The first citizen of People’s Republic of China to be awarded the Nobel Prize for science; the first female Nobel Prize winner from China; the first Nobel Prize awarded to Chinese herb research.

Artemisinin was extracted from the Chinese herb Qinghao (Artemisia annua, English common name: Sweet Wormwood). It has opened new way to battle malaria. This research started in the late 1960’s, since when, Ms Tu has studied and reviewed 2,000 ancient herbal formulae from the Academy of Traditional Chinese Medicine in Beijing. She found a record referring to the treatment of malaria from a classic text from 1,600 year ago (during the East Jin Dynasty). It recommended soaking sweet wormwood (Artemisia annua) in water and drinking the resulting infusion. Ms Tu invented ether extraction of Qinghao and significantly increase the effect of artemisinin. This great invention had saved more than a million lives in Africa. It is a milestone in the treatment of malaria. Through over 40 years of concerted effort by an entire research team, this research has been awarded the highest accolade of scientific research. 

At the Awards ceremony, a Chinese journalist asked: “Can we say this is the first time in you award to traditional Chinese medicine, and can you comment on the contribution to this field?”   Mr.Hans Forssberg of the Nobel Prize committee said: “It is very important that we are not giving prize to traditional medicine. We are giving prize to person inspired by traditional medicine and who has been able to make new drug that can be distributed all over the world.” I think the most important step is the “inspired by traditional medicine”. There are thousands of medicinal herbs in the world. Finding an effective herb for malaria is like searching for a needle under the sea. Only under the guidance of Traditional Chinese Medicine’s classical texts and the clinical experience of 1600 years, was Youyou Tu able to find the critical inspiration to make her discovery.

Qinghao (Artemisia annua) is one of my favourite herbs in my practice. It not only provides effective treatment for malaria but also is used to good effect on the symptoms of menopause. Within the practice of traditional Chinese medicine, the symptoms of hot flushes and night sweats are due to yin deficiency and I often use Qinghao to clear the heat which causes these symptoms.  It has always shown significant positive effects.

Traditional Chinese medicine is a great treasure of the world. The discovery of artemisinin has merely scraped the tip of the iceberg. I believe more and more great discoveries in Chinese medicine research will come in the future.   

How to treat Fibromyalgia with Chinese Medicine?

Tiejun Tang

Fibromyalgia (FM) is a long-term condition that causes pain all over the body. It is a common disease. According to NHS Choices nearly 1 in 20 people may be affected by fibromyalgia to some degree. If you have increased sensitivity to pain, fatigue, muscle stiffness, difficulty sleeping, memory and concentration problems. You might suffer from FM.  

How to treat FM?  If a patient was suspected suffer from FM, their GP will usually refer them to a rheumatologist, neurologist or psychologist. Usually the patients will be given pain killers, antidepressants, muscle relaxants and sleeping pills. These medications may often cause a number of side effects, when used long term. Some non-pharmacological treatment plans are suggested by Fibromyalgia Action UK – the only Fibromyalgia association in UK.  In their treatment guidelines acupuncture, massage therapy and herbal remedies are recommended.

Traditional Chinese medicine uses syndrome differentiation diagnosis to treat FM.

FM has many symptoms that tend to vary from person to person. The main symptom is widespread pain. If the pain is related to cold and dampness weather, it is due to Bi syndrome; if the pain is sharp and in fixed position with long history, it might due to blood stasis; if the pain is related with emotional change with depression, it is due to liver qi stagnation; if the muscles are more stiff than painful, it might due to blood deficiency; if there is more fatigue and the pain worsens when muscles overstrain, it is due to qi deficiency.

The best Chinese medicine treatment is to combine acupuncture, Tuina massage and Chinese herbal medicine.  The acupuncture points selection and herb selection are varied from person to person. Different syndrome differentiation diagnosis will use different treatment principles. For example Taicong (LV3) and Hegu (LI4) can be selected to release the pain due to Qi stagnation and blood stasis. Zusanli (ST36) and Qihai (RN6) can be selected to tonify qi and enhance energy levels. Xuehai (SP10) and Geshu (BL17) can be selected to remove blood stasis; some trigger points or Ashi points must be selected on the region of pain. The mechanism of acupuncture to release and relieve pain has been approved by many researches. I have another blog article discussing this topic so will not mention it further here.  

Acupuncture has a better effect when combined with Chinese herbs. My experience on FM herbal treatment is to use modified Duhuo Jisheng Tang. It is a classical herbal formula originally from Tang Dynasty (AD 652). It contained 15 ingredients. We must do a lot of modification according to clinical symptoms of each individual case. For example: If there is more Qi deficiency add Huangqi, Baizhu; more blood deficiency add Jixueteng; if there is severe pain add Yanhushuo, Chuanlianzi. etc.

Tuina massage is the other good treatment for FM, especially after acupuncture treatment a few minutes of Tuina massage can often make patients feels much better immediately.

The etiology of FM is not yet certain. Western medicine still faces many difficulties in its treatment. Fortunately we have complementary medicine to help patients with this painful condition. 

How to treat menopause syndrome with Chinese herbal medicine?

Tiejun Tang

About 80% of women in the UK will experience menopausal symptoms in their lifetime. It might happen to women at the age of 45—55. In the UK, the average age for menopause is 52 years.

The main symptoms of menopause syndrome are: amenorrhea, hot flushes, night sweats, palpitations, depression, anxiety, headaches, insomnia, loss of libido, vaginal dryness and pain during the sex.

Western medicine treats menopause syndrome by symptoms management, usually sleeping pills were prescribed for insomnia and pain killers for headaches; it only can relieve some symptoms temporarily. Since 1950’ hormone replacement therapy (HRT) was applied to menopause treatment, external hormone was given by tablets, patches or implants. Although HRT can effectively release menopause symptoms, but there is evidence shown that it can increase the risk of cancer in the breast, womb and ovarian, it also leads to increased risk of blood clotting and stroke. Is there any medicine can release menopause symptoms without increasing these risks? The probability of Chinese herbal medicine is a good option.

Traditional Chinese medicine believes kidneys dominate the fertility and reproduction function of human body. Menopause is mainly due to kidney deficiency, hot flushes and night sweats which indicate kidney yin deficiency; palpitations and insomnia indicate disharmony between heart and kidney; depression and anxiety indicate liver qi stagnation; lower libido and vaginal dryness indicate kidney essence deficiency.

Each menopause case might have different clinical manifestations. Chinese medicine will select different herbs according to individual conditions. For Kidney yin deficiency Zhibai Dihuang Wan and Qinhao Biejia Tang will be applied; for heart and kidney disharmony Tian Wang Bu Xin Dan is a good choice; for liver qi stagnation Xiaoyao Wan is suitable. I only mentioned the name of these formulas, actually each formula contains many herbs, and each herb contained has many effective ingredients.   

All herbs come from natural plants, non- toxic, non- side effects, which are much safer than synthetic drugs. Pharmacology research showed many herbs contain isoflavones, lignans and coumarins. These ingredients have oestrogens like function, so they have been called phyto-oestrogens. That is why they show good effect on the menopause syndrome. I would like to recommend this natural HRT to all the menopausal ladies.

Reference:

Eden JA. Managing the menopause: phyto-oestrogens or hormone replacement therapy? Ann Med. 2001; 33(1):4-6.

A classic formula for clean away summer heat

Tiejun Tang

The highest-ever temperature in Britain has been recorded. This Wednesday a temperature of 37.4C was recorded at Heathrow around 1.30pm, the London Weather Centre said. It is the hottest day in recent 25 years.

Most of people feel uncomfortable in these hot days. Many old and weak peoples were was fainting or unconsciousness. The London Ambulance Service said total calls on that day were up 28 per cent on the same period last week.

I would like to introduce a classic Chinese herb formula for fighting the hot weather. It will make you feels much better and safer in this hot summer.

This formula was original from Wang Meng Ying (AD1808-1868), a famous specialist of febrile diseases in Qing Dynasty. The formula named Qing Shu Yi Qi Tang (清暑益气汤).

The ingredients are: Xiyangshen (American ginseng) 5g, Shihu 15g，Maimengdong 9g，Huanglian 3g，Zhuye 6g，Hegen 6g，Zhimu 6g，Gancao 3g，Jingmi 15g，Xiguacuiyi 30g. 

Boiled with water and drink the decoction twice a day.

Note: the dosage usually various in individual person.

The function of this formula is: Clean away summer heat and benefit vital qi; Nourishing yin and promoting body fluid.

Indications are: Fever, excessive sweating, thirsty, restlessness, dark urine, fatigue, short of breath, irritable and lower mood.

Do you have any of above symptoms? Try this Chinese herbal decoction, it will make you feels much refresh and energetic in the hot summer.