Welcome

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. You are welcome to visit my clinic at Hanover square London. W1S 1BN

Thursday 6 June 2024

The best reward for my 40 years clinical practice

Tiejun Tang

This year marks the 40th anniversary of my graduation from the University of Traditional Chinese Medicine, which marked the beginning of my career as a TCM doctor and university teacher. 

An International Chinese media and an authoritative academic institution selected 22 The Overseas Grand Master of Traditional Chinese Medicine and 155 Famous Practitioner of Traditional Chinese Medicine in the world. I am very honored to be selected as one of the 22 Overseas Grand Master of Traditional Chinese Medicine. This is the best reward for my 40 years career.

The certificate of the Overseas Grand Master of Traditional Chinese Medicine was received. I would like to thank the selection committee for their excellent work. Unfortunately, due to the time arrangement, I was unable to attend the awards ceremony in Vancouver today. I wish the conference had successfully accomplished.

At this moment, I would like to say a few words to express my feelings from the bottom of my heart:

First of all, I would like to thank my teachers in the past 45 years since I had entered the world of Traditional Chinese Medicine, including all of my teachers in my undergraduate, MSc, PhD and post-doctoral research stages. I would like to thank every alma mater where I studied and worked together for the past years.

Also, I would like to thank the countless of patients that I had treated in China and the UK in the past 40 years. Your suffering is my motivation to keep making progress. Practitioners' knowledge comes from learning, but most of their clinical experience comes from patients’ feedback

I would like to thank my students who based in China, UK and Europe in the past 40 years. Teaching and learning always enhances each other. Being a good teacher and leading my students on the right path is an additional motivating force to continue my journey.

I would like to thank my classmates, colleagues, and friends at all stages who have supported and helped me over the years. 

At last, I would like to thank my family and relatives who have given me a great support all along.

I’m so grateful to have you all in my life.

Monday 15 April 2024

Precancerous lesions and complementary medicine approach

 TiejunTang 

In recent years, we have often heard bad news about someone who suffers from any type of cancer. According to the statistics of the Cancer Research UK, there are around 375,000 new cancer cases in the UK every year (2016-2018), and around 167,000 cancer deaths in the UK every year (2017-2019). World Cancer Research Fund reported there were 18.1 million cases of cancer diagnosed in 2020 globally.

The prognosis of different cancers are various. Some are completely curable due to the development of medical science; unfortunately some are not. Although they are incurable, we can prevent it. Cancers take time to develop; they often develop from some chronic diseases. These diseases are often called precancerous lesions. If you are being treated appropriately, the condition could be under control.

Below are some examples of common precancerous lesions and the effectiveness of Chinese herbal medicine in these conditions.

1. Atypical Breast Hyperplasia Breast Cancer

Breast cancer is one of the most common cancers, and it often develops from inconspicuous precancerous lesions, such as breast atypical hyperplasia, intraductal papilloma and cystic breast hyperplasia, which are all considered to be precancerous lesions.

From the perspective of traditional Chinese medicine (TCM) , breast hyperplasia is a condition that causes by stagnation of liver qi, which leads to the blockage of qi in the body, resulting in breast pain. TCM herbs that soothe the liver and relieve stagnation can be given to intervene. Commonly used herbs are Xiangfu, Qingpi and Chenpi for soothing the liver and regulating qi. Chishaoyao can be added to activate blood circulation and remove blood stasis, Gualou can be added to resolve phlegm and dissipate stagnation, and Banzhilian & Baihuasheshecao can be added for anti-cancer, as well as reducing the risks of getting breast cancer.

A molecular level experimental study showed: The Chinese herbs Huangqi, Renshen, Fuling and Chaihu, as well as some other herbal formulas can regulate the genetic related and protein expression via pathways such as PI3K/AKT/mTOR, MAPK and Wnt/β-catenin, which inhibits the growth, proliferation, migration, invasion and metastasis of triple-negative breast cancer cell.[1]

2. HPV Infection Cervical Cancer

HPV (human papillomavirus), is divided into high-risk, intermediate-risk and low-risk types according to the risk of causing cervical cancer. Among them, 13 types of viruses are considered in the high-risk category. In the worldwide, there are 90% of cervical cancers are caused by HPV.  In the Western medicine, there isn’t any specific medication for treating HPV, however, It can only be relied on our immunity to cure the disease. In some cases, most of the infections can be healed by themselves within 2 years, however, some patients are potentially suffering from the cervical cancer in the end.

Traditional Chinese Medicine (TCM) believes that this disease is mostly caused by damp-heat, spleen-deficiency, endogenous dampness, as well as toxins which are one of the primary pathologies. Treatment is usually based on strengthening the spleen and removing dampness, clearing away the heat and detoxifying.  The modified formula of the Traditional Chinese medicine, the Simiao Decoction is used in the treatment of HPV, showing the satisfactory efficacy.

The Research shows that the mechanism of Chinese herbal medicine may perform on the regulation of cell apoptosis, viral gene transcription and translation, cell signal transduction pathways and the immune function.[2]

3. Colon Polyps Colon Cancer

Colon cancer is relatively one of the common cancers in the UK, and a large proportion of colon cancers develop from the polyps. Adenomatous polyps have a higher probability of becoming cancerous.  As the size of adenomatous polyps grows, their growth rate is also increased with the total canceration rate ranging from 10% to 20%, therefore, the Western medicine uses endoscopic electrocoagulation resection for the treatment of intestinal polyps, and the recurrence rate is very high.

TCM believes that the causes of colon polyps is due to damp heat, phlegm, and blood stasis that accumulate in the large intestine. The principles of treating this disease are to strengthening the spleen and replenishing the qi, clear away damp heat, and resolve phlegm and blood stasis. In my master degree research in the early 1990s, I applied Jianpi Yikan Pills to treat the intestinal polyps and a satisfactory result was achieved. This patent remedy can be significantly reduced the postoperative recurrence of intestinal polyps.[3]

4. Chronic Atrophic Gastritis Stomach Cancer

For chronic stomachache patient, a gastroscopy is necessary. If the biopsy result of the gastroscopy is chronic atrophic gastritis, We must pay more attention to it, especially if it is accompanied by atypical hyperplasia and intestinal metaplasia, a high risk of stomach cancer is associated.  It is generally believed that the canceration rate is: 3% to 5% in 5 to 10 years, and 10% in more than 10 years. 

TCM believes that the etiology and pathology of atrophic gastritis may include liver and stomach qi stagnation, spleen and stomach deficiency, stomach-yin deficiency or stomach blood stasis. The herb selection should depend on the symptoms of individual cases: Chaihu, Foshou to soothe the liver and relieve the liver qi stagnation ; Dangshen and Baizhu to strengthen the spleen and stomach Qi; Maimendong, Shashen and Shihu to nourish stomach yin;  Chishaoyao and Danshen to remove blood stasis.

Research shows that the mechanism of TCM in treating chronic gastritis include the eradication of Helicobacter pylori, the anti-inflammatory effects, the immune regulation, and the regulation of gastric mucosal cell proliferation, apoptosis, and autophagy levels[4].

5. Pulmonary Nodules Lung Cancer

Chronic cough has increased since the pandemic of COVID-19.  Many people were diagnosed with pulmonary nodules after Covid.  This disease may lead to lung cancer, among which atypical adenomatous hyperplasia which is a type of precancerous lesion.  The bigger the nodule, the higher risk of malignant transformation. People with lung cancer family history are more likely to develop cancer in their lung nodules.

Nevertheless, there is no evidence that pulmonary nodules can be treated by any western medicines, and the surgical operation is necessary for the larger nodules, although the new nodules may reoccur after the surgery.

TCM believes that the main pathogenesis of pulmonary nodules is: deficiency, phlegm, blood stasis, and poison. The treatment principles are to nourish the spleen and lungs, resolve phlegm and detoxify, and dissipate blood stasis and dredge the collaterals.

Usually, Huangqi and Dangshen are used to replenish the qi of the spleen and lungs; Banxia, Qianhu, Zhebeimu and Gualou are used to resolve phlegm and relieve cough, Banzhilian and Yuxingcao are used to clear away heat and detoxify; Sanqi and Danshen are used to activate blood circulation and remove blood stasis.

The Molecular biology and pharmacology research shows that the traditional formula, QianJin WeiJing decoction (QJWJ) can inhibit the growth of lung cancer A549 cell line in a time-dependent manner, which may inhibit the growth of lung cancer cells by inhibiting EGFR and STAT3 signaling pathways, and arresting the cell cycle in G0/G1 phase. The other research showed QJWJ can induce apoptosis in lung cancer cells and enhancing immunity in lung cancer patients. [5]

6. Cirrhosis Liver Cancer

Viral hepatitis is a very common disease in China. In about 10-30% of chronic hepatitis B patients develop cirrhosis within 5-10 years, besides, 5-10% of cirrhosis patients develop liver cancer within 5-10 years as well.  Cirrhosis is considered as a precursor to liver cancer. Although viral hepatitis is relatively rare in the UK, alcoholic cirrhosis becomes the risk factor of liver cancer.

TCM has accumulated immeasurable clinical experiences in treating chronic liver diseases over thousands of years. For those with hypochondriac pain and swelling pain, Chaihu, Qingpi, and Chunlianzi can be used to promote qi and relieve pain; for jaundice conditions, Yinchen, Dahuang and Zhizi can be selected to clear away damp heat and relieve jaundice; for ascites conditions, Fuling, Zexie, Dafupi can be added to diuretic and expel dampness; for patients with hepatosplenomegaly, Danshen, Sanleng, Ezhu can be given to promote the blood circulation and remove blood stasis, or Guiban and Biejia can be used to soften the hardness; for those with cancer tendencies, Banzhilian and Baihuasheshecao can be added to prevent the occurrence of tumors.

There was a cohort study that counted 127,237 liver cancer patients, of which 30,992 (24.36%) were treated with Chinese herbal medicine. Compared with patients who did not use Chinese herbal medicine, The TCM group showed a significantly lower risk of deathModified Xiaoyao San and Chaihu Shugan San were the most effective formulas for improving survival.  [6]

Most importantly, getting early diagnosis and treatment are the most crucial part, as it has a great impact on the patient’s prognosis.

Paying enough attention to the treatment of precancerous lesions can slow down or stop the canceration of cells and avoid the occurrence of cancer. Clinical practice has proven that traditional Chinese medicine can have advantages to the treatments listed above dedicated to precancerous lesions, and its mechanism of action has been confirmed by a variety of scientific studies.

Be aware of the precancerous lesions and eliminate potential risks of cancer is the right choice of your health.

Reference:

1. Zimei Yang. The signaling pathways and targets of traditional Chinese medicine and natural medicine in triple-negative breast cancer. J Ethnopharmacol. 2021 Jan 10:264:113249.

2. Jing Lin. Traditional Chinese medicine for human papillomavirus (HPV) infections: A systematic reviewBiosci Trends. 2017 Jul 24;11(3):267-273.

3. Tiejun Tang. The effect of JPYK pill on T cell subpopulation and immunological function of spleen asthenia mice. Pharmacology and Clinics of Chinese Materia Medica. 1992; 8 (Sep.): 181.

4. Liangjun Yang. Progress in traditional Chinese medicine against chronic gastritis: From chronic non-atrophic gastritis to gastric precancerous lesions Heliyon.2023 May 27;9(6):e16764

5. Peiyu Liu. A Chinese classical prescription QianjinweijingDecoction in treatment of lung cancer: An overview. Biomed Pharmacother. 2022 Dec:156:113913

6. Yueh-Hsiang Liao. Adjunctive traditional Chinese medicine therapy improves survival of liver cancer patients. Liver Int. 2015 Dec;35(12):2595-602.



Tuesday 2 April 2024

Comments on the red yeast incident in Japan

 Tiejun Tang

Recently, there are many people in Japan have been hospitalized or even died due to kidney disease after taking health products containing red yeast rice which produced by Kobayashi Pharmaceutical Company. As of the evening of the 28th March 2024, there were 5 people died and 114 were hospitalized because of the products. It aroused a great attention in Japan and also, many people were alarmed by the incidents, as well as the safety of how to consume the health care products appropriately.

Red yeast rice have been consuming as food and medicine in China for nearly 700 years. In one of the classic books regarding the food and nutrition - "Yin Shan Zheng Yao", which was published in 1330, was stated that this product had the effects of strengthening the spleen, replenishing qi, and warming the stomach at the time.  Li Shizhen, a famous Chinese herbalist in the Ming Dynasty, the author of "Compendium of Materia Medica" also mentioned that red yeast rice had the same beneficial effects.

In 1979, a Japanese scholar Akira Endo isolated Monacolin K from red yeast rice. In 1985, an American scientists Goldstein and Brown further proposed the mechanism of action of Monacolin K in inhibiting cholesterol synthesis, and thus obtained Nobel Prize, therefore, Monacolin K is regards as the first inventor of statins.

Lowering cholesterol is one of the advantages of taking Statin, but for long-term, it shows some side effects.[1] According to the results of many pharmacological studies and randomized controlled clinical trials showed that red yeast rice has lipid-lowering effects similar to those of statins[2-4],  as a natural statin drug, it is relatively safer and is widely used in the treatment of hyperlipidemia in China and Japan.

In traditional Chinese medicine, red yeast often combine with Shanzha (Hawthorn) and  Zexie (Alismatis Rhizoma) and other ingredients that have the similar effect of lowering blood lipids compared with Statin. They are not only lower cholesterol but also reduce triglycerides and balance lipoprotein metabolism.  A research report showed that Chinese herbal medicine, Shanzha have better function in reducing low-density lipoprotein cholesterol (LDL-C) compare to Simvastatin. [5] A molecular biology and network pharmacology study showed that Zexie decoction can decrease total cholesterol (TC), Triglycerides (TG) and LDL-c levels in blood of WD-induced hyperlipidemia mouse model, and improved insulin resistance in vivo.[6]

Why was these incidents happened in Japan?  As Red Yeast Rice has always been considered as a safe and healthy food product.  The current investigation believes that it was due to an error in the process of fermentation during the production, the harmpful substances were in the same batch of the production which caused the people got poisoned accidentially.  The specific investigation results are yet to be determined. The further announcements are to be expecting until further investigations.

Such incident was traumatised, and people would become panicked and worried, however, this incident reminds all pharmaceutical companies that GMP standards and the quality control should be strictly followed.  Moreover, the advantages of using Red Yeast Rice for the treatment of hyperlipidemia as a natural medicine is still valuable.

Reference: 

1.      Natalie C Ward.  Statin Toxicity Circ Res. 2019 Jan 18;124(2):328-350.

2.      Cicero AFG  Red Yeast Rice for Hypercholesterolemia. Methodist Debakey Cardiovasc J. 2019 Jul-Sep;15(3):192-199.

3.      Takuya Minamizuka . Low dose red yeast rice with monacolin K lowers LDL cholesterol and blood pressure in Japanese with mild dyslipidemia: A multicenter, randomized trial. Asia Pac J Clin Nutr2021 Sep;30(3):424-435.

4.      Peng D, Original Research: The Effects of Red Yeast Rice Supplementation on Cholesterol Levels in Adults..Am J Nurs. 2017 Aug;117(8):46-54.

5.      Hong Xu. A study of the comparative effects of hawthorn fruit compound and simvastatin on lowering blood lipid levels. Am J Chin Med . 2009;37(5):903-8.

6.      Zhishen Xie. Zexie Tang targeting FKBP38/mTOR/SREBPs pathway improves hyperlipidemia J Ethnopharmacol. 2022 May 23:290:115101