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. 

Can Acupuncture help to increase the success rate of IVF?

Tiejun Tang

Around one in seven couples may have difficulty conceiving. This amounts to approximately 3.5 million people in the UK. Many of those couples turn to IVF (In vitro fertilisation) in order to get pregnant. The first baby in the world conceived as a result of IVF was born in the UK in 1978. Through over 30 years practice and research the use of IVF became common in the treatment of infertility. Although this technique is continuously developing, its success rate still relatively low. According to NHS statistics in 2010 the IVF success rate in UK was:   
     32.2% for women under 35 
     27.7% for women aged 35-37 
     20.8% for women aged 38-39
    13.6% for women aged 40-42
         5% for women aged 43-44 
      1.9% for women aged over 44

How can the success rate of IVF be increased?  At least two options spring to mind.

Firstly, the patient should choose a good hospital or clinic, which has a long history of infertility treatment with IVF. Many of my clients have successfully become pregnant by using the services at the Centre for Reproductive and Genetic Health (CRGH), the IVF Clinic ARGC and University College London Hospital (UCH) in central London.

The second option is TCM (traditional Chinese medicine), including both acupuncture and Chinese herbal medicine.

Is it necessary to use acupuncture or Chinese herbs during the IVF? Does acupuncture really works or is it just a placebo? Patients often feel confused by the number of differing opinions. After a review of some research reports, the right answer should emerge.

The first report about acupuncture and IVF was published by Stener-Victorin^[1]  in 1999.  The aim of the study was to evaluate the anaesthetic effect during oocyte aspiration. 150 women undergoing IVF were randomized to receive either electro-acupuncture or alfentanil. The result showed compared with the alfentanil group, the electro-acupuncture group had a significantly higher implantation rate, pregnancy rate, and take home baby rate; Paulus^[2] (2002) reported that the use of body acupuncture and auricular acupuncture on the day of embryo transfer (ET), can increase IVF success rate. 160 patients were randomized, grouping them into an acupuncture group and a control group. Acupuncture and auricular acupuncture were administered 25 minutes before and after ET. The result showed that acupuncture group’s success rate was significantly higher than that of the control group. More randomised controlled clinical trials have been carried out since then. Some studies used similar acupuncture protocol to Paulus; Dieterle^[3] did another session 3 days after ET; Westergaard^[4] did one additional session 2 days after ET; and Smith^[5] did one more session on day 9 of ovarian stimulation. Zheng^[6] did a systematic review and meta-analysis on this topic. 24 trials (a total of 5,807 participants) were included in this review. The result showed that acupuncture could improve clinical pregnancy rate and live birth rate among women undergoing IVF.

However, some clinical trials showed different, negative results. El-Toukhy^[7] reported acupuncture performed at the time of ET does not improve the pregnancy or live birth outcome. The Craig^[8] report even showed that acupuncture performed off-site on the day of ET was detrimental to the success of the transfer. El-Toukhy^[9] also did a systematic review and meta-analysis in which 13 relevant trials, including a total of 2500 women randomised to either an acupuncture group or a control group, were identified. The result showed that there is not sufficient evidence that adjuvant acupuncture improves IVF clinical pregnancy rate.

On 10^th March 2010 British Fertility Society (BFS) issues new guidelines on the use of acupuncture and Chinese herbal medicine in fertility treatment. The guidelines found that there is currently no evidence that having acupuncture or Chinese herbal medicine treatment around the time of assisted conception increases the likelihood of subsequent pregnancy.

Why did these clinical trials show different results? My opinion is that the different treatment protocol resulted in different conclusions.

Acupuncture protocols are different in fowling aspects:

1)The treatment times were different: In El-Toukhy’s^[7] report, 5 trials (n=877) acupuncture was performed around the time of egg collection (EC), 8 trials (n=1623) acupuncture was performed around the time of ET. Some reports maybe add 1 or 2 sessions after or before the day of ET.  

2) The acupuncture techniques were different: acupuncture, electric acupuncture and auricular acupuncture were applied in different research.

3)   The acupuncture point selection and manipulation were different in each trial.

4)   Most report only the use acupuncture, no herbs were involved.

The use of Traditional Chinese acupuncture to treat infertility has a long history. The first classic of acupuncture points HuangDi MingTang Jing (黄帝明堂经) (BC138-AD106) recorded 43 acupuncture points which were used to treat gynaecological diseases including Juezi (绝子, infertility). TCM believes fertility function was dominated by kidney. In females it has a close relation with qi and blood, and the function of the Chong and Ren meridians. Some acupuncture points and herbs can regulate the function of Chong and Ren, tonify the kidney and thereby improve fertility. Traditional Chinese acupuncture is often combined with Chinese herbal medicine. Recently Ried^[10] reported that Chinese herbal medicine can improve pregnancy rates 2-fold within a 3-6 month period compared with Western medical fertility drug therapy. The effect of needles and herbs might enhance each other.

A good protocol of IVF treatment in Chinese acupuncture should be: 

• 2 - 3 months before ovarian stimulation the patient should start acupuncture once a week. This treatment can balance hormone levels and create a more receptive environment in the womb for conception. During this period of treatment some of patients might get pregnant naturally.
• During the ovarian stimulation acupuncture and herbs should be used to reduce the side effects caused by IVF drugs, improve response to hormonal stimulation.
• One acupuncture session at an hour before EC, to alleviate the tension and pain during EC.
• Two sessions of acupuncture about an hour before and after ET. Calm the uterus to prepare for implantation.
• Two sessions of acupuncture in the first week after ET
• During pregnancy, acupuncture once a week until week 12 in order to maintain the pregnancy and prevent miscarriage.

Treatment with acupuncture could be likened to the use of Western medical drugs: if used incorrectly, they will be ineffectual. For instance, if an antibiotic were taken by the patient in a much lesser dose or finished earlier than directed, the drug may not have the desired therapeutic effect. The same can be said of acupuncture treatment.

The most recent study^[11] showed that acupuncture did not significantly improve the IVF clinical pregnancy rate when performed only at the time of ET. However, it was found that there was a pooled benefit for IVF when acupuncture was performed at the follicle phase and 25 min before ET, as well as 30 min after ET and at the implantation phase.

Acupuncture point selection is another important factor which can influence the success of IVF. In many clinical trials, the acupoints Sanyinjiao (SP6) and Hegu (LI4) were selected after ET. According to Chinese traditional acupuncture theory these two are “forbidden points” during pregnancy. Although there have been some differing opinions regarding to these two forbidden points in acupuncture history, a research paper by Liu^[12]  showed that electric acupuncture on these points can activate the myoelectrical activities of the uterine tract in both non-pregnant and pregnant rats. I think these two points should be avoided after ET, in order to minimise the risk of miscarriage.

TCM can increase success rate of IVF in varying degrees. The significance of this influence will depend on the treatment protocol, point selection and manipulations. Correct treatment can provide the best conditions for effective results.

References :

1.  Stener-Victorin E. A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization. Hum Reprod. 1999; 14(10):2480-4.
2. Paulus WE. Influence of acupuncture on the pregnancy rate in patients who undergo assisted reproduction therapy. Fertil Steril. 2002; 77 (4): 721-4
3.  Dieterle S. Effect of acupuncture on the outcome of in vitro fertilization and intracytoplasmic sperm injection: a randomized, prospective, controlled clinical study. Fertil Steril. 2006;85(5):1347-51.
4.  Westergaard LG. Acupuncture on the day of embryo transfer significantly improves the reproductive outcome in infertile women: a prospective, randomized trial. Fertil Steril. 2006; 85(5):1341-46.
5.  Smith C. Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril. 2006; 85(5): 1352-58.
6.  Zheng CH. Effects of acupuncture on pregnancy rates in women undergoing in vitro fertilization: a systematic review and meta-analysis.  Fertil Steril. 2012; 97(3):599-611. 
7. El-Toukhy. A new study of acupuncture in IVF: pointing in the right direction. Reprod. Biomed.Online. 2010; 21(3): 278-9.
8. Craig LB. Acupuncture performed before and after embryo transfer: a randomized controlled trial. J, Reprod. Med. 2014; 59(5-6): 313-20. 
9.  El-Toukhy. A systematic review and meta-analysis of acupuncture in in vitro fertilisation. BJOG. 2008; 115(10): 1203-13.
10. Ried K. Chinese herbal medicine for female infertility: An updated meta-analysis. Complement Ther Med. 2015; 23(1): 116-28.
11. Shen C. The Role of Acupuncture in in vitro Fertilization: A Systematic Review and Meta-Analysis. Gynecol Obster Invest. 2015; 79 (1): 1-12.
12.  Liu JL. Effect of electroacupuncture of different acupoints on myoelectrical activities of the uterus in rats. Zhen Ci Yan Jiu. 2007; 32 (4): 237-42.

What is the difference between traditional Chinese herbs and western herbs?

Tiejun Tang, Jasmin Mulvey

Herbs have been widely used to treat disease all over the world. In China, the use of herbal medicine (HM) became an important part of Traditional Chinese Medicine (TCM). In Europe and America HM gradually developed into Western Herbal Medicine (WHM). There are some commonalities and some differences between TCM and WHM. We compared the history, basic theory, function and clinic application of commonly used crossover herbs in TCM and WHM. Through this comparison we hope to build a bridge between Chinese and western herbalists, to exchange ideas and clinical applications of some crossover herbs.

History comparison

Human use of natural plants to treat illness can be traced back for thousands of years. Since the origin of humanity, our ancestors started to use herbs to relieve certain symptoms. The first classic about TCM theory is Yellow Emperor's Canon of Traditional Chinese Medicine (Huangdi Neijing). It was written during the Warring States Period (475 BC – 221 BC). Nearly at the same time, in ancient Greece Hippokrates (460 BC-370 BC) published the humoral theory which became the basis of WHM.

The first classic book about TCM herbs is Shennong's Herbal. It was written at early stage of Eastern Han Dynasty (AD25-220), 365 herbs were recorded in this book. The first classic of western herbs is De Materia Medica which was written between 50 --70 AD by Pedanius Dioscorides, a Greek origin Roman physician. About 600 plants were recorded. Both TCM and WHM have a long history, their basic philosophy was established at nearly the same time – about 2400 years ago.  

Basic theory comparison:                   

Eastern and western cultural differences determined that from their inception TCM and WHM were based on different theories. TCM is based on the theory of Yin/Yang, five elements, Qi/blood, Zang Fu and meridians, and all the herbs are classified in Four Natures (Cold, heat, warm and cool) and Five Flavours (sour, bitter, sweet, pungent and salty). The hot and warming herbs belong to yang, suitable to treat cold syndromes; the cold and cooling herbs belong to yin, suitable to treat heat syndromes. The five flavours are matched to the five elements and five zang organs (liver, heart, spleen, lung and kidney). Each herb has a selective function to some part of the body. It may have strong effect on one or some meridians, but has little effect on other meridians. This is called ‘channel tropism’. For example, many herbs are described as ‘heat clearing’, but because channel tropisms vary, Huanlian (Rhizoma Coptidis) is used to clear heart and stomach fire; Longdancao (Radix Gentianae ) is used to clear liver and gallbladder fire; and Huangqin (Radix Scutellariae) is used to clear lung heat.

In TCM the 5 elements are linked with internal organs, people’s emotions, seasons, weather and environment.

WHM is originally based on the theory of humoral medicine, four elements, Physio-medicalism and the interaction and function of the entire body as a whole terrain. A Holistic patient oriented approach.

The following results can be obtained from the above compare:

1)  The origin and history of TCM and WHM is similar. They both have a very long history.

2) Although they are based on different theories, TCM and WHM both believe the universe is composed of some basic elements. Compare TCM’s five elements and WHM’s four elements: we find three elements are exactly the same. 

3) TCM and WHM both believe these basic elements are connected to internal organs, and related to people’s moods or emotions, the seasons, weather and environment.

4) TCM and WHM both incorporate holistic concepts; they agree that the entire body functions as an organic whole.

5)  TCM and WHM have many similar or exactly the same indications for some herbs. For example: Angelica (Danggui) was used as a blood nutrition agent and a menstrual regulator and female tonic; Ephedra Ephedra sinica (Mahuang) was used to treat asthma.  

6)  For some other herbs TCM and WHM have some different indications. For example: In TCM Mint (Bohe) is used to expel early stage measles, but in WHM it was used as a spasmolytic in some conditions; Ginger (Sheng Jiang) is used to treat nausea & vomiting in both TCM & WHM, but it is also used as an anti-platelet and antipyretic in WHM. In TCM’s opinion it is a pungent & warm herb, only suitable for wind-cold syndrome, not suitable for wind-heat syndrome.

7)  To explain the functions of herbs, TCM uses more traditional theory and terminology like yin/yang; cold/heat; deficiency/excess; qi and meridians; WHM uses more modern medicine terminology like anti-inflammatory, anti-allergic, anti-microbial, anti-Ulcer, etc.

Modern medicine mainly uses chemical synthetic drugs to treat disease. A lot of side effects have been found for most pharmaceutical drugs. Many drugs works well to treat one disease but their side effects may cause new diseases. In some conditions drug addiction and drug resistance are difficult to avoid. Humans need an alternative approach to maintain their health and life. Herbal medicine is a wise choice.

Herbal medicine comes from natural plants; flowers, seeds, leaves, branches, roots and barks.  Compared to chemical synthetic drugs they are much safer and cause fewer side effects. Some herbs can reduce the side effects of chemical drugs when they are combined together. The effect of herbs has been proved by countless cases through thousands of years’ practice. In the east and west of the world, our ancestors leave us a great treasure – herbal medicine.   It is our inheritance and our responsibility to develop this treasure and hand it down to next generation.

TCM and WHM are two main branches of natural herbal therapy. From basic theory to clinical indications they have many similar opinions. For a long time, the practitioners of these two traditions lacked communication, they practiced separately, and did not know much about each other. We hope this crossover study between two different subjects will bring about some new ideas in both TCM and WHM.   

How to treat prolapsed internal organs with Chinese medicine?

Tiejun Tang

Internal organ prolapse is a common clinical condition. Pelvic organ prolapse (POP) is a common condition affecting many adult women. Prolapse can affect a variety of organs, for example, in women it can affect the uterus, vagina or bladder, while rectum prolapse can happen to both sexes. Except pelvic organs, prolapse also might happen in stomach or kidneys.

The clinical manifestations are various according to the effected organ. Uterus and vagina prolapse can cause irritation to vaginal tissues or pain during intercourse, as well as psychological stress; bladder prolapse can cause stress incontinence and difficulty in starting to urinate; rectum prolapse can cause trapped stool, anus pain, pressure, and constipation; stomach prolapse can cause reduced appetite, bloating, nausea, constipation or loose stool; kidney prolapse can cause lower back pain, microscopic hematuria and urinary tract infection. Irrespective of where the prolapsed is, most patients will suffer from fatigue and prolapse sensation in the pelvis or abdomen.

Western medicine will mainly treat internal organ prolapse by surgical operation. A newer option is laparoscopic surgery. These operations maybe cause some complications such as urinary tract infection, temporary or permanent incontinence, infection, bleeding and some women may even develop chronic irritation or pain during intercourse from a suture or scar tissue. There is also a risk of recurrence after operation.

The Chinese medicine theory believes that the spleen dominates muscles. All the internal organs are fixed by smooth muscles to keep them in the normal position. Organs prolapse due to the sinking of the Qi of the middle Jiao, meaning the Qi sinking in the spleen and stomach.

Therefore, Chinese medicine aims to treat the prolapsed organs with the same treatment principle – i.e. lifting the Qi of middle jiao by tonifying the spleen and benefit Qi. Lifting spleen Qi can lift prolapsed organs. There is a famous herbal formula called Bu Zhong Yi Qi Tang and it is the first choose for this condition. This formula contains eight ingredients; the most important ingredient is Huangqi (Radix Astragli) and it must be used in high doses.  Amendments to the original formula are always necessary according to the individual case.

Acupuncture is also significantly effective in lifting spleen Qi. Some acupoints on the spleen and stomach meridian can be selected, like SP10, SP6, ST36, ST25. Some local points on Ren meridian can be selected, like RN12, RN6, RN4 and RN3. All the points should apply tonifying manipulation.

Chinese medicine has adopted this method to treat prolapsed organs since Jin Dynasty (1115 – 1234AD) and there were a great number of successful cases recorded in classic literature. Personally, I have also treated many successful cases in my own practice. A good combination of herbal decoction and acupuncture will see increased effectiveness in lifting prolapsed organs.

Silent myocardial ischemia and its Chinese medicine treatment

Tiejun Tang

Silent myocardial ischemia (SMI), also called asymptomatic myocardial ischemia, is the most common manifestation of coronary heart disease. SMI patients do not seek medical attention as often as angina pectoris patients because SMI does not necessarily cause severe chest pains. Hence the necessary diagnostic procedures such as blood tests, ECG and heart scan are left undone. This places SMI patients under a higher risk of experiencing a sudden and possibly fatal cardiac event. Some cases have been diagnosed as myocardial infarction after been sent to hospital, some cause sudden death. If the myocardial ischemic is emerged in the heart, no matter patient felt pain or not, the potential risk is the same. I would like to remind people, SMI is a silent killer!

Asymptomatic mean no symptom literally. But it does not mean patients didn’t have any symptoms at all. Actually it only means no chest pain. Some SMI patients might experience chest tightness, palpitation and short of breath sometimes, especially after exercise. A person experiencing any of the above symptoms should contact their GP.

Traditional Chinese medicine believes most chest pain and palpitation might due to Qi stagnation and/or blood stasis in heart meridian, or heart yang deficiency. From Han dynasty, Zhang Zhong Jing (AD150-219) applied Gualou Xiebai Tang to treat chest pain due to heart yang deficiency. In Qing dynasty, Wang Qingren (1768-1831) used the herbal formula Xuefu Zhuyu Tang or Buyang Huanwu Tang to treat the chest pain and stroke. Scientific research has approved many Chinese herbs and formulas can improve myocardial ischemia through different methods of action in the body (Refer next paper in this blog).

Kaixin capsule is a patent medicine, combining several herbs, especially developed for treating SMI. The formula was developed from one of my tutor Professor Chen Jinghe. In the 1990s’ I spent three years investigating anti-myocardial ischemia mechanism of the Kaixin capsule through laboratory and clinical research. My research results showed that Kaixin capsule can effectively reduce the risk of myocardial ischemia as well as lower the blood lipid levels.   

Wholism is the characteristic of traditional Chinese medicine, thus one herbal formula consists of several herbs in order to address all aspects of each individuals health condition. Each herbal ingredient plays a unique role, and the choice of herbs and dosage is determined on an individual basis.   

Recently I received a question in the internet could a patient with an elevated ST segment in their ECG reading benefit from Chinese herbs. Elevation of a ST segment indicates myocardial infarction. I replied that even though this is an emergency and requires hospital care, Chinese herbs can be used to improve the insufficient coronary artery circulation, and release the tightness or pain in the chest. Chinese herbs can also be used to reduce high blood pressure and to regulate blood lipid levels.

Sometimes ECG still shows ischemic changes after a coronary bypass operation, PTCA or coronary stents accompanied with chest tightness and shortness of breath. This is believed to be related to re-narrowing of a coronary artery. Also these conditions can be treated like SMI in Chinese medicine.

Apart from Chinese herbal medicine acupuncture also shewed a good effect in MI. (Refer: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0094604 )

Be aware of the risks of SMI, take care of your heart, take care your life.