How does acupuncture treat diseases?

 Tiejun Tang    

Acupuncture is a traditional Chinese medical technique that has been practiced for thousands of years. It involves the insertion of needles into specific points on the body, with the aim of restoring balance and improving health. Over the past few decades, there has been increasing interest in the mechanism of acupuncture treatment, with researchers using modern scientific methods to explore its effects on the body. In this review paper, we will summarize some of the most recent research on the mechanism of acupuncture treatment, focusing on studies published in the past decade.

Mechanism of Acupuncture Treatment:

One of the most widely studied mechanisms of acupuncture treatment is its effect on the central nervous system (CNS). Research has shown that acupuncture can modulate the activity of the hypothalamus-pituitary-adrenal (HPA) axis, which plays a critical role in regulating the body's stress response. Acupuncture has been shown to reduce stress and anxiety, with some studies suggesting that it may increase the release of endogenous opioids and other neurotransmitters such as serotonin and dopamine, which can help to alleviate pain and improve mood (1, 2).

Another mechanism of acupuncture treatment that has received a great deal of attention is its effect on inflammation. Studies have shown that acupuncture can reduce inflammation by modulating the activity of immune cells such as macrophages and T cells, and by decreasing the production of inflammatory cytokines such as tumor necrosis factor (TNF) and interleukin-1β (IL-1β) (3, 4).

In addition, recent research has suggested that acupuncture may modulate the activity of the autonomic nervous system (ANS), which plays a critical role in regulating the body's internal organs. Acupuncture has been shown to increase parasympathetic activity and decrease sympathetic activity, which can help to promote relaxation and improve organ function (5, 6).

Finally, studies have also explored the mechanism of acupuncture treatment in the context of various specific conditions. For example, research has shown that acupuncture can improve symptoms in patients with chronic pain, including low back pain, osteoarthritis, and fibromyalgia (7, 8, 9).  A meta-analysis of 29 randomized controlled trials (RCTs) involving over 17,922 patients found that acupuncture was significantly better than no treatment or sham acupuncture for reducing chronic pain, including lower back pain, neck pain, and osteoarthritis-related pain (10).

Acupuncture has also been studied as a potential treatment for neurological disorders such as stroke, Parkinson's disease, and Alzheimer's disease, with some studies suggesting that it may improve cognitive function and reduce inflammation in the brain (11, 12, 13).

Conclusion:

In summary, recent research has provided a great deal of insight into the mechanism of acupuncture treatment. Studies have shown that acupuncture can modulate the activity of the central nervous system, reduce inflammation, and improve autonomic nervous system function. Acupuncture has also been studied as a potential treatment for a wide range of conditions, including chronic pain and neurological disorders. However, more research is needed to fully understand the mechanism of acupuncture treatment, and to determine its efficacy in specific contexts.

References:

1. Napadow V. What has functional connectivity and chemical neuroimaging in fibromyalgia taught us about the mechanisms and management of 'centralized' pain? Arthritis Res Ther. 2014;16(5):425.

2.  Langevin HM. Acupuncture: A scientific appraisal. Oxford University Press; 2016.

3. Chen Y. The action mechanism of acupuncture treatment for Alzheimer's disease: a systematic review. Front Neurol. 2019;10:734.

4. Zijlstra FJ. Anti-inflammatory actions of acupuncture. Mediators Inflamm. 2003;12(2):59-69.

5. Li P. Electroacupuncture enhances preproenkephalin mRNA expression in rostral ventrolateral medulla of rats. Neurosci Lett. 2010;479(3):267-72.

6. Chae Y. Parsing brain activity associated with acupuncture treatment in Parkinson's diseases. Mov Disord. 2009;24(12):1794-802.

7. Vickers AJ. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444-53.

8. Witt CM. Acupuncture in patients with osteoarthritis of the knee or hip: a randomized, controlled trial with an additional nonrandomized arm. Arthritis Rheum. 2006;54(11):3485-93.

9. Deare JC. Acupuncture for treating fibromyalgia. Cochrane Database Syst Rev. 2013;(5):CD007070.

10. Vickers, A. J. Acupuncture for chronic pain: individual patient data meta-analysis. Archives of Internal Medicine,2012；172(19), 1444-1453.

11. Ding M,. The effect of acupuncture on cognitive function in Alzheimer's disease. J Alzheimers Dis. 2015;43(1):197-205

12. Park J.Ernst E. Effectiveness of acupuncture for stroke: a systematic review. J Neurol. 2001;248(7):558-63.

13.Shergis JL. A systematic review of acupuncture for sleep quality in people with insomnia. Complement Ther Med. 2016;26:11-20.

How to treat Multiple Sclerosis with Chinese medicine and acupuncture?

 Tiejun Tang  

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system, leading to neurological symptoms such as muscle weakness, numbness, and vision problems. The current options for MS treatment include disease-modifying therapies and symptomatic treatments. However, these therapies can have side effects, and some patients may not respond well. Traditional Chinese medicine (TCM), including acupuncture and herbal medicine, has been used to treat MS-related symptoms and may be a promising complementary therapy. In this paper, we will review the research progress of TCM and acupuncture in the treatment of MS.    

Acupuncture for MS         

Acupuncture, a form of TCM, involves the insertion of thin needles into specific points on the body to stimulate and balance the flow of energy (Qi). Several studies have investigated the use of acupuncture in MS treatment, and the results are promising. For example, a randomized controlled trial (RCT) found that acupuncture was effective in reducing fatigue and depression in MS patients (Chen et al., 2020). Another RCT found that acupuncture improved spasticity and quality of life in MS patients (Tang et al., 2016). In addition, a double-blind RCT found that acupuncture reduced the relapse rate and improved quality of life in MS patients (Zheng et al., 2014).

Herbal Medicine for MS

Herbal medicine is another form of TCM that has been used to treat MS-related symptoms. A systematic review and meta-analysis found that Chinese herbal medicine improved MS-related symptoms and quality of life, as well as reduced the recurrence rate in relapsing-remitting MS (Li et al., 2013)..

Combination Therapy

Combining acupuncture and herbal medicine may have synergistic effects in MS treatment. A clinical trial found that combining acupuncture and herbal medicine improved urinary dysfunction in MS patients (Wang et al., 2017). Another study found that a combination of acupuncture and Chinese herbal medicine was effective in reducing spasticity and improving quality of life in MS patients (Liu et al., 2013).

Mechanisms of Action

The mechanisms of action of TCM in MS treatment are not fully understood, but several potential mechanisms have been proposed. Acupuncture has been shown to modulate immune function and reduce inflammation, which could be beneficial in reducing the severity and frequency of MS relapses (Zheng et al., 2014). Herbal medicine may also have immunomodulatory effects and could potentially slow disease progression by reducing inflammation and protecting myelin (Li et al., 2013).

Safety and Adverse Effects

TCM, including acupuncture and herbal medicine, is generally considered that it is safe when administered by qualified practitioners. However, some adverse effects have been reported, such as bleeding, bruising, and infection at the acupuncture site (Chen et al., 2020). Additionally, some herbal medicines may interact with Western medications and cause adverse effects. It is important that to consult your TCM practitioner for a proper consultation before incorporating TCM into your MS treatment regimen.

Conclusion

TCM, including acupuncture and herbal medicine, may be a promising complementary therapy for MS. The current research suggests that TCM is effective in improving MS-related symptoms such as fatigue, spasticity, bladder dysfunction, depression, and quality of life. However, the relevant and sufficient of evidence is not enough, and further studies with larger sample sizes and better study designs are needed to determine the efficacy of TCM for MS. 

References

1.       Liu, X. A randomized controlled trial of combined acupuncture and Chinese herbs for spasticity in multiple sclerosis. Journal of Alternative and Complementary Medicine. 2013; 19(7), 596-602.

2.       Li, X. Chinese herbal medicine for multiple sclerosis: A systematic review and meta-analysis. Journal of Ethnopharmacology.2013; 149(2), 522-528.

3.       Tang, Y. Effects of acupuncture on spasticity and quality of life in multiple sclerosis patients: A randomized controlled trial. European Journal of Integrative Medicine, 2016; 8(2), 190-196.

4.       Wang, Y.  Clinical observation of the treatment of urinary dysfunction in multiple sclerosis with acupuncture and Chinese herbal medicine. Journal of Traditional Chinese Medicine. 2017;  37(1), 104-107.

5.       Zheng, W. Effects and safety of acupuncture in the treatment of multiple sclerosis: A systematic review. Journal of Neuroimmunology. 2014;  274(1-2), 20-26.

6.       National Multiple Sclerosis Society.Treating MS. Retrieved from https://www.nationalmssociety.org/Treating-MS 2022

7.       Mokhtari, R. Complementary and alternative medicine in multiple sclerosis: A systematic review. Complementary Therapies in Medicine. 2019;  43, 188-195.

8.       Ghalamfarsa, G. Multiple sclerosis: Pathogenesis, symptoms, diagnoses and cell-based therapy. Cell Journal. 2020; 22(3), 315-324.

9.       Kong, X. Acupuncture for multiple sclerosis: A systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2019, 1-16.

10.  Lu, W.  Acupuncture for chemotherapy-induced neutropenia in patients with gynecologic malignancies: A pilot randomized, sham-controlled clinical trial. Journal of Alternative and Complementary Medicine. 2009;  15(7), 745-753.

How to treat brain fog post COVID 19?

 Tiejun Tang, Ying Zhang 

"Brain fog" is not a medical terminology, but a colloquial term used to describe slow or fuzzy thinking and slowed-down cognitive response. The symptoms are various depending on different body constitution, such as confusion, memory loss, difficult recalling words, slow thinking, difficulty concentrating, and being easily distracted. Symptoms of brain fog can appear during the recovery period after many viral infections. Serena Spudich, a professor of neurology at Yale University, reported that a person seems to experience more cognitive slowing and emotional problems after contracting the coronavirus than most of other viral infections.Neurological symptoms occurred in 80% of hospitalized patients with COVID-19 investigated in one study.^[1].A survey study published in Eclinical Medicine, The Lancet showed that in 3,762 people with confirmed or suspected COVID-19, 85% reported brain fog ^[2]. A cohort study based on linked electronic health records data from 81 million patients including 273,618 COVID-19 survivors, 36.55% of people have sequelae during the 3-6 months.^[3]  This condition, often referred to as long COVID, a common and particularly difficult problem with long COVID is brain fog. Why does brain fog occur? How to diagnose and treat brain fog in traditional Chinese medicine and western medicine? These questions are important in the long-term treatment of COVID-19 and significant to a nation’s medical system. In this work, we aim to provide an alternative view (TCM) in treating brain fog.

The Mechanism of Brain Fog and the Pathogenesis of TCM

The reason of brain fog is not very clear in modern medicine, but Dr. Spudich believes the most likely cause was inflammation caused by the body's immune response, rather than the virus itself. A study issued in the March 2021 found autoantibodies in the cerebrospinal fluid of COVID-19 patients with neurological symptoms ^[4]. This result suggests that the generation of brain fog may have its pathological material basis, and it is not entirely a psychological problem. It's also possible that the virus itself has somehow entered the brain, possibly by spreading through the top of the nose or by infecting cells known to cross the blood-brain barrier. But in a study by Columbia University published in September 2021, no evidence of coronavirus RNA or protein was found in brain cell samples from 41 people who died of COVID-19 ^[5]but a recent study published in Nature shows strong evidence for brain-related abnormalities in COVID-19. In this study, researchers investigated brain changes in 785 UK-based participants (aged 51-81 years) who underwent imaging twice and found reduced grey matter thickness and tissue contrast in the orbitofrontal cortex and para hippocampal gyrus, which is correlated with changes in functionally relevant regional tissue damage markers, and overall causing brain-capacity reduction. This explains why infected participants also exhibited greater cognitive decline on average between the two time points.

However, whether such deleterious effects can be partially reversed or whether these effects will persist in the long term remains to be further investigated.^[6].

Traditional Chinese Medicine Theory believes that people's spiritual consciousness activities are dominated by the heart. "Huangdi Neijing" (Inner Canon of the Yellow Emperor) recorded: "The heart is the official of the monarch, whom in charge of the consciousness." ZHANG Jiebin (a Chinese Physician, 1563-1640) explained: "The heart is the king of a body, with a vain spirit and it has the ability to cope with many changes. All the internal organs and the whole body are controlled by heart, thus, wisdom and spiritual comes from the heart. And the consciousness comes from heart". In the words of Traditional Chinese Medicine, the brain belongs to the "extraordinary Fu-organ ", with a function in regulating mental activities. JIN Zhengxi (1598-1645) of the China’s Yuan Dynasty said: "The memory and people's inspirations lie in the brain. Children's brains are not full but with gradual growing. Old people’s brainis gradually empty, therefore with memory declining."

There have been some debates in the field of Chinese medicine about whether the heart dominatesmind or the brain dominates mind. Professor DENG Tietao (the author’s supervisor) published "The scientific evidence of the Theory of Heart Dominates the Mind" in the journal of New Chinese Medicine^[7]with an opinion that “the theory of heart dominating the mind comes from practice, which in turn can guide clinical practice. Practice is the criterion for testing the truth. Therefore, this theory is scientific”.One of my articles "A Joined Discussion about the Heart and Brain Dominating the Mind" extended Deng’s work by arguing the mechanism of heart dominating mind as the root, and the brain dominating the mind as the branch ^[8]. In my opinion, although western medicine believes that the brain fog comes from the brain, its origin does come from the heart. According to the principle that treatment must be based on the origin of the pathology, the treatment of brain fog should therefore focus on nourishing the heart and calm the mind at the same time, while taking the opening of the orifices of brain into account.

In addition, according to the TCM,(1) the kidneys govern the bones, and the bones generate marrow, while the marrow nourishes the brain, so nourishing the kidneys and filling essence is to nourish the brain; (2) the liver controls stagnation, regulates qi, thus, relieving the stagnation of liver qi helps relieving depression; (3) spleen is the source of qi and blood, meanwhile related to thinking . Strengthening the spleen and nourishing qi can also indirectly nourish the heart and calm the nerves. Although brain fog is in the brain, to regulate the function of five Zang organs can achieve the purpose of treatment. In particular, nourishing the heart and calming the nerves should be the focus.

Chinese and Western Medicine in Treatment of Brain Fog

Western Medicine Treatment

Western medicine believes that cognitive rehabilitation seems to be the best way to treat brain fog. Cognitive rehabilitation is like physical therapy, but it targets the brain. Usually performed by a neuropsychologist, and the treatment consists of written and oral exams and focuses on strategies to improve certain functions, such as attention or memory. Many hospitals in the U.S. currently have cognitive rehabilitation programs, and many long COVID clinics also offer brain fog treatment. There is some evidence that playing games like CogMed, Lumosity, etc. on a computer or mobile phone can also improve cognitive performance. It can be a great addition to cognitive rehabilitation therapy.

In terms of drug therapy, the United Kingdom has recently launched a combination preparation for the treatment of brain fog called Brainzyme, which includes EMT mixture (theanine, EGCG and polyphenols), guarana seeds, choline, ginkgo biloba, L-Tyrosine, Piperine, Bromelain, Maca Root, Vitamins and Minerals. Among them, ginkgo biloba and pepper are the ingredients of traditional Chinese medicine, and the others are mostly nutritional additives, which are also contained in many traditional Chinese medicines. The efficacy of Brainzyme in the treatment of brain fog has not been reported.

Traditional Chinese Medicine Treatment

Herbal Medicine

Traditional Chinese Medicine treats brain fog according to the principle of syndrome differentiation and treatment. In clinical treatment, I found that there are mainly four common syndromes.

(1) Heart-blood deficiency and heart-yin deficiency:

Main symptoms: Memory loss, lack of concentration, insomnia and dreaminess, dizziness and fatigue, pale complexion or red cheeks, or night sweats or spontaneously sweat, pale tongue or red tongue with little coating, deep and thin pulse.

Treatment principles: Nourishing yin and nourishing blood, calming the mind and the nerves.

Formula selection: Modified BaiziZixinWan.

Herbs selection:Baiziren, Xuanshen, Shudihuang, Gouqizi, Zhigancao, Danggui, Shichangpu, Maimendong, Fuling.

For those with more blood deficiency, add Jixueteng.Heshouwu;

For those with more Yin deficiency, add Baihe, Tianmendong;

For those with sleep disorders, add Suanzaoren, Yejiaoteng.

(2) Disharmony between the heart and kidney:

Main symptoms: Forgetfulness, insomnia, trance, dizziness, palpitations, soreness and weakness of waist and knees, hot flashes and night sweats, tinnitus, red tongue with little or no coating, rapid pulse.

Treatment principles: Nourish yin and calm the mind, regulate heart and kidney.

Formula Selection: Tianwang Buxin Dan

Herbs selection: Baiziren, Suanzaoren, Maimendong, Tianmendong, Shengdihuang, Xuanshen, Taizishen, Wuweizi, Danggui, Yuanzhi, Hehuanpi, Yizhiren.

If the kidney deficiency is the main reason, add Xuduan, Duzhong;

If the heart fire is inflamed, add Zhizi, Huanglian.

(3) Liver qi stagnation:

Main symptoms: Depression, restlessness, irritability, forgetfulness, dreaminess, dizziness, hypochondriac distension, red eyes and bitter mouth, thin white or yellow tongue coating, wiry pulse.

Treatment principles: Soothe the liver and relieve depression, calm the heart and mind.

Formula Selection: Modified XiaoyaoWan

Herbs selection: Chaihu, Danggui, Baishao, Fushen, Baizhu, Xiangfu, Qingpi, Yujin, Zhigancao.

For the cases of live fire excess, add Mudanpi, Zhizi;

For cases with severe emotional depression, add Suxinhua, Meiguihua,Jianghuang;

For the cases of bitter taste in the mouth add Longdancao, Xiakucao.

（4）Heart and spleen deficiency:

Main symptoms: Forgetfulness, anxiety, lack of concentration, fatigue, palpitations, insomnia, loose stools, or abdominal distention, pale tongue, fat tongue with tooth marks, white and slippery coating, slow pulse.

Treatment principle: Nourish the heart and spleen, soothe the nerves.

Formula Selection:  Modified Guipi Wan.

Herbs selection: Renshen, Huangqi, Baizhu, Danggui, Fushen, Yuanzhi, Suanzaoren, Longyanrou, Wuweizi, Zhigancao.

For those with spleen deficiency and loose stools; add Yiyiren, Cheqianzi;

For those with abdominal distension, add Muxiang, Sharen;

For those with poor appetite add Maiya, Guya;

For those with severe memory loss, add Yizhiren and Shichangpu.

Acupuncture

In addition to herbal treatment, acupuncture is also an effective means of treating post-COVID-19 brain fog. Mainly select the points on the Heart Meridian of Hand Shaoyin, the Pericardial Meridian of Hand Jueyin, the Liver Meridian of Foot Jueyin, the Kidney Meridian of Foot Shaoyin, the Du meridian, and local acupuncture points on the head. Scalp acupuncture can also be used entirely, or electro-acupuncture can be added.

Dietary

Healthy dietary can also help brain fog recovery. A healthy diet (including olive oil, fruits and vegetables, nuts and legumes, and whole grains) has been shown to improve thinking and memory. Avoid alcohol and drugs. Getting enough sleep, listening to music, regular aerobic exercise, and participating in social activities can also help eliminatethe symptoms of brain fog.

Conclusion

Brain fog is very common in the duration of COVID 19 infection and its aftermath. Western Medicine usually applies cognitive rehabilitation therapy to treat Brain Fog, while Traditional Chinese Medicine apply herbals to treat based on a TCM theory that many organs (liver, kidneys, spleen) can affect on brain capacity, however, the brain is mainly charged by the heart. This paper suggests that Chinese herbal medicine can be a very effective alternative or/and supplement treatment to eliminate Brain Fog, with the principle of combining heart and brain in the treatment, by nourishing the heart, tranquilizing the mind, clearing the orifices, and refreshing the brain.

Reference

1. Chou, S. H.-Y. Global Incidence of Neurological Manifestations Among Patients Hospitalized With COVID-19-A Report for the GCS-NeuroCOVID Consortium and the ENERGY Consortium. JAMA Netw. Open 2021; 4, e2112131.

2.  Hannah E. Davisa.Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. Lancet. e Clinical Medicine.2021; (38): 101019.

3.  Maxime Taquet. Incidence, co-occurrence, and evolution of long-COVID features: A 6-month retrospective cohort study of 273,618 survivors of COVID-19. PLOS Medicine 28 Sep 2021.

4.  Christiana Franke. High frequency of cerebrospinal fluid autoantibodies in COVID-19 patients with neurological symptoms. Brain Behav Immun. 2021 Mar; 93: 415–419.

5. Kiran T Thakur.COVID-19 neuropathology at Columbia University Irving Medical Center/New York Presbyterian Hospital. Brain. 2021; 144 (9): 2696–2708.

6. GwenaëlleDouaud. SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature.Published: 07 March 2022.

7.  邓铁涛. 心主神明论的科学性[J].新中医,2003,35(3):15-16.

8.  唐铁军.也谈心主神明与脑主神明[J].中华现代中西医杂志,2004,2(5):443-444.

A natural way of anti depression

     

Tiejun Tang

Do you suffer from depression? 

We all have times when we feel down, but for most of us it is short lived, perhaps lasting for a few days. However, for those with depression the feeling of sadness and anxiety will often persist for weeks, months or even years. 

Depression is one of the leading psychological disorder. According to the World Health Organization (WHO), depression is the leading cause of disability worldwide, affecting more than 264 million people of all ages. In the UK. According to the National Institute for Health and Care Excellence (NICE), around one in six people in the UK will experience depression at some point in their lives.

Depression does not discriminate. Regardless of social status, wealth, employment, age, gender, it can affect anyone in society.

It has become common practice for Psychiatrists and Psychologists to prescribe antidepressants as the first line of treatment for many mental health disorders. However, this is not without side effects; certain antidepressants have shown to cause sexual dysfunction in men (Jeffrey H. 1995), and cardiovascular toxicity in both sexes. (Pal Pacher, 2004). Although antidepressants have proven to be effective in reducing suicidal rates amongst patients, most people still prefer not to take them because of the side effects and instead opt for conventional or alternative treatment.

Remember, you are not alone in your battle against depression. No matter the duration of your symptoms, help and support is available and recovery is possible. There is no one treatment that fixes all. Everyone responds differently to different treatments. As a TCM Practitioner, I would like to offer my insight on how depression can and have been successfully treated through Chinese medicine.

In traditional Chinese medicine, depression falls within the category of Yu Zheng (郁证) and Zang Zao (脏躁). Chinese medicine believes that low mood, anxiety and irritability are caused by liver qi stagnation; insomnia, dream disturbed sleep, memory loss and palpitation are due to heart shen disorder;  poor appetite and low energy and other indigestion symptoms are due to spleen deficiency; hot flush, night sweat and dry mouth are due to yin deficiency; cold extremities, pale complexion and low libido are due to kidney yang deficiency.

Xiaoyao Wan is a traditional Chinese medicine formulation that has been used for centuries to treat various mental and physical health conditions, including depression. Several clinical studies have been conducted to investigate the antidepressant effect of Xiaoyao Wan and the mechanism of its action. These studies have found that Xiaoyao Wan can significantly reduce the severity of depressive symptoms in patients with major depressive disorder, postpartum depression, and other types of depression.

One study published in the Journal of Psychiatric Research in 2016 examined the effect of Xiaoyao Wan on brain activity in patients with major depressive disorder using functional magnetic resonance imaging (fMRI). The study found that Xiaoyao Wan increased activity in the anterior cingulate cortex and the dorsolateral prefrontal cortex, two regions of the brain that are associated with the regulation of mood and emotion.

My  colleagues in China use molecular biology techniques investigated the anti depression  mechanism of Xiaoyao San. Their research found  that Xiaoyao Wan  can improve depressive-like behaviors by triggering autophagy to alleviate neuronal apoptosis.  It is an effective supplement for depression treatment, and can be harnessed to enhance autophagy and synergize with antidepressant action.(Wang M 2019)

Except Xiaoyao Wan, Chaihu Shugan Wan or Guipi Wan. Ganmai Dazao Tang and Suanzaoren Tang also can be selected in the treatment of different type of depression,

The selection of acupuncture points should focus on the liver and heart meridians, combining with specific points on the Du meridian and extra points on the head. The points that are commonly used include, Taicong (LV3), Ligou (LV5), Zhangmen (LV13), Qimen (LV14), Shenmen (HT7), Shaohai (HT3), Neiguan (PC6), Baihui (DU20), Shenting (DU24), Yintang (EX-HN3), Taiyang (EX-HN5).

Apart from needling, Tuina massage techniques (especially on the head points as mentioned above) will also help relieve symptoms. Many clinical trials have shown that acupuncture can effectively treat depression. Treatment methods included manual acupuncture (John J 1998), electric acupuncture (Huan Cui 2004), and laser acupuncture (Joo Smith 2005). These research reports showed acupuncture could significantly relieve depression.

Lastly, enjoy your Christmas, enjoy your life. To be depression-free is the first step
to a healthier and happier new year!

Reference:

1. Jeffrey H. Male Sexual Side Effects Associated with Antidepressants: A Descriptive Clinical Study of 32 Patients. The International Journal of Psychiatry in Medicine 1995;  25(2): 191-201.
2. Pal Pacher.  Cardiovascular Side Effects of New Antidepressants and Antipsychotics: New Drugs, old Concerns? Curr Pharm. 2004; 10(20): 2463–2475.
3. Wang M. Modified Xiaoyao San ameliorates depressive-like behaviors by triggering autophagosome formation to alleviate neuronal apoptosis. Biomed Pharmacother.  2019; Mar;111:1057-1065. 
4. John JB. The Efficacy of Acupuncture in the Treatment of Major depression in Women. Psychological Science. 1998; 9(5): 397-401.
5. Han Cui. Clinical study on Electro-acupuncture treatment for 30 cases of mental depression. Journal of Traditional Chinese Medicine. 2004;  24 (3): 172-176.
6. Joo Im. Laser acupuncture for mild to moderate depression in a primary care setting – a randomised controlled trial Acupunct Med 2005; 23(3):103-111.

Note: * First version published in 24th December 2010, updated version at 21st February 2022. 
         

Post COVID "Brain Fog"

How can we conquer the Covid pandemic ?

How to prevent delta variant?

 Tiejun Tang

The Covid pandemic has spread globally for one and a half years, and many European countries have experienced three peaks. Why does this pandemic seem to be endless? The main reason is the mutation of the virus. First, the Alpha variant appeared in the UK, and then the Beta variant appeared in South Africa, the Gamma variant appeared in Brazil, and then the Delta variant appeared in India.

Genetic mutation is the natural to a virus. As you know many people have been vaccinated for influenza in the past, but they still have the flu. That is because the influenza virus is constantly mutating. So does the Coronavirus.

Currently, there is no effective treatment drug for the Covid virus. Doctors mainly rely on vaccines to control the pandemic, but the speed of vaccine research and development cannot keep up with the speed of virus mutation. Therefore, human beings are in a passive situation in the battle against the virus.

Virologist Shahid Jameel, director of the Trivedi School of Biosciences at Ashoka University, said "we don't yet know whether further mutations would make current vaccines useless, this is unlikely. However, the efficacy of vaccines may be reduced due to mutations."

A Public Health England study published on 22 May found that a single dose of either AstraZeneca's or Pfizer's vaccine reduced a person’s risk of developing COVID-19 symptoms caused by the Delta variant by 33%, compared to 50% for the Alpha variant. A second dose of the AstraZeneca vaccine boosted protection against Delta to 60% (compared to 66% against Alpha), while two doses of Pfizer’s jab were 88% effective (compared to 93% against Alpha).

The third wave of pandemic was caused by Delta variant. How to prevent the Delta variant? We can’t just pin our hopes on vaccines, we need some new ideas.

My PhD tutor professor Deng Tietao used to be the leader of the Chinese Medicine Expert Group on SARS in the State Administration of Traditional Chinese Medicine in 2003. I found his calligraphy last year while I studied his clinical experience on anti SARS. I translated it in English. He said: "The prevention and treatment of influenza is the advantage of traditional Chinese medicine. No matter how virus changes, it couldn’t escape the palm of traditional Chinese medicine. The curative effect of Chinese medicine on SARA and swine flu is the evidence. Researching on Chinese medicine to prevent viral infectious diseases, to replace immune injection, it will benefit the whole world." His exposition ten years ago still gives us a lot of inspiration for today’s pandemic.   

Different from the mechanism of vaccines, Chinese herbal medicine anti the viral infectious diseases by enhancing the body’s own immunity. Studies have shown that Chinese herbal compound has a multi-target action. It not only acts on the cellular immune system, but also on humoral immune system. Chinese herbal medicine preparation likes a great sky net for viruses. That is why Professor Deng Tietao can confidently say: "No matter how the virus changes, it cannot escape the palm of Chinese medicine."

Based on Professor Deng’s clinical experience, combined with the latest research results of modern pharmacology, I developed Modified Yupingfeng San for the prevention of Covid 19.

It showed a satisfactory prevention effect on the subject groups in UK, North America and Taiwan. 

Due to the mutation of the virus, the pandemic is difficult to control. I suggest that in addition to vaccines, traditional alternative medicine therapies should be selected as a complementary preventive method.

Anti Covid 19 pandemic under the guidance of Professor Deng Tietao's aca...

The 3rd Traditional Medicine Forum was a international online conference hosted by WTMF and co-sponsored by the World Health Organization. I am honored to be invited to speak at this international conference as the only speaker from UK.

Professor Deng Tietao has over 80 years clinical experience. In 2003 under his supervision China conquered SARS in about 3-4 month. Covid 19 also called SARS-CoV-2. I hope Prof. Deng’s clinical experience on anti SARS can help to anti the pandemic today.  

Where and when acupuncture came from ?

How to prevent the second wave of COVID 19?

Is antidepressant better than painkiller for chronic pain ?

The use of Traditional Chinese Medicines to treat COVID 19 may cause more good than harm

Tiejun Tang

This morning I read an article from the website of Professor Edzard Ernst. The article title is “The use of Traditional Chinese Medicines to treat SARS-CoV-2 may cause more harm than good”. I totally disagree with this opinion and after some investigation, I would like to change a few words in the title of his paper -- "The use of Traditional Chinese Medicines to treat COVID 19 may cause more good than harm."

Actually Mr Ernst is not the author of this article. This paper was originally published by two Australian doctors two month ago ^[1]. Their conclusion was mainly based on an article which was published by a group of Japanese doctors in 2017. It was a Meta-Analysis paper. The author using PubMed and Ichushi-Web-the database of the Japan Medical Abstracts Society to identify articles published between 1996 and 2015 describing patients with Japanese herbal medicine induced pneumonia. They found that 73 patients have been diagnosed with pneumonia after taking Japanese herbal medicine^[2] . The mean age at pneumonia diagnosis was 63.2 ± 15.5 years. The herbal formulas they used were sho-saiko-to (小柴胡汤) （26%）, sairei-to （柴苓汤）（16%）, seishin-renshi-in （清心莲子饮） (8%）and bofu-tsusyo-san (防风通圣散) （8%）.These formulas all are traditional Chinese medicine formulas which were widely used for hundreds or thousands of years in China, but not for early stage common cold or flu complaints.  Chinese medicine diagnosis for early stage common cold or flu is Taiyang syndrome and the treatment principle should be expelling wind cold or wind heat. The indication of sho-saiko-to is Shaoyang syndrome and of course it is not suitable for Taiyang syndrome. The other 3 formulas are all not suitable for this stage of Taiyang syndrome. If the treatment missed the target of diagnosis, it will not work at all.

In addition to the diagnosis problem, I noticed that the mean age at pneumonia diagnosis was over 60. Elderly people are easier to develop into pneumonia when they catch cold, that is common sense. The conclusion of Mr Enomoto’s article was against the basic principle of statistics -- age group differentiation.

Mr.Gray the author of that article believes that the Chinese herb Scutellariae Radix (Huangqin) is the cause of ARDS. Many of the Chinese medicine formulas which are used in Covid 19 treatment contain Huangqin. That is why he gets his opinion of more harm than good. His evidence for this also came from a Japanese report ^[3]. In this report only 5 patients have got ARDS after receiving the herbal treatment. He uses this very small sample report to against the report from Dr Ren^[4]  which includes 701 cases of Covid 19 with a positive result. From Mr Gray’s article I cannot find any evidence based on a large sample RCT research or laboratory research.

Mr Edzard Ernst is a very famous retired professor and critic of Chinese medicine. We all benefit greatly from constructive logically based criticism but this becomes wasteful and distracting if the criticism is not based on the principles of medical statistics, and is selective in it’s use of research results to support a personal agenda. I would like to be able to say that this paper made a useful addition to the discussion on the efficacy of Traditional Chinese Medicines in the modern world, but unfortunately I cannot.

Just a few days ago, we received some positive news from the US National Centre for Biotechnology Information (NCBI) who stated that “overall,” treatment with the Chinese herbal medicine Lianhua Qingwen for 14 days resulted in a “significantly higher rate of, and a shorter time to, symptom recovery.” Their conclusion is  "Traditional Chinese medicine can help COVID 19 patients recover faster” ^[5]

I hope that every reader can have a second thought about this topic. Always follow the science.

Reference:

1. Paul E. Gray. The use of Traditional Chinese Medicines to treat SARS-CoV-2 may cause more harm than good. Pharmacol Res. 2020 Jun; 156: 104776.
2. Enomoto Y. Japanese herbal medicine-induced pneumonitis: a review of 73 patients. Respir. Investig. 2017; 55:138–144.
3. Osamu Sakamoto. Clinical and CT characteristics of Chinese medicine‐induced acute respiratory distress syndrome.  Respirology 2003; 8(3):344-50. doi: 10.1046.
4. Ren J.L. Traditional Chinese medicine for COVID-19 treatment. Pharmacol. Res. 2020:104743.
5. https://www.onenews.ph/us-health-agency-says-traditional-chinese-medicine-can-help-covid-19-patients-recover-faster