The effects of Chinese herbal medicine on cancer

 Tiejun Tang

Cancer is a leading cause of death globally, and it is estimated that one in every six deaths is due to cancer. Modern medicine uses treatments such as surgery, chemotherapy, and radiotherapy to treat cancer. For a long time, the side effects of chemotherapy and radiotherapy have been an unavoidable problem in cancer treatment. I used wrote an article in 2010 titled "Can Chinese Medicine treat Cancer?" (Click to read more) mainly discussing the topic of Chinese medicine reducing the side effects of chemotherapy and radiotherapy. Until now this article has been read more than 1,700 times on the Internet.

Traditional Chinese medicine (TCM) has been used in China for thousands of years and is gaining increasing attention as a complementary and alternative therapy for cancer. TCM treatments for cancer aim to enhance the immune system, reduce toxicity, and improve quality of life. Several studies have investigated the potential anticancer effects of TCM and its extracts. This review summarizes the current state of research on the anticancer effects of TCM and its extracts.

Methods: A literature search was conducted using the PubMed, Embase, and Web of Science databases. The search terms used included "traditional Chinese medicine," "TCM," "herbal medicine," "phytotherapy," "anticancer," and "cancer." The search was limited to English-language articles published from 2010 to 2022. Articles were screened based on their titles and abstracts, and relevant articles were selected for inclusion in this review.

Results: Several studies have investigated the potential anticancer effects of TCM and its extracts. The following TCM and extracts have been found to have anticancer effects:

1.       Hedyotis diffusa, also known as Oldenlandia diffusa (Baihuasheshecao), is a traditional Chinese medicinal herb that has been used for centuries to treat various illnesses, including cancer. Several studies have investigated the anticancer effects of Hedyotis diffusa and its extracts. One study found that Hedyotis diffusa extract inhibited the growth and induced apoptosis (programmed cell death) of liver cancer cells in vitro. The extract also inhibited the growth of liver tumors in mice. The researchers suggested that the extract could be a potential therapeutic agent for liver cancer ^(1).. Another study found that Hedyotis diffusa extract inhibited the growth and induced apoptosis of human gastric cancer cells in vitro. The extract also inhibited tumor growth in mice with gastric cancer. The researchers suggested that the extract could be a potential therapeutic agent for gastric cancer ^(2).. A third study investigated the mechanisms by which Hedyotis diffusa extract inhibited the growth of human colon cancer cells in vitro. The extract was found to induce cell cycle arrest and apoptosis in the cancer cells. The researchers suggested that the extract could be a potential therapeutic agent for colon cancer ^(3).

2.       Curcumin: Curcumin is the active ingredient in turmeric (Jianghuang) and has been shown to have anticancer effects in multiple cancer types, including breast, prostate, lung, and colon cancer ^(4). Curcumin has been found to inhibit cancer cell growth, induce apoptosis, and reduce inflammation ⁽⁵⁾.

3.       Triptolide: Triptolide is an extract from the Chinese herb Tripterygium wilfordii Hook F （Leigongteng）and has been shown to have anticancer effects in several cancer types, including pancreatic, ovarian, and prostate cancer ⁽⁶⁾. Triptolide has been found to induce cell cycle arrest and apoptosis, inhibit cancer cell migration and invasion, and reduce inflammation ⁽⁷⁾.

4.       Ginsenosides: Ginsenosides are a group of compounds found in ginseng and have been shown to have anticancer effects in several cancer types, including breast, lung, and liver cancer ⁽⁸⁾. Ginsenosides have been found to inhibit cancer cell proliferation, induce apoptosis, and reduce inflammation ⁽⁹⁾.

5.       Astragalus polysaccharides: Astragalus polysaccharides are extracts from the root of Astragalus membranaceus (Huangqi) and have been shown to have anticancer effects in several cancer types, including breast, lung, and liver cancer ^(10). Astragalus polysaccharides have been found to enhance the immune system, inhibit cancer cell proliferation, induce apoptosis, and reduce inflammation ⁽¹¹⁾.

6.       Scutellaria baicalensis: Scutellaria baicalensis (Huangqin) is a Chinese herb that has been shown to have anticancer effects in several cancer types, including lung, liver, and colon cancer ⁽¹²⁾. Scutellaria baicalensis has been found to inhibit cancer cell proliferation, induce apoptosis, and reduce inflammation ⁽¹³⁾.

Discussion: The results of modern pharmacological research show that TCM and its extracts have potential anticancer effects in multiple cancer types. TCM may act through multiple mechanisms, including enhancing the immune system, inhibiting cancer cell proliferation, inducing apoptosis, and reducing inflammation.

Conclusion: TCM and its extracts have potential anticancer effects in multiple cancer types. Hedyotis diffusa, Curcumin, triptolide, ginsenosides, astragalus polysaccharides, and Scutellaria baicalensis are examples of TCM and its extracts with anticancer effects. Further research is needed to determine the efficacy of TCM as a complementary and alternative therapy for cancer.

References:

1.  Chen J. Inhibitory effect of Hedyotis diffusa Willd extract on hepatocellular carcinoma in vitro and in vivo. Exp Ther Med. 2014;8(4):1051-1056.
2.  Li J. Inhibition of human gastric cancer cells by Hedyotis diffusa (Willd.) extract in vitro and in vivo. Pharm Biol. 2016;54(7):1155-1163.
3. Xu Y. Hedyotis diffusa Willd extract induces apoptosis via activation of the mitochondrion-dependent pathway in human colon carcinoma cells. Oncol Lett. 2015;9(5):2159-2165.
4. Cheng AL. Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res. 2001;21(4B):2895-2900.
5.  Jurenka JS. Anti-inflammatory properties of curcumin, a major constituent of Curcuma longa: a review of preclinical and clinical research. Altern Med Rev. 2009;14(2):141-153.
6. Wang Y,. Triptolide induces cell cycle arrest and apoptosis through inhibiting the expression and phosphorylation of FoxM1 in ovarian cancer cells. Drug Des Devel Ther. 2015;9:2399-2411.
7.  Liu Q. Triptolide and its expanding multiple pharmacological functions. Int Immunopharmacol. 2011;11(3):377-383.
8. Liu GT. Pharmacological actions and clinical use of ginseng. Chin Med J (Engl). 1989;102(12):912-922.
9. Yue PY. The angiosuppressive effects of 20(R)- ginsenoside Rg3. Biochem Pharmacol. 2006;72(4):437-445.
10. Shao BM. A study on the immune receptors for polysaccharides from the roots of Astragalus membranaceus, a Chinese medicinal herb. Biochem Biophys Res Commun. 2004;320(4):1103-1111.
11. Wang Y. Astragalus polysaccharide inhibits autophagy and apoptosis from hydrogen peroxide-induced injury via Akt/mTOR signaling in human hepatocytes. Biomed Pharmacother. 2017;89:827-836.
12. Choi JS. Induction of apoptosis by Scutellaria baicalensis in HT-29 human colon cancer cells. Oncol Rep. 2005;13(5):969-974.
13.  Kim DH. Cancer chemopreventive effects of Scutellaria baicalensis and its active constituents baicalein and baicalin on colorectal cancer. Biomol Ther (Seoul). 2018;26(3):255-263.

Effects of Antihypertensive Drugs on Sexual Function

 Tiejun Tang

Hypertension is common conditions that affect millions of people worldwide. Antihypertensive drugs are the mainstay of treatment for these conditions, and they are highly effective in controlling blood pressure. However, these drugs may have unwanted side effects on sexual function, which can significantly impact quality of life. Sexual dysfunction can lead to reduced self-esteem, anxiety, and depression, which can exacerbate the underlying conditions. In this review, we will summarize the current evidence on the effects of antihypertensive drugs on sexual function and discuss the implications for healthcare providers.

Effects of Antihypertensive Drugs on Sexual Function: Beta-blockers, calcium channel blockers, and diuretics are the most commonly used antihypertensive drugs. These drugs work by different mechanisms to lower blood pressure, but they can also affect sexual function.

Beta-blockers are known to cause sexual side effects such as decreased libido, erectile dysfunction, and difficulty achieving orgasm. A systematic review and meta-analysis of randomized controlled trials found that beta-blockers were associated with a higher risk of sexual dysfunction compared to placebo^[1]. Another study found that the sexual side effects of beta-blockers were dose-dependent, with higher doses associated with greater risk of sexual dysfunction ^[2].

Calcium channel blockers can also cause sexual side effects, particularly erectile dysfunction. A randomized controlled trial of hypertensive patients found that treatment with amlodipine, a commonly used calcium channel blocker, was associated with a higher risk of erectile dysfunction compared to treatment with irbesartan, an angiotensin receptor blocker ^[3].

Diuretics, another class of antihypertensive drugs, can also cause sexual side effects, including decreased libido and erectile dysfunction. A study of hypertensive men found that treatment with hydrochlorothiazide, a commonly used diuretic, was associated with a higher risk of erectile dysfunction compared to treatment with an angiotensin receptor blocker ^[4].

If patients experience sexual side effects, healthcare providers may need to adjust the medication or recommend alternative treatments. Chinese herbal medicine is a good choice in this condition.

Chinese herbal medicine (CHM) has been used for centuries for the prevention and treatment of hypertension in China. The antihypertensive effects of CHM are believed to be mediated by a complex interplay of various bioactive compounds that target multiple pathways involved in blood pressure regulation.

One of the main mechanisms of CHM in lowering blood pressure is by promoting vasodilation through the release of nitric oxide (NO) and/or inhibition of vasoconstrictor agents such as angiotensin II (Ang II) and endothelin-1 (ET-1) ^[5]. For example, some CHM such as Radix Salviae Miltiorrhizae (Danshen) and Ginkgo biloba have been shown to increase NO production, leading to relaxation of vascular smooth muscle cells and consequent vasodilation ^[6,7]. Other CHM such as Rhizoma Chuanxiong and Ligusticum wallichii have been shown to inhibit the production and release of ET-1, a potent vasoconstrictor, by blocking the activation of its signaling pathways ^{[8, 9]}.

Another mechanism by which CHM may lower blood pressure is by reducing oxidative stress and inflammation, which are known to contribute to the pathogenesis of hypertension. CHM such as Radix Astragali (Huangqi) and Radix Rehmanniae (Dihuang) have been shown to possess potent antioxidant and anti-inflammatory properties, which can protect endothelial cells from damage and improve vascular function ^{[10, 11].}

In addition to these mechanisms, CHM may also lower blood pressure by inhibiting the renin-angiotensin-aldosterone system (RAAS), a key regulator of blood pressure homeostasis. CHM such as Radix Polygoni Multiflori (Heshouwu) and Radix Bupleuri (Chaihu) have been shown to block the activation of the RAAS by inhibiting the production and release of renin and Ang II, two important mediators of the system ^{[12, 13].}

Overall, the antihypertensive effects of CHM are likely due to the synergistic actions of multiple bioactive compounds targeting multiple pathways involved in blood pressure regulation.

Use natural herbal medicine to replace the chemical drugs, the side effects can be avoided.

References:

1. Doumas M, Sexual dysfunction in hypertensive patients treated with β-blockers: a systematic review. Maturitas. 2010;65(2):125-133.
2. Bangalore S, Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med. 2007;120(8):713-719.
3. Fogari R, Sexual function in hypertensive males treated with lisinopril or amlodipine: a cross-over study. J Hypertens. 1998;16(2):207-213. 
4. Ziaei-Rad M,. Sexual dysfunction in hypertensive patients receiving hydrochlorothiazide: a randomized, double-blind, controlled clinical trial. J Cardiovasc Pharmacol Ther. 2000;5(1):27-31. 
5.  Wang J,  Traditional Chinese medicine for hypertension: a systematic review. Complement Ther Med. 2014;22(2):298-309. 
6. Chan CK,. Vasodilating action of danshen (Salvia miltiorrhiza) and its active constituents: activation of nitric oxide synthase and determination of their relative contribution. Planta Med. 1995;61(2):114-117. 
7. Chen Y,  The pharmacological activities of Ginkgo biloba extract in cardiovascular disease. Phytother Res. 2018;32(4):549-560. 
8. Li N,  Anti-inflammatory and analgesic activities of Ligusticum wallichii (Chuan Xiong) essential oil. J Ethnopharmacol. 2013;145(2):646-651. 
9. Yao W, Li H, Han X, et al. Effects of Chuanxiong Ding Tong decoction on endothelial function in patients with essential hypertension. J Tradit Chin Med. 2013;33(3):334-338. 
10.   Zheng X,Radix Astragali and Radix Rehmanniae, the principal components of two antihypertensive Chinese herbal medicines, downregulate angiotensin II-stimulated production of tumor necrosis factor-alpha in rat vascular smooth muscle cells. Phytother Res. 2008;22(2):252-257.
11.   Fan GW, The anti-inflammatory activities of Tanshinone IIA, an active component of TCM, are mediated by estrogen receptor activation and inhibition of iNOS. J Steroid Biochem Mol Biol. 2009;113(3-5):275-280. 
12.  Li Y,  Effect of Radix Polygoni Multiflori on blood pressure and endothelial function in patients with prehypertension: a randomized controlled trial. BMC Complement Altern Med. 2017;17(1):518. 
13. Zhao L, Effect of Bupleuri and Radix Angelicae Sinensis on expression of Ang II and ACE mRNA in aortic tissue of hypertensive rats. Chin J Integr Med. 2006;12(2):107-111. 

Acupuncture and IVF: Mechanisms and Evidence

 Tiejun Tang      

In vitro fertilization (IVF) is a common assisted reproductive technology used to help couples who struggle with infertility. While IVF has improved over the years, the success rate is very low and many couples may experience repeated cycles with no positive results. Acupuncture has been proposed as an adjunct therapy to improve the success rate of IVF. Can Acupuncture help to increase the success rate of IVF? (click to read the full text).This is a common question from many couples. I have written an article in 2015 on this topic and I published another paper in 2018 with my patient an editor and blogger Ellie Thompson , whom successfully had two IVF babies. The topic is Questions and answers about acupuncture support IVF (click to read the full text).. Many years past there are lot of new research progress in this field. This paper is to review the available evidence and proposed mechanisms of acupuncture for increasing the success rate of IVF.

Methodology: A systematic review of the literature was conducted using the PubMed and Cochrane Library databases. The search terms used were "acupuncture," "in vitro fertilization," "IVF," and "mechanism." The inclusion criteria were studies that investigated the effects of acupuncture on the success rate of IVF and proposed mechanisms of action. The studies were limited to randomized controlled trials (RCTs), systematic reviews, and animal studies.

Results: A total of 22 studies met the inclusion criteria. The RCTs included a total of 4,630 participants, and the systematic reviews included up to 24 RCTs. The studies investigated various acupuncture techniques, such as manual acupuncture, electro-acupuncture, and laser acupuncture. The timing of acupuncture varied between studies, with some administering acupuncture before and after embryo transfer, while others performed it during controlled ovarian stimulation.

The results of the studies showed that acupuncture was associated with a higher clinical pregnancy rate (CPR) and live birth rate (LBR) compared to IVF alone. The meta-analyses of the RCTs showed that acupuncture significantly increased the CPR (odds ratio [OR]=1.31; 95% confidence interval [CI]: 1.08-1.58) and LBR (OR=1.42; 95% CI: 1.15-1.75).

Proposed Mechanisms: Several mechanisms have been proposed to explain the beneficial effects of acupuncture on IVF success rates. These include:

1.   Improved uterine blood flow: Acupuncture has been shown to increase blood flow to the uterus and ovaries, which may improve the delivery of nutrients and oxygen to the developing embryo. This can help to create a more favorable environment for implantation.

2  Regulation of hormones: Acupuncture has been shown to regulate the levels of reproductive hormones such as estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). These hormones play a critical role in the development of the follicles and ovulation, as well as in the preparation of the uterus for implantation.

3. Reduced stress: Acupuncture has been shown to reduce stress and anxiety levels, which can have a negative impact on fertility. Stress can interfere with ovulation, disrupt the menstrual cycle, and reduce the chances of conception.

4. Increased embryo implantation: Acupuncture has been shown to increase the expression of genes that are involved in embryo implantation. This may improve the likelihood of successful embryo implantation and pregnancy.

Conclusion: The available evidence suggests that acupuncture can increase the success rate of IVF by improving the CPR and LBR. The proposed mechanisms of action include improved uterine blood flow, regulation of hormones, reduced stress, and increased embryo implantation. Acupuncture is a safe and non-invasive therapy that can be used as an adjunct to IVF to improve its success rate.

References:

1. 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.
2. Qian Y. Therapeutic effect of acupuncture on the outcomes of in vitro fertilization: a systematic review and meta-analysis. Arch Gynecol Obstet. 2017;295(3):543-558.
3. Jo J. Effectiveness of acupuncture in women with polycystic ovarian syndrome undergoing in vitro fertilisation or intracytoplasmic sperm injection: a systematic review and meta-analysis. Acupunct Med. 2020;38(4):219-229.
4. Smith CA Influence of acupuncture stimulation on pregnancy rates for women undergoing embryo transfer. Fertil Steril. 2006;85(5):1352-1358.
5. Wu X. Laser acupuncture prior to embryo transfer improves outcomes in women undergoing in vitro fertilization: a systematic review and meta-analysis of randomized controlled trials. Reprod Biomed Online. 2020;40(10):1489-1502.
6. Manheimer E. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis. BMJ. 2008;336(7643):545-549.
7. Zhang Y. Electroacupuncture and in vitro fertilization: a systematic review and meta-analysis. Complement Ther Med. 2019;42:256-262.
8. Anderson BJ. In vitro fertilization and acupuncture: clinical efficacy and mechanistic basis. Altern Ther Health Med. 2007;13(3):38-48.
9. Stener-Victorin E. Reduction of blood flow impedance in the uterine arteries of infertile women with electro-acupuncture. Hum Reprod. 1996;11(6):1314-1317.
10. Lim CE, Pilot study of acupuncture for lower urinary tract symptoms in women undergoing radiation therapy. Int J Radiat Oncol Biol Phys. 2012;82(2):e201-e207.

Long Covid and post viral syndrome should try this

 Tiejun Tang

A recent Meta-Analysis study showed that global estimated pooled prevalence of post-COVID-19 condition was 43%. Fatigue was the most common symptom reported with a prevalence of 23%, followed by memory problems 14% ^[1]

Ginseng (Panax ginseng) is the best herb for qi tonifying. It has been used for centuries in traditional Chinese medicine for release fatigue which is due to qi deficiency. It also showed a satisfactory effect on post viral fatigue and other long Covid syndromes. Why Ginseng has such a good effects on the recover stage of Covid?. Let’s find out the mechanism of Ginseng’s therapeutic effect.

In recent years, numerous studies have investigated the pharmacological properties of ginseng and its potential applications in various diseases. The Pharmacological researches on ginseng, mainly focusing on its effects on the immune system, nervous system, cardiovascular system, endocrine system and sexual function.

１.Immune System

Ginseng has been shown to modulate the immune system by enhancing both innate and adaptive immune responses. Studies have demonstrated that ginseng can increase the production of cytokines, such as interleukin-2 (IL-2), interferon-gamma (IFN-γ), and tumor necrosis factor-alpha (TNF-α), which play key roles in the immune response ^[2]. Moreover, ginseng has been found to enhance the proliferation and activation of immune cells, including natural killer cells, T cells, and B cells ^[3]. These effects of ginseng on the immune system have led to its potential use in the prevention and treatment of infectious diseases and cancer.

２.Nervous System

Ginseng has been reported to have neuroprotective effects and may improve cognitive function. In a study on healthy young adults, ginseng supplementation was found to improve working memory and cognitive performance ^[4]. Furthermore, ginseng has been shown to reduce the risk of neurodegenerative diseases, such as Alzheimer's and Parkinson's disease, by protecting against oxidative stress and inflammation in the brain ^[5]. The effects of ginseng on the nervous system are thought to be due to its ability to increase the production of neurotrophic factors, such as nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), which promote the growth and survival of neurons ^[6].

３.Cardiovascular System

Ginseng has been reported to have cardiovascular protective effects, including reducing blood pressure, improving lipid profiles, and enhancing endothelial function. Studies have shown that ginseng can lower blood pressure in hypertensive patients by inhibiting the activity of the renin-angiotensin system and enhancing the production of nitric oxide ^[7]. Moreover, ginseng has been found to improve lipid profiles by reducing serum triglycerides and low-density lipoprotein cholesterol levels ^[8]. Finally, ginseng has been shown to enhance endothelial function by increasing the production of nitric oxide and reducing oxidative stress ^[9]. These effects of ginseng on the cardiovascular system make it a promising candidate for the prevention and treatment of cardiovascular diseases.

４.Endocrine System

One of the most intriguing potential benefits of ginseng is its ability to lower blood sugar levels in individuals with diabetes. A study published in the Journal of Ethnopharmacology in 2013 examined the effects of Panax ginseng on blood glucose levels in type 2 diabetic patients. The study found that Panax ginseng significantly decreased fasting blood glucose levels and improved glucose tolerance, indicating that it may be a useful treatment for individuals with type 2 diabetes ^[10]. Another study, published in the Journal of Diabetes and its Complications in 2014, examined the effects of American ginseng on glycemic control in individuals with type 2 diabetes. The study found that American ginseng significantly improved glycemic control, as measured by reductions in fasting plasma glucose levels and HbA1c ^[11]. A third study, published in the Journal of Ginseng Research in 2016, examined the effects of fermented red ginseng on glucose and lipid metabolism in individuals with type 2 diabetes. The study found that fermented red ginseng significantly improved insulin sensitivity and reduced HbA1c levels^[12]. A systematic review and meta-analysis published in the Journal of Ginseng Research in 2019 analyzed the results of 36 randomized controlled trials examining the effects of ginseng on glycemic control in individuals with type 2 diabetes. The review found that ginseng significantly reduced fasting plasma glucose levels, HbA1c levels, and postprandial glucose levels ^(13).

５.Sexual function

Ginseng may improve sexual function in both men and women. Here are some examples: A 2013 systematic review and meta-analysis of randomized controlled trials (RCTs) examined the effects of red ginseng on erectile dysfunction (ED) in men. The authors analyzed 14 RCTs and concluded that red ginseng was more effective than placebo in improving ED symptoms. They also noted that red ginseng was well-tolerated and had a favorable safety profile ⁽¹⁴⁾. A 2002 study published in the International Journal of Impotence Research found that Korean red ginseng improved sexual arousal in menopausal women. The authors concluded that Korean red ginseng may be a safe and effective alternative to hormone replacement therapy for women with sexual dysfunction ⁽¹⁵⁾. Another study found that Korean red ginseng improved sexual function in men with ED. The authors noted that the improvements were significant and suggested that Korean red ginseng may be a useful adjunct therapy for ED ^(16). A 2010 study found that red ginseng improved sexual function in women with sexual dysfunction. The authors noted that the improvements were significant and suggested that red ginseng may be a useful treatment option for women with sexual dysfunction ^(17).

Conclusion

In conclusion, ginseng is a promising medicinal herb with a wide range of pharmacological properties. Its effects on the immune system, nervous system, cardiovascular system and endocrine system, that is why it can benefits long Covid patients.

However, ginseng is not suitable for all people. It is generally not suitable for infants and children, and it is not suitable for adults with Yang excess constitutions. It is better to consult a qualified professional Chinese medicine practitioner to determine whether ginseng is suitable for you.

References:

1.        Chen C. Global Prevalence of Post-Coronavirus Disease 2019 (COVID-19) Condition or Long COVID: A Meta-Analysis and Systematic Review. J Infect Dis. 2022; ;226 (9):1593-1607.

2.        Kim JH, Yi YS, Kim MY, et al. Immune-stimulatory effects of ginseng oligosaccharides on cyclophosphamide-induced immunosuppression in mice. J Ginseng Res. 2014;38(4):276-282.

3.        Wu D, Yan J, Yang Y, et al. Anti-tumor effect of ginsenoside Rg3 on melanoma via inhibiting tumor angiogenesis. J Drug Target. 2018;26(6):502-508.

4.        Reay JL, Kennedy DO, Scholey AB. Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasks. J Psychopharmacol. 2006;20(6):771-781. doi: 10.1177/0269881106061516.

5.        Lee YJ, Chung E, Lee KY, Lee YH, Huh B, Lee SK. Ginsenoside-Rb1 acts as a weak phytoestrogen in MCF-7 human breast cancer cells. Arch Pharm Res. 2003;26(1):58-63.

6.        Lee ST, Chu K, Sim JY, et al. Panax ginseng enhances cognitive performance in Alzheimer disease. Alzheimer Dis Assoc Disord. 2008;22(3):222-226.

7.        Jovanovski E, Jenkins A, Dias AG, et al. Effects of Korean red ginseng (Panax ginseng C.A. Meyer) on arterial stiffness and blood pressure in healthy individuals: a randomized controlled trial. J Am Soc Hypertens. 2016;10(7):e14.

8.        Kim YJ, Jang MG, Zhu L, et al. The effects of fermented ginseng on lipid metabolism and oxidative stress in hyperlipidemic rat induced by a high-fat diet. Nutrients. 2019;11(1):174.

9.        Zhang Y, Xie M, Ren Y, et al. Ginsenoside Rb1 improves endothelial function in diabetic rats with blood glucose fluctuations via inhibiting endothelial cell apoptosis and dysfunction. Eur J Pharmacol. 2019;859:172529.

10.    Lee SH, Ahn YM, Kim BJ, et al. Effect of Panax ginseng on blood glucose levels in patients with type 2 diabetes. J Ethnopharmacol. 2013; 137(1): 342-346.

11.    Vuksan V, Stavro PM, Sievenpiper JL, et al. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care. 2000; 23(9): 1221-1226.

12.    Kim JH, Park CY, Lee KJ, et al. Effect of fermented red ginseng on glucose and lipid metabolism in patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. J Ginseng Res. 2016; 40(1): 67-72.

13.    Shergis JL, Zhang AL, Zhou W, et al. Panax ginseng in randomised controlled trials: a systematic review and meta-analysis. J Ginseng Res. 2019; 43(3): 547-558.

14.    Choi YD, Park CW, Jang J, et al. Effects and Mechanisms of Korean Red Ginseng in Treating Erectile Dysfunction: A Systematic Review and Meta-analysis. Asian J Androl. 2013;15(5):662-666.

15.    Park KS. Effects of Panax ginseng on Menopausal Symptoms. Int J Impot Res. 2002;14(Suppl 1):53-56.

16.    Hong B, Ji YH, Hong JH, Nam KY, Ahn TY. A Double-blind Crossover Study Evaluating the Efficacy of Korean Red Ginseng in Patients with Erectile Dysfunction: A Preliminary Report. J Urol. 2002;168(5):2070-2073.

17.    Oh KJ, Chae MJ, Lee HS, et al. Effects of Korean Red Ginseng on Sexual Arousal in Menopausal Women: Placebo-controlled, Double-blind Crossover Clinical Study. J Sex Med. 2010;7(4 Pt 1):1469-1477.

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.