Traditional Chinese medicine (TCM) has thousands years history. It has unique basic theories and diagnostic methods. It is a very effective therapy in treating many chronic diseases and some acute diseases. If you are interested in TCM, welcome to pop in to this TCM forum, let's discuss on any topic about Chinese herbal medicine and acupuncture. If you have any health problem, you are welcome to visit my clinic Knowhow Acupuncture at No.1 Harley street, London. If you are far away from London, you can pop in my online clinic to get some help. If you like this blog please share it to your friends.

Wednesday, 14 March 2018

Acupuncture can help you to quit smoking

Tiejun Tang

Today is national no smoking day. There are now 7.2 million adults in England who smoke. Are you one of them? Everyone knows smoking is harmful to one’s health. Many smokers hope to quit smoking, but they find it very difficult to stop. Acupuncture is an effective way to help you quit smoking.
When giving up smoking you may experience several symptoms including irritability, headaches, dizziness, cough, sore dry throat, constipation, increased appetite, runny nose, depression, inability to concentrate or sit still, insomnia and craving for cigarettes.  These symptoms called nicotene withdrawal. Acupuncture can reduce these symptoms by stimulating certain points on body surface or ears.  An important acupoint for quit smoking is Tian Mei point which is on your wrists. This point is specific to help smokers control their cravings.

Many RCT reports have been published in the past 30 years to support the efficacy of acupuncture in terms of smoking. Fuller[1] (1982) used acupuncture to help 194 people (118 men and 76 women) quit smoking. 95% of patients quit smoking after three acupuncture treatments. Fifty-five (32%) of the 174 patients who replied to a mailed questionnaire said they had not smoked since treatment; the success rate was: one week, 86%; six months 41%; 12 months, 34% and 24 months, 30%. He[2] (1997) reported acupuncture may help motivated smokers to reduce their smoking or even quit smoking completely. Different acupoints appear to have different effects for smoking cessation and reduction. Waite[3] (1998) applied ear electric acupuncture to treat 78 smokers in a randomized, single-blind, placebo-controlled trial. The result showed ear electric acupuncture treatment was significantly more effective in helping volunteers to quit smoking than placebo treatment. He[4](2001) reported that adequate acupuncture treatment may help motivated smokers to reduce their smoking, or even quit smoking, and the effect may last for at least 5 years. Acupuncture may affect the subjects' smoking by reducing their taste of tobacco and their desire to smoke. An observational study was conducted by Ma[5](2015) to evaluate the effectiveness of acupuncture for smoking cessation. A total of 1002 smokers were recruited; 26-week and 52-week quit rates were 16.8% and 15.8%. A large sample multicenter observational study was reported[6] (2016). The result showed abstinence rate in 2940 subjects was 34.00% in week 8 and 18.40% in week 52. The exhaled carbon monoxide level and the number of cigarettes smoked per day were reduced significantly after treatment. The time to relapse was calculated to be 38.71 days.

It’s time to quit smoking! Have you make up your mind? Maybe you have tried a few times to quit smoking. Acupuncture can reduce your nicotine withdrawal symptoms, and it is a natural, safe and efficient way to quit smoking. 
1.     Fuller JA. Smoking withdrawal and acupuncture.Med J Aust. 1982; 1(1):28-9.
2.     He D. Effects of acupuncture on smoking cessation or reduction for motivated smokers.Prev Med. 1997; 26(2):208-14.
3.     Waite.A single-blind, placebo-controlled trial of a simple acupuncture treatment in the cessation of smoking.Br J Gen Pract. 1998;  48(433):1487-90.
4.     He D. Effect of acupuncture on smoking cessation or reduction: an 8-month and 5-year follow-up study.Prev Med. 2001; 33(5):364-72.
5.     Ma E. Effectiveness of acupuncture for smoking cessation in a Chinese population.Asia Pac J Public Health. 2015; 27(2).
6.     Wang YY. Acupuncture for Smoking Cessation in Hong Kong: A Prospective Multicenter Observational Study.Evid Based Complement Alternat Med. 2016;2016:2865831.

Tuesday, 6 March 2018

My contribution to Your Wellness

Tiejun Tang

Your Wellness is the most complete magazine about living well. This is a high quality and practical magazine which distribute worldwide. I was invited to write short paper in the Q&A column since February 2017. I am very happy to share my knowledge with Your Wellness readers and also my dear blog readers. My contributions in the past year are below:

Q: I'm a 54 years old man and lately I have been feeling really tired and lacking energy. I eat consciously, don’t smoke, and drink only occasionally. Despite my long hours at work I also ensure that I walk at least for half an hour every day as exercise but I have noticed that my sex drive has decreased significantly, my body fat is growing and muscle mass is reduced; I’m low on motivation, finding it difficult to focus and have trouble sleeping. Can you help?

A:  Dear Sir, Traditional Chinese medicine believes kidney dominate the fertility function and libido. Generally speaking low libido usually is due to kidney deficiency. If your body feels hotter and often sweat at night, you might have kidney yin deficiency; if your body feels colder, you might have kidney yang deficiency; if you only feel fatigue and low motivation you might have kidney qi deficiency. Kidney function will decline when people getting old, but this aging process might come earlier or later, slower or faster in individual person. In western medicine this change is due to decline of endocrine system. Your adrenal gland and your testicle produce less hormones then it was. Your age is not very high. You can have better kidney function. How to improve your sex drive and promoting your energy level?  I suggest you try some Chinese herbal medicine to tonify your kidney. The formula selection depends on the deficiency is happened in yin/yang or qi.  Viagra can boost your libido temporarily. Long term use Viagra will lead some side effects. Chinese herbal medicine is pure nature remedy. It can treat the disease from the root. If you select the right formula it always works very well.     

Q:  I am a 50-year-old man with a history of clinical depression. When I was depressed, my memory, especially short-term memory, was affected. Today, even though I no longer suffer from depression and have regained my psychological health, my memory is not too good. What are the ways in which I could boost it? I am willing to look at lifestyle changes, traditional as also modern medicine and everything that contributes to wellness. 

A: For Traditional Chinese medicine theory, memory deterioration is associated with the heart. During your depression your liver and heart were probably disharmonious. This can be caused by stress, ageing, or genetic weaknesses in the kidney. The good news is that all of the above can be addressed by Qi-Gong exercising, Chinese herbs and acupuncture. There is an herb called ‘Yizhiren’ (bitter caramon) has a very good function of benefit memory. Walnut is a good for food therapy of memory loss. Acupuncture on ‘Si Shen Chong’ the Four Alert Spirit, Four Mind hearing’ acupuncture points also can benefit the memory. A good Traditional Chinese Medicine (TCM) practitioner can tailor an integrated plan of herbs, exercise and acupuncture to best fit your individual needs.

Q: I’m a man that has just turned 50. Though my friends say that 50 is the new 40, in this youth-obsessed world, I am now suddenly very aware that I’m not so young anymore. The feeling bogs me down. Should I age gracefully or fight ageing every inch of the way? Are there any specific traditional remedies or a certain lifestyle that would make me feel and remain youthful for long?

A:  Senescence is a nature process of human. Everybody will gradually getting old after middle age, but the speed of aging process can be influenced by many factors. Inherited factor, unhealthy lifestyle, diet, emotional stress, pollution, lack of exercise etc. every factor can effect to the aging process. People hope to delay and slow down the process of aging. What we can do? Actually we can change a lot of these factors except our gene.
Traditional Chinese medicine (TCM) believes kidney qi and kidney essence are very important in aging process. Tonify kidney is the best method of anti aging. In TCM’s theory kidney doesn’t only indicate the two organs. It includes the function of hypothalamus-pituitary-adrenal axis and the function of gonad in male and female.
Take some Chinese herbs, acupuncture some certain points can benefit kidney.   Regular Taiji and Qigong exercise also can help to keep younger. There are many classic formulas were used for anti aging. Find a local practitioner you can get one it might suit you.
My teacher Professor Deng Tietao is the world famous TCM master. He is 101 years old. His health condition is due to his TCM knowledge of anti aging. 

Q:  I have had recurring migraine headaches over many years. My solution has been to rely on OTC medicines, which eliminate the pain within half an hour. My wife is concerned about me taking so many painkillers, and suggests I explore alternate ways of dealing with these frequent headaches. Can you help?

A:  You can’t rely on painkillers. Although painkillers can release your pain temporarily, but long term use painkiller will cause some side effects. It may damage your stomach or liver function. It released your headache but causing stomachache. Some strong pain killer can make your get addiction if long term use. A recent published paper said Ibuprofen (Advil) Kills Thousands Each Year. I suggest you gradually reduce the doses of your painkillers. Try to use some alternative medicine therapies instead.
Acupuncture shows a very good effect on pain release. I used worked in the pain clinic of Whittington Hospital in London many years ago. We use acupuncture treated a lot of patients suffer from different kinds of pain. Most of them have got positive effect. The mechanisms of pain release were analyzed in my previous publication. Except traditional acupuncture a new modern acupuncture technique called Fu's Subcutaneous Needle also showed magic effect on pain release. Many Chinese herbal medicines also can release pain without cause any side effect. You can contact your local Chinese medicine practitioner to get a right prescription.
Be aware of the side effect of your pain killers; select a nature and safer way to manage your pain.    

 Q:  I am a 50-year-old man who works long hours online and has to do a lot of reading both on screen and off it, too. I wear reading glasses. What can I do to maintain good eye health? 

A:  Your condition is very common in this screen times. You need to pay more attention to maintain your eye health. Long time overuse your eye might cause vitreous opacity. You might feel floaters and declined vision. My suggestions are: 1) Avoid long time use computer, take a 5 to 10 minutes break after 1 hour continuous computer work; 2) During the break, close your eyes and massage some acupuncture points around eyes. For example JingMing (BL1), ChengQi (ST1) and TaiYang et al.; 3) Looking far distance for 1-2 minutes; 4) Adjust the distance and position of the screen from the eyes, adjust the brightness of your screen to the half of maximum; 5) Eating more soy products, fish, milk, walnuts, vegetables, cabbage, spinach, tomatoes and fresh fruit; 6) Drinking some herbal tea which can benefit eyes.
Traditional Chinese medicine believes eye is out opening of liver. Overuse eye will damage the liver blood and liver yin. Some Chinese medicine herbs have the function of benefit vision. Gouqizi (Wolfberry) and Juhua (chrysanthemum) are two commonly used herbs. Drinking Gouqi Juhua Tea everyday is a good method to maintain eye health. You can get detailed suggestion from your local TCM practitioner.     

Q:  I’m a 42-year-old woman who suffers from severe leg cramps at night. They’re mostly calf cramps but sometimes my feet and thighs cramp too. What could be the reason for this and what can I do for relief?

A:  Many people have experienced leg cramps during sleep. These cramps actually are due to muscles spasms caused by abnormal activity of nerves and muscles. 
The reasons of this symptom are: 1) Leg muscles overstrain in the daytime. 2) Cold stimulation. 3) Hypocalcemia which is more common in calcium-deficient pregnant women, post menopause and elderly person. 4) Improper sleeping posture leads to vein compression, blood circulation stasis. No matter what kind of reason causing leg cramps, it will produce severe pain and discomfort. We must pay enough attention to this condition.
To prevent the leg cramps you should avoid the above reason. My suggestion is 1) Do few minutes self-massage on leg before sleep. 2) Keep your legs warm enough during sleep do not expose it outside quilt. 3) Test blood calcium. Take calcium supplement if your blood calcium is lower. 4) Keep a proper sleep posture and a comfortable sleep environment.

Traditional Chinese medicine believes all the ligaments and tendons are dominated by liver. Liver blood deficiency will causing leg cramps. Cold evil also can causing muscles spasms. Tuina massage on some certain points can prevent and release the cramp.  Any herbs for nourish liver blood can prevent leg cramps. 

Thursday, 8 February 2018

How to treat tinnitus with acupuncture and Chinese herbal medicine?

Tiejun Tang

This week (5-11 February in 2018) is Tinnitus Awareness Week in UK. Do you have tinnitus?  It is the sensation of hearing noises in your ear or head when there is no external cause. Tinnitus is very common and is reported in all age groups. About 30% of people will experience tinnitus at some point in their lives, but approximately 10% of people who live with persistent tinnitus. The common reasons of Tinnitus might due to loud noise, stress and anxiety, ear infection,  Ménière's diseas and some other chronic diseases. Western medicine only can release some kinds of tinnitus by treat their primary diseases, but for the most of functional tinnitus no effective treatment.

Chinese medicine believes ears are closely related with kidney. Ear is the out opening of kidney. Most of tinnitus is due to kidney deficiency. This theory was proved by some research reports which I have mentioned in my previous paper.  Some high pitched tinnitus is due to liver and gallbladder fire. Tonified kidney or clean the liver and gallbladder fire can reduce or cure tinnitus. We usually use acupuncture and/or herbs to treat tinnitus.

Laureano[1] using ethyl cysteinate dimer single-photon emission computed tomography ((99m)Tc-ECD SPECT) to investigate the effect of acupuncture in patients with tinnitus. The results showed a significant improvement in Tinnitus Handicap Inventory (THI) scores was observed at the end of true acupuncture treatment for all domains; Doi MY[2] reported Chinese scalp acupuncture associated with bilateral electroacupuncture demonstrated, in the short term, a statistically significant improvement by reducing the level of tinnitus intensity, as well as improving the quality of life of individuals with tinnitus; A randomized controlled trial (2018) reported [3], acupuncture is effective in reducing the loudness and severity of tinnitus and can be a useful treatment for nonpulsatile chronic tinnitus.

GuShen Pian is a patent herbal tablets of kidney tonified. Zhai S use this tablets treated 120 cases of sensorineural deafness, the total effective rate of tinnitus was 89.2% and total relieved rate of tinnitus was 59.5%. The result suggests Gushen Pian had beneficial effect on deafness and tinnitus and could effectively alleviate aural fullness and insomnia [4]. Chinese herb decoction usually select a modified the formula according to individual case, it more accurate, more individualized, so it often showed a better effect than patent herbal remedies.
From this week, we should be aware of tinnitus and take care of our ears. 

Reference :
  1.  Laureano  MR. The effectiveness of acupuncture as a treatment for tinnitus: a randomized controlled trial using (99m)Tc-ECD SPECT. Eur Radiol. 2016 ; 26(9):3234-42.
  2. Doi  MY. Effectiveness of acupuncture therapy as treatment for tinnitus: a randomized controlled trial. Braz J Otorhinolaryngol. 2016; 82(4):458-65
  3. Naderinabi B. Acupuncture for chronic nonpulsatile tinnitus: A randomized clinical trial. Caspian J Intern Med. 2018; 9(1):38-45.
  4. Zhai S1Clinical investigation on the beneficial effects of the Chinese medicinal herb Gushen Pian on sensorineural deafness and tinnitus. Cell Biochem  Biophys. 2013; 67(2):785-93.

Friday, 3 November 2017

Corn Silk -- A Natural Herb for Diabetes

Tiejun Tang

Diabetes is a very common disease. According to the WHO Global Report on Diabetes in 2014, there are 422 million adults suffering from diabetes. Most patients have to rely on chemical hypoglycaemic agents or even insulin injection for their whole life. Chemical drugs often cause many side effects after long term use, and the blood sugar levels are still not properly controlled in some cases. Good news for diabetes patient is that a Chinese herb has good effect on reducing blood sugar. It is a natural way to fight diabetes.

Corn silk (CS) is a commonly used Chinese herbal medicine. In Chinese it is called Yumixu. It was used to treat Xiao Ke (diabetes) for hundreds of years in China. It may be used alone or in combination with other herbs according to syndrome differentiation diagnosis. It also can be used as daily food therapy for diabetes patients. The hypoglycaemic mechanisms of CS have been investigated by many researchers around world.

The peroxisome proliferator-activated receptors play a pivotal role in metazoan lipid and glucose homeostasis. Synthetic activators of PPAR alpha (fibrates) and PPAR gamma (glitazones) are therefore widely used for treatment of dislipidemia and diabetes. Rau O (2006) reported CS showed a significant effect of PPAR gamma activator [1]Non-enzymatic glycation and the accumulation of advanced glycation end products (AGEs) are associated with diabetes. Farsi DA (2008) reported that secondary metabolites from several plant species are known to inhibit non-enzymatic glycation and the formation of AGEs, including flavonoids found in CS. The results identify modern resistant and high phenolic maize inbreds as promising candidates for the development of natural AGE inhibitors for the prevention and treatment of diabetic complications[2]. Guo J (2009) reported CS extract markedly reduced hyperglycaemia in alloxan-induced diabetic mice. The action of CS extract on glycaemic metabolism is through increasing insulin level as well as recovering the injured beta-cells. Their research results suggest that CS extract may be used as a hypoglycaemic food or medicine for hyperglycaemic people[3]. Zhao W (2012) reported polysaccharides of CS have significant anti-diabetic effect on streptozotocin (STZ)-induced diabetic rats. The results demonstrated that daily treatment with 100-500 mg/kg body weight of CS extraction the diabetic rats could not only lead to a significant decrease on the animal's blood glucose level, but also reduce the serum lipid level including total cholesterol and total triglyceride [4]. Wen X (2015) reported Corn Silk Polysaccharide (CSP) D3 can inhibit the expression level of TGF-β1 of diabetic rat’s kidney and restrain macrophages in order to protect the kidneys of diabetic rats[5]. Zhang Y (2015) reported flavonoids extracted from CS can significantly reduce the body weight loss, water consumption, and especially the blood glucose of diabetic mice. It can increase serum total superoxide dismutase (SOD) and high density lipoprotein cholesterol level (HDL-C), decrease total cholesterol, triacylglycerol, low density lipoprotein cholesterol (LDL-C) [6]. Sabiu S (2016) reported in vitro analysis of CS extract that the result showed it exhibited potent and moderate inhibitory potential against α-amylase and α-glucosidase, respectively[7]. Cha JH (2016) reported CS extract improves levels of adipocytokine secretion and glucose homeostasis. It is also effective in decreasing the regulatory pool of hepatic cholesterol, in line with decreased blood and hepatic levels of cholesterol through modulation of mRNA expression levels of HMG-CoA reductase, acyltransferase (ACAT), and farnesoid X receptor (FXR)[8]. Chang CC (2016) report, the ethyl acetate fraction of CS exhibits dual antioxidant and anti-glycation activities and protects insulin-secreting cells from glucotoxicity[9]. Wang B (2017) reported CS has multiple beneficial effects, including hypotensive, anti-diabetic, and hypolipidemic properties. This suggests that CS could be used to treat or prevent metabolic syndrome[10]Pan Y (2017) aimed to investigate the physicochemical properties and antidiabetic effects of a polysaccharide obtained from corn silk (PCS2). The results showed that PCS2 was a heteropolysaccharide with the average molecular weight of 45.5kDa. PCS2 treatment significantly reduced the body weight loss, decreased blood glucose and serum insulin levels, and improved glucose intolerance. The levels of serum lipid profile were regulated and the levels of glycated serum protein, non-esterified fatty acid were decreased significantly. The activities of superoxide dismutase, glutathione peroxidase and catalase were notably improved. PCS2 also exerted cytoprotective action from histopathological observation. These results suggested that PCS2 could be a good candidate for functional food or medicine for diabetes treatment[11].

The hypoglycaemic mechanism of CS is a multi-target approach. It not only reduces blood sugar but also balances the blood lipid, preventing and reducing complications of diabetes. This multi-target approach is different from western medicine treatment. The hypoglycaemic effect of CS is not as fast and strong as metformin, but it’s effects are more stable and much safer.  

Except CS many other Chinese herbs also have a good effect to reduce blood sugar. In my clinical practice I usually select few herbs to compose a formula for different individual patients.  For the early stages of Type 2 diabetes the use of herbal medicine can get the sugar level under control. For severe cases, when patients have to use western medicine, CS can be elected to enhance the effect of western medicine and reduce their side effect.

  1. Rau O, et al. Screening of herbal extracts for activation of the human peroxisome proliferator-activated receptor. Pharmazie. 2006; 61(11):952-6.
  2. Farsi DA, et al. Inhibition of non-enzymatic glycation by silk extracts from a Mexican land race and modern inbred lines of maize (Zea mays).  Phytother Res. 2008; 22(1):108-12.
  3. Guo J, et al. The effects of corn silk on glycaemic metabolism. Nutr Metab (Lond). 2009; 23(6):47.
  4. Zhao W, et al. Comparison of anti-diabetic effects of polysaccharides from corn silk on normal and hyperglycemia rats.Int J Biol Macromol. 2012; 50(4):1133-7.
  5. Wen X, et al. The Influence of Corn Silk Polysaccharide on Signal Pathway of TGF-β1 in Type 2 Diabetic Mellitus Rat. Open Biomed Eng J. 2015; 9: 204-8 
  6. Zhang Y, et al. Anti-Diabetic, Anti-Oxidant and Anti-Hyperlipidemic Activities of Flavonoids from Corn Silk on STZ-Induced Diabetic Mice. Molecules. 2015; 21(1):E7.
  7. Sabiu S, et al. Kinetics of α-amylase and α-glucosidase inhibitory potential of Zea mays Linnaeus (Poaceae), Stigma maydis aqueous extract: An in vitro assessment. J Ethnopharmacol. 2016; 183:1-8.
  8. Cha JH, et al. Corn silk extract improves cholesterol metabolism in C57BL/6J mouse fed high-fat diets.Nutr Res Pract. 2016; 10(5): 501-506.
  9. Chang CC, et al. The ethyl acetate fraction of corn silk exhibits dual antioxidant and anti-glycation activities and protects insulin-secreting cells from glucotoxicity. BMC Complement Altern Med. 2016; 16(1):432.
  10. Wang B, et al. Beneficial Effects of Corn Silk on Metabolic Syndrome. Curr Pharm Des. 2017 Sep 26. doi: 10.2174/1381612823666170926152425. [Epub ahead of print] 
  11. Pan Y,et al. Physicochemical properties and antidiabetic effects of a polysaccharide from corn silk in high-fat diet and streptozotocin-induced diabetic mice. Carbohydr Polym. 2017; 164: 370-378. 

Sunday, 13 August 2017

How to prevent and treat coronary in-stent restenosis with Chinese medicine?

Tiejun Tang

Coronary in-stent is the most common treatment in coronary heart disease (CHD).  It can improve myocardial ischemiaand release angina immediately. About 800,000 Americans receive stents each year. Although coronary artery stent is very effective on CHD, but the ischaemic heart disease still is the world’s biggest killer according to WHO’s report (2012). Statistical data showed 73,000 people died from CHD every year in the UK. (200 died per day). The biggest problem in the treatment of CHD is restenosis or re-narrowing of the coronary artery. 

Restenosis usually occurs 6-9 months after stent placement, as a result of neointimal hyperplasia due to the proliferation and migration of vascular smooth muscle cells. A recent research report showed that from 2006 to 2014, 65,443 patients underwent percutaneous coronary intervention (PCI) and 6,872 patients (10.5%) with 8,921 lesions were treated for in-stent restenosis (ISR). The proportion of patients undergoing revascularization for restenosis increased 0.28% per year[1].

The small scaffold stent props open the diseased artery to prevent heart attacks, but because
the body treats stents as foreign, the risk of blood clots is ever present. That is why its short term effects are good, but long term effects are not satisfactory.  Dr Aseem Malhotra said to Daily Mail: ‘There is no evidence that coronary angioplasty reduces risk of heart attack or death in patients with uncomplicated stable angina’

In traditional Chinese medicine (TCM) angina is known as Xin Tong or Xiong Bi. The common pathological mechanisms of this disease were due to heart blood stagnation, heart yang deficiency, cold stagnation or phlegm obstruction. Chinese medicine usually selects different herb formula to treat different individual cases. Some formulas have been used for thousands of years. Every prescription was modified according to the symptoms of the individual patients.


In China, Chinese herbal medicines are widely used for preventing restenosis after stent placement. A Meta-analysis on 52 trials (4905 patients),  the result showed at the end of at least 3 months' follow up, Chinese herb medicine could significantly reduce restenosis rate, cardiac mortality, recurrence rate of angina, acute myocardial infarction, numbers of repeat PCI, and numbers of coronary artery bypass graft[2]. Chinese herb treatment includes extracts from mixtures of herbs, single herbs, or a compound of herb decoction.  The most commonly used single herb is Dan Shen (Salvia miltiorrhiza). More than 230 randomized controlled trials (RCTs) of Danshen dripping pillin treating angina pectoris. Among the included 109 RCTs with 11,973 participants, the efficacy of Danshen was better than isosorbide dinitrate in treating angina pectoris[3]. Dan Shen also showed a good effect on preventing restenosis after coronary stent[4].  Xiong Shao capsule is an herbal remedy which was composed by ChuanxiongLigusticum chuanxiongand Chishao (red paeony root). Clinical study showed it can effectively prevent restenosis after PCI in combination with conventional western medical treatment.[5]

If you have time to read all of reference below this article, you will understand coronary stent and by-pass operation are not only option in CHD treatment. TCM as an alternative option is the right choice, because it can reduce the mortality rate and save lives. 

1. Waldo SW. Incidence, procedural management, and clinical outcomes of coronary in-stent restenosis: Insights from the National VA CART Program.Catheter Cardiovasc Interv. 2017 Jun 28. doi: 10.1002/ccd.27161. 
2. Zheng GH.Systematic Review of Chinese Herbal Medicines for Preventing in-Stent Coronary Restenosis after Percutaneous Coronary Intervention. Evid Based Complement Alternat Med. 2012;2012:253409.
3. Jia Y. How Efficacious is Danshen (Salvia miltiorrhiza) Dripping Pill in Treating Angina Pectoris? Evidence Assessment for Meta-Analysis of Randomized Controlled Trials. J Altern Complement Med. 2017 Jun 26. doi: 10.1089/acm.2017.0069
4. Fu GS. Clinical observation of compound Danshen drop pill preventing restenosis of patients with coronary heart disease after stenting operation (Part 1) China Medical Herald2009; 6:68–69.
5. Lu XY. Clinical study on effect of Xiong Shao capsule on restenosis after percutaneous coronary intervention. Chinese Journal of Integrated Traditional and Western Medicine. 2006;26(1):13–17.

Wednesday, 24 May 2017

How to treat IBS with Chinese herbal medicine and acupuncture?

Tiejun Tang 

Irritable bowel syndrome (IBS) is a common, chronic disease. IBS occurs in 10-20% of the population in the UK, but prevalence is thought to be higher than this as many people with the disorder do not seek medical advice.[1] If you often have unexplained diarrhoea and /or constipation accompanied by abdominal pain and stressed mood,  you may suffer from IBS, and should contact your GP. IBS diagnosis can be confirmed by exclusion using stools test, blood test and colonoscopy results.

Western medicine usually focuses on the symptoms for IBS patients. Antispasmodics can relieve abdominal pain and cramping and antimotility agents can relieve diarrhoea. Laxatives can relieve constipation and anti-depressants can relieve stressed moods. All of these medicines only can release symptoms temporarily. It is difficult to cure the IBS from the root. Many patients have to live with IBS for many years.

According to the philosophy of traditional Chinese medicine depression and stressed mood was due to liver qi stagnation, and diarrhoea and constipation were due to spleen deficiency. If the diarrhoea were triggered by emotional stimulation, the Chinese medicine diagnosis should be “liver restrict spleen” or “disharmonious between liver and spleen”. The treatment principle for this condition must be dispersing the depressed liver and benefiting the spleen. The basic classic formula is Sini San, a prescription which has more than 1700 years history for diarrhoea treatment. Alternatively we also can use modified Senling Baizhu San and Tongxie YaoFang according to patient’s symptoms for individual cases.

In a pharmacological research to investigate the effects of Sini San and fluoxetine on the levels of central and peripheral 5-HT in a rat model of depression, the result showed that after eight weeks Sini San treatment  appeared at least as effective as fluoxetine. It suggested Sini San can replace fluoxetine in the later stages of depression treatment to minimize side effects of this anti-depressant[2].  In another  report from my ex colleague’s research team, it showed Shenling Baizhu San suppresses colitis associated colorectal cancer through inhibition of epithelial-mesenchymal transition and myeloid-derived suppressor infiltration[3]. Baishaoyao (Paeonia lactiflora Pall) is a common ingredient of these three formulas. In in-vitro and in-vivo studies showed it has a beneficial effect of Anti-inflammatory and immunomodulation[4]. With regard to the pathophysiology of IBS a recent report indicated that low-grade mucosal inflammation and immune activation were involved.[5] Based on thousand years clinical experience of Chinese medicine and modern scientific research, we have enough reasons to try Chinese medicine in IBS treatment.

Acupuncture and moxibustion also have good effect on IBS if a good protocol is selected. Although there is much evidence indicating that acupuncture works well on IBS,[6] unfortunately NICE did not recommend acupuncture in their clinical guidance. Maybe their decision based on different treatment protocols.

The advantage of TCM is to combine herbs and needles. The treatment effect of herbs and acupuncture can enhance each other. Chinese medicines tend to cure the disease from the root and not just control the symptoms.

1.   Guidelines on the Irritable Bowel Syndrome: Mechanisms and Practical Management; British Society of Gastroenterology (May 2007)
2. Li Y. Effects of Sini San used alone and in combination with fluoxetine on central and peripheral 5-HT levels in a rat model of depression. J Tradit Chin Med. 2013 Oct;33(5):674-81.
3. Lin X. Shenling Baizhu San supresses colitis associated colorectal cancer through inhibition of epithelial-mesenchymal transition and myeloid-derived suppressor infiltration.BMC Complement Altern Med. 2015 Apr 22;15:126.
4. He DY. Anti-inflammatory and immunomodulatory effects of paeonia lactiflora pall, a traditional Chinese herbal medicine. Front Pharmacol. 2011 Feb 25;2:10
5.  Holtmann GJ . Pathophysiology of irritable bowel syndrome.Lancet Gastroenterol Hepatol. 2016 Oct;1(2):133-146.
6.  Xiao-Peng Ma. Acupuncture-moxibustion in treating irritable bowel syndrome: How does it work? World J Gastroenterol. 2014 May 28; 20(20): 6044–6054.