Traditional Chinese Medicine (TCM) Discussion

The most sought-after commodity in areas hit by the H7N9 flu outbreak is a 10-yuan ($1.60) herbal remedy, indigowoad roots, or banlangen, which has been selling out in stores across Shanghai and Jiangsu, Zhejiang and Anhui provinces.

Daily supplies at pharmacies are being cleared within hours, and demand is so high the government has imposed strict price restrictions to prevent profiteering.

No one is absolutely certain what the humble herb can do to fight the disease, but Jiangsu provincial health bureau said on April 3 that banlangen can keep the H7N9 virus at bay, something which has eluded most advanced medicines, suggested pharmacists.

“No one knows what might happen with bird flu, so they are buying it,” said a clerk at the Renshoutang Pharmacy in Shanghai.

Xiong Wei, the general manager of LBX Pharmacy in Shanghai, said sales of the herb surged between Thursday and Sunday.

“Demand soared from April 3. We had to order 4,800 packets of banlangen the next day from Hangzhou because some stores in Shanghai reported a shortage.

“By Saturday, almost every city in the Yangtze River Delta had reported a shortage and we have had to order the drug from other parts of the country.”

On usual days, Xiong said LBX sells about 300 packets of banlangen a day. Ever since the bird flu outbreak, sales have been about 10 times that.

More than 3,000 packets were sold on Sunday, Xiong added, although sales had calmed in recent days.

“But we have promised not to raise prices at any of our stores, and hope other drugstores don’t either.”

An employee surnamed Yang at the pharmacy of Shanghai Shuguang Hospital, which is affiliated to Shanghai University of Traditional Chinese Medicine, said: “Banlangen at our hospital is priced at 5.4 yuan a pack.

“So far sales have been steady, with no significant growth.”

Price control officials in Nanjing, Jiangsu province, released a notice on Monday urging that prices of all traditional Chinese medicines sold at drugstores and hospitals should not be allowed to increase during the prevention and control period of bird flu.

Xue Li, a sales representative at Nepstar drugstore in South Huaxia Road in Wuxi, Jiangsu province, said it had been selling banlangen in nine- and 10-yuan packs, ever since the news of the outbreak was reported at the beginning of this month.

“For the cheaper ones, fewer than 10 packets are left at the end of every day.”

Hua Liping, the manager of a drugstore near Wuxi People’s Hospital, said they have been running out of banlangen since Saturday, and was not sure whether they could have the drug restocked until Tuesday.

There are seven major producers of banlangen drugs in China, with Hutchison Whampoa Guangzhou Baiyunshan Chinese Medicine Co the largest, with about 60 percent of the market.

Last year the company’s banlangen sales were worth 336 million yuan.

Some commonly used Chinese herbs:

The flower of Albizzia and its bark is used to soothe the mood of the person because of its calming properties. It is often used for those who are in the middle of emotional difficulty.

Alisma strengthens water metabolism in the body and is used to reduce weight. It can also be useful for those who have urination problems and who suffer from diabetes.

Used as a means to boost the immune system, the Astralagus is an herb that has been used in China for about 4000 years. It helps the blood cells perform beyond their usual capacity.

Black & Red Reishi Mushrooms are prized herbs in Chinese herbal medicine. They are used to strengthen the immune system and increase the effects of antioxidants. Overall, these mushrooms have a calming effect.

Ephedra has been in use for over 5000 years. It is used to improve blood pressure, to treat asthma and to enhance the heart function. Ephedra also has the function of increasing the production of adrenalin.

Ginko Biloba has been used in the practice of TCM since its inception. It is used to improve the performance of the lungs and the heart. Other effects include reduction of inflammation and the supplementing of nutrition.

Ginseng is a root that enhances healing in the body. It has the ability to replenish body fluids and increase energy. It is also believed to remove toxins and stimulate the sex glands.

Licorice root is a well-known Chinese herb because it is often used to detoxify the body. It also invigorates and cools down the body. Licorice root can be used as a natural sweetener.

The lotus seed tones the vital organs such as the spleen and kidney. It can also help in stimulating the appetite.

Prepared Aconite is a Chinese herb that has to be used expertly. When the dosage is excessive, it can become toxic. It is also poisonous when it is taken raw. Prepared Aconite can be used to help patients with fertility problems and also those suffering from arthritis and rheumatism.

The herbal medicines are grouped under five flavors, i.e., acridness, sweetness, sourness, bitterness and saltiness, which exert different effects. Generally speaking, acridness serves to expel and to activate; sweetness, to invigorate, to regulate and to moderate; sourness, to astringe and to preserve; bitterness, to lower, to release and to dry; saltiness, to soften and to purge.

Every herbal medicine possesses a specific character and flavor of varying degrees. It is the combination of both that constitutes the overall action of individual medicine. Hence, the clinical application of herbal medicines, including the antineoplastic therapy, should be based on this conventional theory. The property and flavor of each herbal medicine are mentioned in this book as a reference for their selection in clinical practice.

However, the component of individual herbal medicines is rather complicated and its effect is usually multiple and not single. So, besides the antineoplastic effect, the other effects are also presented. And although the active antineoplastic ingredients have been isolated from some of the herbal medicines, these ingredients may exert effects other than antineoplastic. This multiple effect phenomenon is also observed in some of the western mono-component antineoplastic drugs. For example, cyclo-phosphamide can act on the various phases of proliferative cells causing degeneration of DNA, RNA, enzymes and protein and serves as a killer of tumor cells, and it is also an immunosuppresant and applied for autoimmune diseases, Corticosteroids can inhibit the lymphatic tissue and serves as an antineoplastic agent for some tumors, but it also exerts antiphlogistic, immunosuppressive, antishock and other effects, and is widely used in various diseases. Therefore, the indications of each herbal medicine presented in this site include the diseases other than neoplasms, so as to help browsers to have a more complete understanding of their effects.

Some of the pharmacologic effects of herbal medicines are also presented here. The information listed under this segment are mostly obtained from the published literatures of the experimental animal research, in vivo or in vitro, based on the principle of antineoplastic pharmacology. It has been found that the antineoplastic mechanism of herbal medicines is attributed to their actions chiefly on the proliferative phase of the tumor cells. Some of them inhibit the DNA synthesis, such as Fructus et Radix Camptothecae Acuminatae, Indigo Naturalis, Fructus Bruceae, Rhizoma Zedoariae, Radix Stephaniae Tetrandrae, etc., and some inhibit the synthesis of protein, such as Semen, Cortex, Ramulus et Folium Cephalotaxi Hainanensis, Mylabris, Radix Tylophorae Floribundae, etc. Only a few selectively act on the mitotic phase of tumor cells, such as Herba Catharanthi Rosei, Semen Coicis, etc.

Furthermore, some of the data are obtained from both animal experiment and clinical observation on the non-specific antineoplastic mechanism (chiefly the immunologic function), indicating that the enhancement of bodily immunologic function may be an important antineoplastic mechanism of herbal medicines. It has been proved that many herbal medicines can promote the phagocytosis of macrophages (e.g. Herba Hedyotis Diffusae, Herba Sarcandrae, Ganoderma Lucidum seu Japonicum, Poria, Radix Sophorae Flavescentis, etc.). Some can enhance the cellular immunity (e.g. Radix Trichosanthis, Herba Taraxaci, Bulbus Allii, etc.), and some can enhance the humoral immunity (e.g. Radix Stephaniae Tetrandrae, Radix Actinidiae Chinensis, etc.). Some can promote the activty of natural killer cells (e.g. Radix Ginseng) while some can induce the production of interferon (e.g. Radix Astragali, Radix Ginseng, Radix Actinidiae Chinensis, etc.).

In summary, the herbal medicines achieves their antineoplastic effect through various ways. Moreover, some medicine can bring on several actions, for example, they may directly inhibit the growth of tumor as well as indirectly exert an antineoplastic effect by enhancing the bodily immunologic function. Generally they elicit no significant adverse effect on the human body, and this is a strong point of herbal medicine for antineoplastic treatments. Nevertheless, research in this field is only preliminary and we need further in-depth studies to obtain conclusive results.

DeKosky and colleagues reported in the Dec. 23/30 issue of The Journal of the American Medical Association that the hot-selling herbal supplement ginkgo biloba doesn’t slow age-related mental decline.

    The six-year clinical study has already shown that ginkgo does not prevent dementia or Alzheimer’s disease in the elderly.

Ginkgo-Biloba Challenged

    Now study leader Steven T. DeKosky, MD, and colleagues have sifted through the data to look for some sign that ginkgo might slow mental decline in healthy, aging individuals — or, perhaps, in those already showing the first signs of cognitive impairment.

    No such sign was found.

    “Compared with placebo, the use of Ginkgo biloba, 120 mg twice daily, did not result in less cognitive decline in older adults with normal cognition or with mild cognitive impairment,” the researchers conclude.

    The problem wasn’t potency. The study used the standardized ginkgo extract from Schwabe Pharmaceuticals that is regulated and sold as a medication in Germany.

    And the problem wasn’t rigorous testing. Twice a year, the 72- to 96-year-old study participants received a battery of tests that measured various aspects of mental function, including memory, attention, visuospatial abilities, language, and executive function.

    Regardless of which mental function was measured, the tests show gingko doesn’t help slow cognitive decline.

    The findings echo those of a 2009 Cochrane Review of ginkgo studies that identified no cognitive benefit from the supplement.

    The Council for Responsible Nutrition, a group representing the supplement industry, suggests that the DeKosky study “should not be viewed as the final work” on ginkgo.

    In a written statement, Douglas MacKay, ND, CRN vice president for scientific and regulatory affairs, notes that cognitive decline has many causes and that neither ginkgo nor any other single treatment is a magic bullet.

    “As a former practicing licensed naturopathic doctor, I have had the benefit of working with patients and have seen first-hand how Ginkgo biloba can be effective in improving cognitive function,” MacKay says. “I would continue to recommend Ginkgo biloba to older adults as a safe, effective option for supporting cognitive health and would encourage consumers to talk to their own healthcare professional about what is right for them.”

Chinese medical specialists announced Thursday they had developed a Chinese herbal medication to treat the A/H1N1 flu.
Seven months of scientific and clinical studies showed the remedy, called “Jin Hua Qing Gan Fang,” was effective in treating A/H1N1 flu patients, said Wang Chen, president of Beijing’s Chaoyang Hospital.
“It can shorten patients’ fever period and improve their respiratory systems. Doctors have found no negative effects on patients who were treated in this way,” he said.
“It is also very cheap, only about a quarter of the cost of Tamiflu,” he said at a press conference held by the Beijing Municipal Government.
Tamiflu, a product of Swiss drugmaker Roche Holding, was recommended by the World Health Organization (WHO) for the treatment of the A/H1N1 flu.
“The municipal government has gathered the most outstanding medical experts in the Chinese capital to develop the new medication,” Zhao Jing, director of the Beijing Municipal Administration of Traditional Chinese Medicine, said at the press conference.
Over the past seven months, more than 120 medical specialists, led by academicians Wang Yongyan and Li Lianda from the Chinese Academy of Engineering, had participated in the research, she said.
The municipal government earmarked 10 million yuan (1.47 million U.S. dollars) for the project, she said.
“Medical experts proved the effectiveness of Jin Hua in treating A/H1N1 flu from both the basic scientific studies and clinical studies,” she said.
The basic scientific studies lasted for almost five months and were conducted by experts from the China Academy of Chinese Medical Sciences, Chinese Academy of Medical Sciences and Beijing University of Technology.
“In vivo and in vitro, experiments on mice and rabbits show JinHua can bring down a fever and resist the A/H1N1 flu virus,” said Huang Luqi, vice president of the China Academy of Chinese Medical Sciences.
Thursday’s Beijing Daily hailed the new herbal medication as the “world’s first traditional Chinese medicine to treat the A/H1N1 flu”.
Citing medical officials, the paper said “Jin Hua” was picked from among more than 100 classic anti-flu prescriptions based on traditional Chinese herbal medicine.
“Science workers proved its effectiveness through medical experiments on more than 4,000 mice and clinical studies on 410 patients with slight A/H1N1 flu syndrome,” it said.
The “Jin Hua” prescription had been adopted in many local traditional Chinese medicine hospitals, it said.
Zhao Jing said 11 hospitals nationwide, including Chaoyang Hospital and Ditan Hospital in Beijing, had conducted clinical studies on “Jin Hua” and gave positive assessments.
“We are applying for patents for ‘Jin Hua’ both at home and abroad,” she said.
“We are further developing the medicine and trying to present it to the whole country and world as soon as possible, thus offering an alternative to treat the A/H1N1 flu,” she said.
The Chinese mainland has reported almost 108,000 A/H1N1 flu cases, including 442 deaths, according to the Ministry of Health.
Dr. Cris Tunon, senior program management officer at the WHO Representative Office in China, said Thursday the “WHO welcomes the clinical results,” as the traditional Chinese medicine offered a low-cost treatment of A/H1N1 flu.

Some TCM prescription that may prevent swine flu:

Prescription 1 :
Applying to physical sturdy or over-alcohol crowd, it is consisted of:
Puerarin 15 grams, Radix scutellariae 10 grams, Wrinkled Gianthyssop Herb 10 grams, Raw Wheat seed 10 grams, Raw liquorice 5 grams. Efficacy: removing heat and dampness, relief evil through surface.

Prescription 2:
Applying to physical weakness or spontaneous sweat or getting cold easily crowd, it is consisted of:
Radix astragali 20 grams, Radix sileris 10 grams, Atractylis ovata 10 grams, Honeysuckle flower 10 grams, Raw licorice 5 grams. Efficacy: cleaning and supplement, preventing cold and wind, encouraging Qi, resisting exogenous pathogenic factor.

Prescription 3 :
12 grams of mulberry leaves, chrysanthemum 12 grams, 10 grams of almonds north, leaves 12 grams, 15 grams Puerarin, Health Adlay 15 grams, 15 grams of root, Platycodon 12 grams, 12 grams Phillyrin, Folium 15 grams, silver spent 12 grams, 6 grams licorice, those Chinese herbs mentioned above should be washed and they are soaked in water; 15 minutes should be taken to boil with Wu fire. The recipe taste better. Sugar should not be put in them when taking it.

Prescription 4:
The National Chinese medicine Administrative bureau issued Chinese medicine Prevention Plan of A/ H1N1 Flu. Chinese medicine Prevention Plan of A /H1N1 Flu prescribe traditional Chinese medicine formula on how to prevent flu for different group of the population:

Formula is 10 grams radix pseudostellariae, 6 grams folium perillae, 10 grams radices scutellariae, 10 grams fructus arctii to crowds of fragility and easy affection of exotenous wind-cold.

The formula is 5 grams herba taching, 5 grams Lithospermum officinale L., 5 grams crude liquorice to crowds of red complexion, oral pharynx and sometimes nose dry.

The formula is 10 grams folium perillae, 10 grams herba eupatorii and 10 grams pericarpium citri reticulatae to crowds of dark complexion and sometimes abdominal distension.

The formula is 6 grams ageratum, 6 grams folium perillae, 10 grams FLOS LONICERAE and 10 grams crude hawkthorn to children of easy excessive internal heat and putrid sour breath.

The above decoction for oral use is 1 dose every day which decocted by clear water with once in the morning and evening. 3-5 doses are advisable.

Chinese Herbal Remedy For H1N1 Flu, Treat A Flu With Chinese Herbs, Chinese Herbs Against H1N1 Flu

The outbreak speed of H1N1 flu (swine flu) is fast and nobody would predict precisely to what extent this H1N1 flu (swine flu) will affect human being’s life. In China some hospitals have adopted the traditional Chinese herbal medication to treat this disease and received expected good result. To share this information with all who are concerned with affection of H1N1 flu (swine flu), we present the prescription of Chinese herbal medicine here that was released online by Guangdong Provincial Chinese Herbal Medicine Hospital. This information is purely for your reference and we hold no responsibility for its actual result. The final decision will be made by your local doctor.

Some other flu-related natural prescriptions:
Prescription for symptom of sore throat and heat:
金银花 (Flos Lonicerae / jin yin hua) 15g
连翘 (Weeping Forsythia / lian qiao) 15g
薄荷 (Peppermint / bo he) 10g and the last element to be boiled
荆芥穗 (Spica Schizonepetae / jing jie sui) 10g
牛蒡子 (Greater Burdock / niu pang zi) 15g
桔梗 (Platycodon Root / jie geng) 10g
芦根 (Reed Rhizome / lu geng) 15g
生甘草 (Licorice Roots Northwest Origin / sheng gan cao) 5g

Prescription for symptom of heavy cough:
桑叶 (Mulberry Leaf / sang ye) 15g
菊花 (Florists Chrysanthemum / ju hua) 15g
薄荷 (Peppermint / bo he) 10g and is the last element to be boiled
连翘 (Weeping Forsythia / lian qiao) 15g
芦根 (Reed Rhizome / lu geng) 15g
桔梗 (Platycodon Root / jie geng) 10g
杏仁 (Bitter Apricot Kerne / xing ren) 10g
生甘草 (Licorice Roots Northwest Origin / sheng gan cao) 5g

Yahoo Malaysia news reported that doctors at Ditan Hospital in Beijing claimed that a combination of various Chinese herbs had a 75 percent cure rate in the 117 patients treated there for swine flu.

http://malaysia.news.yahoo.com/bnm/20090723/tts-flu-herbs-993ba14.html

The government had allocated 10 million yuan (about $1.5 milliom US) to research treatment of swine flu using traditional Chinese medicine, including one study comparing results with Tamiflu treatment.

Doctors at Ditan Hospital first stared treating all patients with the antiviral drug, Tamiflu plus the herbal combination, but discontinued the Tamiflu for the non-critical patients within a month after determining that the herbal medication was effective by itself.

In the article, hospital spokesman Dr. Wang Yuguang, deputy dean of the Centre of Integrated Traditional and Western Medicine was quoted: “From our clinical tests and observation, the traditional method of treatment left no after effects and it is safe.” He added that the recovery period was shorter than in patients who received Tamiflu and the daily cost of the herbal remedy at about 12 yuan ($1.76 US) was lower as compared to Tamiflu treatment at 56 yuan ($8.20 US),

Wang would not reveal the actual herbs used, stating that the advantage of traditional Chinese medicine is that doctors can gear their herbal prescriptions to the specific patient’s condition. In his news briefing, he claimed that doctors at the hospital had recently used this approach with high-risk patients with good results. Given these findings, the Chinese government has apparently advised hospitals to use traditional treatment as a first line approach and resort to Western medicine only after Chinese medicine fails.

In the meantime, while 11 Chinese companies work on developing a swine flu vaccine to prevent the disease, Beijing Traditional Chinese Medicine Hospital has introduced an A/H1N1 swine flu prevention herbal medicine pack which, according to Jin Wei, Deputy Director of the hospital, contains seven small packs of four types of herbs in combination and taken mixed with hot water as a tea or used as mouthwash. Jin Wei said the pack could even cure mild cases of swine flu, but that if patients did not recover after taking the herbs for seven days, they were advised to go to the hospital for further treatment.

According to the news article, the combination of the herbs is as follows:

Lonicera Japonica Thund (honeysuckle flower)-3 grams,
Isatis Indigodica- 3 gms,
Mentha Haplocalyx Brip (mint).-3 gms
Glycyrrhiza Glabra(licorice)-3 gms.

These herbs are available in Chinese herbal medicine shops. It should be noted that a search of the scientific literature, the web and discussions with infectious disease colleagues did not produce a primary source for these claims, so the herbs and their doses reported in the news article may or may not be accurate.

What are these herbs and what do they purport to do?

Lonicera
Laboratory investigations of lonicera have mainly focused on demonstrating anti-inflammatory actions. In vitro and animal studies indicate antibacterial and antiviral activity (mainly tested for seasonal influenza). In traditional Chinese medicine it is used almost exclusively for prevention and treatment of the common cold and upper respiratory tract infections, sore throats and general flu-like symptoms

Isatis
Also known as Woad root, this herb is thought to have very broad anti-infection properties, which partly explains its repeated use in these formulas. It contains the dye indigo (a crude form is used as the Chinese medicinal substance qingdai), which has been used worldwide as an antimicrobial medicine.

Mentha
These are Chinese peppermints and were described by the Chinese as early as 470 AD in the Oriental Materia Medica as a treatment for fever, headaches, excessive tearing, sore throat, oral and skin lesions, rash, and toothache. The principal active constituents of mentha are the essential oils, which comprise about 1% of the herb. They dilate peripheral blood vessels, inducing perspiration and alleviating aching.

Glycyrrhiza Glabra (European licorice)
Therapeutic use of licorice dates back to the Roman Empire. Hippocrates (460BC) extolled its use as an expectorant and gas reliever. It is one of the most commonly used herbs in the Chinese Materia Medica and is traditionally said to “harmonize” a formula in Chinese medicine, acting as a guide drug to enhance the activity of other ingredients, reducing toxicity, as well as improving flavor. In Western medicine it is commonly found in cough medicines. Recognized side effects of prolonged use includes hypertension, water retention, sodium retention and loss of potassium.

The theory in traditional Chinese medicine is that rather than using a single herb or a single formulation to treat an infection like flu, a collection of herbs and formulas working together will produce a better response in the patient. Many of these formulations evaluated in large scale studies in China from the 1950s through the 1970s claimed to demonstrate preventive properties. These findings, which appeared in Chinese medical journals and books, were reviewed at the Institute for Traditional Medicine (ITM) in Oregon. In a 2006 report, Subhuti Dharmananda, PhD, Director of ITM, explained that “while there is insufficient proof from these studies that Chinese herbal therapies can cure or impede influenza because of problems in methodology and reporting, practitioners of Chinese medicine and their patients are convinced of the efficacy of this approach.”

Routine prescription of Chinese herbs for seasonal flu or other therapeutic applications continues to be limited primarily to those countries like China, Japan and Korea where traditional herbal medicine is officially recognized. In other countries, including the US, herbs are available mainly through the work of licensed acupuncturists, naturopaths, and other non-M.D. practitioners, as well as through direct marketing of products to consumers.

Although Chinese research has recently been tainted by allegations of widespread fraud,
there is clearly much to be learned from the potential use of herbs to treat various diseases including swine flu. As Americans turn more and more to alternative medicine, it will be critical to have good scientific data to document the safety and efficacy of herbal formulations. It is important to remember that herbs, though “natural” often have strong medicinal properties that may include dangerous side effects.
- Deborah Shlian Miami Health Care Examiner

A number of traditional Chinese herbs may help control blood sugar levels in people at high risk of diabetes, a new research review suggests.

The review, which examined 16 clinical trials of 15 different herbal formulations, found that the herbs generally helped lower blood sugar levels in people with “pre-diabetes” — those with impaired blood-sugar control that can progress to full-blown type 2 diabetes.

When the researchers pooled data from eight of the studies, they found that adding an herbal remedy to lifestyle changes doubled the likelihood of participants’ blood sugar levels returning to normal.

What’s more, people using the remedies were two-thirds less likely to progress to diabetes during the studies, which ran for an average of nine months.

The findings appear in the Cochrane Library, which is published by the Cochrane Collaboration, an international organization that evaluates medical research.

The results, say the researchers, are “quite promising.” However, they also stress that the studies had shortcomings in their methods that make it hard to draw firm conclusions.

There are a lot of herbal medicine products on the shelves, but few have been subjected to a rigorous trial,” lead researcher Suzanne J. Grant, of the Center for Complementary Medicine Research at the University of Western Sydney, in Australia, told Reuters Health in an email.

Many of the trials her team examined, she explained, had a “high risk of bias” that can overestimate the effects of the treatments.

The gold standard for proving a treatment’s efficacy is a clinical trial where participants are randomly assigned to receive either the real treatment or a placebo, with both the researchers and participants unaware of who is taking the real drug.

Grant’s team found that those processes were often absent or not clearly detailed in the trials they reviewed.

It may, according to a new review published by the Cochrane Collaboration, an international nonprofit that analyzes health care information.

The review, which looked at results of two randomized studies of Chinese herbal medicine involving 158 women, suggested that Chinese herbs may provide better relief of pelvic pain and other symptoms than one of the prescription drugs normally used in the West, Danazol.

Endometriosis occurs when tissue from inside the uterus escapes to other parts of the body. Outside the uterus, this tissue is seen as “foreign’’ by the immune system, which means that the body mounts an inflammatory response that can cause pain and scarring.

In the review, researchers at the University of Southampton in England found that Chinese herbs – which were not specified and which typically vary from patient to patient in Chinese medicine – were better at relieving menstrual pain than Danazol, a testosterone-derived drug, and were also better at shrinking endometrial masses. They did not prove better for other types of endometrial discomfort, such as rectal pain.

Dr. Aaron Styer, a reproductive endocrinologist at the Massachusetts General Hospital Fertility Center, noted that in the West, the first line of treatment for endometriosis is birth control and other hormonal drugs, which suppress secretion of estrogen by the ovaries. Although the Chinese herbal study is not conclusive, he said, “if a patient has not done well with traditional therapy or doesn’t want to proceed with it, she should investigate these approaches more completely, as long as there’s no potential health risk of taking these herbs.’’

Dr. Hope Riccotti, clinical director of obstetrics and gynecology at the Dimock Community Health Center, cautioned that “herbs are drugs and drug interactions can be dangerous,’’ which makes it important for women to tell their health care providers if they are taking these herbs.

Chinese herbal medicine may have the same benefits as conventional medicines for women with endometriosis, but with fewer side effects, according to a large review of the research. But better quality studies are needed to be sure.

What do we know already?
Endometriosis is a painful condition affecting some women. Cells from the womb lining (the endometrium) travel to other parts of the body, such as the bowel and the ovaries, and grow into patches of tissue. Every month they grow, then break down, in the same way that the cells lining the womb grow and break down, during a woman’s menstrual cycle. This can be painful and may make it hard for a woman to get pregnant.

Treatments include surgery to remove these patches of endometriosis cells, and hormonal treatments to reduce the growth of the patches, or to stop them coming back after surgery. But endometriosis often comes back after surgery, or after hormone treatment is stopped. Also, some hormone treatments can have unpleasant side effects, including acne and symptoms of the menopause.

Practitioners of traditional Chinese medicine have treated endometriosis using a combination of herbs for many years. But there has been little good-quality research to assess how well these herbal treatments work. A new study by an international team of researchers looked at all the studies that have been published about endometriosis and Chinese herbal medicine, to see what conclusions they could draw.

What does the new study say?
The researchers found more than 100 studies, but say only 2 of them were suitable to assess in their review. The others weren’t reliable.

The two studies had promising results, although they don’t give us enough information. In one study, women who’d had an operation to remove endometriosis patches were given either a hormonal treatment (gestrinone) for 3 months, or Chinese herbal medicine for 3 months, after surgery. Afterwards, more than 9 in 10 women in both groups said they no longer had symptoms of endometriosis, such as pain and tiredness.

In the second study, researchers compared Chinese herbal medicine with another hormonal treatment (danazol). Again, both groups took the treatment for 3 months, but neither group had surgery to remove endometriosis patches first. More than half of the women who took Chinese herbal medicine said they no longer had symptoms of endometriosis after treatment, compared with about 1 in 10 women who took danazol.

Tell me more about the study’s findings
The women in the first study took the herbal medicine both by mouth and in the form of a daily enema (when the rectum (back passage) is washed out). In the second study, half the women taking Chinese herbs took them just by mouth, while the other half took daily enemas as well. The ones having daily enemas as well were more likely to report being free of symptoms.

In the second study, although more women said that overall, their symptoms had gone completely if they’d taken Chinese herbs, other measures didn’t show a clear difference. For example, if you just look at how bad women’s pain was during their periods, on average, there was no difference between the group taking Chinese herbs and the group taking hormone treatments (danazol).

The women taking hormonal treatments said they had more side effects than the women taking Chinese herbs. Acne, weight gain, and irregular periods were the most common side effects.

In both studies, the women’s symptoms were assessed after the 3 month treatment period, so we don’t know whether the improvements would last after the women stopped taking the treatments.

How reliable are the findings?
The review found only 2 studies suitable to be assessed in a scientific way, and they had questions about how reliable these two studies were. So we can’t rely on the findings.

Where does the study come from?
The review of the studies was done by a group of researchers from Southampton University in the UK and Beijing University of Chinese Medicine in China. The original studies were all carried out in China.

What does this mean for me?
It’s always difficult to say how relevant studies are for people in the UK, when they’ve been done in very different countries, with different medical systems. In this case, the original studies were all done in the Chinese healthcare system, with doctors who are used to working in the Chinese medical tradition. Also, the women taking part were all used to being treated with herbal medicine, so perhaps might be more willing to consider treatments like daily herbal enemas, than women used to the Western medical tradition. Even the way that the researchers recorded the results of the treatment differ from the methods that Western doctors use.

Because of this, we can’t really say whether women in the UK are likely to get the same benefits from treatment with Chinese herbs.

What should I do now?
It’s important to bear in mind that herbal medicines can have side effects or can react with other medicines you are taking. Herbal medicines are not regulated in the same way as conventional medicines, and their quality can vary. If you’re considering herbal medicine for endometriosis, talk to your doctor.

From:
Flower A, Liu JP, Chen S, et al. Chinese herbal medicine for endometriosis. Cochrane Database of Systematic Reviews. 2009; Issue 3.