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Research News

Chinese herb cuts alcohol consumption

The Chinese herb Kudzu, or Ge Gen (Puerariae Radix) appears to be able to reduce alcohol consumption in heavy drinkers. Those who were given the herb extract in capsule form for seven days prior to a drinking session cut their alcohol consumption by almost 50% compared to controls given a placebo. Not only did they consume fewer beers, but they took more and fewer sips and therefore consumed the beer more slowly.

In a report published by the journal, Alcoholism: Clinical & Experimental Research, scientists have found that the extracts from the herb kudzu may be effective in reducing alcohol consumption. The study performed at McLean Hospital gave subjects either kudzu extract or a placebo for seven days and allowed them the chance to drink as much of their favorite beer as they wanted. Subjects were in their twenties and generally consumed three to four drinks a day. Results from four 90-minute sessions showed a decrease in the overall consumption and sip volume with an increase in time to finish the beer. After administering the kudzu or placebo the beer was weighed sip by sip to give a complete analysis of consumption. Researchers were unsure how the kudzu effected consumption but that presumed that the extract somehow increased the effects of the alcohol and blood alcohol levels. No side effects were reported. kudzu could prove to be a safe and effective way to decrease alcohol cravings and consumption in alcoholics.

In 2003, a Harvard lab found kudzu's inhibitory effects on alcohol consumption in rats and hamsters and recently completed the follow-up human study. Plans are to find a way to safely manufacture a drug for use as a supplement to alcoholism therapies.

Source:
Lukas SE, et al. An Extract of the Chinese Herbal Root Kudzu Reduces Alcohol Drinking by Heavy Drinkers in a Naturalistic Setting. Alcoholism: Clinical & Experimental Research 2005;29:756-762.

Acupuncture may treat chronic headaches

The October issue of the journal Headache has published a study that found that supplementing medical management with acupuncture may result in improvements in frequency and pain intensity of headaches.

Researchers at the University of North Carolina at Chapel Hill School of Medicine were lead by Dr. Wunian Chen, an instructor in the department of family medicine trained in the use of traditional Chinese acupuncture. A randomized, controlled trial of 74 patients with chronic daily headache (CDH) compared medical management provided by neurologists to medical management plus ten acupuncture treatments. Daily pain severity and headache-related quality of life (QoL) were measured.

Medical management plus acupuncture resulted in an improvement of three points on the Headache Impact Test and eight or more points on Short Form 36 Health Survey. After six weeks, patients receiving acupuncture were 3.7 times more likely to have less headaches.

The International Headache Society criteria for chronic tension-type headache are headaches on 15 or more days a month (180 days per year), for at least six months. It is estimated that 4-7 percent of Americans suffer with chronic headaches.

Source:
Coeytaux RR, et al. A randomized, controlled trial of acupuncture for chronic daily headache. Headache 2005;45:1113-1123.

Acupuncture for pregnancy depression

Pharmaceutical medication is largely unsuitable for depression during pregnancy and therefore any non-pharmaceutical alternative is potentially of great value. In a study carried out at Stanford University, 61 women with major depressive disorder were randomly assigned to receive one of three treatments: (i). Individually tailored true acupuncture designed to treat their depression, (ii). True acupuncture but with points not chosen to treat the depression, and (iii). Massage treatment (included to provide a control for attention, physical contact, relaxation and respite from daily stress). Acute phase treatment was given for twelve sessions over eight weeks, with continued treatment throughout pregnancy for those who responded. As far as possible the acupuncture treatment was double-blinded, with the treatment to be given by a treating acupuncturist determined by a different (assessing) acupuncturist. The assessment, treatment design, needle insertion, and needle stimulation were all standardised. Response rates at the end of the acute phase were 68.8% in the depression specific acupuncture, 47.4% in the non depression-specific acupuncture, and 31.6% in the massage group. The study also showed that successful treatment of depression during pregnancy offers protection from postpartum depression. (Journal of Affective Disorders, Volume 83, Issue 1, 15 November 2004, Pages 89-95).

Acupuncture helps facial pain

Twenty-five patients suffering from orofacial pain (myofascial pain 15, temperomandibular joint synovitis 5, fibromyalgia 2, neuropathic pain 2, trigeminal neuralgia 1) were assessed for pain before and after treatment by acupuncture). All patients were treated at Hegu L.I.-4, with further points needled according to individual presentation. Patients received a mean of 3.8 treatments each. All experience a reduction in pain after treatment, with mean value pain scores dropping from 5.28 to 2.26 over the study period, a significant reduction. (Med Sci Monit, 2005; 11(2): CR71-74).

Cinnamon for diabetes

Researchers have found that Cinnamon can help increase insulin sensitivity and therefore may be a potential treatment for diabetes. The active ingredient in cinnamon hydroxychalcone affects insulin receptors to help promote glucose uptake into cells and promote glycogen synthesis. In a December 2003 Diabetes Care study (1), cinnamon was found to improve glucose and lipids in people with diabetes. Sixty patients with type 2 diabetes who were taking a sulfonylurea (glyburide) were given doses of cinnamon or a placebo for 40 days. Fasting blood glucose declined by 18 to 29 percent after 40 days and 20 days after stopping use fasting glucose was still lower than at baseline. Also in December 2003 a rat study found that cinnamon extract improved insulin action via increasing glucose uptake in vivo through enhancing the insulin-signaling pathway in skeletal muscle (2). In 2004, researchers at a USDA center in Maryland reported that polyphenols in cinnamon potentiate insulin action making them beneficial in the control of glucose intolerance and diabetes (3). Researchers have also found that cinnamon extracts can prevent the development of insulin resistance at least in part by enhancing insulin signaling and possibly via the NO pathway in skeletal muscle (4). German researchers found earlier this year that cassia extract (a species of cinnamon) has a direct antidiabetic potency as evidenced by an insulin release from INS-1 cells (5).

Cinnamon is a spice often used in food, beverages, chewing gums, toothpastes, mouthwash, liniments, nasal sprays and suntan lotions. Although cinnamon bark and flowers have been used medicinally in Asia for thousands of years. Cinnamon has been used for type 2 diabetes, gastrointestinal problems, diarrhea, infections, the common cold, menopausal symptoms, rheumatic conditions, hypertension, angina and kidney disorders. Although there are no serious side effects have been reported, blood glucose levels should be monitored in diabetic patients when taking supplemental doses. Medication adjustments may be necessary.

American Ginseng may prevent colds

A study published in the October issue of the Canadian Medical Association Journal has found that taking ginseng supplements may reduce the number of colds experienced. Researchers at the University of Alberta conducted a randomized, double-blind, placebo controlled study on 323 participants at the onset of the influenza season in November 2003. All subjects had reported a history of at least 2 colds in the previous year. People were given two 200mg capsules of North American ginseng extract or a placebo to be taken after breakfast each day for four months.

The ginseng supplements were tested for batch-to-batch consistency to contain 80 percent poly-furanosyl- pyranosylsaccharides and 10 percent protein from North American ginseng. Colds were measured on reports filled out by participants once a day documenting the severity of symptoms (sore throat, runny nose, sneeze, nasal congestion, malaise, fever, headache, hoarseness, earaches and cough) on a four-point scale. A two-day symptom score greater than 14 met modified Jackson criteria for a cold. Results for the 130 who received and used their ginseng supplements found that the mean number of Jackson-verified colds per person was less in the ginseng group than in the placebo group. Also the proportion of subjects with recurrent Jackson-verified colds during the four months and overall symptom scores were significantly lower in the ginseng group.

Ginseng has long been associated with helping ward off influenza and the common cold but there is little clinical evidence to support its use. Further studies must be done to validate these results, because although the study was properly randomized it was paid for by CV Technologies Inc, the manufacturer, of the popular Canadian cold medication, Cold-fx®.

Source:
Predy GN et al. Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005;173(9)V.

Xiao Yao Wan and bipolar depression

In a double-blind, placebo-controlled randomised controlled trial, the efficacy of i. Carbamazepine (CBZ), ii, CBZ plus the Chinese herbal medicine Free and Easy Wanderer (Xiao Yao Wan), and iii. Placebo, was compared in the treatment of 124 bipolar depressed and 111 manic patients over a twelve week period. CBZ plus Xiao Yao Wan produced significantly better outcomes on three measures of depression at four and eight weeks and significantly greater clinical response rate in depressed subjects (84.8% versus 63.8%), but no such benefit was found in manic subjects. There was a lesser incidence of dizziness and fatigue in the combination therapycompared to CBZ monotherapy. These results suggest that adjuvant Xiao Yao Wan has additive beneficial effects in bipolar patients, particularly for those in depressive phase.

Source:
Zhang ZJ, et al. Adjuvant herbal medicine with carbamazepine for bipolar disorders: A double-blind, randomized, placebo- controlled study. Journal of Psychiatric Research 2006; in press.

Chinese herbs and asthma

ASHMI, or anti-asthma herbal medicine intervention, a Chinese preparation comprised of three herbs (a simplification of a fourteen-herb formula used to treat asthma in Chinese hospitals) was found to be almost as effective as prednisone in a comparative study, with none of the negative affects on adrenal function associated with the prednisone. Each ASHMI capsule contained 0.3 g dried aqueous extract. The total daily dose of 12 capsules (3.6 g) is equivalent to extracts of a mixture of the raw herbs Ling Zhi (Ganoderma) 20 g, Ku Shen (Radix Sophorae Flavescentis) 9 g, and Gan Cao (Radix Glycyrrhizae) 3 g.

It is the first time a controlled study has shown Chinese herbal medicine proving as effective as a corticosteroid for aiding asthma patients. The study was conducted on over 90 patients who were given either oral ASHMI, prednisone, or a placebo. After four weeks, both the ASHMI and prednisone groups showed significant lung function improvement. There was a slight, but still measurable, greater improvement in the prednisone group. ASHMI, however, unlike prednisone, also has the benefit of having no negative effects on adrenal function.

Source:
Wen MC, et al. (Journal of Allergy and Clinical Immunology 2005, 116 (3): 517-524).

Laser acupuncture for depression

In a double-blind randomized controlled trial, active laser acupuncture was found to be significantly more effective for the treatment of mild to moderate depression (at twelve weeks from trial onset) compared to sham laser acupuncture. In this trial, the practitioner did not know during treatment whether the laser device was active or not and was asked not to communicate with the patient other than a first greeting. Treatment was given twice a week for four weeks, then weekly for four weeks. The principal points used were Qimen LIV-14 (right), Jiuwei REN-15, Juque REN-14, Shenmen HE-7, Ququan LIV-8 (left). Additional points were used in cases where anxiety scores were high, (mainly Yingu KID-10).

Laser acupuncture is non-invasive and therefore free of infection risk. Laser acupuncture is well tolerated with transient fatigue as the most common adverse effect. The technique is relatively easily learned by community based general practitioners. Laser acupuncture is worth further investigation as a treatment for mild to moderate depression in primary care.

Source:
Quah-Smith JI, et al. Laser acupuncture for mild to moderate depression in a primary care setting - A randomized controlled trial. Acupuncture in Medicine 2005; 23:103-111.

Acupuncture is a more effective and less costly treatment for patients with chronic low back pain

Objective: To test whether patients with persistent non-specific low back pain, when offered access to traditional acupuncture care alongside conventional primary care, gained more long-term relief from pain than those offered conventional care only, for equal or less cost. Safety and acceptability of acupuncture care to patients, and the heterogeneity of outcomes were also tested.

Design: A pragmatic, two parallel group, randomised controlled trial. Patients in the experimental arm were offered the option of referral to the acupuncture service comprising six acupuncturists. The control group received usual care from their general practitioner (GP). Eligible patients were randomised in a ratio of 2:1 to the offer of acupuncture to allow between-acupuncturist effects to be tested.
Setting: Three non-NHS acupuncture clinics, with referrals from 39 GPs working in 16 practices in York, UK. Participants: Patients aged 18-65 years with non-specific low back pain of 4-52 weeks' duration, assessed as suitable for primary care management by their general practitioner.
Interventions: The trial protocol allowed up to ten individualised acupuncture treatments per patient. The acupuncturist determined the content and the number of treatments according to patient need. Main outcome measuews: The Short Form 36 (SF-36) Bodily Pain dimension (range 0-100 points), assessed at baseline, and 3, 12 and 24 months. The study was powered to detect a 10-point difference between groups at 12 months post-randomisation. Cost--utility analysis was conducted at 24 months using the EuroQoL 5 Dimensions (EQ-5D) and a preference-based single index measure derived from the SF-36 (SF-6D). Secondary outcomes included the McGill Present Pain Index (PPI), Oswestry Pain Disability Index (ODI), all other SF-36 dimensions, medication use, pain-free months in the past year, worry about back pain, satisfaction with care received, and safety and acceptability of acupuncture care.
Results: A total of 159 patients were in the 'acupuncture offer' arm and 80 in the 'usual care' arm. All 159 patients randomised to the offer of acupuncture care chose to receive acupuncture treatment, and received an average of eight acupuncture treatments within the trial. Analysis of covariance, adjusting for baseline score, found an intervention effect of 5.6 points on the SF-36 Pain dimension [95% confidence interval (CI) -1.3 to 12.5] in favour of the acupuncture group at 12 months, and 8 points (95% CI 0.7 to 15.3) at 24 months. No evidence of heterogeneity of effect was found for the different acupuncturists. Patients receiving acupuncture care did not report any serious or life-threatening events. No significant treatment effect was found for any of the SF-36 dimensions other than Pain, or for the PPI or the ODI. Patients receiving acupuncture care reported a significantly greater reduction in worry about their back pain at 12 and 24 months compared with the usual care group. At 24 months, the acupuncture care group was significantly more likely to report 12 months pain free and less likely to report the use of medication for pain relief. The acupuncture service was found to be cost-effective at 24 months; the estimated cost per quality-adjusted (QALY) was 4241 pounds sterling (95% CI 191 pounds sterling to 28,026 pounds sterling) using the SF-6D scoring algorithm based on responses to the SF-36, and 3598 pounds sterling (95% CI 189 pounds sterling to 22,035 pounds sterling) using the EQ-5D health status instrument. The NHS costs were greater in the acupuncture care group than in the usual care group. However, the additional resource use was less than the costs of the acupuncture treatment itself, suggesting that some usual care resource use was offset.
Conclusions: Traditional acupuncture care delivered in a primary care setting was safe and acceptable to patients with non-specific low back pain. Acupuncture care and usual care were both associated with clinically significant improvement at 12- and 24-month follow-up. Acupuncture care was significantly more effective in reducing bodily pain than usual care at 24-month follow-up. No benefits relating to function or disability were identified. GP referral to a service providing traditional acupuncture care offers a cost-effective intervention for reducing low back pain over a 2-year period. Further research is needed to examine many aspects of this treatment including its impact compared with other possible short-term packages of care (such as massage, chiropractic or physiotherapy), various aspects of cost-effectiveness, value to patients and implementation protocols.

Source:
Thomas KJ, et al. Longer term clinical and economic benefits of offering acupuncture care to patients with chronic low back pain. Health Technology Assessment 2005;9(32):1-109. CAM reduces sick leave

A study by researchers at the University of Duisburg-Essen I Germany found that complementary and alternative medicine (CAM) reduces the sick leave of chronically ill patients with non-life-threatening chronic diseases such as back pain, migraine, skin diseases, allergies) that has not been improved with conventional therapies. Sick-leave per year of 441 chronically ill patients at work increased from 22 days to 31 days within three years prior to intervention, and decreased to 24 days in the second year of treatment, sustaining at this level in the following two years.

Patients involved in this study received the following CAM therapies: acupuncture, electric acupuncture, neuraltherapy, homoeopathy, colon therapy, manual therapy, reflexzone therapy, orthomolecular medicine, isotherapy, symbiosis regulation. Patients were treated on average with three different therapy modalities, with acupuncture, homoeopathy, oxygen therapy, and neuraltherapy as the most often used. As this is an uncontrolled observational study efficacy of any specific CAM treatment can not be proven. However, the results might indicate an general effectiveness of CAM in primary care. Future studies should identify the most suitable patients for CAM practices, the most appropriate and safe treatments, which will help to properly position complementary and alternative medicine in the modern health care system.

Source:
Moebus S, et al. An analysis of sickness absence in chronically ill patients receiving Complementary and Alternative Medicine: A longterm prospective intermittent study. BMC Public Health 2006;6(1):28

Traditional Medicine Derivatives Kill Cancer Cells

Compounds derived from indirubin, a component of a Chinese herbal medicine Qing Dai (Indigo Naturalis), can cause human cancer cells to self-destruct, researchers have shown.
A traditional Chinese medicine, Danggui Longhui Wan, is used to treat leukemia. In previous experiments, the active ingredient indirubin has seen to kill cells by blocking an enzyme called CDK and thus interrupting the normal cell cycle.
Now, Dr. Richard Jove, from the Moffitt Cancer Center and Research Institute in Tampa, Florida, and colleagues report in the Proceedings of the National Academy of Sciences on another way that derivatives of the indirubin kill cancer cells. The researchers discovered that the compounds induce breast and prostate cancer cells to shut down and die by inhibiting a signaling pathway, known as Src-Stat3. "These findings provide evidence of another mechanism for indirubin's antitumor activity," Jove's group writes. One of the derivatives, designated E804, was particularly potent in destroying cancer cells and "has potential as an antitumor therapeutic agent in epithelial malignancies," the team concludes.

Source:
Nam S, et al. Indirubin derivatives inhibit Stat3 signaling and induce apoptosis in human cancer cells. Proc Natl Acad Sci USA 2005;102:5998-6003.

US NCCAM funds TCM research Centers

The National Center for Complementary and Alternative Medicine (NCCAM) of the US has recently awarded grants to several research centers of Chinese medicine.

The Center for Arthritis and Traditional Chinese Medicine at the University of Maryland in Baltimore received funds to study traditional Chinese medicine approaches, including acupuncture and herbal remedies and their effects on arthritis. The center will conduct a clinical trial of HLXL, an 11-herb Chinese formula, on osteoarthritis of the knee; animal studies will test acupuncture's ability to relieve inflammatory pain and the use of HLXL on autoimmune arthritis.

Center for Chinese Herbal Therapy at New York's Mount Sinai School of Medicine will determine the mechanism of action, active components, and efficacy of a three-herb formula, ASHMI, in the treatment of allergic asthma. Additional studies will look at how the herbs might work and will identify the active components.

Functional Bowel Disorders in Chinese Medicine - Multiple centers will compose a group to study Functional Bowel Disorders in Chinese Medicine. The University of Maryland, Chinese University of Hong Kong, University of Illinois and the University of Western Sydney (Australia) will conduct multidisciplinary research on traditional Chinese medicine (TCM). The group will determine the effects of acupuncture and herbal preparations in irritable bowel system (IBS) sufferers. This collaboration will conduct research on TCM practices--acupuncture and herbs - for the treatment of irritable bowel syndrome (IBS). Researchers will study the effects of acupuncture and a TCM herbal preparation in an animal model of IBS. They will also conduct a preliminary study of the herbal preparation in people with IBS.

NCCAM also announced another international center, which is being funded by the National Cancer Institute: International Center of Traditional Chinese Medicine for Cancer. The University of Texas M.D. Anderson Cancer Center in Houston will team with Fudan University Cancer Hospital in Shanghai (China) to conduct preclinical and clinical studies of herbal formulations, acupuncture and Qi Gong. The research focus is studies of TCM approaches - herbs, acupuncture, and Qi Gong - for cancer, its symptoms, and treatment-related side effects.