Information from the American Cancer Society: There is evidence that acupuncture eases nausea caused by chemotherapy and surgical anesthesia and relieves pain after dental surgery. It may also assist withdrawal from addiction to drugs and alcohol, and help relieve headaches, menstrual cramps, tennis elbow, low back pain, carpal tunnel syndrome, and asthma.
Study: Acupuncture Works for Back Pain
By THE ASSOCIATED PRESS
Published: September 24, 2007
Filed at 11:13 p.m. ET
CHICAGO (AP) -- Acupuncture performs much better than usual care, German researchers have found. Almost half the patients treated with acupuncture needles felt relief that lasted months. In contrast, only about a quarter of the patients receiving medications and other Western medical treatments felt better.
Even fake acupuncture worked better than conventional care, leading researchers to wonder whether pain relief came from the body's reactions to any thin needle pricks or, possibly, the placebo effect.
''Acupuncture represents a highly promising and effective treatment option for chronic back pain,'' study co-author Dr. Heinz Endres of Ruhr University Bochum in Bochum, Germany, said in an e-mail. ''Patients experienced not only reduced pain intensity, but also reported improvements in the disability that often results from back pain and therefore in their quality of life.''
Although the study was not designed to determine how acupuncture works, Endres said, its findings are in line with a theory that pain messages to the brain can be blocked by competing stimuli.
Positive expectations the patients held about acupuncture -- or negative expectations about conventional medicine -- also could have led to a placebo effect and explain the findings, he said.
In the largest experiment on acupuncture for back pain to date, more than 1,100 patients were randomly assigned to receive either acupuncture, sham acupuncture or conventional therapy. For the sham acupuncture, needles were inserted, but not as deeply as for the real thing. The sham acupuncture also did not insert needles in traditional acupuncture points on the body and the needles were not manually moved and rotated.
After six months, patients answered questions about pain and functional ability and their scores determined how well each of the therapies worked.
In the real acupuncture group, 47 percent of patients improved. In the sham acupuncture group, 44 percent did. In the usual care group, 27 percent got relief.
''We don't understand the mechanisms of these so-called alternative treatments, but that doesn't mean they don't work,'' said Dr. James Young of Chicago's Rush University Medical Center, who wasn't involved in the research. Young often treats low back pain with acupuncture, combined with exercises and stretches.
Chinese medicine holds that there are hundreds of points on the body that link to invisible pathways for the body's vital energy, or qi. The theory goes that stimulating the correct points with acupuncture needles can release blocked qi.
Dr. Brian Berman, the University of Maryland's director of complementary medicine, said the real and the sham acupuncture may have worked for reasons that can be explained in Western terms: by changing the way the brain processes pain signals or by releasing natural painkillers in the body.
In the study, the conventional treatment included many methods: painkillers, injections, physical therapy, massage, heat therapy or other treatments. Like the acupuncture patients, the patients getting usual care received about 10 sessions of 30 minutes each.
The study, appearing in Monday's Archives of Internal Medicine, used a broad definition for low back pain, but ruled out people with back pain caused by spinal fractures, tumors, scoliosis and pregnancy.
Funding came from German health insurance companies, and the findings already have led to more coverage in Germany of acupuncture.
In the United States, some health plans cover acupuncture for some conditions, but may require pre-approval, according to the National Center for Complementary and Alternative Medicine. An acupuncture session can cost $45 to $100, Young said.
Acupuncture for Osteoarthritis of the Knee Study Results
A landmark study has shown that acupuncture provides pain relief and improves function for people with osteoarthritis of the knee and serves as an effective complement to standard care. The study, the largest Phase III clinical trial of acupuncture for knee osteoarthritis, was funded by NCCAM and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, both components of the National Institutes of Health.
LOS ANGELES (AP) -- Tai chi is already known as a good low-impact exercise for older people. Now a recent study suggests it offers benefits beyond improving fitness and balance: It may help prevent shingles, a painful skin condition.
Researchers found older people who performed the slow, graceful movements of tai chi had a better immune response against the virus that causes shingles than those who only got health education, according to the most rigorous test to date.
It's unclear how tai chi, an ancient Chinese martial art that has become increasingly popular in the West, affects the immune system. But health experts were encouraged by the positive results.
''The message is that older people need to maintain healthy behavior,'' said Andrew Monjan of the National Institute on Aging, which helped fund the research. ''It's nothing that our mothers haven't told us, but we're seeing it certainly holds up to scientific inquiry.''
The study appears in the April issue of the Journal of the American Geriatrics Society and was led by Dr. Michael Irwin of the University of California, Los Angeles.
Shingles is a painful skin rash that can pop up in people who have had chickenpox. The chickenpox virus can remain dormant in the body and resurface as shingles years later. It usually starts with pain and itching on the skin that later turns into an irritating rash.
An estimated 1 million Americans are afflicted with shingles every year and it commonly occurs in people 50 years old and older.
The UCLA study involved 112 healthy adults, ages 59 to 86, who have had previous cases of chickenpox.
Half of them took tai chi classes three times a week for three months and the rest attended health education classes where they were taught good diet habits and stress management. Then both groups were vaccinated with a chickenpox vaccine. Researchers took periodic blood tests before and after vaccination to determine their level of immunity against shingles.
After six months, the tai chi group had nearly twice the level of immunity against shingles than the education group.
Those who performed tai chi before vaccination had an immune response that was similar to what a vaccine would produce in a younger population. Tai chi combined with the vaccine showed a 40 percent increase in immunity than the vaccine alone, researchers found.
The results weren't surprising to tai chi instructor Howard Chuck, who owns a tai chi academy in Sunnyvale, Calif.
Although none of his students are trying to ward off shingles, Chuck said the exercise is popular among his older people who prefer tai chi's meditation aspects.
''Tai chi requires a lot of mind power not just muscle power,'' he said.
------ Reprinted from the New York Times - April 8, 2007
New UC Berkeley study suggests promise of Chinese herbal medicine as treatment for chronic hepatitis B 01 October 2002
By Sarah Yang, Media Relations
Berkeley - Chinese herbal treatments combined with standard therapy may be more effective than standard therapy alone for treatment of chronic hepatitis B, according to an analysis of randomized, controlled trials led by University of California, Berkeley, researchers.
Researchers analyzed 27 clinical trials in which chronic hepatitis B patients using Chinese herbal medicine alone, or with interferon alfa, were compared with a control group of patients that were taking only interferon alfa. The protein interferon alfa is a standard treatment for hepatitis B infection. Some of its side effects include strong flu-like symptoms, fatigue and depression.
The meta-analysis, to be published Oct. 1 in the American Journal of Public Health, found that the most encouraging results came from patients who used a combination of Chinese herbal treatments and interferon alfa.
"The results are encouraging enough that, if I had chronic hepatitis B and had previously failed interferon alfa treatment, I would talk to my doctor about combining interferon alfa with Chinese herbal medicine," said Michael McCulloch, a doctoral student in epidemiology at UC Berkeley's School of Public Health and lead author of the study.
According to the World Health Organization, 2 billion people worldwide are infected with hepatitis B, 350 million of whom have the chronic form of the disease. About three-fourths of those with chronic hepatitis B live in Asia.
"There is a wealth of data about hepatitis B from researchers in Asia because the disease is endemic in that part of the world, but accessing that information has been - and still is - difficult because few of those studies are published in English-language journals," said McCulloch, who is also a research fellow at the Chinese Academy of Sciences in Beijing.
McCulloch, who earned his bachelor's degree in Chinese studies at UC Berkeley, searched through six databases of medical literature, including clinical trials data published in Chinese-language journals.
The ingredients in the herbal treatments included mixtures of plant and root extracts, and they varied from study to study. Two of the 27 studies specifically looked at bufotoxin, an extract from the skin of the toad Bufo gargarizans. Another two studied kurorinone, an extract from the root of the plant Sophorae flavescentis.
The authors only included trials in which patients used Chinese herbal medicine alone or with interferon alfa and were then compared with a control group using only interferon alfa at least three times per week. The studies were required to include data on at least one of three markers of infection: levels of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg) and hepatitis B virus (HBV) DNA. All three measures indicate an active infection.
Overall, Chinese herbal medicine combined with interferon alfa was 1.5 to 2 times as effective as interferon alfa alone in reducing the hepatitis B viral load to undetectable levels for all three measures of infection. In particular, bufotoxin combined with interferon alfa was significantly more effective than interferon alfa alone in measures of HBeAg and HBV DNA, but not for measures of the surface antigen. Kurorinone was nearly as effective as interferon alfa in the two studies that tested it.
For measures of the surface antigen, patients receiving herbal treatment alone performed twice as well as those receiving only interferon alfa. The results did not differ significantly between the two groups for measures of HBeAg or HBV DNA.
"Bufotoxin and kurorinone have been singled out as having the best potential for being investigated for drugs," said McCulloch, a licensed acupuncturist for 16 years. "However, it may be that the key to the way these herbal therapies work is by acting together as a group. That's one of the great challenges in studying herbal treatments, yet it is one of the most fascinating aspects of Chinese medicines. These particular mixtures are a distillation of centuries of clinical use."
The investigators also showed that the quality of the studies left much room for improvement. Many of the studies had incomplete information on how patients were randomized, and "blinding" of patients and doctors to the type of treatment administered did not occur in most of the studies.
"We cannot make firm conclusions about the use of Chinese herbal medicines based upon the results from these clinical trials," said Dr. Jack Colford, associate professor of epidemiology at UC Berkeley's School of Public Health and senior researcher for the study. "But the findings revealed by this analysis certainly justify additional investigation of these herbal therapies in more rigorous trials."
Other co-authors of the study are Michael Broffman, co-founder with McCulloch of the Pine Street Clinic in San Anselmo; and Dr. Jin Gao, senior researcher and director of the Institute of Biophysics at the Chinese Academy of Sciences.
Lifting Tiger Trade Ban a Catastrophe for Conservation
13 March 2007 – Any lifting or easing of the current Chinese ban in tiger trade is likely to be the death sentence for the endangered cat species, a new TRAFFIC report says.
The report 'Taming the tiger trade': China's markets for wild and captive tiger products since the 1993 domestic trade ban warns that Chinese business owners who stand to profit from the tiger trade are putting increasing pressure on the Chinese Government to overturn the 1993 ban. This would allow domestic trade in captive-bred tiger parts for use in traditional medicine and for clothing to resume.
According to TRAFFIC, the Chinese ban has been essential to prevent the extinction of tigers by curbing demand in what was historically the world’s largest consumer in tiger parts. In compliance with the resolutions of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES), the ban has virtually eliminated the domestic market for tiger products in traditional medicines.
“In the early 1990s, we feared that Chinese demand for tiger parts would drive the tiger to extinction by the new millennium. The tiger survives today thanks in large part to China’s prompt, strict and committed action,” said Steven Broad, Executive Director of TRAFFIC. “To overturn the ban and allow any trade in captive-bred tiger products would waste all the efforts that China has invested in saving wild tigers. It would be a catastrophe for tiger conservation.”
Measures to implement and enforce the Chinese trade ban have ranged from public education campaigns and promotion of effective substitutes for tiger medicines to severe punishment for law breakers, the report shows. As a result, undercover surveys by TRAFFIC found little tiger bone available in China. Less than 3 per cent of 663 medicine shops and dealers claimed to stock it, and most retailers were aware that tigers are protected and illegal to trade.
However, a TRAFFIC survey documented 17 instances of tiger bone wine for sale on Chinese auction websites, with one seller offering a lot of 5,000 bottles. And demand for big cat skins as status symbol clothing, particularly in China’s Tibetan Autonomous Region, is increasing, with about 3 per cent of Tibetans in major towns claiming to own tiger or leopard skin garments even though they knew it was illegal. Investors in the growing number of large-scale captive-breeding “tiger farms” in China are pushing for legalizing trade of products from these facilities, which now house 4,000 tigers, the report adds.
“Allowing trade in tiger parts to resume, even if they are from captive-bred tigers, would inevitably lead to an increase in demand for such products,” said Dr Susan Lieberman, Director of WWF’s Global Species Programme. “And a legal market in China could give poachers across Asia an avenue for ‘laundering’ tigers killed in the wild, especially as farmed and wild tiger products are indistinguishable in the marketplace.”
TRAFFIC and WWF are calling on the Chinese Government to maintain its domestic trade ban; strengthen its efforts to enforce the law against the illegal trade in tigers and other Asian big cats, particularly of skins; impose a moratorium on all tiger breeding; destroy the stocks of tiger carcasses; and increase public awareness of the current trade ban. For further information: Sabri Zain, TRAFFIC International, t +44 1223-277 427, email: Sabri Zain Caroline Liou, Program Officer- Communications, TRAFFIC East Asia, t (86 10) 6522-7100 ext 3811, email Caroline Liou
Youfeng makes certain that her herbals and medicinal formulas contain no banned or endangered species products. Only safe and certified ingredients are used for her patients. The reckless destruction of the globe must end and each of us has a responsibility to do our part to make a better world for future generations. What do you think? Drop us a line if you have any comments about this or any other topics raised in our website. We will publish those we think would be interesting to our readers.
A recent reader inquired about colitis:
From the National Institutes of Health
What is ulcerative colitis?
Ulcerative colitis is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. Ulcers form where inflammation has killed the cells that usually line the colon, then bleed and produce pus. Inflammation in the colon also causes the colon to empty frequently, causing diarrhea.
When the inflammation occurs in the rectum and lower part of the colon it is called ulcerative proctitis. If the entire colon is affected it is called pancolitis. If only the left side of the colon is affected it is called limited or distal colitis.
Ulcerative colitis is an inflammatory bowel disease (IBD), the general name for diseases that cause inflammation in the small intestine and colon. It can be difficult to diagnose because its symptoms are similar to other intestinal disorders and to another type of IBD called Crohn’s disease. Crohn’s disease differs because it causes inflammation deeper within the intestinal wall and can occur in other parts of the digestive system including the small intestine, mouth, esophagus, and stomach.
Ulcerative colitis can occur in people of any age, but it usually starts between the ages of 15 and 30, and less frequently between 50 and 70 years of age. It affects men and women equally and appears to run in families, with reports of up to 20 percent of people with ulcerative colitis having a family member or relative with ulcerative colitis or Crohn’s disease. A higher incidence of ulcerative colitis is seen in Whites and people of Jewish descent.
What is inflammatory bowel disease?
Inflammatory bowel disease is the name of a group of disorders that cause the intestines to become inflamed (red and swollen). The inflammation lasts a long time and usually comes back over and over again. More than 600,000 Americans have some kind of inflammatory bowel disease every year.
If you have inflammatory bowel disease, you may have abdominal cramps and pain, diarrhea, weight loss and bleeding from your intestines. Two kinds of inflammatory bowel disease are Crohn's disease and ulcerative colitis. Crohn's disease usually causes ulcers (open sores) along the length of the small and large intestines. Crohn's disease either spares the rectum, or causes inflammation or infection with drainage around the rectum. Ulcerative colitis usually causes ulcers in the lower part of the large intestine, often starting at the rectum.
Diet & Nutrition
While diet and nutrition do not play a role in causing IBD, maintaining a well-balanced diet that is rich in nutrients can help you to live a healthier life. Proper nutrition depends, in large part, on whether you have Crohn's disease or ulcerative colitis, and what part of your intestine is affected. It's important to talk to your doctor (and it also can be helpful to ask your physician to recommend a dietitian) to develop a diet that works for you.
Morphological study on colonic pathology in ulcerative colitis treated by moxibustion
World Journal of Gastroentorology
Huan Gan Wu1, Li Bin Zhou1, Da Ren Shi2, Shi Min Liu1, Hui Rong Liu1, Bi Meng Zhang3, Han Ping Chen1 and Lin Shan Zhang1
ISSN 1007-9327 CN 14-1219/R World J Gastroenterol 2000;December6(6):861-865
Abstract AIM: To observe the therapeutic effect of moxibustion on ulcerative colitis and its influence on the colonic mucosal morphology. METHODS: Forty-six patients with ulcerative colitis were randomly divided into the moxibustion with herbal medicine underneath group and the western medicine group. Thirty patients were treated with the above moxibustionand 16 patients with Salicylaye fapyridine(SASP). The colonic mucosa of 13 patients in the moxibustion group was observed by colonoscopy before and after the treatment. Mucin was also analyzed by H.E and AB-PAS staining. RESULTS: Seventeen patients were clinically cured, 12 were improved and 1 unchanged in the moxibustion group. In the control group, 5 patients were clinically cured, 7 improved and 4 unchanged. Thirteen patients with active UC were taken as the subjects for histopathologic analysis in this study. The colonic mucosal lesions were remarkably improved and the characteristic of the mucin also changed. In most sections, the chronic inflammation of mucosa was geatly ameliorated (P＜0.01). The inflammatory cell infiltratation much decreased and neutrophils, disapeared in most sections (P＜0.001). The goblet cells significantly increased (P＜0.001); crypt paracrypt abscess or mucosal ulceration was seen (P＜0.001). CONCLUSION: The rate of cure of ulcerative colitis by moxibustion with herbal medicine beneath is superior to that by SASP. This sort of moxibustion can effectively improve the colonic mucosal lesions and restore the proportion of mucoprotein to near normal.
Pharmacological effects of ba-wei-xi-lei powder on ulcerative colitis in rats with enema application.
Liu DY,
Zhao HM,
Zhao N,
Xin ZP,
Lu AP.
National Pharmaceutical Engineering Research Center, Nanchang, Jiangxi Province, 330077, China.
Ba-wei-xi-lei powder is a classical herbal mixture, and is widely used for the treatment of oral ulcer and ulcerative colitis. This study aimed to explore the effect of Ba-wei-xi-lei powder with enema application on ulcerative colitis in rats. Ulcerative colitis was induced by immunization with rabbit's colonic mucosal protein emulsified with Completely Freund's Adjuvant. The mucosal inflammatory reaction and ulcer have been observed in the model rats. Characteristic changes of ulceractive colitis include that CD4 lymphocyte increased in peripheral blood while CD8 lymphocyte decreased; CD8 lymphocyte and TNF-alpha expression area increased in colonic mucosa, while CD4 lymphocyte decreased. Ba-wei-xi-lei powder and sulfasalazine with enema application could alleviate the pathological changes in the model rats. The results suggest that the pharmacological effects of Ba-wei-xi-lei powder on ulcerative colitis in rats are similar to the effect of sulfasalazine.
PMID: 16710895 [PubMed - indexed for MEDLINE]
Acupuncture and moxibustion in the treatment of ulcerative colitis: a randomized controlled study.
Department of Medicine I, Friedrich-Alexander-University of Erlangen-Nuremberg, Germany. stefanie.joos@med.uni-heidelberg.de
OBJECTIVE: Acupuncture has traditionally been used in the treatment of inflammatory bowel disease in China and is increasingly applied in Western countries. The objective of this study was to investigate the efficacy of acupuncture and moxibustion in the treatment of active ulcerative colitis (UC). MATERIAL AND METHODS: In a prospective, randomized, controlled clinical trial 29 patients with mild to moderately active UC (mean age 37.8 +/- 12.0 years) were randomly assigned to receive either traditional acupuncture and moxa (TCM group, n = 15), or sham acupuncture consisting of superficial needling at non-acupuncture points (control group, CG, n = 14). All patients were treated in 10 sessions over a period of 5 weeks and followed-up for 16 weeks. The main outcome measure was the change in the Colitis Activity Index (CAI) after treatment; secondary outcome measures were changes in quality of life, general well-being and serum markers of inflammation. RESULTS: In the TCM group, the CAI decreased from 8.0 (+/- 3.7) to 4.2 (+/- 2.4) points and in the control group from 6.5 (+/- 3.4) to 4.8 (+/- 3.9) points (TCM versus CG: p = 0.048). In both groups these changes were associated with significant improvements in general well-being (TCM group: from 3.0 (+/- 1.8) to 1.8 (+/- 1.0); CG: from 3.2 (+/- 1.9) to 2.2 (+/- 1.7)) and quality of life (TCM group: from 146 (+/- 23) to 182 (+/- 18); CG: from 157 (+/- 20) to 183 (+/- 23)). No significant differences between the TCM and CG were found regarding these secondary outcome measures. CONCLUSIONS: Differences in efficacy between traditional acupuncture and sham acupuncture were small and significant only for CAI as the main outcome measure. Both traditional and sham acupuncture seem to offer an additional therapeutic benefit in patients with mild to moderately active UC.
PMID: 16938719 [PubMed - indexed for MEDLINE]
Acupuncture and moxibustion in the treatment of active Crohn's disease: a randomized controlled study.
Department of Medicine I-Gastroenterology, Research Group for Alternative Medicine, Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany. s.joos@gmx.de
BACKGROUND: Acupuncture has traditionally been used in the treatment of inflammatory bowel disease in China and is increasingly being applied in Western countries. The purpose of this study was to investigate the efficacy of acupuncture in the treatment of active Crohn's disease (CD). METHODS: A prospective, randomized, controlled, single-blind clinical trial was carried out to analyze the change in the CD activity index (CDAI) after treatment as a main outcome measure, and the changes in quality of life and general well-being, serum markers of inflammation (alpha(1)-acid glycoprotein, C-reactive protein) as secondary outcome measures. 51 patients with mild to moderately active CD were treated in a single center for complementary medicine by three trained acupuncturists and randomly assigned to receive either traditional acupuncture (TCM group, n = 27) or control treatment at non-acupuncture points (control group, n = 24). Patients were treated in 10 sessions over a period of 4 weeks and followed up for 12 weeks. RESULTS: In the TCM group the CDAI decreased from 250 +/- 51 to 163 +/- 56 points as compared with a mean decrease from 220 +/- 42 to 181 +/- 46 points in the control group (TCM vs. control group: p = 0.003). In both groups these changes were associated with improvements in general well-being and quality of life. With regard to general well-being, traditional acupuncture was superior to control treatment (p = 0.045). alpha(1)-acid glycoprotein concentration fell significantly only in the TCM group (p = 0.046). CONCLUSIONS: Apart from a marked placebo effect, traditional acupuncture offers an additional therapeutic benefit in patients with mild to moderately active CD. Copyright 2004 S. Karger AG, Basel
Herb-Drug Interactions: What Every Patient Needs to Know
By John Chen, PhD, PharmD, OMD, LAc
The first and most important thing to understand about herb-drug interactions is communication. It is important that patients tell their health care practitioners what herbs and drugs they are currently taking so that practitioners can provide comprehensive care. Knowing this information is crucial to designing the best treatment and avoiding potential herb-drug interactions.
There are two fundamental mechanisms that contribute to interactions: pharmacokinetic and pharmacodynamic. Pharmacokinetic interactions refer to changes that occur as medicines move in and out of the body, such as with absorption, distribution, metabolism and elimination. Pharmacodynamic interactions refer to how medicines actually behave inside the human body, as they can sometimes increase or cancel out the effectiveness of one another.
Absorption, distribution, metabolism and elimination are four cycles that all medicines go through in the body. After a medicine is taken, it is absorbed from the intestines, distributed throughout the body, metabolized (broken down) in the liver, and finally, eliminated from the body through the kidneys.
Many factors may interrupt these cycles, leading to interactions. For example, ingestion of an antacid or anti-ulcer medication will reduce the acidity of the stomach, therefore decreasing the absorption of other medications and herbs. In addition, some drugs may interfere with blood circulation and affect the distribution of medicines or herbs to the affected parts of the body. Finally, some drugs may be harmful to the liver or kidneys, impairing the ability of the body to break down and eliminate the medicines or herbs. The extent and severity of each interaction will vary depending on specific circumstances such as dosage, sensitivity, metabolic rate, and the type of drugs and herbs taken.
Certain medicines have the same or opposite effects and, when taken together, may increase or cancel out the effect of each other. For example, a person taking coumadin (warfarin) to treat a clotting disorder should not take other substances that affect the blood, such as aspirin or ginkgo. Concurrent use of these medications may increase the effect of each other, leading to side-effects such as bleeding or bruising. Furthermore, a person with high blood pressure treated with drugs should not take any supplements that have a stimulant effect, such as ephedra, without supervision. Use of stimulants may increase the blood pressure, thereby canceling the effect of the drug treatment.
In short, drug-drug or drug-herb interactions occur as a result of inappropriate combinations. If a patient notices anything normal, he/she should contact their healthcare practitioner immediately. When detected early, most interactions can be stopped immediately. Interactions can be prevented simply by adjusting the dosage; changing the dosing schedule; or modifying the therapy. Once again, it is important that healthcare practitioners know exactly which drugs/herbs/supplements their patients are taking so that they can provide a comprehensive evaluation.
The following table lists some drugs that are more likely to cause interactions. Patients should make sure to inform their healthcare practitioners if they are taking any of these medications and ask if the herbs and/or supplements they are taking are compatible with the drugs they are taking. Remember: communication is the key to comprehensive care!
Common Drugs and Possible Interactions
Brand Name
Generic Name
Type of Drug
Effect of Interaction
Amphotericin
amphotericin
antifungal
may reduce elimination by the kidney
Axid
nizatidine
acid-reducer
may interfere with absorption by reducing stomach acid
Carafate
sucralfate
anti-ulcer
may interfere with absorption due to its binding effect
Cholestid
colestipol
antihyperlipidemic
may interfere with absorption due to its binding effect
Coumadin
warfarin
anticoagulant
effect may change if other substences that affect the blood are also given
Diflucan
fluconazole
antifungal
may slow metabolism by the liver
Dilantin
phenytoin
anticonvulsant
may increase metabolism by the liver
E-Mycin
erythromycin
antibiotic
may slow metabolism by the liver
EES
erythromycin
antibiotic
may slow metabolism by the liver
Eryc
erythromycin
antibiotic
may slow metabolism by the liver
Ethanol
alcohol
alcohol
may interfere with metabolism by the liver
Haldol
haloperidol
antipsychotic
may interfere with absorption in the intestines
Maalox
antacid
antacid
may interfere with absorption in the intestines
Methotrexate
ketoconazole
anticancer
may reduce elimination by the kidney
Mylanta
antacid
antacid
may interfere with absorption in the intestines
Nizoral
ketoconazole
antifungal
may slow metabolism by the liver
Pepcid
famotidine
acid reducer
may interfere with absorption in the intestines
Phenobarbital
phenobarbital
anticonvulsant
may increase metabolism by the liver
Prilosec
omeprazole
acid reducer
may interfere with absorption in the intestines
Questran
cholestyramine
antihyperlipidemic
may decrease absorption in the intestines
Reglan
metoclopramide
GI stimulant
may interfere with absorption in the intestines
Rifadin
rifampin
antibiotic
may increase metabolism by the liver
Sporonox
itraconazole
antifungal
may slow metabolism by the liver
Tagamet
cimetidine
acid reducer
may interfere with absorption in the intestines and slow metabolism by the liver
Tegretol
carbamazepine
anticonvulsant
may increase metabolism by the liver
Tums
antacid
antacid
may interfere with absorption in the intestines
Zantac
ranitidine
acid reducer
may interfere with absorption in the intestines
References
D'Arcy PF. Adverse reactions and interactions with herbal medicine. Part 2 - drug interactions. Adverse Drug React Toxicol Rev 1993;12(3):147-162.
Bensky D, Gamble A. Chinese Herbal Medicine Materia Medica, Revised Edition. Eastland Press, 1986.
Berkow R, Fletcher AJ. The Merck Manual of Diagnosis and Therapy, 16th edition. Merck Research Laboratories, 1992.
Fauci AS, et al. Harrison's Principles of Internal Medicine, 14th edition. McGraw-Hill Health Professions Division, 1998.
Hansten PH. Understanding drug-drug interactions. Science and Medicine January/February 1998, 16-25.
Kalant H, Roschlau W. Principles of Medical Pharmacology, 6th edition. Oxford University Press, 1998.
Segal S, Kaminski S. Drug-nutrient interactions. American Druggist July 1996;42-49.
John K. Chen, PhD, PharmD, OMD, LAc Professor, Emperor's College of Traditional Oriental Medicine Professor, Yo San University Adjunct Professor, University of Southern California School of Pharmacy 1124 N. Hacienda Boulevard La Puente, CA 91744 Tel: (626) 916-1070 Fax: (626) 917-7763 ">
lotusherbs@aol.com
Care needs to be exercised when using Herbal Medicines
Do not implicitly trust internet sites that sell herbal medicines to be both safe and harmless. Every medication, if it is used to treat some kind of medical condition or disease has the potential for harm if inappropriately prescribed or used. This warning is a stark reminder to people to be careful when you buy herbal medications. Only use trusted sources and only buy from people who are trained to be aware of the benefits as well as the dangers of different herbs. Although many herbs are safe and natural medicines tend to have fewer side effects compared to synthetic medications, dangers do exist for unsuspecting consumers.
Dangerous herbal readily available through Web despite FDA import ban
By Robert Sanders, Media Relations | 16 October 2003
BERKELEY – A Chinese herbal product known to cause kidney failure and cancer in people and banned for importation two years ago by the U.S. Food & Drug Administration (FDA) is readily available through the Internet, pointing out the need for FDA policies regulating the sale of dangerous herbals through the Web, according to University of California, Berkeley researcher Lois Swirsky Gold.
In a letter in today's issue of The New England Journal of Medicine, Gold, who directs the Carcinogenic Potency Project at UC Berkeley and Lawrence Berkeley National Laboratory, reports that herbal products containing aristolochic acid can be easily purchased through the Internet, despite 105 documented cases of rapid kidney failure due to use in a Belgian clinic in 1993 of a diet supplement containing the herbal extract. Half of the 39 women who had their kidneys removed after taking the supplement were found to have cancer of the urinary tract, the letter notes. Kidney failure associated with aristolochic acid has been seen in eight other countries and urothelial cancer in two other countries, Gold said.
Many names are used for such products, including fang ji (Aristolochia fangchi) and wild ginger (Asarum canadense). The herbal products, which include those marketed as "Cramp Relief," "Cold Away," "Mother Earth's Cough Syrup," "Old Indian Herbal Syrup" and "PMS-Ease," are recommended on the Web for gastrointestinal symptoms, weight loss, cough, immune stimulation and menstrual cramps, among others. A list of products is at http://potency.berkeley.edu.
"Aristolochia and aristolochic acid are known human and rat carcinogens," Gold said in an interview. "What is also disturbing is that the recommended dose for at least one product on the Internet is the same as the dose that gave cancer to rats. These products should not be available."
A reader had a question about shingles and resulting neuralgia.
What is Shingles? Shingles (herpes zoster) is an outbreak of rash or blisters on the skin that is caused by the same virus that causes chickenpox — the varicella-zoster virus. The first sign of shingles is often burning or tingling pain, or sometimes numbness or itch, in one particular location on only one side of the body. After several days or a week, a rash of fluid-filled blisters, similar to chickenpox, appears in one area on one side of the body. Shingles pain can be mild or intense. Some people have mostly itching; some feel pain from the gentlest touch or breeze. The most common location for shingles is a band, called a dermatome, spanning one side of the trunk around the waistline. Anyone who has had chickenpox is at risk for shingles. Scientists think that in the original battle with the varicella-zoster virus, some of the virus particles leave the skin blisters and move into the nervous system. When the varicella-zoster virus reactivates, the virus moves back down the long nerve fibers that extend from the sensory cell bodies to the skin. The viruses multiply, the tell-tale rash erupts, and the person now has shingles.
Are other complications associated with shingles?
Yes. If shingles appears on the face, it can lead to complications in hearing and vision. For instance, if shingles affects the eye, the cornea can become infectd and lead to temporary or permanent blindness. Another complication of the virus is postherpetic neuralgia (PHN), a condition where the pain from shingles persists for months, sometimes years, after the shingles rash has healed.
National Institute of Neurological Disorders and Stroke: Shingles Information Page National Institutes of Health
How does acupuncture treat shingles?
The shingles virus attacks the nerves under the skin. Pain signals move along the neural sensors and pain medications may not bring relief. Boosting the patient's own immune system with acupuncture may provide long-lasting relief. Acupuncture points may be accessed on various positions of the body, frequently away from the area of pain. Careful diagnosis on an individual basis is essential to identify the most efficaceous locations. Herbal supplements may also be given to the patient to provide additional relief from the pain.
EXPERIENCE AND RESULTS OF COMBINATED ACUPUNCTURE THERAPY OF TRIGEMINAL NEURALGIA
Dr. 0. Mastalier - M.D. (Germany)
The clinical picture of trigeminal neuralgia is one of the most dreaded pain sensations and at the same time a challenge to therapists. Decisive for optimal care of patients is the exacting compilation of the history, anamnesia findings, pain analysis and differential diagnostics. The interdisciplinary consillary examination should be exploited to the fullest extent. Presented in the lecture report are the results of longterm monitoring and control as well as the biological-oriented therapy.
Before treatment was commenced the patients from two groups underwent biological, radiological, orthopedic, otorhinolaryngologic, ophthalmic and dental examinations. Particular importance was attached to the disturbance field disorders and focus factors. Psycho-social and other possible causes such as immune deficiency and environmental stress were also considered. Considered, more especially were disorders in the crania-gnatho-sacral relation as significant and not very seldom causes.
Only chronic cases of trigeminal neuralgia in the patient collective were included. In the case of all patients there was almost a continuous stereotype increase in the dose of medication, generally Carbamazepine, forced by fear of the pain experience or because of the deficient effect of the dose, a few were also given psycho-pharmaceutics. Uncontrolled self medication has already led in some cases to undesirable stressing of liver and kidney function with simultaneous paradox effect of reduced analgetic effectiveness. Because of the increasing problems an alternative possibility of treatment had to be employed, which was free of side effects as much as possible in order to counteract more, especially the psychical crisis pressure.
The observance of all individual modalities is particularly important. As one therapy acting on the body's own pain retarding system is acupuncture in its body, ear and cerebral acupuncture variations. To the greatest extent the aim behind this change in therapy, was to ensure a significant dampening of the sensitivity to pain, of nociception and the frequency of the attacks, to save the patients from the psy' the through pain paroxysm - and as a result, to also reduce the psychotrope medication.
Treated were also patients who despite preceding irreversible therapies (ambient alcohol injections. periphery neurexeresis or suffered the same pain after neural therapy as well as multimorbide patients.
I would like to mention the following as a result of my own observations: the needled body or ear points evidenced significant differences in temperature measured with a microsensor measuring probe with very fast reaction time and measuring tolerance of 0.2°C measurable over a range of 0 to 40°C.
The long-term monitoring served to assess the success of the treatment and the lasting effect. It was possible not only to take away the fear of pain but also ensure longer intervals free of pain attacks and significant lowering of the sensitivity to pain. Altogether the chance in therapy appeared to be dependent on the individual modalities and the psychological situation. This was obviously very favourable to the patient to get away from feeling dependent on threatened medication. To be seen as an unrestricted advantage in the course of the treatment without side effects, a clear reduction in pain killers and protection of the psyche, the effects of real causal therapy. Epicrisis: The therapy brought month long to two year recidive and painless intervals without having to take the forced earlier medication in considerable number of the treated patients. The results of the treatment of 2 patient groups with 17 and 28 cases were documented with statistics. They characterize the honest efforts to relieve pain according to
Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS.
Mukherjee M, McPeak LK, Redford JB, Sun C, Liu W. The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors. OBJECTIVE: To quantitatively assess the change in spasticity of the impaired wrist joint in chronic stroke patients after electro-acupuncture treatment. DESIGN: Crossover design. SETTING: University medical center research laboratory. PARTICIPANTS: Seven chronic stroke subjects (age, 63.14+/-7.01y). INTERVENTION: Participants received two 6-week treatment regimens: combined electro-acupuncture and strengthening twice a week, and strengthening twice a week only. Muscle strength and spasticity of the wrist joint were quantified by using the Biodex multijoint System 3 Pro. Electro-acupuncture was given through a commercial electro-acupuncture device. MAIN OUTCOME MEASURES: Velocity sensitivity of averaged speed-dependent reflex torque (VASRT); segmented averaged speed-dependent reflex torque (SASRT); Modified Ashworth Scale (MAS) scores; and integrated electromyographic activity of the affected wrist flexors during passive stretch of the affected wrist joint. RESULTS: VASRT was reduced significantly in the combined treatment group (P=.02) after the 6-week period, but not in the strengthening-only group (P=.23); however, no significant immediate effect of electro-acupuncture was observed (P>.05). MAS scores also showed a significant reduction (P<.01). SASRT did not differ significantly across different positions of the joint or across velocity; however, significant differences were present between the 2 treatment groups (P<.05) for each position and at all the velocities except at 20 degrees /s. Integrated electromyographic activity showed a trend for reduction after the combined treatment. CONCLUSIONS: A combination of electro-acupuncture and muscle strengthening exercise for 6 weeks significantly reduced spasticity. The effect of spasticity reduction was consistent across different joint positions and different velocities of passive stretch.
Department of Anesthesiology and Intensive Care Medicine (B), Outpatient Pain Center, University of Vienna, Vienna, Austria. sabine.sator@univie.ac.at Acupuncture is an established adjuvant analgesic modality for the treatment of chronic pain. Electrical stimulation of acupuncture points is considered to increase acupuncture analgesia. In this prospective, randomized, double-blind, controlled study we tested the hypothesis that auricular electroacupuncture (EA) relieves pain more effectively than conventional manual auricular acupuncture (CO) in chronic low back pain patients with insufficient pain relief (visual analogue scale [VAS] > or = 5) treated with standardized analgesic therapy. Disposable acupuncture needles were inserted in the auricular acupuncture points 29, 40, and 55 of the dominant side and connected to a newly developed battery-powered miniaturized stimulator worn behind the ear. Patients were randomized into group EA (n = 31) with continuous low-frequency auricular EA (1 Hz biphasic constant current of 2 mA) and group CO (n = 30) without electrical stimulation (sham-electroacupuncture). Treatment was performed once weekly for 6 wk, and in each group needles were withdrawn 48 h after insertion. During the study period and a 3-mo follow-up, patients were asked to complete the McGill questionnaire. Psychological well being, activity level, quality of sleep, and pain intensity were assessed by means of VAS; moreover, analgesic drug consumption was documented. Pain relief was significantly better in group EA during the study and the follow-up period as compared with group CO. Similarly, psychological well-being, activity, and sleep were significantly improved in group EA versus group CO, the consumption of analgesic rescue medication was less, and more patients returned to full-time employment. Neuropathic pain in particular improved in patients treated with EA. There were no adverse side effects. These results are the first to demonstrate that continuous EA stimulation of auricular acupuncture points improves the treatment of chronic low back pain in an outpatient population. IMPLICATIONS: Continuous electrical stimulation of auricular acupuncture points using the new point stimulation device P-stim significantly decreases pain intensity and improves psychological well-being, activity, and sleep in chronic low back pain patients. PMID: 15105215 [PubMed - indexed for MEDLINE]
The Efficacy of Acupuncture in the Treatment of Temporomandibular Joint Myofascial Pain
Smith P, et al. School of Dentistry, The University of Manchester, Higher Cambridge Street, Manchester M15 6FH, United Kingdom.
OBJECTIVES: To compare the effect of real acupuncture and sham acupuncture in the treatment of temporomandibulat joint myofascial pain, in order to establish the true efficacy of acupuncture. METHODS: A double blind randomised controlled trial conducted in the TMD Clinic, at the School of Dentistry, The University of Manchester. Twenty-seven patients were assigned to one of two treatment groups. Group 1 received real acupuncture treatment whilst Group 2 received a sham acupuncture intervention. Both the assessor and the patient were blinded regarding the group allocation. Baseline assessment of the outcome variables was made prior to the first treatment session, and was repeated following the last treatment. RESULTS: The results demonstrated that real acupuncture had a greater influence on clinical outcome measure of TMJ MP than those of sham acupuncture, and the majority of these reached a level of statistical significance. CONCLUSION: Acupuncture had a positive influence on the signs and symptoms of TMJ MP. In addition, this study provides evidence that the Park Sham Device was a credible acupuncture control method for trials involving facial acupoints. J Dent. 2006 Nov 7;
Source PubMed
Sedative Effect of Acupuncture during Cataract Surgery
Gioia L, et al. Departments of Anesthesiology, Vita-Salute University of Milan, and H. San Raffaele, Milan, Italy.
PURPOSE: To assess the effectiveness of acupuncture in reducing anxiety in patients having cataract surgery under topical anesthesia. SETTING: Vita-Salute University of Milan and IRCCS H. San Raffaele, Milan, Italy. METHODS: In a prospective randomized double-blind controlled trial, anxiety levels before and after cataract surgery in 3 groups (A = no acupuncture, B = true acupuncture starting 20 minutes before surgery, C = sham acupuncture starting 20 minutes before surgery) were compared using the Visual Analog Scale (VAS). Twenty-five patients scheduled for inpatient phacoemulsification were enrolled in each group. All surgeries were performed using topical anesthesia. Exclusion criteria were refusal to provide informed consent, use of drugs with sedative properties, psychiatric disease, pregnancy, knowledge of the principles of acupuncture, anatomic alterations, or cutaneous infections precluding acupuncture at the selected acupoints. RESULTS: Preoperative anxiety levels were significantly lower only in Group B (P = .001). Anxiety in Group B was significantly lower than in Group A (P = .001) and Group C (P = .037). Regarding postoperative anxiety, the mean VAS score was 39 +/- 5 in Group A, 19 +/- 3 in Group B, and 31 +/- 4 in Group C. The difference was significant only between Group A and Group B (P = .003). CONCLUSION: Acupuncture was effective in reducing anxiety related to cataract surgery under topical anesthesia. J Cataract Refract Surg. 2006 Nov;32(11):1951-4.
Source: PubMed
Tongxinluo (Tong Xin Luo or Tong-Xin-Luo) Capsule for Unstable Angina Pectoris
Wu T, et al. West China Hospital, Sichuan University, Chinese Cochrane Centre, Chinese EBM Centre, No. 37, Guo Xue Xiang, Chengdu, Sichuan, China. txwutx@hotmail.com
BACKGROUND: Tongxinluo capsule is a medicine consisting of traditional Chinese herbs and insects used for cardiovascular diseases in China and some other Asian countries. To date the evidence of its effect has not previously been subject to systematic review, making it difficult to derive robust conclusions about its actual benefits, and indeed, possible harms. OBJECTIVES: To assess systematically the effects of tongxinluo capsule in people with unstable angina pectoris. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, Issue 4 2004, MEDLINE, EMBASE, Chinese Biomedical Database, China National Knowledge Infrastructure, Japana Centra Revuo Medicina (all 1995 to 2005). We also handsearched the relevant Chinese journals, checked with manufacturers and registers of ongoing studies. SELECTION CRITERIA: Randomised trials comparing either tongxinluo capsule only or standard treatment plus tongxinluo capsule with standard treatment or other anti-angina pectoris drugs, placebo or no intervention. DATA COLLECTION AND ANALYSIS: Two authors identified relevant studies for the review independently and went on to abstract data, and assess trial quality. Authors of included studies were contacted to obtain further information as required. MAIN RESULTS: 18 short term follow-up trials involving 1413 people were included. The studies did not provide strong support of a benefit of tongxinluo for reducing the combined outcome of acute myocardial infarction, angioplasty (PTCA) coronary artery bypass graft (CABG) and sudden death or all-cause mortality (RR 0.42, 95% CI 0.07 to 2.59, P=0.35; RR 0.33, 95% CI 0.01to 7.78, P=0.49, respectively). Tongxinluo reduced the frequency of acute angina attacks (WMD -1.20, 95%CI -1.38 to -1.02, P<0.00001 and RR -2.36, 95%CI -2.53 to -2.18, P<0.00001, respectively), improved ECG (RR 1.31, 95% CI 1.08 to 1.57, P=0.005) and angina symptoms (RR 1.21, 95% CI 1.06 to 1.40; P=0.007). AUTHORS' CONCLUSIONS: Tongxinluo in combination with routine angina therapy appears to reduce the risk of subsequent AMI, PTCA or CABG, angina attacks and severity, as well as improving symptoms and ischaemic changes on the electrocardiogram (ECG). Due to the methodological limitations of the studies, the evidence is insufficient to make any conclusive recommendations about the use of this treatment for patients presenting with unstable angina. Large high quality randomised controlled trials are warranted. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD004474. Source: PubMed
THE USE OF ACUPUNCTURE IN DENTISTRY (A WORKSHOP)
Dr. P. Rosted - M.D. (UK) Introduction Acupuncture is not going to replace the drill, but it certainly has quite a lot to offer in dentistry. A recent review paper on the scientific validity of published papers was able to identify 74 papers regarding the use of acupuncture in dentistry. Among those papers 15 were randomised controlled studies. In I1 out of 15 papers acupuncture proved effective in the treatment of Temperomandibular dysfunction and as analgesic. Moreover acupuncture has proved effective in the treatment of Sjoegrens disease in a number of papers not included in this review. Facial pain and phobias are another major problem where acupuncture has something to offer. Presentation of scientific evidence for the use of acupuncture in dentistry Relevant randomised controlled studies regarding the use of acupuncture in dentistry will be presented and discussed. The basis for the relevant techniques The techniques applicable in dentistry will be discussed in the view of modern neurophysiology. The practical application of acupuncture in dentistry The practical application of acupuncture in the treatment of Temperomandibular dysfunction, postoperative pain, Sjoegrens disease, facial pain, neuralgia, headache, migraine, stress, phobias and ENT related diseases will be illustrated by case stories and prescriptions. Abstracts of ICMART '99 International Medical Acupuncture Symposium ICMART INTERNATIONAL SYMPOSIUM ON MEDICAL ACUPUNCTURE AND VI CONGRESS OF BALTIC STATES ON ACUPUNCTURE AND TRADITIONAL CHINESE MEDICINE The Challenge of Acupuncture Riga, May 21-23, 1999
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