Asthma and Chinese Medicine

At the Northside Holistic Center we see many respiratory problems, ranging from acute diseases like colds, flus and bronchitises to more chronic issues like asthma. Bronchial asthma effects more than 17 million people in the USA and, by some estimates, 7.7% of the population. Over the last half a century, rates of asthma have been dramatically escalating with the Center for Disease control reporting that the rates had increased by 75% between 1980 and 1994.Consequently we are seeing many more cases in the clinic.

Satisfyingly, Chinese medicine can be quite effective in mitigating asthma for our patients and most clients find themselves to very satisfied with this holistic and long lasting approach. Asthma, like most conditions in the Chinese medical view of the body must be differentiated into what we term patterns. Patterns are constellations of symptoms and physical propensities which, when considered as a whole, give a trained practitioner insight into how to treat both the condition and the root of the problem simultaneously. It is what gives Chinese medicine it's considerable power in treating chronic issues, such as asthma.

Research Links on Chinese Medicine, Acupuncture and Asthma:

• A German study on in-patient pediatric patients found significant benefit to adding acupuncture to western interventions. (an article about the study can be read here):

The addition of acupuncture to an inpatient asthma rehabilitation programme results in improvement in bronchial hyper-reactivity and reduced anxiety for paediatric patients.

In the post-treatment acupuncture group, peak expiratory flow variability (a measure of bronchial hyper-reactivity) was found to show significant improvement compared with that of control patients. In addition, the acupuncture group was found to show significantly reduced levels of perceived anxiety on discharge from hospital.

• This article comes from a Chinese journal on pulmonary research and is titled, Effects of Acupuncture on Clinical Symptoms and  Pulmonary Function in Patients with Bronchial Asthma.  The study looks at 104 people suffering from asthma and being treated by acupuncture using a specific protocol with constitutional modifications. It concludes that acupuncture can be very useful in treating asthma, with a good immediate outcome. However the researchers also followed the study cohort for six months afterwards and was able to determine that even after treatment had ended the patients were dramatically less likely to suffer asthma attacks and used far less medication then those who had not been treated by an acupuncturist.

• A research study from a hospital in China, following 100 patient admissions showed a dramatic effect using acupuncture to treat an acute asthma attack. While we in the USA rarely treat this situation because patients' usually already have inhalers and access to the emergency room, it is exciting to see research supporting the contention that acupuncture can be useful to treat all stages of bronchial asthma.

• A 2006 study from the China Academy of Chinese Medical Sciences in Beijing is very interesting, despite being rife with the specific terminology of Chinese medicine. In essence it demonstrates a strong response to acupuncture revealed by an dramatic increase in pulmonary function and significant decrease in heart rate variability during an acute asthma attack.

• A small pilot study in the Journal of the Chinese Medical Association showed immediate bronchiodilating effect and improvement in pulmonary function in those suffering from asthma.

• This article is more of a biomedical discussion of how some of the acupuncture points that we might choose to treat asthma may work, from a western perspective. Still very interesting.

Pregnancy and Acupuncture

While a large part of my practice involves the treatment of infertiliy, once the client has conceived she may opt to continue therapy. There are many reasons that clients who have used Chinese medicine to conceive will continue to work with us through the beginning of their pregnancy, to seek treatment toward the end of term, or use us to help them throughout the entire gestation. In the beginning of the pregnancy, usually through the first trimester, acupuncture can be very useful to minimize the chances of miscarriage due to uterine insufficiency. For women who have had previous miscarriages or who worry that they may carry a risk of such an occurrence may opt for this careful approach by using Chinese medicine. Additionally, acupuncture may be used to minimize or eliminate uncomfortable effects of pregnancy such as morning sickness, digestive problems, lowered energy and musculoskeletal pain - for which it can be extraordinarily effective.

Some women, by virtue of their age, risk factors or general health may opt to work with an acupuncturist throughout the entire pregnancy to ensure that her body remains as strong as possible and to minimize risk to the baby. The added bonus of this type of ongoing work is that labor and delivery is often quite a bit easier as a result.

Finally, many women will use an acupuncturist's services in the last month of pregnancy in order to help with a breach presentation of the baby, induce labor if the child is past term and the mother wants to avoid using chemical means of inducement or Caesarian section; or simply to ease the delivery.

All of these strategies can be very useful for a pregnant woman. Below I've included a few western medical studies demonstrate that the scientific community is beginning to recognize these benefits:

Research:

From the journal, Pain and Symptom Management, and summarized in Acupuncture Today, comes a study which demonstrates dramatic reduction in morning sickness in women receiving acupuncture versus placebo. 

The Journal of Complementary Medicine, 2009 published a study in which it was showed that women who used acupuncture during their pregnancy and labor had much lower rates of Caesarian section and a subjectively higher rate of comfort during the actual labor process.

From the US Pharmacists journal comes a compendium of many other studies demonstrating the utillity of acupuncture for morning sickness.

From the  Scandinavian journal, Acta Obstetricia et Gynecologica Scandinavica comes a study evaluating the treatment of pelvic and low back pain with acupuncture, during preganancy. Not only did the study conclude that acupuncture was very effective at treating this type of pregnancy related pain, but it also found that it obtained a superior result to using physical therapy as the sole treatment for this type of discomfort.

Using acupuncture to treat pregancy and/or post-partum related depression often yields powerful results. And we see this quite often in our clinic. In The Journal of Affective Disorders, there is a study which demonstrates this positive effect.

In the Journal Obstetric and Gynecologic Investigation, a rat model is used to investigate the potential chemical basis for acupuncture's effect in preventing one type of miscarriage.

From an Austrian Obstetrics journal, Wien Klin Wochenschr, comes a study on the effectiveness of using acupuncture to induce labor and ripen the cervix.

A small study in the journal, Acupuncture Medicine, demonstrates the effectiveness of using acupuncture to treat the insomnia which can be connected to pregnancy in many women.

From Science comes this French study on the successful management of  pelvic pain in pregnant women.

Children and Allergies

I treat a lot of children's issues at the Northside Holistic Center and allergies are one of the frequent complaints that children, as well as adults present with. Frequently, my pediatric patients present with a variety of allergy related issues such as asthma, eczema, and digestive problems. This kind of work is very satisfying to most acupuncturists for, while most allergies respond to what we do quite well, children will often appear to be almost magical in their ability to rapidly get well from our work.

The first question that many parents have about using acupuncture as a modality is, "How can you persuade a child to lay still for the placement of the acupuncture filaments?"

The child's parents are usually relieved to find that this is usually much easier than it sounds. Unlike the treatment of adults, children usually only need to retain the filaments for a few minutes per point. This makes keeping them interested much easier. For toddlers and infants, the mother or father can simply hold the child or read them a story. For older kids a toy can be used as a distraction tool while the treatment is proceeding. Most of my clients under fifteen come to enjoy acupuncture therapy as much as adults and parents are surprised to find that many children look forward to their treatment - gratifying to all parties involved!

Links for Other Resources:

This link is from a mother dedicated to helping other parents' with their childrens' allergy issues. Her meetup link allows members to share information about their children's health, recipes, and techniques to help parents cope with and treat their kids.

http://www.meetup.com/no-nutz-mamas/

Research Links and Articles

• From ABC News comes both an article and a video covering the use of acupuncture for seasonal allergies. The entire article can be read and the video viewed here. An excerpt is below:

 Aniko Foldi and Marty Rudolph said they have battled severe allergy symptoms for years with no relief. "You name it, I have every kind of symptom," Aniko said.

"I have had surgery, I've gone to an allergist's office two times a week for shots," Marty said. Both of them desperate for help they turned to acupuncture as a last resort and both said it worked. "It absolutely mitigates the impact," Marty said.

"It's just amazing to me it's like a 100% improvement," said Aniko.

Dr. Marshall Sager in Bala Cynwyd, Montgomery County practiced traditional medicine for years before becoming a certified acupuncturist. He said he's seen great success treating allergies with the ancient technique.

Aniko said Cheryl's treatments have been life changing. "I'm not taking any meds at all," Aniko said. "I would say that she saved my life."

Aniko Foldi and Marty Rudolph said they have battled severe allergy symptoms for years with no relief. "You name it, I have every kind of symptom," Aniko said."I have had surgery, I've gone to an allergist's office two times a week for shots," Marty said.

Both of them desperate for help they turned to acupuncture as a last resort and both said it worked."It absolutely mitigates the impact," Marty said."It's just amazing to me it's like a 100% improvement," said Aniko.

Dr. Marshall Sager in Bala Cynwyd, Montgomery County practiced traditional medicine for years before becoming a certified acupuncturist. He said he's seen great success treating allergies with the ancient technique.Aniko said Cheryl's treatments have been life changing."I'm not taking any meds at all," Aniko said. "I would say that she saved my life."

• From the journal Pediatrics:  A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis.

Department of Paediatrics, Kwong Wah Hospital, 25 Waterloo Rd, Kowloon, SAR, Hong Kong. dkkng@ha.org.hk

OBJECTIVE: To compare active acupuncture with sham acupuncture for the treatment of persistent allergic rhinitis among children. METHODS: Subjects with persistent allergic rhinitis were recruited from the pediatric outpatient clinic. They were randomized to receive either active acupuncture or sham acupuncture. Main outcome measures included daily rhinitis scores, symptom-free days, visual analog scale scores for immediate effects of acupuncture, daily relief medication scores, blood eosinophil counts, serum IgE levels, nasal eosinophil counts, patients' and parents' preferences for treatment modalities, and adverse effects. RESULTS: Eighty-five patients were recruited from the pediatric outpatient clinic at Kwong Wah Hospital, in Hong Kong. Thirteen patients withdrew before randomization; 35 patients (mean age: 11.7 +/- 3.2 years) were randomized to receive active acupuncture for 8 weeks, and 37 patients (mean age: 11 +/- 3.8 years) were randomized to receive sham acupuncture for 8 weeks. Acupuncture was performed twice per week for both groups. Both the assessing pediatricians and the patients were blinded. There were significantly lower daily rhinitis scores and more symptom-free days for the group receiving active acupuncture, during both the treatment and follow-up periods. The visual analog scale scores for immediate improvement after acupuncture were also significantly better for the active acupuncture group. There was no significant difference in the following outcome measures between the active and sham acupuncture groups: daily relief medication scores, blood eosinophil counts, serum IgE levels, and nasal eosinophil counts, except for the IgE levels before and 2 months after acupuncture in the sham acupuncture group. No severe adverse effects were encountered. Numbness, headache, and dizziness were found in both the active and sham acupuncture groups, with no difference in incidence, and the effects were self-limiting.

CONCLUSIONS: This study showed that active acupuncture was more effective than sham acupuncture in decreasing the symptom scores for persistent allergic rhinitis and increasing the symptom-free days. No serious adverse effect was identified.

• From SeatlePi.com comes an article on pediatric acupuncture: www.seattlepi.com: It describes a few practitioners experience with treating children.

• While not specifically child-oriented, but applicable come a study from the International Journal of Immunopharmacology comes a study of more than one hundred Taiwanese patients treated with an herbal formula that we commonly use for allergies:

Xin Yi San reduces nasal symptoms in patients with perennial allergic rhinitis (AR) due to its diverse immunomodulatory effects. One hundred and eight Taiwanese patients with AR received either XYS or a placebo for three months. The investigators found that XYS attenuated the nasal symptoms of sneezing, rhinorrhoea and nasal congestion through reduction of nasal airflow resistance and increase in the cross-sectional area of nostrils. They also observed that XYS exerted diverse in vitro immunomodulatory effects, including suppression of serum IgE levels and increased production of the cytokines IL-10, sICAM-1 and IL-8. (Traditional Chinese medicine, Xin-yi-san, reduces nasal symptoms of patients with perennial allergic rhinitis by its diverse immunomodulatory effects. Int Immunopharmacol. 2010 Aug;10(8):951-8)."

A global study in the prestigious journal Pediatrics, evaluating the saftey of acupuncture with children, found that:

Treating kids with acupuncture is a common practice and generally safe, according to a new study.

“Like adults, acupuncture is very safe when applied to the children’s population,” said Jamie Starkey, an acupuncturist from the Cleveland Clinic, who did not take part in the study. “And so it basically mimics exactly what is seen in the adult population.”

“Any of the serious side effects that they found were definitely due in part to the clinician’s malpractice,” Starkey said. “So, it was certainly somebody who was not necessarily the most trained. The take-home message is that it is absolutely safe in both the adult and pediatric world, but you have to go to somebody who is trained.” [italics mine]

 An article about the study is readable here.

Effective Treatment of Trigeminal Neuralgia with Acupuncture

Trigeminal neuralgia is a very painful condition of the nerves in the face which often torments those who suffer from it for long periods of time. Western medicine struggles, often quite unsuccessfully, in addressing the discomfort and patients are rarely satisfied with their treatment. Happily, acupuncture is an extremely useful means of addressing this problem and we see many cases of it in our clinic with the vast majority of clients extremely pleased with what we are able to do for them. 

Acupuncturists will not only ask the client for a description of where on the face the pain is, but also for a detailed overview of their whole system. The process of doing Chinese medicine properly involves evaluating any one problem, in this case trigeminal neuralgia, against the backdrop of the patient's whole constitution. It often surprises our clients that we seem to be as interested in their digestion, skin, or menstrual cycles as we are in the reason they came in to see us. The reason for this is no one symptom exists in a vacuum and to take care of the problem most effectively, we need to treat the person's whole body. This ensures that not only will the problem be treated, but that it is less likely to return and that the patient is healthier overall.

For reference, I am excerpting and publishing links to a small smattering of the enormous number of articles and studies on acupuncture and Chinese herbal treatment of trigeminal neuralgia below:

A small study showing the utility of acupuncture in the treatment of trigeminal neuralgia:

Research/Articles

From the journal Headache comes a research study evaluating acupuncture for trigeminal neuralgia entitled, Acupuncture Treatment of Chronic Facial Pain -- a Controlled Cross-over Trial. A summary of it can be read here. The patients received 10 treatments over the course of two weeks. The study's summary concludes that,

Traditional Chinese acupuncture was found to be significantly more pain-relieving than placebo acupuncture according to the pain registration of the patients themselves and to their subjective preferences.

In a controlled trial the effect of traditional Chinese acupuncture versus placebo acupuncture was evaluated in 16 patients with chronic facial pain (13 atypical facial pain, 2 atypical and I typical trigeminal neuralgia). All patients suffered from daily pain, the intensity of which was recorded by the patients over a period of 16 weeks. Each patient was treated by traditional Chinese acupuncture as well as placebo acupuncture in a cross-over design following randomization. Each period of treatment comprised 10 treatments during two weeks of hospitalization.

Traditional Chinese acupuncture was found to be significantly more pain-relieving than placebo acupuncture according to the pain registration of the patients themselves and to their subjective preferences.

Effect of Acupuncture in Trigeminal Neuralgia

Tapan K. Chaudhuri, Abhisek Ray. Medical Acupuncture. December 2008, 20(4): 231-237. doi:10.1089/acu.2008.0640.

(excerpted from the complete study, which can be viewed at: liebertonline.com/

Results: Of the 17 patients, 2 did not have classic TN. Three patients did not return after the second treatment. These patients were excluded from this series. Of the remaining 12 patients with classic TN, 4 of 5 men and all 7 women responded with markedly decreased visual analog scale scores (VAS; from mean [SD], 8.75 [1.02] to 1.95 [2.84]; P < .001). Five patients (1 man and 4 women) stayed in complete remission, which has lasted 11–15 months following their last acupuncture treatment. These 5 patients stopped taking all medications for TN. The remainder of the patients have continued to receive acupuncture on an as-necessary basis (mean [SD], 31.65 [18.26] days) for the maintenance of pain relief and no resistance to therapy has developed, with the longest follow-up being 18 months. The patients who had a history of multiple operations and procedures also had a good response. No adverse effects were observed.

Conclusions: Acupuncture produced beneficial effects in the majority of patients in this series. Acupuncture should be considered as a safe therapeutic option in patients with TN, especially before invasive intervention is done.

Definition of trigeminal neuralgia from Acupuncture.com: (see complete article at: acupuncture.com

Trigeminal Neuralgia (TN), also called tic douloureux, is a condition that affects the trigeminal nerve (the 5th cranial nerve), one of the largest nerves in the head. TN is primarily known for the intense level of pain it causes. The trigeminal nerve is responsible for sending impulses of touch, pain, pressure and temperature to the brain from the face, jaw, gums, forehead and around the eyes. The disorder is more common in women than in men and rarely affects anyone younger than 50. 

What are the symptoms of trigeminal neuralgia?

TN is characterized by a sudden, severe, electric shock-like or stabbing pain typically felt on one side of the jaw or cheek. The attacks of pain, which generally last several seconds and may be repeated one after the other, may be triggered by talking, brushing teeth, touching the face, chewing or swallowing. The attacks may come and go throughout the day and last for days, weeks or months at a time.

A small research study: (see complete article at: acupuncture.com

Practical Application of Meridian Acupuncture Treatment for Trigeminal Neuralgia

By Beppu S; Sato Y; Amemiya Y; Tode I.

Practical application of meridian acupuncture treatment for trigeminal neuralgia.

Anesthesia and Pain Control in Dentistry, 1992 Spring, 1(2):103-8.
(UI: 93005964)

Abstract: This report evaluates the effect of meridian acupuncture treatment on trigeminal neuralgia. Ten patients aged 26 to 67 years (mean 55.4 years) who visited the outpatient Dental Anesthesiology Clinic at Tsurumi University Dental Hospital from 1985 to 1990 were studied. Five of the patients suffered from idiopathic and five from symptomatic trigeminal neuralgia. The patients underwent meridian treatment by acupuncture alone or acupuncture combined with moxibustion. The acupuncture method used was primarily basic treatment employing only needles without electrical stimulation. Meridian acupuncture treatments were repeated from two to four times a month.

Five patients were restored to a pain-free state. The other five patients noted a decrease in pain, but with some level of pain remaining (significant pain in one patient). It is concluded that meridian acupuncture treatment is useful and can be one therapeutic approach in the management of trigeminal neuralgia.

From China:

Therapeutic effect of acupuncture at local acupoints on trigeminal neuralgia

Zhang XY.

Sanya City TCM Hospital, Hainan, China. yangyang496@eyou.com

OBJECTIVE: To search for an effective method for increasing therapeutic effect on trigeminal neuralgia. METHODS: Ninety cases of primary trigeminal neuralgia were randomly divided into a deep needling group and a routine needling group, 45 cases in each group. The routine needling group were treated by shallow acupuncture at local acupoints and distal acupoints along the Hand and Foot-Yangming Channels, and the deep needling group were treated by acupuncture at the above acupoints and deeply needling at the local acupoints to nerve stem for 3 courses. RESULTS: In the deep needling group 12 cases were clinically cured, 24 cases were markedly effective, 7 cases improved and 2 cases were ineffective, with a total effective rate of 95.6%; and in the routine needling group, the corresponding figures were 7, 15, 12, 11, 75.6%. The therapeutic effect in the deep needling group was better than that in the routine needling group (P<0.05). CONCLUSION: Deeply needling local acupoints plus acupuncture at distal acupoints along the Hand and Foot-Yangming Channels can increase significantly the therapeutic effect on trigeminal neuralgia.

Flu {Swine, Avian and Other} and Chinese Medicine

 

With the last year's concern over the potential for a Swine Flu pandemic, clients and practitioners have been contacting the Northside Holistic Center with questions over the role of acupuncture and Chinese medicine in the treatment of influenza. This is a bit of a repeat of what happened when Avian Flu and SARS were in the news and most of my responses remain the same and bear repeating during this more recent viral season. At the Northside Holistic Center, we treat colds and flus throughout the year with tremendous success.

Historically in Asia, the flu has been treated effectively by acupuncture and herbal medicine and there is little reason to doubt that this would not be so in many cases of this particular genetic variation of Swine Flu. While I would recommend seeking Western biomedical assessment before a client came to see me for flu-like symptoms, as recommended by the CDC, I would not hesitate to use the tools of Chinese medicine to treat such a manifestation. All evidence to date suggests that we can dramatically shorten the course of most respiratory disorders and research supports the notion that acupuncture can be immune supportive and herbal formula, when correctly tailored to the patient, can be extremely useful in targeting the virus itself.

Studies, Articles and Links:

A new study, published in the Annals of Internal Medicine found that a Chinese herbal formula was comparable to Tamiflu in successfully treating the flu. You can read about it here.

Significant reductions in the time to fever resolution, compared with the control group were seen with oseltamivir (34%), maxingshigan-yinqiaosan (37%), and oseltamivir plus maxingshigan-yinqiaosan (47%). Time to fever resolution was reduced by 19% with oseltamivir plus maxingshigan-yinqiaosan compared with oseltamivir. 

I would add that in most clinicians' experience, adding acupuncture into the mix, in order to boost the immune system further and to address specific symptoms of the flu yields even better results.

A link to a study showing the effectivenss of Chinese medicine for treatment of the H1N1 virus. According to a spokesman for the study group, "From our clinical tests and observation, the traditional method of treatment left no after effects and it is safe, more over the recovery period was shorter and the cost relatively lower as compared to Tamiflu treatment," said Wang Yuguang, spokesman of Ditan Hospital at a special briefing for the media at Ditan Hospital Wednesday afternoon.

From a September 2009 New York Times article: good information for parents about Swine Flu.

The link below discusses treatment of flu from a TCM perspective. It was written by the Institute for Traditional Medicine (ITM) in response to Avian Flu concerns in 2006 but remains relevant in the face of this current health concern.

http://www.itmonline.org/arts/flu.htm

This link was written by ITM in 2003 when the world was in a panic over the potential SARS epidemic.

http://www.itmonline.org/arts/sars.htm

Here is a link to the Center for Disease Control (CDC) with up-to-the-minute updates on the movement of the Swine Flu, as well as prevention methods outlined, including the perennially-good idea: frequent hand washing.

http://cdc.gov/SwineFlu/

And finally, a link to an abstract from a research study into using acupuncture for upper respiratory infections and fever.

http://www.ncbi.nlm.nih.gov/pubmed/1291818?ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum