Autoimmune Disorders, including Rheumatoid Arthritis Well Treated by Acupuncture

Many recent article (a few of which can be read here and here) describes the use of acupuncture and TCM to treat a variety of autoimmune disorders. The autoimmune category is so vast that it is difficult to even approximate a meaningful overview of them except to say that we treat a lot of these types of problems and that quite a large number of them respond well to acupuncture and Chinese herbal intervention.

The article, in part, reads,

Autoimmune diseases are a group of disorders in which the immune system attacks the body and destroys or alters tissues. There are more than eighty serious chronic illnesses in this category including rheumatoid arthritis, type 1 diabetes, lupus, thyroid disease, inflammatory bowel disease, Addison's disease, pernicious anemia, celiac disease, multiple sclerosis, myasthenia gravis and Guillain–Barré syndrome. According to the American Autoimmune Related Diseases Association (AARDA) twenty percent of the population suffers from autoimmune disorders. Each disease appears uncommon on an individual basis but, as a group, the disorders make up the fourth-largest cause of disability among women.

Due to the complexity of treating autoimmune disorders, integrative medicine solutions including acupuncture and Oriental medicine have received much attention as successful therapies in their treatment particularly for use in providing pain relief, regulating the immune system, managing symptoms and improving overall quality of life.

Autoimmune diseases are a group of disorders in which the immune system attacks the body and destroys or alters tissues. There are more than eighty serious chronic illnesses in this category including rheumatoid arthritis, type 1 diabetes, lupus, thyroid disease, inflammatory bowel disease, Addison's disease, pernicious anemia, celiac disease, multiple sclerosis, myasthenia gravis and Guillain–Barré syndrome. According to the American Autoimmune Related Diseases Association (AARDA) twenty percent of the population suffers from autoimmune disorders. Each disease appears uncommon on an individual basis but, as a group, the disorders make up the fourth-largest cause of disability among women.Due to the complexity of treating autoimmune disorders, integrative medicine solutions including acupuncture and Oriental medicine have received much attention as successful therapies in their treatment particularly for use in providing pain relief, regulating the immune system, managing symptoms and improving overall quality of life.

The article concludes,

Clinical research has shown that acupuncture causes physical responses in nerve cells, the pituitary gland, and parts of the brain. These responses can cause the body to release proteins, hormones, and brain chemicals that control a number of body functions. It is proposed that, by these actions, acupuncture affects blood pressure, body temperature and the immune system. 

A recent Chinese study on rheumatoid arthritis and acupuncture in Chinese Journal of Integrative Medicine found that, 

. . . acupuncture can lower levels of pro-inflammatory cytokines in the blood and synovial fluid of rheumatoid arthritis (RA) patients. 

The research, which can be read about here, describes the experiment:

Sixty-three RA patients were assigned to receive either EA or manual acupuncture (‘simple’ needling - SN). Points were selected mainly from yang meridians and local ashi points. EA or SN was applied every other day for a course of 10 treatments and each patient received a total of three courses of treatment. Blood and synovial fluid levels of the pro-inflammatory cytokines tumor necrosis factor-α (TNF-α) and vascular endothelial growth factor (VEGF) were reduced significantly after treatment in both groups. The lowering of VEGF after treatment was more significant in the EA group than that in the SN group. (Effect of electro-acupuncture on tumor necrosis factor-α and vascular endothelial growth factor in peripheral blood and joint synovia of patients with rheumatoid arthritis.

A tantalizing analysis of studies published on the NIH website showed benefit for multiple sclerosis patients using Chinese medicine. [readable here] Though the researchers concluded that the intervention,

could improve neurological signs, clinical symptoms and immune indexes, and reduce recurrent frequency. 

and that, 

The reported adverse events in the CHM (Chinese Herbal Medicine) group were less than those in the control group.

They also pointed out that,

further well-designed research is needed to evaluate the beneficial effects of CHM. 

A recent study published by Harvard researchers looks at the effects of one of many herbs which we may use in creating a tailored herbal intervention for our patients, chang shan. Chang shan, the scientists found, modulates the pathological aspect of the autoimmune process and may be useful in treating many of these types of diseases. You can read an article about this here, but an excerpt reads:

In an effort to better understand the therapeutic benefits of chang shan, the team evaluated its active components and observed that one component in particular, halofuginone (HF), blocks the development of T helper 17 (Th17) cells. Th17 cells are highly inflammatory cells that appear to play a primary role in the development of autoimmune disorders such as multiple sclerosis, psoriasis, juvenile diabetes, rheumatoid arthritis and Crohn's disease.

As a fairly substantial bonus, researchers from other universities have found many potent anti-cancer uses for the herb – again something that Chinese medicine has known for millienia, 

But chang shan's benefits do not stop there. In 2011, researchers from the University of Sao Paulo, the University of Brazil, and Tel Aviv University discovered that HF is capable of fighting leukemia. Not only does HF prevent leukemia cancer cells from spreading, but it also induces apoptosis, also known as cell death.

Similarly, a 2003 study published in the journal Clinical Cancer Research found that HF contains specific anti-tumor properties that are effective in treating a variety of other cancers besides leukemia. According to the findings, HF can inhibit the progression of both bladder carcinoma and prostate cancer tumors, and may even be a potential preventive treatment that blocks the initial development of these and other cancers.

More can be read on my site here (PKD), here (Crohn's), here (MS), and here (psoriasis). The number of autoimmune issues which I treat is quite a bit more vast than what has yet been written about on this site, but I will get to each of them as the site grows.

Cancer, Acupuncture, and Chinese Medicine

Recently, a client who I treat to minimize the side effects she has experienced from combined chemo and radiation therapy asked me for more information on the use of acupuncture and Chinese medicine for such purposes. This woman has recently become very active in leading support groups for other people who are going through what she has and is trying to improve their lives, so of course I was happy to provide her everything that I could on the topic. However, it got me to thinking that this might be interesting blog material, since I often work with people going through cancer treatment.

In this young woman's case she had undergone a complete hysterectomy and as a consequence was experiencing menopausal symptoms: hot flashes, anxiety, heart palpitations, vaginal dryness and decreased libido. Because her cancer was estrogen dependent she was unable to use hormone replacement therapy and was expected to spend the rest of her life suffering with these symptoms. In addition, she was justifiably concerned that some other form of cancer might develop and wanted to use acupuncture and herbal therapy to minimize the chances of this occurring.

This creates a context for discussing cancer from a Chinese medical perspective: acupuncture and herbology are very useful to mitigate the side effects of modern oncological intervention and to improve the immune system of patients who have had theirs damaged from chemo or radiation therapy. Historically it was also used to treat the cancer itself directly. However, while tumor attacking protocols are still used today, they are very rare. Even in China most patients routinely combine both Western oncological therapy with acupuncture and herbology. This is because many clinical trials in China have established that the best outcomes in cancer patients come from merging the two traditions to offer the patient the strengths of each system in a united front.

Regardless of the cancer that the client has been diagnosed with, we approach each person as an individual. A strength of Chinese medicine is that it works with the sum total of the person. This includes the disease diagnosis as well as all other symptoms that the person may present with. As a simplistic example of what this means, if two people present with a late stage pancreatic cancer but one has a propensity for being cold and the other for being hot, each person would receive a slightly different acupuncture treatment. This gives superior results to a cookie cutter approach wherein every patient receives the same treatment without considering the idiosyncrasies of their body.

Below I list an embarrassment of riches, link-wise. There is so much information on cancer and acupuncture/Chinese medicine that it was quite difficult to limit the list to the following.  Some of them are intended for laypeople, while others are oriented toward the practitioner. The latter will probably be of much more interest to another acupuncturist or to western medical professionals. In addition, listing a few of the studies demonstrates that acupuncture and herbology are not static fields. Rather they are adaptive and continually improving the protocols used to help our clients.

Links and Research: 

 A study done by the Cancer Treatment Centers of America, and which can be read about here, found that acupuncture was extemely useful for treating chemotherapy related neuropathy, noting that:

 . . . all of the patients reported or had improvement in their CIPN grades after starting acupuncture.

The researchers note that using customized acupuncture point prescriptions in the TCM style produces superior patient outcomes when the use of distal acupuncture points are employed. The researchers emphasize the need for customization of the acupoint prescriptions per each patient’s differential diagnostics for maximum clinical efficacy. In addition, they emphasize that distal acupoints “increase blood flow” and therefore have an especially important role in the treatment of CIPN.

• New research supports our use of the Chinese herb coriolus versicolor to prevent cancer recurrence. This herb is frequently added to our tailored formulae and has further evidence to bolster it's inclusion:

A meta-analysis from Hong Kong has provided strong evidence that the fungus Yun Zhi (Coriolus versicolor) can increase survival rates in cancer patients, particularly those suffering from carcinoma of the breast, stomach and colon. Thirteen clinical trials met the authors’ inclusion criteria. The results showed that Yun Zhi confers a significant survival advantage compared with standard conventional anti-cancer treatment alone. Of patients randomised to Yun Zhi, there was a 9% absolute reduction in five-year mortality, resulting in one additional patient alive for every 11 patients treated. In patients with breast cancer, gastric cancer, or colorectal cancer treated with chemotherapy, the effects of the addition of Yun Zhi to the treatment regime on the overall five-year survival rate were evident, however this was not true for oesophageal cancer and nasopharyngeal carcinoma. (Efficacy of Yun Zhi (Coriolus versicolor) on Survival in Cancer Patients: Systematic Review and Meta-Analysis. Recent Pat Inflamm Allergy Drug Discov. 2012 Jan 1;6(1):78-87).

• A recent study evaluated a well known Chinese medical formula that acupuncturists frequently use, called Gui Zhi Fu Ling Wan, and found that it had potent anti-bladder cancer effects:

When tested, researchers discovered that Gui Zhi Fu Ling Wan may be as effective as the chemotherapy drugs mitomycin C, epirubicin and cisplatin. Further, the researchers made an important and unexpected discovery. The herbal formula exhibited significantly greater selectivity towards cancer cells than did the chemotherapy agents. In other words, Gui Zhi Fu Ling Wan is more effective in targeting cancer cells than conventional chemotherapy agents. This highly targeted mechanism of action may point to one of the reasons, combined with its low toxicity, why the herbal formula does not cause harmful side effects. The researchers were able to measure the exact biochemical processes by which the herbal formula exhibited its effects and suggest that Gui Zhi Fu Ling Wan causes genotoxic stresses on highly replicating cancer cells. The highly targeted genotoxic effects of Gui Zhi Fu Ling Wan damage the DNA of aggressive cancers cells thereby eliminating them and preventing them from replicating while leaving healthy cells unharmed. Gui Zhi Fu Ling Wan was discovered to activate CHK2 and P21, important proteins involved in cell cycle arrest, thereby interfering with the cell cycle progression of cancer cells.

• See my post on the recent Wall Street Journal article on cancer and Chinese herbology here.

• One study, investigating the effects of acupuncture on chemotherapy induced pain, found that the therapy reduced pain throughout the body, particularly in lower body neurapathies. The research, which can be read about here, found that,

...both the speed and intensity of nerve signaling improved in five of the six patients who had acupuncture, and the five patients also said that their condition had improved.

Among patients in the comparison group, nerve speed stayed the same in three, improved in one and decreased in one. Nerve intensity improved in two, decreased in two, and stayed the same in one. 

• A British study found that acupuncture can significantly improve fatigue, nausea and hot flash experiences after cancer chemotherapy. The study, which can be read about here, compared three groups of patients: one treated with acupuncture, one with acupressure and the final group only with 'sham' acupuncture' – acupuncture at fake points. The study showed dramatic differences in symptom improvement between the acupuncture groups and the other two.

. . . these studies show, acupuncture can reduce fatigue, anxiety, and even pain caused by chemotherapy cancer treatments. 

• A Yale study, readable here, evaluated hot flash reduction in breast cancer survivors and found that there was,

a 30 percent reduction of hot flashes for women receiving acupuncture. The women received traditional acupuncture points indicated for hot flashes and menopausal symptoms including acupuncture points for sleep disturbances, loss of concentration, pain, headaches, and anxiety. They received a total of eight, 20-30 minute, acupuncture treatments over a period of 12 weeks. 

In most cases, the use of the chemotherapy agent tamoxifen initially caused or intensified hot flashes. Other hormonal agents also caused the hot flashes. The study shows that acupuncture is an appropriate treatment protocol for women receiving chemotherapy for the treatment of breast cancer. The study also measured physical improvements for women receiving acupuncture over the control group, “There was a significant difference in the average physical quality of life scores from Week 1 to Week 11 in the Acupuncture Specific treatment group. This indicates the acupuncture treatment had an impact on physical symptoms separate from hot flashes.”

• The journal, Bioscience Trends has an article reviewing the evidence for herbal medical intervention as a complementary approach to chemo- and radiation therapies. As reported in the article (readable here):

By reducing side effects and complications during chemo- and radio- therapy, Chinese herbal medicines have a significant effect on reducing cancer-related fatigue and pain, improving respiratory tract infections and gastrointestinal side effects, protecting liver function, and ameliorating the symptoms of cachexia. (Chinese herbal medicines as adjuvant treatment during chemo- or radio-therapy for cancer. Biosci Trends. 2010 Dec;4(6):297-307).

• A research study on hot flashes and prostate cancer, readable here, and published in the International Journal of Radiation Oncology•Biology•Physics, found that, " 

Acupuncture provides long-lasting relief to hot flashes, heart palpitations and anxiety due to side effects of the hormone given to counteract testosterone, the hormone that induces prostate cancer

• Here is a nice overview of traditional Chinese medicine's approach to understanding cancer, including the emotional component: www.itmonline.org

• The Institute for Traditional Medicine discusses cancer and emotion from an Acupuncture/Chinese Medicine perspective: itmonline.org.

Breast Cancer Survival and Chinese Medicine 

• A study was conducted by the Cochrane Collaboration, a UK charity, focusing on reviewing health-specific scientific data, and reported here.

Scientists analysed data from seven studies involving 542 women with breast cancer. They concluded that Chinese medicines [herbal formula] may safely reduce the immuno-suppressive side effects of powerful anti-cancer drugs. These side effects include nausea, vomiting, fatigue, inflammation of the gut lining, reduced blood counts, and suppressed immune systems.

Lymphedema and Chinese Medicine

An unpleasant sequela to some breast cancer surgeries can be a painful, and disfiguring condition wherein the arms swell dramatically. This is due to the removal of the lymph nodes. This article discusses the acupuncture and herbal approaches available to deal with this problem. At itmonline.org

• Excerpted from WebMD.com: (see their site for the complete article at: webmd.com

Sept. 22, 2008 -- Acupuncture eases the hot flashes and night sweats common in women taking tamoxifen and Arimidex after breast cancer treatment.

In a clinical trial, acupuncture helped hot flashes as much as Effexor, the antidepressant currently prescribed for women suffering the menopausal side effects of anti-estrogen drugs.

Effexor itself has troubling side effects, but acupuncture doesn't, says study leader Eleanor Walker, MD, a radiation oncologist at Detroit's Henry Ford Hospital.

"With acupuncture you can get a treatment for those hot flashes that can alleviate them equal to drug therapy -- without side effects and with improved quality of life," Walker tells WebMD.

Men, too, can improve their sexual function with acupuncture treatment. Walker says acupuncture can ease the side effects of chemical castration -- androgen-deprivation therapy -- in men treated for prostate cancer.

• Excerpted from Medicine.net (see site for full article at: http://www.medicinenet.com/script/main/art.asp?articlekey=89904 ) 

• Acupuncture Eases Side Effects of Head, Neck Cancer Treatments

By Amanda Gardner

June 1 (HealthDay News) — Two of the more common and unpleasant side effects of treatment for head and neck cancer patients may be relieved by the ancient Chinese practice of acupuncture.

A new study found significant reductions in both dry mouth and pain and shoulder dysfunction after neck dissection in patients receiving acupuncture. 

• Excerpted from BreastCancer.org (see complete article at: breastcancer.org/treatment

"I had such miserable hot flashes from tamoxifen that I couldn't sleep. Finally, a friend suggested acupuncture. I was very skeptical—I couldn't believe these tiny needles would do anything. All I know is that it didn't hurt, and after four or five sessions, my hot flashes weren't gone, but they were certainly not as frequent or severe."
—Inez, breast cancer survivor 

• From an Acupuncture Today article. (For full article see: acupuncturetoday.com

Yet ... as an adjunctive therapy, acupuncture also can help cancer patients endure and recover from the ravages of cancer treatment. Vivien Griffiths, PhD, an acupuncturist and coordinator of postgraduate studies and the master's of health science in acupuncture program at Australia's Southern Cross University, is also a breast cancer survivor. When she was diagnosed two years ago, Vivien said she initially didn't consider acupuncture a primary treatment due to the shock and expediency of her diagnosis. She had the opportunity to undergo surgery and chose to have the tumor removed. Although unsure, she chose chemotherapy,as well. Due to the side-effects of the chemotherapy, she then sought an acupuncturist who was prepared to become involved in her recovery plan.

Following the mastectomy, her own personal acupuncturist used needles coupled with electrical stimulation at the leading edges of her surgical scar. Within 12 hours, the scar changed color from blue to a warm pink, and her pain related to movement greatly lessened. This improvement allowed her to undertake lymphatic drainage therapy and more vigorous physiotherapy.

Dr. Griffiths believes there is enormous potential for using acupuncture for post-cancer patients: first, to enhance the immune system of clients who are immunosuppressed (by chemotherapy and radiation) to assist their own bodies staying in remission; and second, for preventive care.

"As a cancer patient, you receive a cancer diagnosis and a whirlwind of activity begins: constant tests, surgery, chemotherapy, radiation," she said. "But once the cancer is arrested, it's a long struggle to regain the health one had prior to the diagnosis. It seems as if having a strong, healthy immune system is not perceived as 'that important' by conventional medicine. You're sent on your way and told to report back for a check-up once a year. You hold your breath hoping the cancer doesn't return. When you get a good result from your check-up, you think 'Thank God, I've got another year.' Your life depends on those words 'in remission' or 'clear.' Who or what is helping cancer survivors to stay in that category?"

• From ABCnews.com (for complete article see: abcnews.go.com

New research suggests that acupuncture, an ancient Chinese form of healing, is as good or better than modern medicine in helping ease the side effects of breast cancer treatment. Researchers say acupuncture, which has been around for thousands of years, can give cancer patients a wide range of benefits. Dr. Barrie Cassileth, chief of integrative medicine services at Memorial Sloan-Kettering Cancer Center in New York, shares her advice and answers common questions about acupuncture for cancer patients.

• From ScienceDaily.com (for complete article see: sciencedaily.com

ScienceDaily (Apr. 25, 2009) — Twice weekly acupuncture treatments relieve debilitating symptoms of xerostomia - severe dry mouth - among patients treated with radiation for head and neck cancer, researchers from The University of Texas M.D.Anderson Cancer Center report in the current online issue of Head & Neck.

"The quality of life in patients with radiation-induced xerostomia is profoundly impaired," said Chambers, the study's senior author. "Symptoms can include altered taste acuity, dental decay, infections of the tissues of the mouth, and difficulty with speaking, eating and swallowing. Conventional treatments have been less than optimal, providing short-term response at best."

M. Kay Garcia, LAc, Dr.P.H., a clinical nurse specialist and acupuncturist in M.D.Anderson's Integrative Medicine Program and the study's first author, noted that patients with xerostomia may also develop nutritional deficits that can become irreversible. The twice weekly acupuncture treatments produced highly statistically significant improvements in symptoms. Measurement tools included: the Xerostomia Inventory, asking patients to rate the dryness of their mouth and other related symptoms; and the Patient Benefit Questionnaire, inquiring about issues such as mouth and tongue discomfort; difficulties in speaking, eating and sleeping; and use of oral comfort aids. A quality-of-life assessment conducted at weeks five and eight showed significant improvements over quality-of-life scores recorded at the outset of the study.

• From the National Cancer Institute: (for complete article, see: www.cancer.gov

Acupuncture, a complementary and alternative (CAM) therapy used in cancer management, has been used clinically to manage cancer-related symptoms, treat side effects induced by chemotherapy or radiation therapy, boost blood cell count, and enhance lymphocyte and natural killer (NK) cell activity. In cancer treatment, its primary use is symptom management; commonly treated symptoms are cancer pain,[4,5] chemotherapy-induced nausea and vomiting, [6] and other symptoms that affect a patient’s quality of life, including weight loss, anxiety, depression, insomnia, poor appetite, and diarrhea. [7-9] Acupuncture is generally accepted by children aged 10 years and older.[10]

• From Acupuncture Today, citing the Canadian Cancer Society: (for complete article, see: acupuncture.com/

Acupuncture for various stages of cancer
For conditions where the cancer is detected early, acupuncture can maintain and promote the normal functioning of the body.(10) Several studies done primarily on animals have shown its ability to boost the immune system and encourage the growth of healthy functioning cells.(3) This could be important for counteracting the result of radiation and chemotherapy that tend to attack both normal and abnormal cells. An additional benefit of acupuncture is that it can induce a state of deep calm and relaxation and alleviate physical and emotional tensions.

In cases where a tumour has formed, acupuncture can be used pre- and post-operatively where appropriate as an adjuvant therapy to surgery, radiation, or chemotherapy.(10) According to a study done by Poulain (1997) on 250 patients who underwent gynecological surgery for cancer, acupuncture was shown to speed recovery time.(11) A recent study done by Aldridge (2001) on a series of 40 breast cancer patients, found that acupuncture could reduce nausea and vomiting following surgery and significantly reduce post-operative pain.(12)

For advanced stages of cancer, acupuncture can be used in conjunction with other forms of palliative care to significantly reduce the sensation of pain.(10) In some cases, patients may be able to reduce the dosage of pain medication substantially and thereby avoid the harsh side effects that are often associated with them.(11)

• Metastatic Bone Cancer

abstracted & translated by Bob Flaws, Lic. Ac., FNAAOM (USA), FRCHM (UK)

excerpted from BluePoppy.com

Metastatic bone cancer occurs when cancer cells from the original tumor area travel (or metastasize) through the body and move into the bone. Metastatic lesions are common with cancer of the breast, lung, prostate, kidney, and thyroid. One of the main symptoms of bone cancer is bone pain. The treatment of cancer of the bone, especially metastatic cancer, has two goals: 1) management of the neoplasm and 2) management of the symptoms produced by the local lesion. Prognosis is affected by a patient’s age, the size of the primary tumor, grade and stage, degree of lymphatic and blood vessel invasion, the duration of symptoms and the location of the tumor on the arm, leg, or trunk. There are two ways bone metastasis is treated in standard Western medicine. Systemic therapy, aimed at cancer cells that have spread throughout the body, includes chemotherapy, hormone therapy, and immunotherapy. Local therapy, aimed at killing cancer cells in one specific part of the body, includes radiation therapy and surgery. At present, there is no cure for metastatic bone disease.

On pages 16-17 of issue #1, 2005 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Wang Yun-qi, of the Hunan Provincial Tumor Hospital, published an article titled, "Clinical Observations on the Treatment of 30 Cases of Metastatic Bone Cancer with Yang He Tang Jia Wei (Yang-harmonizing Decoction with Added Flavors) Combined with 99m Technetium-Methylene Diphosphate [TC-MDP] Compared to 30 Cases Only Treated with TC-MDP." Since this study suggests that the combination of Chinese herbal medicine in tandem with chemotherapy gets better results than chemotherapy alone in the treatment of metastatic bone cancer, a summary of this study is presented below.

• Acupuncture & Late Stage Digestive Tract Cancer Lack of Appetite (Treated by Acupuncture)

Abstracted & translated by Honora Lee Wolfe, L.Ac., FNAAOM (USA)

Excerpted from BluePoppy.com

On pages 67-68 of issue #4, 2006 of Xin Zhong Yi (New Chinese Medicine), Li Pei-xun and Jia Ying-jie of the First Affiliated Hospital of the Tianjin College of Chinese Medicine published an article titled, "Observations on the Therapeutic Effects of Treating 27 Cases of Late Stage Digestive Tract Cancer Lack of Appetite with Acupuncture." A summary of this study is presented below.

Cohort description:

Altogether, there were 50 cases of late stage digestive tract cancer anorexia enrolled in this two-wing comparison study. These were randomly divided into a treatment group of 27 cases and a comparison group of 23 cases. In the treatment group, there were 17 males and 10 females 45-76 years of age, with an average age of 54.8 years. Six of these cases had large intestine cancer, six had various types of stomach cancer, three had pyloric cancer, two had pancreatic cancer, and 10 had liver cancer, with 15 cases having accompanying cancer in the abdominal lymph nodes, four having multiple metastases to the abdominal cavity, and six cases having recurrences after surgery. In the comparison group, there were 14 males and nine females 43-75 years of age, with an average age of 54.3 years. Five of these had large intestine cancer, four had various types of stomach cancer, two had pyloric cancer, two had bile duct cancer, one had pancreatic cancer, one had esophageal cancer, and eight had liver cancer. Eleven cases had abdominal cavity lymph node involvement, four had intra-abdominal metastases, and five had recurrences after surgery. Therefore, the two groups were judged to be statistically comparable for the purposes of this study.

• A Study on the Integrated Chinese-Western Medical Treatment of Prostate Cancer

excerpted from BluePoppy.com

abstracted & translated by Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

Study outcomes:

1. Quality of life

The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) was administered before and after treatment. Marked effect was defined as 20 point of more increase in score after treatment. Some effect was defined as a 10-20 increase in score, and no change was defined as an increase of 0-9 points after treatment. After treatment for 12 months using the above treatment protocol, 115 cases (81.0%) experienced some improvement in their quality of life. In addition, 22.4% had developed hot flashes, 13.8% had developed osteoporosis, and 11.7% had developed breast swelling and pain.

2. Survival rate & PSA relapse (i.e., time to progression [TTP])

These 142 cases were followed up for 1-50 months. During that time, 16 patients died. Therefore, the total survival rate was 88.73%. The overall average survival time was 27.7 months. The overall average time of non-progression of disease was 25.2 months. Among the 21 cases who were T3-4NxM1c, their condition did not progress for an average of 24.3 months. In addition, after castration and a PSA of 0, their PSA relapsed within a median of 23.9 ± 19.2 months, while their PSA increased within a median of 24.1 ± 20.4 months. Among the 110 cases who were T3-4NxM1b, their condition did not progress for an average of 24.3 months. Further, after castration and a PSA of 0, their PSA relapsed within a median of 20.1 ± 15.2 months, while their PSA increased within a median of 22.3 ± 17.4 months.

3. Bone metastases & emission computed tomography (ECT) bone scan

In the 110 patients who were T3-4NxM1b with bone metastases, those metastases disappeared in four cases and shrunk or became paler in 79 cases, in 18 cases, there was no further spread or increase, and in the other nine patients, there were no new metastases seen. Prior to treatment, the mean number of metastases seen with ECT was 7.6 ± 4.7. After 12 months of treatment, it was 3.4 ± 1.7; after 24 months of treatment, it was 2.6 ± 1.4; and after 36 months of treatment, it was 4.8 ± 2.1.

4. Changes in blood analysis from before to after treatment

The following table shows mean numbers of white blood cells (WBCs), hemoglobin (Hb), and blood platelet count (BPC) from before to after treatment.

Blood factor Before tx At 12 months At 24 months At 36 months WBC (x109/L) 6.47 ± 2.35 7.32 ± 2.51 7.46 ± 1.94 7.37 ± 2.15 Hb (g/L) 106 ± 12 120 ± 11 128 ± 14 121 ± 12 BPC (x109/L) 206 ± 14 231 ± 23 227 ± 25 224 ± 16

Based on these outcomes, after treatment for 24 and 36 months, WBCs were markedly higher than before treatment. In addition, at 12, 24, and 36 months of treatment, both Hb and BPC were markedly higher than before treatment.

Discussion:

According to its authors, this study was designed to see if standard Western medical treatment combined with Chinese medical therapy to support the righteous and repress cancer (fu zheng yi ai) can improve the survival rates, quality of life (QL) and time to progression (TTP) of prostate cancer as well as mitigate some of the common side effects of the standard Western medical care for this difficult-to-treat disease. The supplementing or righteous-supporting medicinals in the above formula have an immune-modulating effect and can strengthen and increase lowered physical immunity. Hence, clinically, it was demonstrated that the above protocol did markedly increase WBCs, Hb, and BPC after treatment. On the other hand, Chinese medicinals which disinhibit dampness, dispel stasis, and clears heat and resolve toxins have been shown to either suppress or kill prostate cancer cells. In particular, Bai Hua She She Cao has been shown to promote prostate cancer cell apotosis (death). The authors of this study conclude that the combination of Chinese medicinals to support the righteous and repress cancer with standard Western medical care can increase the survival rate and markedly improve quality of life in patients with prostate cancer.

• Post Breast Cancer Chemotherapy Leukopenia & Acupuncture

excerpted from BluePoppy.com

abstracted & translated by  Bob Flaws, L.Ac., FNAAOM (USA), FRCHM (UK)

On page 46 of issue #1, 2008 of the Zhe Jiang Zhong Yi Za Zhi (Zhejiang Journal of Chinese Medicine), Wu Jian-jun and Cheng Ling-juan published an article titled “The Treatment of 21 Cases of Post Breast Cancer Chemotherapy Leukopenia by Acupuncture-moxibustion at Zu San Li.” Leukopenia is a common term to describe a low white blood cell (WBC) count. A summary of this article is presented below.

Study outcomes:

Outcomes criteria were based on those found in Zhong Yao Xin Yao Lin Chuang Yan Jiu Zhi Dao Yuan Ze (Reference Principles for Chinese Medicinal & New Medicinal Clinical Research). After 1-2 courses of treatment, 19 cases experienced a marked effect. This meant that their WBCs increased to 4.0 X 109/L and remained at that level for at least one week after stopping treatment. In addition, there was a marked reduction in these patients’ clinical signs and symptoms. One other case got some effect. This meant that their WBCs were still slightly less than 4.0 X 109/L. However, they had increased after treatment by 0.5-1.0 X 109/L, this increase had remained stable for one week after cessation of treatment, and their signs and symptoms had improved. The last case got no effect. This meant that their WBCs were still less than 4.0 X 109/L and had only increase by less than 0.5 X 109/L and there was no improvement in their clinical signs and symptoms. Therefore, the total effectiveness rate was 95.24%.

Discussion:

Leukopenia after chemotherapy for breast cancer is a commonly seen complication of that treatment. In Chinese medicine, this condition corresponds to the traditional Chinese disease category of vacuity taxation and is mostly the result of qi and blood dual depletion. Zu San Li. Moxibustion at Zu San Li can prevent disease and improve health as well as strengthen the patient’s immune function. It has the function of supplementing vacuity and boosting the qi. Moxibustion is able to warm and supplement the spleen and kidneys in order to promote the engenderment and transformation of the qi and blood. When patients’ righteous qi is vacuous and weak, this point should be needled lightly with mild hand techniques in order to diffuse and scatter evils but without further damaging the righteous qi. As stated in the Ling Shu (Magic Pivot), “When the vessels are replete, needling deeply drains this qi; when the vessels are vacuous, needling shallowly promotes the essence qi without obtaining its discharge.” When Zu San Li is needled along with other points based on following the patient’s personally presenting signs and symptoms, it treats post-chemotherapy leukopenia relatively well. Therefore, the two Chinese authors of this study think that it should be more widely used by other practitioners.

From the journal Lung Cancer: excerpted from Pubmed:

• Oral Chinese Herbal Medicine (CHM) as an Adjuvant Treatment During Chemotherapy for Non-Small Cell Lung Cancer

Chen S, et al. School of Medicine, University of Southampton, Southampton, UK.

Non-small cell lung cancer (NSCLC) remains a major global health problem because of its prevalence and poor prognosis. Treatment options are limited and there is a need to explore alternatives. This systematic review evaluates the role of Chinese herbal medicine (CHM) in association with chemotherapy for NSCLC. METHODS: English and Chinese databases were searched for RCTs comparing CHM with conventional biomedical treatment or placebo. Papers were reviewed systematically and data were analyzed using standard Cochrane software Revman 5. RESULTS: Fifteen Chinese trials involving 862 participants met the inclusion criteria. All trials were of poor quality with a considerable risk of bias. There was a significant improvement in quality of life (QoL) (increased Karnofsky Performance Status) (RR 1.83, 95% CI 1.41-2.38, p<0.00001 for both stages III, IV only NSCLC and all stages NSCLC) and less anaemia (RR 0.37, 95% CI 0.15-0.91, p=0.03 for stages III, IV only NSCLC; p=0.005 for all stages NSCLC) and neutropenia (RR 0.42, 95% CI 0.22-0.82, p=0.01 for stages III, IV only NSCLC; p<0.00001 for all stages NSCLC) when CHM is combined with chemotherapy compared to chemotherapy alone. There was no significant difference in short term effectiveness and limited inconclusive data concerning long term survival. Five promising herbs have been identified. CONCLUSION: It is possible that oral CHM used in conjunction with chemotherapy may improve QoL in NSCLC. This needs to be examined further with more rigorous methodology.

Lung Cancer. 2009 Dec 14.

• From the journal Agricultural Food Chemistry. Excerpted from PubMed

Anticancer Effects of Flavonoid Derivatives Isolated from Millettia reticulata Benth (Ji Xue Teng) in Hepatocellular Carcinoma Cells. Fang SC, et al. Department of Food Nutrition, Chung Hwa University of Medical Technology, 89 Wenhwa First Street, Tainan 71703, Taiwan.

Millettia reticulata Benth is cultivated in Asian countries. M. reticulata Benth has multiple biological functions and is one of the oldest tonic herbs in traditional Chinese medicine. It has been elevated to one of the most commonly used herbs in modern Chinese medicine. The aims of this work were to study the in vitro anticancer activity of flavonoid derivatives isolated from the stems of M. reticulata Benth. Six flavonoid derivatives including (-)-epicatechin (1), naringenin (2), 5,7,3',5'-tetrahydroxyflavanone (3), formononetin (4), isoliquiritigenin (5), and genistein (6) were isolated from the stems of M. reticulata Benth. The structures of 1-6 were determined by spectroscopic methods. The effects of flavonoid derivatives (1-6) on the viability of human cancer cells (including HepG2, SK-Hep-1, Huh7, PLC5, COLO 205, HT-29, and SW 872 cells) were investigated. The results indicated that genistein (6) had the strongest inhibitory activity with an IC(50) value of 16.23 muM in SK-Hep-1 human hepatocellular carcinoma cells. Treatment of SK-Hep-1 cells with genistein (6) caused loss of mitochondrial membrane potential. Western blot data revealed that genistein (6) stimulated an increase in the protein expression of Fas, FasL, and p53. Additionally, treatment with genistein (6) changed the ratio of expression levels of pro- and anti-apoptotic Bcl-2 family members and subsequently induced the activation of caspase-9 and caspase-3, which was followed by cleavage of poly(ADP-ribose) polymerase (PARP). These results demonstrate that genistein (6) induces apoptosis in SK-Hep-1 cells via both Fas- and mitochondria-mediated pathways.

J Agric Food Chem. 2009 Dec 8.

• Another source on this information, Oncology Nurse Advisor recommends acupuncture to manage symptoms of cancer, including fatigue. This is based on many sources, including a UCLA acupuncture study with cancer patients which found that, 

Fatigue was reduced by 66% among the study participants in the treatment group.

• From the June 2011 edition of the journal, Acupuncture Medicine, comes a study of acupuncture for people in the terminal stages of cancer. The study found that there was a significant reduction in symptoms (pain, nauseau, fatigue) when working in this type of palliative care setting. A synopsis can be read here.

Patients with advanced incurable cancer appear to benefit from incorporating acupuncture in their treatment.

 

• File under reductionist advances: a study from the National Center for Biotechnology Information/National Institutes for Health found that the Chinese herb Yuan Zhi (Coriolus versicolor) offered a very strong immune enhancing property for survivors of cancer. In general, acupuncturists combine Yun Zhi with other ingredients in formulae that are tailored to the specific cancer and constitutional type of the patient. Still, this is yet another supportive piece of data which underscores the use of Chinese medicine for cancer and for preventing recurrences of cancer. The study, which can be read about here, concluded that,

This meta-analysis has provided strong evidence that Yun Zhi would have survival benefit in cancer patients, particularly in carcinoma of breast, gastric and colorectal. Nevertheless, the findings highlight the need for further evidence from prospective studies of outcome to guide future potential modifications of treatment regimes. Recent patents on the use of mushrooms for the treatment of cancer are also summarized in this review.

• Researchers from the University of Machester studied cancer, anxiety, fatigue when treated with acupuncture. (you can read about it here).

[They recruited]302 volunteers diagnosed with breast cancer. Seventy-five of the patients received the standard care, while the remainder received acupuncture in addition to their regular medical treatments. Treatment was delivered by acupuncturists once a week for six weeks. At the end of the study, the patients who received acupuncture showed improvements in the “General Fatigue” score on the Multidimensional Fatigue Inventory (MFI). They also reported less pain, less anxiety and depression, and an improved quality of life.

"I am quite excited with these results. They provide some good evidence of an effect of acupuncture for the management of a very debilitating and burdensome symptom for patients," said Dr. Molassiotis. "Acupuncture is a complementary therapy that not only can have direct effects on the symptom experience of patients, but also ... provide the opportunity [for] patients to be more involved with their symptom management and empower them more.

Fibromyalgia as Treated by TCM

Acupuncturists are often called upon to treat fibromyalgia, a complex of symptoms that frequently include muscle and joint pain; sensitivity to pressure; symptoms of the nervous system, such as numbness and tingling; fatigue; and bowel and bladder problems.  

Image copied from http://commons.wikimedia.org/wiki/File:Symptoms_of_fibromyalgia.png

Using a combination of acupuncture and highly tailored herbal approaches we can almost always remedy this problem for our patients.

From a UK acupuncturist's website comes these western research stubs:

(1) A new study has been carried out to assess the effectiveness of acupuncture in treating pain levels and decreasing the number of tender points in fibromylagia patients. Twenty nine patients with at least a six year history of fibromylagia were given acupuncture and tested by using a pain scale and by dolorimetry (a method of measuring pain perception in degrees ranging from unpleasant to unbearable by using heat applied to the skin). No other pain medication was taken. Pain levels were found to decrease from 64.0 to 34.5 after acupuncture, with a decrease in the number of tender points from 16.0 to 11.8. Results also showed an increase in certain blood chemicals (serotonin and substance P) which help to regulate pain. (Pain treatment of fibromyalgia by acupuncture. Sprott H, Franke S, Kluge H, Hein G. Rheumatol Int 1998;18(1):35- 36).

(2) A recent review of the literature on the treatment of fibromyalgia using acupuncture showed improvements in the myalgic index, in the number of trigger points, and in quality of life for the patients. (Current Pain Headache Report 2002;6(5):379-83).

The well regarded Cochrane Report reviewed much of the quality research on fibromyalgia and acupuncture and created a consensus report, which can be viewed here and suggests a strongly positive therapeutic role for acupuncture and Chinese medicine in treating this disorder.

Parkinson's, Acupuncture and Chinese Medicine

Parkinson's disease (PKD) is a progressive degenerative neurological disorder characterized by muscle rigidity, tremor,  slowing of movement and, in extreme cases, nearly complete loss of movement (akinesia).  The initial cause of the disease is still unknown, from a Western medical perspective.

However the effects are quite clear: there is a gradual loss of the neuronal cells which secrete dopamine in the part of the brain called the substantia nigra.

Many people suffering from the effects of PKD seek out the help of an acupuncturist and this is because Chinese medicine can be very useful in dramatically slowing and, in many cases reversing many of the symptoms of the disease. Depending on where a person is in the disease process, we can often slow the need for more or higher dose of drugs. In many cases, I have had had clients able to reduce the amount of pharmaceuticals and thus spare themselves the side effects of those drugs.

Research/Articles/And a nice letter from a patient

University of Arizona doctors find acupuncture effective for the treatment of balance and gait disorders in Parkinson’s disease patients. 

 A study from physicians at the University of Arizona revealed that:

Balance, gait and stride length were all significantly improved by the application of acupuncture. Use of a sham acupuncture control group eliminated the possibility of the placebo effect. As a result, the researchers concluded, “(acupuncture) is an effective therapy in improving certain aspects of balance and gait disorders in PD (Parkinson’s disease).” 

A testimonial from the daughter of one of my patients:

 Speaking of Care: Bonnie and Parkinson's (http://speakingofcare.blogspot.com/p/bonnie-and-parkinsons.html)

Mom was diagnosed with Parkinson’s in 2001.  I was studying abroad in England at the time, and while it certainly was disconcerting, it wasn’t exactly a surprise.  I had noticed nondescript symptoms for over a year- she was easily f

atigued, her handwriting was getting hard to read, and it was taking longer to do routine tasks.  Aside from getting assessments and care plans from a variety of neurologists and specialist, Mom made a point of getting regular bodywork at Ohashiatsu Chicago (now Zen Chicago).  Besides providing stimulation for her muscles and nervous system, the therapists at Ohashiatsu were the first to suggest acupuncture, and recommended Mark Reese at the Northside Holistic Center. 

Fast-forward nine years.  Mom has gotten weekly treatments from Mark and takes a steady course of Chinese herbs and supplements in addition to her three Western drugs.  She is taking relatively low doses of Amantadine, Azilect, and Requip, which act as both neuroprotectors and dopamine agonists.  Her Western doctors can’t believe how well she is doing on such a small amount of medication- Parkinson’s drugs are difficult because the body gets used to the dosages and they need to be increased, but there is only so high you can go.  Many patients max out and need to seek out alternate treatments, such as Deep Brain Stimulation.  

It’s not been without low periods- there were times when she couldn’t drive for months, had no energy whatsoever, or couldn’t dress herself.  We’ve looked seriously into moving her into a nearby assisted living facility.  But for now, she rents out my old bedroom and the whole third floor to boarders through Interfaith Housing Center so I feel comfortable knowing somebody is there.  I swing by often enough to help with small things, like opening jars and changing light bulbs, and am there for all the big things, like doctor appointments. 

I truly believe getting acupuncture therapy from the beginning has bought Mom dozens of years of quality of life. Mark has degrees in Microbiology and Biochemistry, and an impeccable understanding of the body’s energy and functioning.  I see immediate results after she has a treatment, and she doesn’t have the side effects associated with her drugs: nausea, lethargy, and confusion.  I call him Mark the Magician and can’t speak highly enough of him. 

• A study [which can be read here] examines the role of one important herb, Gou Teng, which is frequently included in our formulae for PKD. While it is almost never the case that we use only one ingredient in a formula, most having between 10-30 ingredients, this is an important bit of research which underscores our overall effectiveness by examining one mechanism for our success. The study found that:

... patients who took Gouteng together with levodopa experienced fewer side effects from the drug while showing a marked improvement in their communication skills.

• A recent study highlights the use and mechanism of acupuncture in managing Parkinson's. In particular, the brain protective aspect via an antioxidant effect is deliniated. A summary of it can be read here. The conclusion reads:

Researches determined that stimulation of St36 and Sp6 with electroacupuncture protects the brain by creating antioxidative and antiapoptosis effects. The electroacupuncture protected a part of the mid-brain called the substantia nigra. The substantia nigra is an important part of the brain in controlling movement. Parkinson’s disease is caused by the deterioration of dopaminergic neurons in a part of the mid-brain called the substantia nigra pars compacta.

An interesting study of Parkinson's disease demonstrating an improvement in symptom profile, decrease in the need for pharmaceutical intervention and delay in disease progression. Reprinted on the National Institutes of Health (NIH) website: J Tradit Chin Med. 2000 Dec;20(4):265-7. 

Acupuncture treatment of Parkinson's disease--a report of 29 cases. Zhuang X, Wang L. Second Clinical College, Nanjing University of Traditional Chinese Medicine and Pharmacy:

It can be concluded that acupuncture possesses definite therapeutic effectiveness for Parkinson's disease, which is mainly represented by improvement in the clinical symptoms and signs, delaying of the disease's progression, decrease in the dosage of anti-parkinsonian drug, and expectant treatment of the complications and symptoms induced by the drug side-effects.

•The Institute for Traditional Medicine (ITM) published an essay which aggregates many protocols for the treatment of Parkinson's disease along with a  concise description of how Traditional Chinese Medicine (TCM) frames Parkinson's disease. The essay is entitled,Parkinson's Disease: Possible Treatment with Chinese Medicine, and can be read in full here.

•From a study reprinted on the Michael J. Fox Foundation's website: Acupuncture May Be Effective in Treating Parkinson's. This study examines the use of acupuncture in murine models in an attempt to understand the mechanism by which acupuncture may be useful in treating Parkinson's disease. The lead researcher, Sabina Lim, summed up her experience by saying:

The mechanism behind this effect is still unknown, but . . . because inflammation in the brain often accompanies and worsens other symptoms of Parkinson's disease, acupuncture might maintain dopamine levels by preventing inflammation.

•From ScienceDirect.com comes an abstract from the Journal of Traditional Medicine (JTM) which shows an extremely dramatic change in motor function in Parkinson's disease patients using acupuncture. The summary states:

Acupuncture can enhance therapeutic effects of western medicine and lessen the dose of the medicine needed." The research showed a 92% improvement in the study group.

•From the journal Nature comes a summary of research which shows:

Acupuncture appears to normalise levels of dopamine in the brain. However, from other studies we know that this is not the only brain chemical which levels seem to be restored by acupuncture. Strong indications exist for endorphin and melatonin (J. S. Han et al. Trends Neurosci. 26, 17, 2003; D. W. Spence et al. J. Neuropsychiatry Clin. Neurosci. 16, 19, 2004). Furthermore, it was found that acupuncture normalises levels of among others norepinephrine, dopamine, ACTH and corticosterone (S. H. Han et al. Physiol. Behav. 66, 217, 1999).

• These findings are of particular interest not only for patients with Parkinson’s disease, but also indicate that acupuncture could have a positive influence on other patient groups as well. There is, for instance, a growing body of literature pointing to a dysregulation of the dopaminergic and stress systems in schizophrenia (L. J. Phillips et al. Aust. N. Z. J. Psychiatry 40, 725, 2006; M. Laruelle et al. Ann. N. Y. Acad. Sci. 1003,138, 2003). Further scientific research based on thorough western methods is therefore necessary, and promising.

• From Neuroscience Letters comes a more technical article entitled: Effect of acupuncture on 6-hydroxydopamine-induced nigrostratal dopaminergic neuronal cell death in rats. The gist is that the stimulation of one particular acu-point prevented damage of the cells in the brain which are destroyed during the Parkinson's disease process:

In this study, we investigated the effect of acupuncture at the Zusanli acupoint (ST36) on the nigrostriatal dopaminergic neuronal cell death in the rats with Parkinson's disease. Two weeks after unilateral injection of 6-hydroxydopamine (6-OHDA) into the striatum, an apomorphine-induced rotational behavior test showed significant rotational asymmetry in the rats with Parkinson's disease. Immunostaining for tyrosine hydroxylase demonstrated a dopaminergic neuronal loss in the substantia nigra and dopaminergic fiber loss in the striatum. Acupuncture at the ST36 for 14 days significantly inhibited rotational asymmetry in the rats with Parkinson's disease, and also protected against 6-OHDA-induced nigrostriatal dopaminergic neuronal loss. These effects of acupuncture were not observed for the non-acupoint (hip) acupuncture. The present study shows that acupuncture at the ST36 acupoint can be used as a useful strategy for the treatment of Parkinson's disease.

• From the journal  Proteomics comes an article analyzing a single acupoint and it's effects upon preventing the degeneration of dopamine in the substantia nigra,

• These results suggest that acupoint GB34-specific [acupuncture stimulation] changes protein expression profiles in the SN [substantia nigra] in favor of DA [dopaminergic neurodegeneration] neuronal survival in MPTP-treated mice, and that [acupuncture] treatment may be an effective therapy for PD patients.

How Acupuncture can influence Fertility

At the Northside Holistic Center, a large part of my practice involves helping families conceive when fertility has been elusive. Although so much as already been written in both the scientific, as well as the popular literature, about using acupuncture and herbology to influence both women and mens' reproductive health I wanted to touch upon how we approach this issue at the Northside Holistic Center.

The crux of any Chinese medical treatment is an evaluation of the whole patient. This includes asking questions about issues which may not immediately seem relevant to fertility, such as inquiries into digestive health, the client's energy, skin, respiratory health, and temperature sensitivities. From there, a practitioner will ask deeper questions about the menstrual cycle and what outcome previous attempts at pregnancy have resulted in since, for example, we often see clients who conceive with little difficulty but are prone to miscarriages and we can very often dramatically help with this as well.

Research and Other Articles:

• A new article citing research published in the Journal of Clinical Acupuncture found that acupuncture and Chinese herbology was more than twice as effective as IVF and drug therapies for helping couple conceive a child.  

  The alternative treatment was compared to popular drugs used to boost ovulation with scientists finding acupuncture increased the chance of pregnancy to 43.3 per cent compared to 20 per cent through the medication.

  Women who struggle with infertility caused by hyperprolactinemia can be helped by acupuncture, a new study has found

  Dr Zhiguang Hu, who led the research conducted at the Mawangdui Hospital of Hunan Province in China, said: “One important mechanism responsible for the fertility treatment success with acupuncture is hormonal regulation.

• An Australian government funded study, which can be read about here, found that Chinese medicine (acupuncture and herbal therapy) essentially double the likelihood of fertility within a given menstrual cycle over a typical IVF treatment cycle. The study, which assembled a cohort of almost 2000 women found that acupuncture and Chinese medicine,

can improve pregnancy rates 2-fold within a 4 month period compared with Western Medical fertility drug therapy or IVF. Assessment of the quality of the menstrual cycle, integral to TCM diagnosis [Traditional Chinese Medicine], appears to be fundamental to successful treatment of female infertility. 

 A Brazilian study, evaluating IVF success when implantation had failed, found that acupuncture and an adjunctive Chinese medical treatment called moxabustion, dramatically increased the clinical pregancy rate in those that received acupuncture. The researchers concluded that,

...acupuncture and moxibustion increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF, when embryo implantation had failed.

• A recent article in the Times cited research from the University of Southampton demonstrating higher conception rates with women who used regular acupuncture treatment versus those who didn't. You can read the Times article here. 

• From an article on Acufinder.com, comes an overview of Chinese medicine and acupuncture and how it related to fertility, both unassisted and IVF and IUI. It also cites some of the available research which has been published on the subject. The whole article and the research summary can be seen at: www.acufinder.com. However two parts worth excerpting here are: 1. Mechanisms of action of acupuncture and Chinese medicine, 2. Things that the client can do. The Acufinder article begins by talking about what biomedical fertility experts think might be the mechanism of acupuncture on fertility:

"Acupuncture provides better circulation and better blood flow to the womb,” said Dr. Raymond Chang, director of New York's Meridian Medical Group, who has been incorporating acupuncture into fertility treatments for the past decade. "It will give a better chance for the eggs to be nourished and therefore carried." Acupuncture seems to help some women because it improves circulation to your ovaries and to your uterus. It aids ovarian stimulation, improves the thickness of uterine lining, and therefore can help with implantation. Acupuncture is relaxing, which helps to lower your cortisol levels and increase progesterone output, important factors in decreasing your chance of having a miscarriage.

 Western medicine works with an eye on the numbers. The main goal is to increase the quantity of eggs or sperm, thereby increasing your chances of a viable pregnancy. In contrast, Traditional Chinese Medicine is holistic and cumulative. It will likely include suggestions about diet and lifestyle as well as acupuncture. TCM is very personalized. Your practitioner will needle specific points and may suggest specific herbs, all depending on your body and your situation. When your body is healthy and balanced, you increase your chances of getting pregnant and producing a healthy child. The goal of acupuncture is to return your body to a state of health. The effects take time; the results get better over time. Even if your Western doctor does not understand the benefits of acupuncture, most physicians now agree that it does not cause harm.

• The article continues with good self help information which, from a Chinese medical perspective can change one's probablity of conceiving:

"Nourish the Soil before Planting the Seed”

Plan ahead. The ideal time to begin preparing your body for a baby is three months before conception or an IVF cycle. This is the time to begin acupuncture treatments, but many couples wait until they are actively trying to conceive. In my practice, I recommend twice weekly treatments until we get a positive pregnancy test and once a week for the first trimester to reduce the risk of miscarriage.

Of course, making good nutritional choices is always important for both mother and child. Specific suggestions can be found in one of my previous articles, “The ABCs of Fertility: Acupuncture, Babies, Chinese Medicine” which can be read on Acufinder.com and on tcm007.com

You can also help your body’s readiness by attending to the following suggestions:

1. Caffeine: Reduce or cut out coffee from your diet. A joint US/Swedish study of 562 women found that 1-3 cups of coffee increased miscarriage rate by 30% and more than 5 cups increased it by 40%. Also, in another study conducted during the first trimester of pregnancy, women who had a high caffeine intake showed an increased risk of repeated miscarriage.
2. Stress: Stress has been linked to irregularieties in ovulation and abnormal sperm development. When you can lower your levels of physiological stress, you have increased your chances of conception.
3. Sleep: Treatment in Chinese medicine always aims to improve your sleeping pattern. Lack of sleep has long been recognized as influencing fertility. It leads to physiological disruptions including the inhibition of growth hormones.
4. Alcohol: Women who drink alcohol may delay conception because it is poorly metabolised and can lead to a disturbance of the oestrogen/ progesterone balance. During IVF, men and women are both advised to avoid alcohol because, in women, it can lead to reduced egg production and, in men, it may reduce the number of healthy sperm.
5. Weight: Being too thin or too heavy can have an impact on how quickly you conceive. Excessive thinness is known to interfere with menstrual periods. Now, it is also believed that if both partners are overweight or obese, conception will take longer.
6. Smoking: Smokers have an increased rate of repeated miscarriage. Women smokers have been shown to have lower levels of oestrogen which may delay conception. Smoking is also thought to influence tubal factor infertility, and can cause early menopause. In men, smoking may damage sperm. When men stop smoking, their sperm count increases quickly.

References

1. Paulus, W., et al. Fertility and Sterility. April, Vol. 77 (4):721-724, 2002.
2. Dieterle,S., Ying, G., Hatzmann, W., Neuer, A. Fertility and Sterility, May, Vol. 85 (5):1347-135, 2006.
3. Westergaard, L., Mao, Q., et al. Fertility and Sterility, May, Vol. 85 (5): 1341-1346, 2006.
4. Smith, C., Coyle, M., et al. Fertility and Sterility, May, Vol. 85 (5) 1352-1358, 2006.
5. Pei, J., Strehler, E., Noss, U. et al. Fertility and Sterility, July, Vol. 84 (1), pgs. 141-7, 2005.
6. Cnattingius, S. et al, New England Journal of Medicine Vol.343(25):1839-1845, Dec., 2000.
7. George, L., et al. Paediatric and Perinatal Epidemiology, Vol. 20 (2): 119-126, March, 2006.
8. Ibid.

•  A Brazilian medical journal published the results of a study asessing the success rates of IVF with and without acupuncture, which can be read here, that found,

... acupuncture and moxibustion increased pregnancy rates when used as an adjuvant treatment in women undergoing IVF, when embryo implantation had failed.

• Tel Aviv University researchers have published an study in the Journal of Integrative Medicine, which can be read about here, finding that there was

... a significant increase in fertility when the therapies [acupuncture/herbology and IVF] are administered side-by-side.

In a retrospective study, Dr. Lev-Ari and Sela followed the progress of 29 women between the ages of 30 and 45 who were receiving IUI treatment combined with TCM therapy, and compared their results to a control group of 94 women between the ages of 28 and 46 who were undergoing IUI treatment alone. In addition to their IUI treatments, the 29 women in the first group received weekly sessions of acupuncture and a regime of Chinese medicinals, which consisted of powdered or raw Chinese herbs such as Peonia Albae and Chuanxiong, designed to meet each woman's specific needs. All herbal preparations were approved by the Israeli Health Ministry.

In terms of both conception and take-home baby rates, the test group fared far better than the control group. Out of the 29 women in the test group, 65.5 percent conceived, and 41.4 percent delivered healthy babies. In the control group, only 39.4 percent conceived and 26.9 percent delivered. The vast difference in success rates is even more surprising when the age of the average participant was taken into account, Dr. Lev-Ari and Sela note. "The average age of the women in the study group was 39.4, while that of the control group was 37.1. Normally, the older the mother, the lower the pregnancy and delivery rates," they explain.

In a retrospective study, Dr. Lev-Ari and Sela followed the progress of 29 women between the ages of 30 and 45 who were receiving IUI treatment combined with TCM therapy, and compared their results to a control group of 94 women between the ages of 28 and 46 who were undergoing IUI treatment alone. In addition to their IUI treatments, the 29 women in the first group received weekly sessions of acupuncture and a regime of Chinese medicinals, which consisted of powdered or raw Chinese herbs such as PeoniaAlbae and Chuanxiong, designed to meet each woman's specific needs. All herbal preparations were approved by the Israeli Health Ministry.

In terms of both conception and take-home baby rates, the test group fared far better than the control group. Out of the 29 women in the test group, 65.5 percent conceived, and 41.4 percent delivered healthy babies. In the control group, only 39.4 percent conceived and 26.9 percent delivered. The vast difference in success rates is even more surprising when the age of the average participant was taken into account, Dr. Lev-Ari and Sela note. "The average age of the women in the study group was 39.4, while that of the control group was 37.1. Normally, the older the mother, the lower the pregnancy and delivery rates," they explain.

• From the fertility jounal, Fertility and Sterility comes a research study demonstrating the effectivenss of using acupuncture to improve the quantity and health of sperm. At the Northside Holistic Center we often work with both the man and the woman in improving the probability of conception. An excerpt from the study: 

Higher sperm numbers and health can greatly enhance the chances of a conception in any given month. However, new research shows that acupuncture can significantly improve the quality and health of sperm. In a study published in Fertility and Sterility, researchers analyzed sperm samples from men with infertility of unknown cause before and after acupuncture treatments. They found that acupuncture was associated with fewer structural defects in sperm and an increase in the number of normal sperm. 

• This link is from a web page on infertility and acupuncture at the American Association of Oriental Medicine's website: www.aaaomonline.org. This  page is more of a listing of  articles by other members of  the American Association of Oriental Medicine on a broad range of topics related to fertility and Chinese Medicine.

• From Fertility and Sterility comes resul t that shows the couples using acupuncture and herbal strategies to conceive have an equal chance of success using such natural means as by using the Western medicine:

Chang noted in an interview with Reuters Health that one previous study has also shown that women who used acupuncture without any other fertility treatments were just as likely to conceive in the same period of time as women who took a fertility drug. This finding indicates that acupuncture for infertility “can be done as a stand-alone treatment,” he said.

• A research study found in a PubMed search found that, what they term, 'Luteal Phase Acupuncture' (which simply means performing acupuncture during this time in a woman's cycle) results in dramatically higher rates of successful pregnancy during IVF or ICSI.

A USA Today article on Fertility and acupuncture can be read here.