Acupuncture and Herbs Outperform Drug Therapy for IBS

Acupuncture and Herbs Outperform Drug Therapy for IBS

Acupuncture and herbs outperform drug therapy for the treatment of irritable bowel syndrome (IBS). Researchers compared two groups, one received acupuncture and herbal medicine and the other received drug therapy. The group receiving acupuncture and herbs had superior positive patient outcome rates. Acupuncture and herbs produced clinical outcomes yielding greater improvements in stool consistency and significantly greater reductions of abdominal pain, mucus in the stool, bloating, and bowel urgency.

Chongqing Nanchuan Hospital researchers started with a sample size of 126 human patients with IBS. The patients were randomly divided into the acupuncture plus herbs group and the drug group, with a total of 63 patients in each group. For both groups, there were improvements in abdominal pain and discomfort scores. However, the acupuncture plus herbs group demonstrated significantly greater clinical improvements. In addition, the group receiving acupuncture plus herbs had greater reductions of anxiety levels and behavioral disorders. The data indicates that the acupuncture plus herbs group had significant improvements in general psychological well-being and overall perceived energy levels.

IBS affects the large intestine and involves cramping, distention, diarrhea or constipation, and abdominal pain. Often, there is mucus in the stool and the condition is chronic. Exacerbating factors include specific foods, hormonal changes, stress, and secondary illnesses. IBS tends to occur in younger patients and the rate is double for women. IBS, when presenting as a long-standing illness, often involves dietary restrictions and accidental malnourishment caused by an attempt to avoid exacerbating foods. The long-standing nature of the illness may also contribute to mental depression. Two major types of diagnostic criteria define IBS, the Rome criteria and the Manning criteria.

For the Rome criteria, one important parameter is that abdominal pain lasts for a minimum of 3 days per month and involves at least two of the following: decreased pain after defecation, changes in frequency of defecation, changes in consistency of stool. The Manning criteria includes pain relieved by defecation but also takes into account mucus in stool, incomplete bowels movements, and variability of stool consistency. An MD may order a colonoscopy, sigmoidoscopy, lower GI series (liquid barium X-ray), or CT scan to confirm the diagnosis.

All participants and procedures were approved by the Chongqing Nanchuan Hospital medical ethics committee. All participants were volunteers with a diagnosis of IBS, prerequisite abdominal pain, and abnormal defecation. No participants were admitted to the study groups that had taken medications within three month prior to the investigation. Exclusion criteria involved several other parameters: mental illness, low blood pressure, history of abdominal surgery.

The sample size involved 67 males and 59 females, with an average age of 55 years. The average duration of IBS per patient was 31 years. After randomization into the two groups, there were no significant differences in terms of age, gender, and course of IBS duration.

The group receiving drug therapy was administered loperamide hydrochloride capsules (1 tablet, 3 times per day), 30 minutes before meals. In addition, they received 9 g of Si Shen Wan, two times per day. Loperamide hydrochlorida (trade name IMODIUM) is used to control diarrhea. Functionally, loperamide hydrochloride slows bowel movements to achieve its effective action. The drug may cause drowsiness, fatigue, or dizziness and is not recommended for breast-feeding mothers because the drug is transferred through the milk. In this acupuncture continuing education study, the group receiving acupuncture plus herbal medicine was administered the following medicinal formula (prepared in the form of a decoction):

Bai Zhu

Shan Yao

Bai Zhi

Chen Pi

Huang Qin

Chai Hu

Wu Mei

Gan Jiang

Zhi Gan Cao

Fang Feng

Based on diagnostics, modifications were made to the formula. For patients with severe diarrhea, Bai Bian Dou and Fu Ling were added. Zhi Ke, Fo Shou, and Mu Xiang were added for cases of pronounced abdominal swelling and pain. For mucus in the stool, Huo Po and Cang Zhu were added. Yu Li Ren was added for patients with constipation. The following protocolized set of acupuncture points were administered to the patients:

Shangjuxu, ST37 (Upper Great Void)

Quchi, LI11 (Pool at the Crook)

Dachangshu, BL25 (Large Intestine Shu)

Tianshu, ST25 (Heaven’s Pivot)

Sterile filiform acupuncture needles were used. At ST37, the needle insertion depth range between 1–2 inches. For LI11, the depth of insertion was 0.5–2 inches. For BL25, the insertion depth was 0.8–1.2 inches. For ST25, needle depth was 1–1.5 inches. Reinforcing and reducing manual acupuncture techniques were applied with twisting, lifting, and thrusting motions. Total needle retention time was 30 minutes per acupuncture visit. For both the drug and acupuncture plus herbs groups, the total treatment duration was 28 days. Dietary modifications for all patients in both groups included the following recommendations:

No raw, cold, or spicy food

Regulate consumption of food to moderate levels of intake

Regular meals consumed at regular intervals, 3 times per day

Non-oily, light foods that are easily digested are appropriate

Non-oily, light, and easily digested foods are appropriate

Several important findings were made. The acupuncture plus herbal medicine group had greater positive patient outcomes. In addition, the relapse rate was lower in the acupuncture plus herbs group than the drug group. The results indicate that acupuncture, herbs, and continuing patient education on dietary modifications is an effective integrative approach to patient care for patients with IBS.

Herbal medicine gained recognition for the treatment of IBS in the Journal of the American Medical Association (JAMA). The prestigious journal published the findings of an Australian randomized, double-blinded, placebo controlled study conducted by gastroenterologists and herbalists. The researchers concluded that Chinese herbal medicine “offer[s] improvements in symptoms for some The results reflect an enhanced positive patient outcome rate, which is consistent with the flexibility of the study design.patients with IBS.” The results reflect an enhanced positive patient outcome rate, which is consistent with the flexibility of the study design.

Reference:

Zhang Yousheng, Zhang Xiaodong, Investigation of the Effect on Treatment of Irritable Bowel Syndrome with Traditional Chinese Medicine and Acupuncture, Chongqing Nanchuan Hospital, 2016.

Sun YZ & Song J. (2014). Therapeutic Observation of Acupuncture at Jiaji (EX-B2) for Irritable Bowel Syndrome. Shanghai Journal of Acupuncture and Moxibustion. 34(9).

Zhongguo Zhen Jiu. 2012 Oct;32(10):957-60. [Meta analysis of acupuncture-moxibustion in treatment of irritable bowel syndrome]. Pei LX, Zhang XC, Sun JH, Geng H, Wu XL. Acupuncture and Rehabilitation Department, Jiangsu Province Hospital of TCM, Nanjing, China.

JAMA. 1998 Nov 11;280(18):1585-9. Treatment of irritable bowel syndrome with Chinese herbal medicine: a randomized controlled trial. Bensoussan A, Talley NJ, Hing M, Menzies R, Guo A, Ngu M. Research Unit for Complementary Medicine, University of Western Sydney Macarthur, Campbelltown, New South Wales, Australia.

Liu, Xiao-xia. “Moxibustion on Shenque (CV 8) improves effect of acupuncture for diarrhea-predominant irritable bowel syndrome.” Journal of Acupuncture and Tuina Science 12, no. 6 (2014): 362-365.

http://www.healthcmi.com/acupuncture-continuing-education-news

The Science of Acupuncture

The Science of Acupuncture

New CT scan technology reveals acupuncture points. Click the following to read the story: Acupuncture Point Discovery.

Researchers have discovered how to measure and validate the existence of acupuncture points and their meridians. MRI studies and oxygen sensor studies come from some of the most prestigious universities in the world. Today, I want to start with remarkable research from investigators at one of the most prestigious universities in Korea.

Sungkyunkwan University (Seoul) was founded in 1398. Yes, over 600 years ago! It was recently acquired by the Samsung Group in 1996, which has helped preserve its legacy of excellence with substantial financial support. The university is a leader in many fields including nanotechnology and natural sciences, features a dual degree program with Ohio State University and has a collaborative program with the MIT (Massachusetts Institute of Technology) Sloan School of Management.

Two researchers from Sungkunkwan Univeristy worked with another researcher from the Department of Chemistry and Nano Science at Ewha Womans University on this ground breaking research. Notably, Ewha Womans University is considered one of the most prestigious schools in Korea and produced Korea’s first female doctor, lawyer, justice on the Constitutional Court and the first female prime minister of Korea.

Why all the fuss about researchers and the schools they hail from? In the many years I have worked in Chinese and Oriental Medicine, I have uniformly come across skepticism and resistance to valuable, peer reviewed research. I want to give a little background before going forward with something as important as this research. For some it seems, no research institute or study is sufficient so long as it says something positive about acupuncture and herbal medicine. Ethnocentrism abound, I wanted to stave off imperious pans decrying putative proofs and to assuage presumptive skepticism and concomitant guetapens. Perhaps establishing the authenticity and seriousness of the institutions from which the research emanates helps equanimity to mollify incredulity and for rapprochement to exist between the skeptic and modern scientists whose works demonstrate the existence of acupuncture points and their functions.

The research from Sungkyunkwan University and Ewha Woman University is entitled Heterogeneity of Skin Surface Oxygen Level of Wrist in Relation to Acupuncture Point.[1] The study used an amperometric oxygen microsensor to detect partial oxygen pressure variations at different locations on the anterior aspect of the left wrist. The researchers concluded that partial oxygen pressure is significantly higher at acupuncture points.

Below are two images from the study measuring the increase of partial oxygen pressure combined with an overlay of the local acupuncture point locations. The images are representative of typical readings found in the study and remarkably map the Lung Hand Taiyin, Pericardium Hand Jueyin and Heart Shaoyin channels and their associated local points. Depicted are P7 and P6 clearly showing high oxygen pressure levels. The same is true for LU9, LU8, HT7, HT6, HT5 and HT4. Note that non-acupuncture point regions do not show higher oxygen pressure levels. These measurements are not needled points but are natural resting states of acupuncture points absent stimulation. This biomedical research gives us insight into the structural makeup of acupuncture points. This type of basic research is not isolated and numerous studies from multitudes of the top research centers and universities demonstrate specific properties and physiological actions of acupuncture points.

Wrist acupuncture points including the Peridcardium channel and Lung channel.  (Seen Above)

The nexus of most research on the physical existence of acupuncture points and acupuncture meridians is hemodynamic, MRI, oxygen pressure, histological, physiological, clinical and electroconductivity research. Researchers at the University of California School of Medicine (Irvine, California) noted, “Recent evidence shows that stimulation of different points on the body causes distinct responses in hemodynamic, fMRI and central neural electrophysiological responses.” The investigators reviewed MRI results and noted that “stimulation of different sets of acupoints leads to disease-specific neuronal responses, even when acupoints are located within the same spinal segment.” This summarizes research in the vanguard of technical documentation on acupuncture.[2][3]

University of California researchers Choi, Jiang and Longhurst note of acupuncture, “hemodynamic, functional magnetic resonance imaging and neurophysiological studies evaluating the responses to stimulation of multiple points on the body surface have shown that point-specific actions are present.”[4] Naturally, they are running into the difficulty of AhShi points and their specific actions. Perhaps they will discover new effective actions for AhShi points as a result of basic research. Other research shows point specificity in brain physiology and reflects the overall direction of scientific investigation in the field of acupuncture.

The Journal of Magnetic Resonance Imaging featured research on the neurophysiological effects of acupuncture points using MRI imaging noting that acupoint GB40 stimulation enhanced “connectivity between the superior temporal gyrus (STG) and anterior insula.” The investigators concluded, “The current study demonstrates that acupuncture at different acupoints could exert different modulatory effects on RSNs. Our findings may help to understand the neurophysiological mechanisms underlying acupuncture specificity.”[5] Here, the researchers have validated acupuncture point specificity and suggest a possible physiological model of understanding acupuncture points.

HRV (Heart Rate Variability) is a measure of cardiovascular health. One study notes that, “HRV changes significantly during auricular acupuncture….” This research also notes that, “HRV total increases during auricular acupuncture….”[6] Another related study from the International Society for Autonomic Neuroscience notes that acupuncture “causes the modulation of cardiac autonomic function.” These are but two examples of investigations citing specific medicinal actions of specific acupuncture points and is in no way exhaustive of the vast body of research demonstrating acupuncture point specificity for the treatment of hypertension, atrial fibrillation and other cardiovascular disorders.[7] Investigators from the University of California (Los Angeles and Irvine) “have shown that electroacupuncture stimulation activates neurons” in specific brain regions thereby reducing hypertension.[8]

Dr. Berman, M.D. served as a lead researcher in a University of Maryland School of Medicine investigation published in the prestigious Annals of Internal Medicine. The research concludes that, “Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.”[9] What is interesting in this clinical trial is that it was an early study showing that sham acupuncture was not as effective as verum acupuncture. The study sought to isolate and address the placebo effect and found that it is not responsible for the medical benefits associated with acupuncture therapy. There are many papers showing the specific medical benefits of acupuncture on internal organs, tissues and towards the resolution of specific ailments. I thought I would highlight this investigation given its historical value.

Einstein’s Theory of Relativity initially did not catch on and was ridiculed before acceptance. The same is true for much of medicine both old and new. People’s presuppositions often circumvent equanimity and receptiveness to new insights. Backing up a bit, one might have thought that a basic neurologic test for the Babinski Sign was pure fiction. It may have seemed logical and self-evident that rubbing someone’s foot and looking for dorsiflexion of the great toe and fanning of the other toes could not possibly indicate brain or spinal cord damage. Yet, the great French neurologist of Polish origin, Babinski, discovered that this plantar reflex identifies central nervous system damage, which is now an accepted medical reality by medical doctors and is an effective diagnostic tool for central nervous system damage.

Acupuncturists and herbalists have faced acrimonious traducements and caluminiations towards substantiated supportive research. Often there is a predilection towards rejecting the efficacy of Chinese and Oriental Medicine that trumps the realities of hard evidence and smacks of ethnocentrism. The Flat Earth Society felt the same way about the infidels suggesting that the earth is round. Galileo had his fair share of troubles too. It cannot be underestimated how high the stakes really are for patient care and beneficial patient outcomes. At risk is non-integration of cost-effective medicine that roots out the source of suffering by healing illness. A time honored traditional clinical medicine history combined with supportive modern research data suggests that acupuncture is an effective modality of therapeutic care. Acupuncture seems impossible? Recall the words of Mark Twain, “Fiction is obliged to stick to possibilities. Truth isn’t.”

It may appear to some that it is self-evident and logical that acupuncture points exist only as part of some sort of chimerical hermeneutic system. However, extensive research has already been conducted at major universities worldwide demonstrating not only that acupuncture points and meridians exist but also how they physiologically function. There is a resistance to an enormous body of research. Cloaked in veil of mature skepticism and realism, naysayers grasp at piecemeal attack pieces to fight off what has already been measured, documented and peer reviewed both in individual studies and large scale meta-analyses. I suggest an era of open-mindedness towards the modern research documenting the efficacy of Chinese and Oriental medicine, acupuncture and herbal medicine.

Footnotes:
[1] Minyoung Hong, Sarah S. Park, Yejin Ha, et al., “Heterogeneity of Skin Surface Oxygen Level of Wrist in Relation to Acupuncture Point,” Evidence-Based Complementary and Alternative Medicine, vol. 2012, Article ID 106762, 7 pages, 2012. doi:10.1155/2012/10a6762.
[2] Point specificity in acupuncture. Chin Med. 2012 Feb 28;7:4. doi: 10.1186/1749-8546-7-4. Choi EM, Jiang F, Longhurst JC.
[3] Susan Samueli Center for Integrative Medicine, Department of Medicine, School of Medicine, University of California, Irvine CA 92697-4075, USA.
[4] Point specificity in acupuncture. Chin Med. 2012 Feb 28;7:4. doi: 10.1186/1749-8546-7-4. Choi EM, Jiang F, Longhurst JC.
[5] Zhong, C., Bai, L., Dai, R., Xue, T., Wang, H., Feng, Y., Liu, Z., You, Y., Chen, S. and Tian, J. (2011), Modulatory effects of acupuncture on resting-state networks: A functional MRI study combining independent component analysis and multivariate granger causality analysis. Journal of Magnetic Resonance Imaging.
[6] Evidence-Based Complementary and Alternative Medicine. Volume 2012 (2012), Article ID 817378, 7 pages. doi:10.1155/2012/817378. Sino-European Transcontinental Basic and Clinical High-Tech Acupuncture Studies—Part 1: Auricular Acupuncture Increases Heart Rate Variability in Anesthetized Rats. Xin-Yan Gao, Kun Liu, Bing Zhu and Gerhard Litscher.
[7] Kurono Y, Minagawa M, Ishigami T, Yamada A, Kakamu T, Hayano J. Auton Neurosci. Acupuncture to Danzhong but not to Zhongting increases the cardiac vagal component of heart rate variability. 2011 Apr 26;161(1-2):116-20. Epub 2011 Jan 7.
[8] Evidence-Based Complementary and Alternative Medicine. Volume 2012 (2012), Article ID 878673, 9 pages. doi:10.1155/2012/878673. Neuroendocrine Mechanisms of Acupuncture in the Treatment of Hypertension. Wei Zhou and John C. Longhurst. Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA. Department of Medicine, University of California Irvine, Irvine, CA.
[9] Ann Intern Med, Berman, Lixing, Lagenberg, Lee, Gilpin, Hochberg. 2004; 141:901-910.

The Health Benefits of Pistachios in a Nutshell

Our twins love pistachios. We can’t crack the shells open fast enough. And we can feel good about giving this healthy snack that benefits their heart, blood, eyes, immune system, nervous system, and skin.

Eye Health – Pistachios have two types of antioxidants called carotenoids which aren’t in many other nuts. Lutein and zeaxanthin protect your tissue from free radicals in the body, which can lead to macular degeneration among other things.

Immune System – The B6 found in pistachios is essential for a healthy immune system and brain activity.

Blood Health – Vitamin B6 also helps the body make red blood cells and maintain lymphoid glands. These help the thymus, spleen, and lymph nodes produce white blood cells that protect the body from infection. B6 also produces hemoglobin, the protein that carries oxygen in the blood stream.

Diabetes Help – Pistachios are rich in phosphorous, which helps the body break proteins into amino acids. It also supports glucose tolerance, which is may help prevent Type 2 diabetes.

Skin Health – The Vitamin E found in pistachios is a powerful fat-soluble antioxidant that maintains the integrity of cell membranes. It also protects the skin from UV damage, and is a great defense against skin cancer and premature skin aging.

Heart Health – Pistachios can help the body reduce LDL cholesterol and increase HDL levels after being in your diet for only a short period of time.

Pain Reduction – Vitamins A & E are antioxidants found in pistachios. These help fight inflammation which can trigger arthritis pain and more.

Digestive Health – A serving of pistachios contains 3 grams of dietary fiber, almost the same amount as in oatmeal.

We hear about the virtues of almonds constantly, and they’re great to have in the snack arsenal, but when you’re looking for a change of pace, grab a handful of these cute little nuts. There’s even something therapeutic about cracking open the shells when you need to get a little stress out of your system. As an added bonus, pistachios have fewer calories and less fat than most other nuts, supporting weight loss and maintenance.

Squash the Flu

Having a hard time shaking off that cold/flu that’s been going around? It got passed around our family, too.  There are alternatives to toughing it out or taking drugs that give you cotton mouth and medicine head.  Cupping uses vacuum pressure to activate the lymphatic system, increase circulation, and release toxins.  Gua Sha uses a small massage tool to activate the lymphatic system, restore normal movement of fluids, and flush waste from the body.  Both techniques should be available at your local acupuncturist.  If you’re in the Nashville area, give us a call – we have appointments available. 615-939-2787