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November 2018

Acupuncture Enhances Weight Loss Program, Lowers Cholesterol

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Acupuncture Enhances Weight Loss Program, Lowers Cholesterol

 

Acupuncture enhances weight loss and improves blood chemistry in patients with simple obesity. Researchers tested the efficacy of warm needle acupuncture by adding it to a weight loss dietary program. Patient outcomes improved significantly for patients receiving acupuncture plus dietary therapy when compared with patients receiving only dietary therapy.

Hospital researchers conclude that warm needle acupuncture successfully reduces body fat and adiposity, decreases serum triglycerides and total cholesterol, reduces harmful low-density lipoprotein (LDL) cholesterol, and raises beneficial high density lipoprotein (HDL) cholesterol levels when combined with a standardized weight loss diet program. The results demonstrate that the combined therapy is significantly more effective than dietary changes alone. [1]

Researchers at the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine (department of acupuncture and moxibustion) conducted a clinical trial consisting of sixty patients with simple obesity. They were randomized to receive either standardized dietary education plus warm needle acupuncture, or dietary education alone. The warm acupuncture group was comprised of 14 male and 16 female participants ages 19–45 years (mean age 30.3 years). They had obesity for a mean duration of 5.5 years and had a mean body mass index (BMI) of over 30, indicating clinical obesity. The control group was comprised of 13 male and 17 female participants ages 18–53 years (mean age 32.0 years). They had obesity for a mean duration of 6.0 years and had a mean BMI over 30. There were no statistically significant differences in gender, age, duration of disease, or BMI at the beginning of the study period.

For inclusion in the study, patients were required to be at least 18 years of age with a clinical diagnosis of simple obesity in line with both biomedical and traditional Chinese medicine (TCM) criteria. Patients with serious heart, liver, or kidney dysfunction, poor coagulation or bleeding disorders, and infectious diseases were excluded from the study, as were pregnant or lactating women and patients unable to comply with treatment due to dementia or psychological disorders. No other weight loss treatments were permitted for one month before commencement of the study.

 

Diagnostic Criteria
The diagnosis of clinical obesity is generally determined using BMI as a measure. A BMI of 18.5–25 is considered healthy, and a BMI of 25–29.9 is considered overweight. A BMI over 30 is considered clinically obese. For patients in the latter group, secondary obesity due to endocrine, hypothalamic, or congenital disorders must be excluded in order to make a diagnosis of simple obesity.

From a TCM (Traditional Chinese Medicine) perspective, simple obesity is caused by the accumulation of excessive dampness and phlegm. Other possible symptoms of this diagnostic pattern include headaches, weakness of the four limbs, abdominal distension, loose stools, generalized heaviness and swelling, lack of thirst, and cough with expectoration. For this diagnosis, the tongue has a sticky, white coating and the pulse is taut, slippery, and soft.

 

Treatment Protocols
The participants in both groups received standardized dietary education. They were instructed to reduce fat, sugar, and salt consumption, while increasing protein intake by eating more high protein foods such as eggs and yogurt and using protein supplementation if necessary. The patients in the warm needle acupuncture group also received treatment at the following acupoints:

  • Hegu (LI4)
  • Tianshu (ST25)
  • Zhongwan (CV12)
  • Zhongji (CV3)
  • Zusanli (ST36)
  • Fenglong (ST40)
  • Yinlingquan (SP9)

The patients were treated while resting in a supine position using 0.30 × 40mm or 0.30 × 50mm disposable filiform needles. All acupoints were needled bilaterally and stimulated using a reducing technique. After the arrival of deqi, needles were retained for 30 minutes. Warm needle acupuncture was applied at the acupoints Hegu, Tianshu, Zhongwan, and Zusanli. These points were warmed by igniting a piece of moxa, approximately 2cm in length, attached to the needle handles. This process was repeated for each of the aforementioned points 2–3 times per treatment. Treatment was provided on alternate days for a total of eight weeks.

 

Outcomes and Discussion
At the end of the eight week study period, the two groups underwent assessment and comparison in the areas of BMI, body fat percentages, body adiposity index (BAI), serum triglycerides, total serum cholesterol, LDL cholesterol, and HDL cholesterol. In both groups, BMI, body fat percentages, and BAI decreased by the end of the eight week period, with the greatest decreases ocurring in the acupuncture group.

Patients with a body fat reduction of 26% for men and 30% for women, resulting in a BMI of 26–27 were classified as fully recovered. For patients with a 5% reduction in body fat and a reduction in BMI of over 4, the treatment was classified as highly effective. For patients with a 3–5% reduction in body fat and a reduction in BMI of 2–4, the treatment was classified as effective. For patients with a reduction in BMI of under 2, the treatment was classified as ineffective.

In the acupuncture group, one patient fully recovered and there were 16 cases of highly effective, 10 cases of effective, and 3 cases of ineffective treatment, yielding a total effective rate of 90%. In the dietary program monotherapy control group, no patients fully recovered. However, there were 11 cases of highly effective, 8 cases of effective, and 11 cases of ineffective treatment, yielding a total effective rate of 63.3%.

To assess triglycerides, total cholesterol, LDL cholesterol, and HDL cholesterol, fasting samples of venous blood were collected before and after the treatment period and underwent biochemical analysis. In both groups, triglycerides, total cholesterol, and LDL cholesterol levels reduced by the end of the study, and HDL cholesterol levels rose. These improvements were all greater in the warm needle acupuncture group, and the improvements in triglycerides and total cholesterol were statistically significant.

The results of this study indicate that warm needle acupuncture effectively enhances weight loss achieved by dietary adjustments. In addition, it improves serum triglyceride and total cholesterol levels, while decreasing harmful LDL cholesterol and increasing beneficial HDL cholesterol levels. The researchers note that these findings indicate that warm needle acupuncture may help reduce the risk of cardiovascular disease, heart attacks, and strokes in obese patients, as well as helping them to achieve a healthy BMI. To find out more, contact a licensed acupuncturist in your area.

 

Reference
1. Li Wei-qin, Jiang Wei, Liu Jian (2018) “Treatment of Simple Obesity Patients with Phlegm Dampness Stagnation Syndrome with warming Needle Moxibustion” Acupuncture Research Vol. 43 (8) pp. 522-525.

Source: HealthCMi

Acupuncture Beats Drugs for Prostatitis

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Acupuncture Beats Drugs For Prostatitis

 

Acupuncture outperforms drugs for the treatment of chronic prostatitis. Researchers from the First Affiliated Hospital of Chongqing Medical University gathered objective and subjective data in a controlled clinical trial consisting of patients with chronic prostatitis. The acupuncture treatment group achieved a total effective rate of 87.5% and the drug control group achieved a total effective rate of 62.5%.

National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores indicate that acupuncture produces significant improvements in pain or discomfort intensity levels, urinary symptoms, and quality of life scores. Urethral sphincter electromyography uroflow rates show that acupuncture restores urethral sphincter and pelvic floor muscle function. The researchers conclude that acupuncture significantly outperforms drugs for the treatment of chronic prostatitis. [1]

 

Design
Researchers (Zhang et al.) used the following study design. A total of 48 patients were treated and evaluated in this study. All patients were diagnosed with chronic prostatitis. They were randomly divided into an acupuncture treatment group and a drug control group, with 24 patients in each group. Patients from the control group consumed one tablet each of sparfloxacin and Prostat tablets, twice a day, for a total of 4 weeks. Sparfloxacin is a fluoroquinolone antibiotic used for patients with bacterial infections. Prostat contains pollen extract EA-10 and P5 and is used in the treatment of benign prostatic hyperplasia and chronic prostatitis. The treatment group received electroacupuncture monotherapy. The diagnostic criteria included the following:

Symptoms (perineal and lumbosacral pain, abnormal urination) lasting for more than 3 months
Hard, tender, and normal sized/enlarged prostate found by the digital rectal exam
Positive or negative results for urine and prostatic secretion tests
NIH-CPSI scores ≥ 10

 

Acupuncture Points
Patients from the treatment group received acupuncture at the following primary acupoints:

  • CV4 (Guanyuan)
  • 
CV3 (Zhongji)
  • 
BL32 (Ciliao)
  • 
BL35 (Huiyang)

Additional secondary acupoints were added based on differential diagnostic considerations:

  • Qi and blood stagnation: LV3 (Taichong), SP10 (Xuehai), SP6 (Sanyinjiao)
  • Damp-heat pouring downward: LV3 (Taichong), ST40 (Fenglong), SP9 (Yinlingquan)

  • Fire excess due to yin deficiency: KI3 (Taixi), BL23 (Shenshu), SP6 (Sanyinjiao)

  • Kidney yang deficiency: BL23 (Shenshu), CV6 (Qihai), ST36 (Zusanli)

Upon disinfection of the acupoint sites, a 0.30 mm × 50 mm filiform acupuncture needle was inserted into each acupoint to a depth of 25-35 mm. Needles were rotated, lifted, and thrust rapidly after insertion to achieve a deqi sensation. For Guanyuan, Zhongji, Ciliao, and Huiyang, a deqi sensation radiating toward the perineum, penis, and testicles was noted by the researchers as producing better clinical outcomes. It is written in the Ling Shu (The Miraculous Pivot) that “A deqi sensation in the lesion area ensures the effectiveness of acupuncture.”

The acupuncture needles were attached to an electroacupuncture device. A continuous wave (1 Hz) was applied with an intensity level set to patient tolerance levels or until muscle contractions were observable. A 30 minute needle retention time was observed, timed from the initiation of electroacupuncture current. Electroacupuncture was applied once per day. Each treatment course consisted of 8 acupuncture treatments followed by a two-day break before the next course began. All patients received a total of 3 treatment courses.

 

Scoring
NIH-CPSI scores, changes in urethral sphincter electromyography determined uroflow rates, and total efficacy rates were measured before and after treatment. NIH-CPSI is a measurement instrument used to assess symptom severity in patients with chronic prostatitis. NIH-CPSI measures three different aspects including pain, urinary symptoms, and quality of life. Higher scores in NIH-CPSI assessment denote a more severe condition.

The urethral sphincter electromyography determined uroflow rate is a non-invasive test used to assess sphincter and pelvic floor muscle function, including measurements of maximum urine flow rates (Qmax), average urine flow rates (Qave), and TL value. TL value is a derived parameter from urethral sphincter EMG used to measure the degree of detrusor-sphincter synergia. [2] TL quantifies coordination of the detrusor and sphincter; “In normal humans, the bladder is supposed to empty by a synergistic contraction of the detrusor and relaxation of the sphincter during micturition.” [3] If both contract simultaneously, it is termed detrusor-sphincter dyssynergia. After completion of treatment, the efficacy rate for each patient was categorized into 1 of 3 tiers:

  • Recovery: Complete absence of symptoms. NIH-CPSI scoring reduction of at least 2/3.
  • Normal Qmax, Qave, and TL value.
  • 
Effective: Improvement of symptoms. NIH-CPSI scoring reduction of 1/3 to 2/3. Improvement of Qmax, Qave, and TL value.
  • 
Ineffective: No improvement of symptoms. NIH-CPSI scoring reduction of less than 1/3. No improvement of Qmax, Qave, and TL value.

 

Basis
The researchers provided a historical context for the acupuncture point selection administered during the investigation. Guanyuan and Zhongji are located on the Ren meridian. Needling Guanyuan reinforces the kidneys and strengthens yang energy. Guanyuan is indicated for seminal emission, impotence, inhibited urination, frequent urination, lower abdominal pain, and white turbidity of urine. According to the Qian Jin Yao Fang (A Thousand Gold Pieces Formulary), Zhongji is indicated for lower back pain, inhibited urination, impotence, premature ejaculation, and white turbidity of urine. Ciliao and Huiyang are located on the foot Taiyang bladder meridian. Ciliao is indicated for lower back pain, strangury (blockage or irritation of the bladder resulting in pain or urgent urination), and red urine. Needling Huiyang resolves dampness, clears heat, replenishes essence, and benefits the kidneys.

 

Summary
Subjective clinical and objective electromyography data indicate that acupuncture outperforms drugs for the treatment of chronic prostatitis. According to the research, common protocols involve the application of acupoints Guanyuan (CV4), Zhongji (CV3), Ciliao (BL32), and Huiyang (BL35) for this condition. Patients interested in learning more about acupuncture are recommended to contact a local licensed acupuncturist.

 

Prostatis vs. Benign Prostatic Hyperplasia (BPH)
Prostatitis is a term referring to prostate inflammation, usually caused by injury or infection. Bacterial infections in the blood (bacteremia) may cause prostatitis. Inflammation of the epididymis (epididymitis) may also cause prostatitis. The epididymis is a duct posterior to the testis that sperm passes through. Risk factors include catheterization, prostate biopsy, and pelvic trauma. Dysuria (painful or difficult urination), frequent urination, nocturia, urgent urination, hematuria (blood in the urine), painful ejaculation, and pain in the groin, penis, or testicles are all symptoms associated with prostatitis. Benign prostatic hyperplasia (BPH) is a different condition wherein the prostate becomes enlarged. It usually occurs as a result of aging. The aforementioned research applies to prostatitis.

 

References
[1] Zhang J, Liu CD, Ding Y, Tang QB. Clinical Observation on Therapeutic Effect of Electroacupuncture on Chronic Prostatitis and Detection of Urethral Sphincter EMG [J]. Chinese Acupuncture & Moxibustion, 2010,30(1):13-17.
[2] Qu CY, Xu DF, Wang CZ, Chen J, Yin L, Cui XA. Anal Sphincter Electromyogram for Dysfunction of Lower Urinary Tract and Pelvic Floor. 2017.
[3] Chang, Shyang, Shu-Ting Mao, Shih-Jen Hu, Wen-Ching Lin, and Chen-Li Cheng. “Studies of detrusor-sphincter synergia and dyssynergia during micturition in rats via fractional Brownian motion.” IEEE transactions on biomedical engineering 47, no. 8 (2000): 1066-1073.

Source: HealthCMi

Acupuncture Low Back Disc Protrusion CT Scan Results

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Acupuncture Low Back Disc Protrusion CT Scan Results

 

Acupuncture is effective for patients with lumbar disc protrusions. CT scans confirm that acupuncture reduces disc protrusion size and increases healthy space in the spinal canal. Along with relief from nerve compression, investigators conclude that acupuncture improves range of motion and reduces pain for patients with lumbar disc protrusions.

Researchers from the Nanyang Municipal Central Hospital tested two acupoint prescriptions. The results of the investigation demonstrate that both acupuncture point prescriptions that were tested are effective for alleviating lumbar disc protrusions, but one is more effective than the other. We will take a look at both. CT (computed tomography) scans confirm the results, including improvements across multiple parameters (i.e., anteroposterior diameter of the thecal sac, sagittal diameter of the spinal canal, nerve root compression ratio). [1]

Patients were evaluated before and after the treatment course. Both subjective and objective instruments were used to measure patient outcomes. The objective data was gathered using CT scans (also known as CAT scans), which are computer-processed X-ray images. The scans demonstrate that acupuncture reduces disc protrusions and alleviates nerve compression. CT images confirmed improvements in the thecal sac anteroposterior diameter and sagittal diameter of the spinal canal as well as the nerve root compression ratio.

Subjective data was gathered with two instruments. First, the Oswestry Disability Index (ODI) was used to measure functional disability of the lower back. Second, the Japanese Orthopedic Association Lower Back Pain Evaluation Questionnaire (JOABPEQ) was used as an outcome measure for patients with lumbar disc protrusions. Patients demonstrated improvements with both the ODI and JOABPEQ.

 

Symptoms
The following are results of the ODI and JOABPEQ for two separate groups receiving two different acupuncture treatment point prescriptions. The ODI score for the standard acupuncture control group averaged 23.35 before treatment and 8.34 after treatment. The ODI score for the acupuncture Yao San Zhen (lumbar three needles) treatment group averaged 23.12 before treatment and 5.28 after treatment.

The JOABPEQ score for the standard acupuncture control group was 6.22 before treatment and averaged 17.14 after treatment. The JOABPEQ score for the acupuncture Yao San Zhen (lumbar three needles) treatment group averaged 6.35 before treatment and 21.53 after treatment. The researchers conclude that the Yao San Zhen treatment group outperformed the standard acupuncture control group regarding the improvements of ODI and JOABPEQ scores.

 

CT Scans
The thecal sac (dural sac) is a sheath around the spinal cord (above L2) and cauda equina. It is composed of dura mater, which is a thick connective tissue membrane. The anteroposterior diameter of the thecal sac for the standard acupuncture control group decreased to an average of 35.72 mm after treatment, from a pre-treatment value of 56.44 mm. The anteroposterior diameter for the Yao San Zhen acupuncture treatment group averaged 56.35 mm before treatment and 26.14 mm after treatment. These measurements indicate a decrease in the size of the disc protrusions.

The sagittal diameter of the spinal canal for the standard acupuncture control group averaged 6.32 mm before treatment and 11.16 mm after treatment. The sagittal diameter for the Yao San Zhen acupuncture treatment group was 6.51 mm before treatment and 14.24 mm after treatment. This parameter is negatively associated with lumbar pain and the improvements are reflected by higher numbers. The Yao San Zhen style of acupuncture outperformed the standard acupuncture protocol.

The nerve root compression ratio for the standard acupuncture control group averaged 0.64 before treatment and 0.48 after treatment. The nerve root compression ratio for the treatment group averaged 0.67 before treatment and 0.32 after treatment. Both groups achieved significant improvements in CT measured parameters. Overall, the improvements were greater for the Yao San Zhen acupuncture treatment group.

 

Correlation Between ODI and CT
Correlation between ODI and CT parameters (anteroposterior thecal sac diameter, sagittal spinal canal diameter, nerve root compression ratio) for two groups were analyzed. The results showed that the anteroposterior diameter and nerve root compression ratio were positively correlated with ODI scores, while the sagittal diameter of was negatively correlated with ODI scores. The researchers concluded that, “In patients with lumbar disc protrusion, the more severe the nerve root compression, the narrower the sagittal diameter on the CT, and the larger the anteroposterior diameter of the thecal sac, the more serious the clinical symptoms.”

 

Design
A total of 78 patients participated in the study. They were diagnosed and treated for lumbar disc protrusions between January 2016 and January 2017. The following inclusion criteria were applied:

  • Meeting the diagnostic criteria for both western medicine and Traditional Chinese Medicine
  • Ages between 20–50 years
  • Pain in the lower back and lower extremities
  • Confirmed lumbar protrusions by CT or MRI
  • Positive straight leg raise (SLR) test

The following exclusion criteria were applied:

  • Comorbid tumors, lumbar vertebral spondylolisthesis, spinal stenosis, and spinal compression fractures
  • Severe and comorbid blood diseases and coagulation disorders
  • Pregnant or lactating
  • Neurological or mental diseases

Participants were randomly divided into two groups: Yao San Zhen treatment and standard acupuncture control, with 39 participants in each group. Both groups were equivalent in all relevant demographics. The treatment group was comprised of 26 males and 13 females. The average age of the Yao San Zhen treatment group was 39.21 years. The course of treatment of the Yao San Zhen treatment group was 3.53 months. The control group was comprised of 24 males and 15 females. The average age of the treatment group was 38.37 years. The course of treatment of the treatment group was 3.32 months.

 

Acupuncture Sessions
Patients from both groups received the following acupuncture points:

  • Huatuojiaji
  • GB30 (Huantiao) affected side
  • BL54 (Zhibian) affected side
  • Ashi points

Secondary acupuncture points were added bilaterally based on diagnostic considerations:

  • Lower back pain due to cold-dampness: BL39 (Weiyang), GV3 (Yaoyangguan)
  • Lower back pain due to damp-heat: GB34 (Yanglingquan), SP6 (Sanyinjiao)
  • Lower back pain due to blood stasis: SP10 (Xuehai), BL17 (Geshu)
  • Lower back pain due to kidney deficiency: KD3 (Taixi), GV4 (Mingmen)

Acupuncture treatments commenced with patients in a prone position. After disinfection of the acupoint sites, a 40 or 75 mm disposable filiform needle was inserted into each acupoint with a high needle entry speed, reaching a depth of 1–1.5 cun (with the exception of 2–3 cun for Huantiao). After achieving a deqi sensation, the needles were manipulated with the Ping Bu Ping Xie (attenuating and tonifying) technique.

The acupuncture needles were connected to an electroacupuncture device. A low frequency continuous wave (5–10 Hz) was applied with an intensity level set to patient tolerance levels or until muscle contractions were observable. The needles were retained for 30 minutes after the initiation of electric current.

For the treatment group patients, a special acupoint prescription called Yao San Zhen (lumbar three needles) of Jin’s three needling technique was added. This technique was established by Dr. Jin Rui, Ph.D. (chief professor supervisor of Guangzhou University of Traditional Chinese Medicine). The principle of the technique is to use three needle combinations to treat specific diseases. The Yao San Zhen prescription utilized the following acupoints:

  • BL23 (Shenshu)
  • BL25 (Dachangshu)
  • BL40 (Weizhong)

Needles were inserted into each acupoint with a high needle entry speed, reaching a maximum depth of 1–1.5 cun. Upon the arrival of a deqi sensation, the needles were manipulated with the Ping Bu Ping Xie (attenuating and tonifying) technique. A 30 minute needle retention time was observed. For both groups, treatments were applied every two days, 10 sessions as one treatment course, for a total of 8 weeks.

 

Summary
The clinical results demonstrate that acupuncture produces positive patient outcomes for the treatment of lumbar disc protrusions. Patients that received acupuncture saw improvements in ODI and JOABPEQ scores and parameters measured by CT (i.e., anteroposterior diameter of the thecal sac, sagittal diameter of the spinal canal, nerve root compression ratio). The data indicates that acupuncture is safe and effective for the treatment of lumbar disc protrusions.

 

Reference
[1] Fang F, Wei YX. Clinical observation on lumbar three needles in the treatment of lumbar disc protrusion and imaging changes [J]. World Chinese Medicine, 2018(5).

Source: HealthCMi

 

Acupuncture and Herbs Stop Shingles Pain, Outperforms Drugs

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Acupuncture and Herbs Stop Shingles Pain, Outperforms Drugs

 

Acupuncture and herbs prove effective for the treatment of shingles. Researchers from three independent studies conclude that acupuncture and herbal medicine significantly relieve rashes and pain associated with the herpes zoster virus (shingles). Importantly, acupuncture and herbal medicine outperformed antiviral and anti-inflammatory medications, indicating that usual care protocols are suboptimal without inclusion of acupuncture and herbal medicine.

The shingles viral infection is characterized by painful blisters, usually located in a single strip on either side of the trunk, neck, or face. Even once the blisters have subsided, patients can be left with severe neuralgia (nerve pain), which may last for several weeks or months. According to Traditional Chinese medicine (TCM) principles, this condition usually falls into the category of either excess liver fire, liver and gallbladder damp heat, or spleen deficiency with accumulated pathogenic dampness. Rashes associated with shingles are sometimes referred to as “snake string sores” in TCM, reflecting the nature of their physical presentation.

 

People’s Hospital
The first study we will look at today was conducted by researchers at the People’s Hospital of Shenyang Economic and Technological Development Zone. [i] A total of 88 patients with a clinical diagnosis of a herpes zoster infection were recruited and randomly assigned to an acupuncture and herbal medicine observation group or a drug control group (including anti-inflammatory and antiviral medications).

The acupuncture and herbal medicine group produced significantly greater patient outcomes. This includes a higher cure rate, a higher overall effective rate, and a lower failure rate. The results indicate that standard procedures to alleviate shingles in hospital and outpatient settings absent acupuncture and herbs are definitively not the most effective means to provide relief to patients.

The observation group comprised 20 male and 24 female participants with a mean age of 43.6 years. Their mean duration of disease was 3.4 days. The control group comprised 18 male and 26 female participants, with a mean age of 42.8 years. The mean duration of disease in this group was 3.6 days. There were no statistically significant differences in baseline characteristics between the two groups at the outset of the investigation.

 

Treatment Procedures
The control group was treated with conventional drug therapy including:

  • Acyclovir (200mg, three times a day)
  • Vitamin B1 (10mg, three times a day)
  • Ibuprofen slow release capsules (300mg daily)
  • Acyclovir topical ointment

The observation group was treated with a modified version of the herbal formula Long Dan Xie Gan Tang containing the following herbs:

  • Sheng Di 30g
  • Che Qian Zi 30g
  • Ban Lan Gen 30g
  • Huang Qin 15g
  • Chi Shao 15g
  • Zhi Zi 15g
  • Da Qing Ye 15g
  • Long Dan Cao 12g
  • Ze Xie 12g
  • Chai Hu 10g
  • Dang Gui 10g

Modifications

  • For patients suffering from concurrent constipation, Da Huang (10g) was added to the formula.
  • For patients with symptoms of exuberant heat, Sheng Shi Gao (30g), Zhi Mu (15g), and Mu Dan Pi (15g) were added.
  • For patients with pus-filled blisters, Pu Gong Ying (30g) was added.
  • For patients with severe pain, Zhi Ru Xiang (10g) and Zhi Mo Yao (10g) were added.

The herbs were decocted in water and one dose was taken daily, divided into two portions for morning and evening consumption. The patients in the observation group were also treated with acupuncture at the following acupoints:

  • Huatuojiaji (MBW35)
  • Zhigou (TB6)
  • Yanglingquan (GB34)
  • Yinlingquan (SP9)

Acupuncture was also administered locally in the area of herpetic rashes. Needles were inserted into the spaces between blisters, approximately 1.5 cun apart. The needles were manipulated slightly then withdrawn immediately, and the puncture was not sealed with cotton. The incidental drawing of a small drop of blood was considered a beneficial effect. The affected area was also warmed with a moxa cigar. Treatment was administered once daily. Both groups underwent treatment for a total of ten days, with an initial assessment of rashes after five days.

 

Clinical Outcomes
Patients with a complete resolution of rashes and clinical symptoms (including pain) were classified as cured. In patients with at least a 30% improvement in rashes and pain reduction, the treatment was classified as effective. In patients showing less than 30% improvement in rashes and no change or worsening of pain, the treatment was classified as ineffective.

In the drug control group, 15 patients were cured, 21 cases were classified as effective, and 8 cases were classified as ineffective, yielding a total effective rate of 81.8%. In the acupuncture and herbal medicine observation group, 25 patients were cured, 18 cases were classified as effective, and one case was classified as ineffective, yielding a total effective rate of 97.7%.

A combination of acupuncture and herbal medicine has been used for the treatment of shingles for over 1,000 years. This modern study confirms the efficaciousness of a common TCM protocol for the treatment of herpes zoster. A rethinking of usual care standards seems appropriate based on the findings. At the Healthcare Medicine Institute (HealthCMi), we examine traditional acupuncture continuing education standards and repeatedly find that an integrative medicine model for the treatment of shingles is superior to drug monotherapy. Let’s take a look at the second study in our review of shingles treatments.

 

Changjizhou and Jimusa’erxian TCM Hospital
The second study conducted by researchers at the Changjizhou and Jimusa’erxian TCM Hospital (department of acupuncture and moxibustion) determined that acupuncture and herbal medicine are effective for the treatment of shingles. [ii] For this study, a total of 40 patients were recruited and randomly assigned to either an observation or control group.

The observation group was comprised of 12 male and 8 female participants, ages 18–63 years (mean age 35.5 years). Their duration of disease was 1–10 days (mean duration 5.5 days) at the outset. The control group was comprised of 13 male and 7 female participants, ages 18–65 years (mean age 36.5 years). Their duration of disease was 1–8 days (mean duration 4.5 days). There were no statistically significant differences in baseline characteristics between the two groups at the outset of the investigation.

 

Treatment Procedures
Both groups were treated with herbal decoctions according to their TCM differential diagnoses. Patients diagnosed with excessive heat in the liver channel were prescribed a version of Qing Re Zhi Tong Tang containing the following herbs:

  • Lian Qiao 15g
  • Jin Yin Hua 15g
  • Huang Qin 10g
  • Zhi Zi 10g
  • Huang Lian 10g
  • Long Dan Cao 5g
  • Gan Cao 5g
  • Da Qing Ye 25g
  • Ling Ci Shi 25g

Patients diagnosed with spleen deficiency with accumulation of pathogenic dampness were prescribed a version of Chu Shi Wei Ling Tang containing the following ingredients:

  • Cang Zhu 10g
  • Chen Pi 10g
  • Shao Bai Zhu 10g
  • Che Qian Zi 15g
  • Ze Xie 15g
  • Fu Ling 15g
  • Jin Yin Hua 15g
  • Long Dan Cao 5g
  • Ling Ci Shi 25g

Both decoctions were taken as a daily dose for a total of 21 days. Patients in the observation group also received acupuncture in the area affected by the herpetic rash. Following standard disinfection, 3–6 needles were inserted surrounding the rash at a distance of approximately 0.5–1cm. The needles were inserted transversely to a depth of 20–50mm, angled towards the midpoint of the rash. The needles were manipulated using a balanced reinforcing-reducing method and were retained for 30 minutes. Treatment was administered daily for 14 days.

 

Clinical Outcomes
For patients whose rash and clinical symptoms fully resolved, treatment was classified as markedly effective. For those whose rash improved by more than 70% and experienced some reduction in pain, treatment was classified as effective. For those whose rash improved by less than 30% and experienced no reduction in pain, treatment was classified as ineffective.

In the control group, there were 10 markedly effective, 6 effective, and 4 ineffective cases, yielding a total effective rate of 80%. In the observation group, there were 15 markedly effective, 4 effective, and one ineffective cases, yielding a total effective rate of 95%.

The patients also rated their pain using a visual analog scale (VAS). VAS scores of 7–10 indicated severe, unbearable pain. Scores of 4–6 indicated severe but tolerable pain, 1–3 indicated mild pain, and scores of 0 indicated a complete absence of pain. At the beginning of the study, mean VAS scores in the control group and observation group were 7.36 and 7.25 respectively. By the end of the study, scores decreased significantly to 4.20 and 2.04 respectively, with significantly greater improvements in the observation group. The results indicate that a combination of acupuncture and herbs is more effective than using only herbal medicine.

 

Yungang Community Sanitation Service Center
The final study we will examine was conducted by researchers at the Chinese medicine and acupuncture department of the Yungang Community Sanitation Service Center in Beijing. [iii] A total of 36 herpes zoster patients were recruited for the study and were treated with acupuncture, herbs, and cupping therapy. The study group was comprised of 8 male and 28 female patients, ages 25–78 years. Of these participants, 8 had a disease duration of less than 2 days, 11 had a disease duration of 2–14 days, and the remaining 17 participants had a disease duration of over 14 days at the outset of the study.

 

Treatment Procedure
All patients were treated with a version of Long Dan Xie Tang and Wu Wei Xiao Du Yin. The ingredients were as follows:

  • Sheng Di 20g
  • Hei Shan Zhi 15g
  • Long Dan Cao 10g
  • Huang Bai 10g
  • Chai Hu 10g
  • Huang Qin 10g
  • Che Qian Zi 10g
  • Ze Xie 10g
  • Mu Tong 10g
  • Sheng Gan Cao 10g
  • Jin Yin Hua 10g
  • Lian Qiao 10g
  • Ye Ju Hua 10g
  • Zi Hua Di Ding 10g
  • Pu Gong Ying 10g

Modifications

  • For patients suffering from concurrent constipation, Da Huang (10g) and Lai Fu Zi (10g) were added to the formula.
  • For patients with symptoms of excessive heat, Huang Lian (10g) was added.
  • For patients with severe pain, Chuan Lian Zi (10g) and Yuan Hu (10g) were added.

The herbs were decocted in water on a daily basis and were subsequently divided into three portions to be taken morning, noon, and evening. Acupuncture was administered in the area of the herpetic rashes. Needles were inserted between blisters and were stimulated using a reducing method to elicit a distending pain in the region. Needles were retained for 30 minutes.

Modifications

  • For patients whose symptoms originated in the area of the limbs, Quchi (LI11), Taichong (LV3), and Chezi (LU5) were added.
  • For those whose symptoms originated on the back of the torso, Huatuojiaji (MBW35) and Hegu (LI4) were added.
  • For those with a TCM diagnosis of liver fire blazing, Taichong (LV3), Chize (LU5), and Zhigou (TB6) were added.
  • For those with a TCM diagnosis of damp-heat in the Stomach and Spleen, Xuehai (SP10) and Sanyinjiao (SP6) were added.
  • For those with a TCM diagnosis of qi stagnation and blood stasis, Geshu (BL17) was added.

Needles at Huatuojiaji points were inserted perpendicularly to a depth of 0.7–0.8mm. The needles were manipulated using a balanced reinforcing-reducing method, and after the arrival of deqi, were retained for 20 minutes. Needles at the remaining acupoints were inserted and manipulated using a lifting, thrusting, and rotating reducing technique. These needles were also retained for 20 minutes. Treatment was administered daily for a total of ten days.

Cupping therapy was administered on every third day of the treatment period. A three-edged needle was used to puncture the skin surrounding the herpetic blisters. For those with a relatively small area affected by the rash, a single puncture was made. For those with a larger rash, the punctures were made approximately 3–5cm apart. A cup was then placed over the puncture(s) and were retained for 10 minutes.

 

Clinical Outcomes
Patients with a complete resolution of both rashes and associated pain were classified as recovered. For patients whose symptoms resolved almost completely, the treatment was classified as markedly effective. For patients whose symptoms partially resolved, the treatment was classified as effective. For patients whose symptoms did not improve or worsened, the treatment was classified as ineffective.

For patients whose symptoms had been present for less than two days, all 8 were fully recovered, yielding a 100% effective rate. Among those whose symptoms had been present for 2–14 days, 5 were classified as recovered and 2 were classified as markedly effective, yielding a total effective rate of 63.6%. For those whose symptoms had been present for over 14 days, one was classified as recovered and one was classified as effective, yielding a total effective rate of 11.8%.

 

Results
The results of three independent studies indicate that acupuncture combined with herbal medicine is a highly effective treatment combination for rashes and pain associated with the herpes zoster virus. Additionally, treatment is significantly more effective the earlier it is administered. For more information, contact a local licensed acupuncturist to learn about treatment options in your area.

 

References
[i] Cao Bo (2018) “Clinical Study of Longdan Xiegan decoction Combined with Acupuncture and Moxibustion for Herpes Zoster” Guide of China Medicine Vol.16(25) pp. 174-175.
[ii] Zhang Qin, Ding Yujie (2018) “Study on the Effect of Dialectical Treatment with Chinese Medicine and Acupuncture on Clinical Symptoms of Herpes Zoster Neuralgia” Cardiovascular Disease Journal of Integrated Traditional Chinese and Western Medicine Vol.6(25) pp. 134.
[iii] Zhao Yun (2018) “Observation on the Effect of Combined Chinese Medicine and Cupping Method on 36 Patients with Herpes Zoster” Traditional Chinese Medicine Vol.16(16) pp.172-174.

Source: HealthCMi