Fibromyalgia sufferers might benefit from tailored acupuncture

Fibromyalgia sufferers might benefit from tailored acupuncture

by Tim Newman

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Fibromyalgia affects an estimated 5 million Americans, 80-90% of whom are women. The disorder is characterized by widespread pain and diffuse tenderness. Although there is no cure, tailored acupuncture might provide some welcome respite, according to a new study.

New research shows that tailored acupuncture might relieve fibromyalgia symptoms.

Although difficult to categorize, fibromyalgia is considered a rheumatic condition because it impairs soft tissue and joints and causes pain.

Fibromyalgia carries with it a number of other life-disrupting symptoms that vary from individual to individual.

These symptoms can include muscle stiffness, headaches, irritable bowel syndrome (IBS) and sensitivity to temperature, sounds and bright lights.

The exact causes of fibromyalgia are not well understood; however, hypothesized culprits include traumatic or stressful life events and repetitive injuries.

There might also be links to other diseases such as lupus and rheumatoid arthritis; some researchers believe there is a genetic component at work, too. Because there are no known biological markers, diagnosing fibromyalgia can be problematic. To reach a conclusive decision, other overlapping disorders must first be ruled out.

Because of these questions surrounding genesis and diagnosis, effective treatments for fibromyalgia are not forthcoming.

A recent study conducted at Doňa Mercedes Primary Health Centre, in Seville, Spain, looked at the potential use of acupuncture to ease fibromyalgia's symptoms.

Complementary medicine and fibromyalgia

Perhaps because of the lack of medical treatments for fibromyalgia, one study found that 91% of sufferers seek solace in complementary medicine such as hydrotherapy, massage and acupuncture.

Acupuncture is used by 1 in 5 fibromyalgia patients within 2 years of diagnosis.

Previous clinical trials testing acupuncture's efficacy have been inconclusive, but these studies did not tailor the course of acupuncture to suit the individual needs of each fibromyalgia patient.

To investigate whether this might make a difference, the research team, led by Dr. Teresa Leiva, compared tailored acupuncture against sham acupuncture in 153 patients. Sham acupuncture involved using the same guide tubes as the genuine acupuncture group, but without inserting needles. The sham treatment solely focused on the dorsal and lumbar regions.

Each patient (sham and tailored) received 20-minute-long treatments, every week for 9 weeks. During the trial, the patients continued taking any prescription drugs they were already using.

The participants completed questionnaires rating various parameters such as levels of pain, depression and the overall impact of the disease on their lives. These reviews were carried out before the trial, at 10 weeks, 6 months and 12 months.

Sham vs. tailored acupuncture in fibromyalgia

At the 10-week mark, the tailored acupuncture group reported a 41% drop in pain, whereas the sham acupuncture group reported a 27% reduction.

Twelve months later, the effect was still apparent. The tailored group and sham group reported 20% and 6% reductions in pain, respectively.

The questions that rated the overall impact of fibromyalgia on participant quality of life told the same story across all three time points. The tailored group reported reductions in the disease's negative impact of 35%, 25% and 22%; the sham acupuncture group, at the same points in time, registered reductions of 24.5%, 11% and 5%.

Also, general measures of anxiety, fatigue and depression were significantly better at the 10-week mark for the tailored acupuncture group. The differences were still evident after a year, but the researchers note that antidepressant usage in the group had also risen, making the results difficult to interpret.

The authors of the report, published in Acupuncture in Medicine, a BMJ journal, concluded:

"This treatment produced an improvement in the participants' condition [...] Such an outcome has not been reported by previous studies following the application of standardized treatments: therefore, our results suggest that applying individualized treatment algorithms when starting a course of acupuncture may be important."

As the authors are quick to mention, this is the first time such a positive result has been found; additional, large-scale work will need to be carried out before solid conclusions are drawn. Because current medication only deals with the symptoms of fibromyalgia, any intervention that can ease the suffering will be a welcome advance. 

Source of the report is here.

World can gain from more TCM research

World can gain from more TCM research

Lee Wei Ling

Doctors might be asked to express their view of traditional medicine from time to time. It can be a sensitive subject as traditional medicine tends to be bound up with a philosophical system.

Consequently, cultural chauvinism might surface, as during discussions about national healthcare systems. This was evident in reactions to the award of the 2015 Nobel Prize in medicine, half of which went to China's Tu Youyou. She was recognised for extracting an effective anti-malarial drug, artemisinin, from sweet wormwood.

There is no question that she deserves her Nobel award as artemisinin is the most effective anti-malarial drug now available. But I am ambivalent about the impact of the award because it might lead laymen to believe traditional Chinese medicine (TCM) is more effective than it actually is.

Indeed, the Nobel committee had stressed that it was not giving a prize to traditional medicine but for specific scientific work inspired by it. This contradicts what Chinese Premier Li Keqiang said when he hailed her discovery as an example of the "great contribution of TCM to the cause of human health".

Although I am cynical about TCM, I am not saying all TCM treatments are ineffective. What the world can benefit from is research into the active components of each particular TCM medicine and into how it works.

The extent to which chauvinism and vested interests can rise even here is illustrated by what was faced by Singapore's father of paediatrics, Professor Wong Hok Boon. In the late 1970s, Prof Wong, publicly stated that to ingest TCM is equivalent to eating grass. Soon after that, he received death threats. Prof Wong took the threats seriously enough to accept the presence of security officers who accompanied him publicly for a couple of weeks.

As a scientifically trained doctor, I have always tried to dissuade my patients from turning to TCM for many reasons. First, TCM, until recent years, generally does not adopt a scientific approach to illness and the medicines do not usually target specific illnesses. Second, faith in TCM often has cultural roots and is not based on clear evidence of its efficacy.

TCM champions argue that it is unlikely for no effective medicines to emerge after five thousand years of continuous Chinese civilisation. Even my father was inclined to believe this. My reply to Papa was: "Life is cheap in China."

A cultural bias can also lead to contradictions. Professor Volker Scheid of London's University of Westminster, who studied TCM for 30 years, said: "I would say 95 per cent of Chinese would think I cannot be a very good TCM practitioner because I am not Chinese, but, at the same time, China wants to make Chinese medicine global."

I personally think TCM is unreliable (regardless of who the TCM practitioner is) because it lacks a scientific basis. Most times, it could be just hocus-pocus.

The basis of TCM is not about human biology, as we know it. It postulates that the human body contains a life force called qi. And illness is the result of imbalances between the five elements - fire, water, earth, metal and wood. None of this has ever been proven but, to believers, that is irrelevant.

Nobel laureate Tu's achievement is that she chemically extracted the active ingredient of a single plant in isolation. Such extraction is absent when a TCM shop prepares doses from a variety of plant and, occasionally, animal sources. No one knows the active ingredient at work, the concentration of such substances, or the presence of active components that are detrimental to health. But instructions on how to prepare and take the herbal brew, combined with folklore and cultural belief, can give the patient a false sense of security.

Every now and then, our Health Sciences Authority issues a statement of caution warning the public that certain batches of TCM medicines have been tested and found to contain lead or arsenic. Both these substances are toxic and dangerous to humans.

In 1980, I accompanied my parents on Papa's second official visit to China. The wife of the Chinese official accompanying us on that trip was a doctor trained in TCM and Western medicine. She told me that spine X-rays of a patient with back pain often show excess bone on the spinal column (spondylosis), a problem common in older people which may or may not cause back pain.

According to her, after practising qigong for some time, the X-rays of patients revealed no excess bone. She had published her findings in a Chinese medical journal. This is totally unbelievable, since qigong cannot cause bone to disappear. What is possible is that the patient did have back pain (which may or may not have been due to spondylosis) and the qigong, as a form of exercise, helped to reduce the back pain.

Many TCM practitioners sell hope. I will never forget a 10-year-old old girl whom I saw with brainstem glioma (brain tumour). When I told her parents the prognosis was grim in her case, they asked around and found a TCM practitioner who assured them that if he treated the girl, there was a 30 per cent chance of a cure.

I tried to dissuade them from taking this route but her father said: "He offers me a chance for hope, how can I not try it?" A few weeks later, the parents brought the patient back to see me because her condition had deteriorated due to the natural progression of the disease. The father was $20,000 poorer by then (this was in the 1980s when $20,000 represented a large sum of money). TCM did not lead to adverse effects but my treatment would have somewhat relieved the patient of suffering, although Western medicine could not change the natural course of the disease.

TCM physicians claim that, unlike Western medicine, TCM works gently and gradually. Western drugs are said to be too powerful and abrupt in their action. This situation makes it difficult for patients to know whether the medicine is effective, and also difficult for science to establish if the medicine works. When patients delay seeking proper treatment by seeing TCM physicians instead, that delay could have detrimental consequences.

TCM often uses herbs, and practitioners claim what they prescribe is natural and works like a general tonic, unlike a drug that specifically targets certain organs or certain diseases. Examples are ginseng and cordyceps.

Laymen, as a rule, connect "natural" with "safe". But remember that nature did not evolve to serve mankind. For example, digoxin, which is used in treating heart disease, was first obtained from the leaves of a digitalis plant. But it certainly can be fatal in overdose.

Quite a few TCM practitioners might add effective Western medicine to their "natural" prescription. For an asthmatic, they might include a corticosteroid such as prednisolone. That will indeed improve the asthma and make the patient put on weight. Both are desirable outcomes for the mother of a patient. But there are other important negative effects to health when ingesting excessive amounts of certain substances.

Although I am cynical about TCM, I am not saying all TCM treatments are ineffective. What the world can benefit from is research into the active components of each particular TCM medicine and into how it works. By doing so, we can more precisely identify what agents are effective and test their wider application as well as their side effects. In studying the mechanism of action of the active agent, we will gain valuable knowledge of the pathogen as well as how the human body reacts towards the pathogen.

I do not reject TCM but I feel patients deserve better care than the way TCM is currently applied. I also hope researchers will be able to learn more about the benefits possible from TCM medicines. Whatever the form of medicine, ultimately what matters is that patients are helped to recover and risks to them are minimised.

The source of this article is from

Integrate TCM and Western medicine to best benefit patients

Integrate TCM and Western medicine to best benefit patients

I thank Dr Lee Wei Ling for encouraging more research into traditional Chinese medicine (TCM) and for recognising that, like all medicine, not all TCM treatments are effective ("World can gain from more TCM research"; Jan 17).

There is an enormous amount of scientific research that has already gone into TCM.

Nobel laureate Tu Youyou's work was recognised because it produced an important Western drug from Chinese herbal sources. It also showed that TCM research institutions are capable of doing good-quality scientific work.

As a TCM physician who has received degrees in both biomedical sciences and TCM, I am able to see medicine from both perspectives, an advantage that people with pure biomedical training may not have.

TCM adopts an approach based on the patient's external manifestations, which compel a holistic view based on inferences regarding imbalances in the body.

In contrast, Western medicine (biomedicine) focuses on diagnostic tests at the microscopic level.

This results in biomedicine tending to be disease-centric, while TCM tends to be patient- centric, directing attention to the overall condition of the patient.

To borrow a term from Dr Lee, it is "cultural chauvinism" for either to make an exclusive claim to scientific truth or therapeutic efficacy.

Let us not cite anecdotes of failed TCM treatments to discredit TCM as a whole. In every trade, there are black sheep.

There are numerous accounts and clinical trials that show the successful outcomes of TCM. We should not deny these just because of a few black sheep.

I am heartened by doctors who encourage TCM research.

However, a distinction has to be made between testing TCM theory and its therapies on the one hand, and clinical trials conducted on herbs for drug discovery purposes on the other.

Searching for active ingredients in herbs is just scraping the surface of what TCM can offer.

TCM is based on empirical knowledge gained from detailed case studies accumulated over centuries. This is now being supplemented with evidence-based medicine protocols.

There is a vast amount of information in TCM that we can integrate with current biomedical knowledge, in order to best benefit humankind. We should pick out the things that are useful in TCM, use them and pass them on to future generations. This requires an open mind among both TCM and biomedical physicians.

Let us all work towards adopting a more positive scientific attitude towards a system of health and healing that continues to play an important role in Singapore healthcare.

Don't sniff at traditional Chinese medicine

Don't sniff at traditional Chinese medicine

It would be myopic for the medical world to reject alternative medicine as a form of treatment ("World can gain from more TCM research"; Jan 17 and "Integrate TCM and Western medicine to best benefit patients" by Ms Melissa Ong Zhi Lin; last Sunday).

If practitioners of modern medicine and alternative practices like traditional Chinese medicine (TCM) keep fighting among themselves instead of working together, the only ones who suffer are the patients.

China has carried out extensive research in the field of TCM. Many of its hospitals have successively integrated TCM with modern medicine to increase the efficacy of treatment programmes.

Take cancer treatment, for example. In hospitals with an integrated treatment programme, patients undergoing chemotherapy, radiotherapy or surgery would be prescribed TCM as well.

The statistics shows that not only does the efficacy of the chemotherapy and radiotherapy treatments increase, but patients also suffer from fewer side effects and have lower chances of suffering from relapses.

China has even successfully incorporated arsenic, which has been known as a medicine and a poison, into the treatment of acute promyelocytic leukaemia.

In another case, a train crash near London in 2002 left Ms Tanya Liu, a TV anchorwoman of Hong Kong's Phoenix TV, fighting for her life.

She was airlifted back to Beijing, where she underwent an integrated treatment programme formulated by her doctors. It included surgery, Western medicine and Chinese medicine.

She woke up from her coma after about two months, could stand and walk on her own after half a year, and was back at work in two years.

It is time modern medicine took a look at TCM again and ask how it can be incorporated to help patients.

It is evident that most doctors have little or no understanding of Chinese medicine. This has to change. At the end of the day, the health and well-being of the patients should be the top priority for all medical practitioners, Western and TCM alike.

This article comes from here.

Huang Qin Tang

 Huang Qin Tang

Scutellaria Decoction (Huang Qin Tang) is a combination of four herbs: Scutellaria baicalensis (Huang Qin), Glycyrrhiza uralensis (Gan Cao), Paeonia lactiflora (Bai Shao), and Ziziphus jujuba (Da Zao). Shang Han Lun: On Cold Damage, Line 172 says, "When, in a greater yang/lesser yang combination disease, spontaneous diarrhea is manifested, Huang Qin Tang is prescribed."¹ Zhang Zhongjing goes on to state that Huang Qin Tang is prescribed for lesser yang pathogenic heat distressing yang brightness, with symptoms of diarrhea, abdominal pain, and scorching heat in the anus.1 Since the third century, Huang Qin Tang has been documented to treat common gastrointestinal distress and its concomitant symptoms of fever, headache, extreme thirst, nausea, vomiting, diarrhea, abdominal spasms, and subcardiac distention. In the 17th and 18th centuries, the application was broadened to include the treatment of warm-pathogen diseases. Seventeenth-century physician Zhang Lu observed that Huang Qin Tang basically treats "spring and summer warm pathogen heat where fever develops from within (i.e., without marked exterior symptoms like chills at the onset)."² Later, Ye Tianshi, a great physician of the Warm Febrile Disease school, extended Zhang Lu's theory and practice to the treatment of lurking pathogens. In his text, Differentiating Lurking Pathogens and Externally-Contracted Diseases During Three Seasons, Ye Tianshi stated: "Cold that attacks the body in winter lurks in the kidneys, transforms into heat, and manifests in the gallbladder in the spring. Huang Qin Tang is prescribed for this condition to clear heat with bitter and cold herbs."³