Chinese Herbs From A Western Medicine Viewpoint

How a Harvard-trained doctor began to appreciate Traditional Chinese Medicine, TCM.

As a child growing up in China, I was always aware of Traditional Chinese Medicine (TCM). TCM is what we refer to as Eastern medicine, in contrast to the Western medicine we know from U.S. hospitals. I never understood much about TCM, only that it somehow involves herbs and that many Chinese people used it. The more I progressed in my medical training in major U.S. academic centers, the more distanced I felt from TCM. Why should I learn about something that lacks evidence, when there’s so much to know about for which there is good research?

 

Last fall, I went to China on a research trip. While my study is primarily on its Western medical system, I was so fascinated by what I learned of Eastern medicine that I spent many free evenings observing TCM practitioners. There is so much I didn’t know. As a discipline, TCM is far too complex for me to understand in my short observation, but there are some very important “lessons from the East” that are applicable to our Western medical practice:

 

#1. Listen—really listen. The first TCM practitioner I shadowed explained to me that to practice TCM is to “listen with your whole body”. Pay attention and use every sense you have, he said. I watched this doctor as he diagnosed a woman with new-onset cervical cancer and severe anemia the moment she walked into his exam room, and within two minutes, without blood tests or CTs, sent her to be admitted to a (Western) medical service. I’ve seen expert clinicians make remarkable diagnoses, but this was something else!

“How could you know what you had and that she needed to be admitted?” I asked.

“I smelled the cervical cancer,” he said. “I looked and saw the anemia. I heard her speak and I knew she could not care for herself at home.” (I followed her records in the hospital; he was right on all accounts.)

 

#2. Focus on the  diagnosis. I watched another TCM doctor patiently explain to a young woman with long-standing abdominal pain why painkillers were not the answer.

“Why should we treat you for something if we don’t know what it is?” he said. “Let’s find out the diagnosis first.” What an important lesson for us—to always begin the diagnosis.

 

#3. Treat the whole person. “A big difference between our two practices,” said one TCM doctor, “Is that Western medicine treats people as organs. Eastern medicine treats people as a whole.” Indeed, I watched her inquire about family, diet, and life stressors. She counseled on issues of family planning, food safety, and managing debt. She even helped patients who needed advice on caring for the their elderly parents and choosing schools for their child. This is truly “whole person” care!

 

#4. Health is not just about disease, but also about wellness. There is a term in Chinese that does not have its exact equivalent in English. The closest translation is probably “tune-up to remain in balance”, but it doesn’t do the term justice, because it refers to maintaining and promoting wellness. Many choose to see a TCM doctor not because they are ill, but because they want to be well. They believe TCM helps them keep in balance. It’s an important lesson for doctors and patients alike to address wellness and prevention.

 

#5. Medicine is a life-long practice. Western medicine reveres the newest as the best; in contrast, patients revere old TCM doctors for their knowledge and experience. Practicing doctors do not rest on their laurels.

“This is a practice that has taken thousands of years to develop,” I was told. “That’s why you must keep learning throughout your life, and even then you will only learn just a small fraction.” Western medicine should be no different: not only are there new medical advances all the time, doctors need to continually improve their skills in the art of medicine.

 

#6. Evidence is in the eyes of the beholder. Evidence-based medicine was my mantra in Western medical training, so I was highly skeptical of the anecdotes I heard. But then I met so many patients who said that they were able to get relief from Eastern remedies while Western treatments failed them. Could there be a placebo effect? Sure. Is research important? Of course. But research is done on populations, and our treatment is of individuals. It has taken me a while to accept that I may not always be able to explain why—but that the care should be for the individual patient, not a population of patients.

“In a way, there is more evidence for our type of medicine than for yours,” a TCM teacher told me. “We have four thousand years of experience—that must count for something!”

 

There is so much I have not covered about TCM. Its practices vary regionally, and no doubt, there are more and less capable practitioners (as there are in Western medicine). More research into TCM methods will be important. However, regardless of whether we Western doctors want to prescribe TCM treatments, we should recognize there is much to learn from Eastern medicine, including what it means to be a physician to really care for our patients. Upon my return from China, I, for one, have a new found appreciation for Eastern medical practice and a renewed understanding of holistic medical care.

Sexy New Natural Products like Sleep Aids through Science

We can create better nutrition through science, right?  We can isolate green tea extract and mix it into our processed cereal to create a heart healthy product, right?  We can remove the curcuminoids from curcumin (which originates in herbs like turmeric) and add it to a chocolate bar to help reduce cholesterol, right?  Through chemistry we can isolate every health polysaccarides, saponin, polyphenol and trace mineral and put them into a drink, a food bar or any other new product formulation and call it a "natural product", right?

Technically speaking the answers to the above questions are yes.  But are we missing the forest from the trees.  We have no long term historical use that eating chemically extracted and combined super foods is actually good for the human body. 

Scientists/product developers are continually trying to improve upon nature for new natural product formulations for sleep, energy, hot flashes, well being, or … you fill in the blank.    But maybe, just maybe, our bodies don't know how to handle this new nutrition.  Does anybody stop and consider this is the first time in the history of man's diet that people are eating this way? 

Do our genetics change overnight to process these nutritional supplements which we've never ingested before?

What's lost in the process is the human bodies response to this myriad of natural chemical components that maybe, just maybe were never meant to be together in the first place.  Maybe a blueberry was never meant to cross paths with a chemically created biotin because the chemical components would never be found together in nature.

What I love about Chinese herbal medicine natural supplements is the lack of artificially created chemicals.  Chinese herbs combined together with other Chinese herbs, have already passed the test of mans digestive system.  The record books on Traditional Chinese herbal medicine far exceeds anything Guiness Books can duplicate, Chinese herbs are proven effective sleep aids, energy boosters, immune enhancers, the list goes on.  They don't need science to extract their individual active components and marry them off to a vitamin supplement or other extracted ingredient.  They have already been proven effective, no need for science to tell us which individual active ingredient works best with another. Natural ingredients work best synergistically together as whole foods for the whole body.

Before the microscope and before chemistry could explain which flavonol worked best with which gingerol, Chinese herbal medicine perfected the marriage of combining whole roots, barks, fruits, seeds etc. through thousands of years of use. They learned which plants worked best with each other. Not as a single ingredient extract, because nature never intended for us to use just one small chemical in the apple. Nature provides us the whole apple to eat and enjoy as a whole. When we piece meal the phyto-nutrients from the juice or the skin, we no longer have what nature intended.  How can our bodies possibly know what to do with a single chemical when it's spent millions of years eating it whole.

The message here is easy, when your looking for a natural sleep aid, energy drink or hot flash natural treatment, look for ALL natural ingredients that contain plant names.. not chemical names.

Study Shows Chinese Herbs Help Sleeplessness

iSleepherbpac.comAsian countries commonly treat sleeplessness with Chinese herbs more affordably and without the side-effects associated with prescriptions. A study done in Taiwan showed patients complaining of  insomnia were successfully treated with Chinese herbs.  

 

This study included 16,134 participants who received a total of 29,801 Chinese Herbal Medicine prescriptions. This large-scale study which used data assembled by the National Health Insurance of Taiwan, evaluated the frequency and patterns of Chinese herbs in treating insomnia

What’s unusual about this study is not just the sheer numbers of participants but the amount of data collected. Read the full study here.

The reason the study has such a large group of participants is simply because Taiwan has instituted a unique computerized data entry system as part of their health care system.    Patients can choose to visit either a Western hospital or a Traditional Chinese Medicine hospital. All data from patient visits are recorded in a national computer data base. Because data is readily available in electronic form, large scale analysis is easy. Data in this study covers the  course of one year.  The numbers reflect the patients who, according to diagnostic codes for insomnia, were treated with Traditional Chinese Herbal Medicine in 2002.

 

Included in this data are the following:

  • How many patients complained of insomnia, demographics on age, sex etc?
  • How many patients were prescribed various Chinese herb formula combinations in packets? (herbal packets are the preferred delivery method of Chinese herbs in Taiwan hospitals and clinics.)
  • How many patients were prescribed single Chinese herbs in packets?
  • Which Chinese herb formula was the most prescribed?
  • Which individual  herbs were often added to the prescribed Chinese herbal medicine formula?

Conclusion:

The data concluded the most common individual Chinese herbs prescribed for insomniawere Polygonum multiflorum used 23.8% of the time, followed by Ziziphus spinosa (18.3%) and Poria cocos (13.3%). Suan Zao Ren Tan was the most commonly prescribed formula.   These are the same Chinese herbal ingredients found in iSleep Herb Pack.

_____________________________________________________________________________________________ PUBLISHED IN:   EVIDENCE BASED COMPLEMENTARY & ALTERNATIVE MEDICINE CAM Advance Access published online on April 1, 2009 eCAM, doi:10.1093/ecam/nep018 © 2009 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Prescriptions of Chinese Herbal Medicines for Insomnia in Taiwan during 2002 Fang-Pey Chen1,2, Maw-Shiou Jong1,2, Yu-Chun Chen2,3, Yen-Ying Kung1,2, Tzeng-Ji Chen2,3, Fun-Jou Chen4 and Shinn-Jang Hwang2,3 1Center for Traditional Medicine, Taipei Veterans General Hospital, 2National Yang-Ming University School of Medicine, Taipei, 3Department of Family Medicine, Taipei Veterans General Hospital and 4Graduate Institute of Integration Chinese and Western Medicine, Chinese Medical University, Taichung, Taiwan

Chinese herbal medicine (CHM) has been commonly used for treating insomnia in Asian countries for centuries. The aim of this study was to conduct a large-scale pharmaco-epidemiologic study and evaluate the frequy and patterns of CHM use in treating insomnia.

We obtained the traditional Chinese medicine (TCM) outpatient claims from the National Health Insurance in Taiwan for the year 2002. Patients with insomnia were identified from the diagnostic code of International Classification of Disease among claimed visiting files.

Corresponding prescription files were analyzed, and an association rule was applied to evaluate the co-prescription of CHM. Results showed that there were 16 134 subjects who visited TCM clinics for insomnia in Taiwan during 2002 and received a total of 29 801 CHM prescriptions. Subjects between 40 and 49 years of age comprised the largest number of those treated (25.3%). In addition, female subjects used CHMs for insomnia more frequently than male subjects (female:male = 1.94:1). There was an average of 4.8 items prescribed in the form of either an individual Chinese herb or formula in a single CHM prescription for insomnia. Shou-wu-teng (Polygonum multiflorum) was the most commonly prescribed single Chinese herb, while Suan-zao-ren-tang was the most commonly prescribed Chinese herbal formula.

According to the association rule, the most commonly prescribed CHM drug combination was Suan-zao-ren-tang plus Long-dan-xie-gan-tang, while the most commonly prescribed triple drug combination was Suan-zao-ren-tang, Albizia julibrissin, and P. multiflorum.

For reprints and all correspondence: Prof. Shinn-Jang Hwang, Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan, ROC. Tel: +886-2-287-57460; Fax: +886-2-287-37901; E-mail: sjhwang@vghtpe.gov.tw

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National Institute of Health – PubMed study abstract on Suan Zao Ren Tang

J Biomed Sci. 2007 Mar;14(2):285-97. Epub 2006 Dec 7.

Gamma-aminobutyric acid (GABA) receptor mediates suanzaorentang, a traditional Chinese herb remedy, induced sleep alteration.

Yi PL, Tsai CH, Chen YC, Chang FC.

Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan.

Abstract

The sedative-hypnotic medications, including benzodiazepines and non-benzodiazepines, are the most common treatments for insomnia. However, concerns regarding patterns of inappropriate use, dependence and adverse effects have led to caution in prescribing those sedative-hypnotic medications. On the other hand, a traditional Chinese herb remedy, suanzaorentang, has been efficiently and widely used in clinic for insomnia relief without severe side effects in Asia. Although suanzaorentang has been reported to improve sleep disruption in insomniac patients, its mechanism is still unclear. The present study was designed to elucidate the effects of oral administration of suanzaorentang on physiological sleep-wake architectures and its underlying mechanism in rats. We found that oral administration of suanzaorentang at the beginning of the dark onset dose-dependently increased non-rapid eye movement sleep (NREMS) during the dark period, but had no significant effect on rapid eye movement sleep (REMS). Our results also indicated that intracerebroventricular (ICV) administration of gamma-aminobutyric acid (GABA) receptor type A antagonist, bicuculline, significantly blocked suanzaorentang-induced enhancement in NREMS during the dark period, but GABA(B) receptor antagonist, 2-hydroxysaclofen had no effect. These results implicated that this traditional Chinese herb remedy, suanzaorentang increases spontaneous sleep activity and its effects may be mediated through the GABA(A) receptors, but not GABA(B) receptors.

Warning, Those Sleeping Pills May Be Causing Other Health Hazards

  1-Pharmacies-thumb-300x354-103Friends just returned from their traditional summer camping trip.   This years’ trip was more exhausting for one particular husband, he was tired all day long.  He wasn’t getting a restful nights sleep even though he loves to camp, was out in the fresh air and ON vacation.  The problem stems from his addiction to his sleeping pills, which he needs even on a camping trip.  Although the nightly pill provided him some sleep it made him extremely drowsy during the day, especially since he's increased the dosage to get the desired effect.  He often wanted to just sit at the camp site and take a nap. If this you or someone you know, it’s time to kick the sleeping pill habit.  

Sleeping pills are an expensive habit both monetarily and physically because of the lingering side effects. Use of sleeping pills is becoming a growing problem.  If your taking them for any length of time,  you will notice the need to increase your dosage as your body's tolerance grows. At a  certain point they become completely ineffective.  The most popular "A" sleep pills and other sleep medications were designed to be taken for only a week or two at most. If you continue on this  medication  longer than two weeks the greatest concern is the side effects, which according to the label “cannot be anticipated”.

Side effects may include: allergies, daytime drowsiness, dizziness, drugged feeling, headache, indigestion and nausea.  If you experience any of these side effects, the price you pay for a good nights sleep just went up ten fold. For some, using "A", along with taking a SSRI or serotonin boosting antidepressant, will produce unusual changes in their thinking and/or behavior, according to  the insert information. Most definitely alert your doctor if this happens to you.  

Side effects of sleeping pills can also develop or change in intensity, so keep this in mind if you suddenly develop indigestion it may be caused by the sleeping pill, not necessarily related to an otherwise digestive/gut  problem.  Other warning from the manufacturers of this medicine can cause a special type of memory loss. It should not be taken on an overnight airplane flight of less than 7 to 8 hours, since "traveler's amnesia" may occur. Yikes, what’s travelers amnesia? Do you completely forget where you are and where your going.  (Apparently this has happened or it would not be a written warning).

The most common risk with prescription sleep aids used long term, is the risk of increasing the dosage in an attempt to keep the effectiveness as your bodies tolerance level increases. The same problem my friends husband was experiencing.   The overdose warning alone scares me from going near this drug. “People who take too much may become excessively sleepy or even go into a light coma. The symptoms of overdose are more severe if the person is also taking other drugs that depress the central nervous system. Some cases of multiple overdose have been fatal.”

All we want is a good nights sleep, this is just getting to complicated. I don’t  want to die.   I’m baffled that a drug with this many warnings can sell as much as it does. There’s more on the label, lets not miss this part of the warning:  “Until you know whether the medication will have any "carry over" effect the next day, use extreme care while driving, and you should be aware that they may be more apt to fall.”   Hope your  taking mass transit if your using a lot of this drug.  Older adults, in particular need to be careful. All I can figure is most people don’t read this stuff, they do print it in extra small writing.   More from the label, “use "A" cautiously if you have liver problems. It will take longer for its effects to wear off.” “If you take this sleep aid for more than 1 or 2 weeks, consult your doctor before stopping."

Sudden discontinuation of a sleep medicine can bring on withdrawal symptoms ranging from unpleasant feelings to vomiting and cramps.” "When taking "A", do not drink alcohol. It can increase the drug's side effects. If you have breathing problems, they may become worse. "If "A" is used with certain other drugs, the effects of either drug could be increased, decreased, or altered. It is especially important to check with your doctor ." 

These are direct quotes from the Ambien official website.  Maybe it's time for a natural sleep aid for that restful night of sleep you so desire.