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Posts Tagged ‘depression’

Sour Grapes or Sour Dates?

August 19th, 2010 No comments

I am a big fan of sleep.  I believe that good sleep is the best medicine, not just laughter.  I would like to write about a patient of mine, a fifty-something male, with complaints of hypertension and insomnia.

I was not the first TCM physician who the patient saw.  He had been given herbs before but his hypertension was still unabated.  When I saw him for the first time, history revealed that he had severe insomnia.  Logic dictates that his hypertension could be due to the lack of sleep.

Acupuncture, however, did not work at all.  I tried the patent remedy Zao Ren An Shen Ye, which helped a bit, but not so much.  Also, his blood pressure was still in the 180/100 range.  Not acceptable to me.

I brought out the heavy artillery.  I decided to use Suan Zao Ren Tang (Sour Jujube decoction).

After three days of taking the formula, the patient followed up.  He is sleeping better and his blood pressure is down to 140/90.  Talk about treating the branch by treating the root!

So what’s so special about Sour Jujube?

wild chinese jujube 300x225 Sour Grapes or Sour Dates?

Wild Chinese Jujube, courtesy foodsnherbs.com

A lot of people know about Da Zao (jujube or red dates) but what about Suan Zao Ren or sour jujube seeds?

Suan Zao Ren is sweet and sour in flavor, meaning it tonifies and preserves yin and fluids.  It’s nature is neutral so it will neither promote nor modulate physiology and inflammation.  It enters the Heart and Liver meridians so it affects the Mind through the Heart and the Qi through the Liver.  Great Chief herb.

Anyway that’s enough for now.  In a few days we will present an analysis of Suan Zao Ren Tang – the formula itself!

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Society of Fetal Medicine: Acupuncture Treats Depression

February 21st, 2010 No comments

Now before we wonder how fetuses in mommies get depression, let me clarify that what is mentioned here is depression of the mother-to-be.

Two New Studies Show Acupuncture Can Relieve Pain and Depression

The first study we have already mentioned (Scientists Find How Acupuncture Deactivates Pain (well, one of the ways) ) so let’s go to the second one:

Meanwhile, a study that was included in the 30th annual meeting of the Society for Maternal-Fetal Medicine in Chicago revealed that depression among pregnant women can be effectively treated with acupuncture.
I can’t get over a previous comment (see Some Guy: “No evidence for acupuncture”; Real World: “Lots of Evidence!“) where a commenter says that “the company that did the testing probably is in the work of acupuncture.  You think they’re gonna release anything that says anything EXCEPT “acupuncture works”?”  By that logic, then that whole society must be in the “work of acupuncture”.  It also means we should not take western medicine studies at their word because the company that did the testing is probably in the work of… selling western medicines.  Duh to the max.

Depression during pregnancy poses a tough dilemma for would-be mothers because anti-depression drugs can disrupt normal development of the fetus.
Nothing we don’t already know.
Experts at the acupuncture New York center suggest that the risk of miscarriage may increase upon intake of anti-depressants, especially Selective Serotonin Reuptake Inhibitors (SSRIs).
Mothers who take anti-depression medication during pregnancy are also prone to give birth prematurely to underweight and sickly infants.
“The results of our study show that the acupuncture protocol we tested could be a viable treatment option for depression during pregnancy,” Dr. Rosa Schyner, one of the authors of the study, said.
I wish the online text would specify what article it is…  (http://www.live-pr.com/en/two-new-studies-show-acupuncture-can-r1048405456.htm)
Previous studies providing scientific evidence validating the efficacy of acupuncture are plentiful.
Dr. Mike Cummings, Medical Director of the British Medical Acupuncture Society, pointed that decades of brain imaging data have already shown results like those of Dr. Asghar and Schyner’s studies.
*sarcasm alert* REALLY?!?!!? WOW, I didn’t KNOW THAT!!! (or as a blind, biased skeptic, I refuse to accept it)
He said that activity of primitive brain parts linked with pain and suffering decrease with acupuncture.
Dr. Cummings also said that acupuncture “appears to be particularly effective at treating pain and the suffering related to pain, but it may also have some effects on mood disorders, such as depression, through its general effects on the brain.”

Given that the qi sensations associated with REAL acupuncture are easily explained by stimulation of certain sensory fibers, and that all sensory stimuli pass through the hypothalamus, and that the hypothalamus is a collection of nuclei that affect everything from circadian rhythm to effecting the pituitary, I’m not surprised.

I still wish I could FIND the actual article and not just rely on the press release.  Google time.

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Scientists Find How Acupuncture Deactivates Pain (well, one of the ways)

February 7th, 2010 4 comments

… but are a bit lacking in their conclusion.  Let me explain.

Their headline is “Acupuncture ‘lessens pain in brain not body’, scientists discover”.

Acupuncture works by making the brain, rather than the body, no longer experience pain, according to new research.

by Andrew Hough (http://www.telegraph.co.uk/health/healthnews/7167362/Acupuncture-lessens-pain-in-brain-not-body-scientists-discover.html)

Scientists who scanned the brains of volunteers as they were given the Chinese therapy found it deactivated pathways that govern pain.
Complementary medicine expert Dr Hugh MacPherson, of the University of York, said: “These results provide objective scientific evidence that acupuncture has specific effects within the brain which hopefully will lead to a better understanding of how acupuncture works.”
A commenter earlier hinted that I am not being objective while citing evidence in this blog.  Fine.  I’m not objective.  I’m biased because I use acupuncture myself and can see the effects on patients firsthand.  I cannot help but acknowledge it works.  I myself am a “victim” of being “duped” as my headaches were gone for four years.  So don’t take my word for it.  Take the scientists’ word for it.  Oh wait, another commenter said that these studies that promote acupuncture are funded by companies that make money of it.  Let’s ignore the fact that most if not all western medicine studies on drugs are also funded by the drugs’ manufacturers.  I’m just saying let’s be consistent.  If we’re going to accuse acupuncture research of being biased because of who funds it, let’s distrust western medicine also!
Anyway, if I’m not being objective, let’s take Dr. MacPherson’s word for it.  Or are we to think that the University of York makes money by selling acupuncture needles?
The findings, published in Brain Research, suggest acupuncture has a significant effect on specific nerve structures.
Dr MacPherson and colleagues explained when a patient receives acupuncture treatment a sensation called deqi can be obtained. Scientific analysis showed this switches off areas within the brain that are associated with the processing of pain.
After reading this, I came to the realization that one reason that people do not understand that it is quite difficult to conduct double blind studies with acupuncture is the fact that they fail to see that acupuncture is more than just sticking needles into points.  The manipulation of the aforementioned needles is important, as they lead to the deqi sensation.  The feeling of deqi (“acquiring qi”) or “needling sensation” can be present upon inserting the needles alone (if done right), or through a bit of manipulation.  These manipulations are very dependent on the manual skill of the practitioner.  Hence, acupuncture should be treated as a PROCEDURE and not a pill.
G 06A 300x251 Scientists Find How Acupuncture Deactivates Pain (well, one of the ways)

Electroacupuncture is a supplement to enhance the "de qi"

You can insert the needles on the same points and not have the same effect if one acupuncturist just pricks the skin and the other manipulates them properly according to the specific needs of the patient.  For example I know that some patients are sensitive at LI 4 and only insertion is needed.  At the same time others may need a bit of stroking at the handle of the needle to obtain the deqi.  This knowledge comes from experience both with the points themselves in general and from knowing patients personally.
Dr MacPherson said: “We carried out two tests of acupuncture on our participants, one where the needles are inserted at a shallow depth which is the practise in Japan and the other where they went in much deeper which is the Chinese tradition.
“We found 10 out of the 17 experienced ‘deqi’ while the others didn’t, and this appeared to help in deactivating areas in the brain that are associated with pain.
“The Chinese have been using acupuncture for 2,000 years for wide ranging illnesses but we have only touched the surface at the moment.
“We believe it can help relieve a number of conditions, including depression which we have recruited 640 people for another study where half will receive acupuncture and the others counselling.”
Note the sequence of events: those who experienced “de qi” deactivated pain centers in the brain.  Those who did not… well.  I recall the words of the Yellow Emperor’s medical classic, and I paraphrase: for acupuncture to work, you need to obtain de qi.  Once de qi is obtained, there is no further need for manipulation.
needle Scientists Find How Acupuncture Deactivates Pain (well, one of the ways)

It's not enough to stick it in. The needles may have to be manipulated to obtain the qi sensation or "de qi"

As for that depression study, I am looking forward to it.  Then again the skeptics will just say that a sample size of 640 is too small.  Then 1000 will be too small… then 10,000… sigh.
Last summer acupuncture was recommended for the first time by the drugs watchdog NICE (National Institute for Health and Clinical Excellence) as a treatment option for NHS patients with lower back pain.
Guidelines now state that GPs should “consider offering a course of acupuncture comprising a maximum of ten sessions over a period of up to twelve weeks” for patients with this common condition.
Nice of NICE to say so.
Co researcher Dr Aziz Asghar, a neuroscientist at Hull York Medical School, added: “The results are fascinating. Whether such brain deactivations constitute a mechanism which underlies or contributes to the therapeutic effect of acupuncture is an intriguing possibility which requires further research.”
The team is currently researching if acupuncture has the ability to successfully treat irritable bowel syndrome and depression. Previous studies have indicated the holistic treatment works on knee pain and migraines.
Dr MacPherson and colleagues say their research could help to clear the way for acupuncture to be more broadly accepted as a treatment option on the NHS for a number of medical conditions.
But it’ll never be good enough for the “skeptics”.
Oh and my beef about the article title?  It shows the linear method of thinking.  The scientists found that acupuncture “defuses” pain sensations in the brain – so they conclude that that’s ALL it does.  Previous studies have shown acupuncture mediates pain in the spinal level and local level through various mechanisms (google the research of Bruce Pomeranz and Gabriel Stux).  It is multifactorial.
For reference, here is the abstract of the article (http://tinyurl.com/yb5p452)
Research Report
Acupuncture needling sensation: The neural correlates of deqi using fMRI
Aziz UR Asghara, b, Gary Greena, Mark F. Lythgoec, George Lewithd and Hugh MacPhersone, Corresponding Author Contact Information, E-mail The Corresponding Author
a York Neuroimaging Centre, University of York, Y10 5DG, UK
b Hull York Medical School and Department of Biological Sciences, University of Hull, Hull, HU6 7RX, UK
c RCS Unit of Biophysics, UCL Institute of Child Health, University College London, WC1N 3JH, UK
d Complementary Medicine Research Unit, University of Southampton, SO17 1BJ, UK
e Department of Health Sciences, University of York, YO10 5DD, UK
Accepted 7 December 2009.
Available online 16 December 2009.
Abstract
The needling sensation of deqi is considered by most acupuncturists to be an important component of acupuncture, yet neuroimaging research that investigates this needle sensation has been limited. In this study we have investigated the effect of deqi and acute pain needling sensations upon brain fMRI blood oxygen level-dependent (BOLD) signals. Seventeen right-handed participants who received acupuncture at the right LI-4 (Hegu) acupoint were imaged in a 3T MRI scanner. fMRI datasets were classified, on the basis of psychophysical participants’ reports of needling scores, into those that were associated with predominantly deqi sensations versus those with predominantly acute pain sensations. Brain areas showing changes in BOLD signal increases (activations) and decreases (deactivations) were identified. Differences were demonstrated in the pattern of activations and deactivations between groupings of scans associated with deqi versus pain sensations. For the deqi grouping, significant deactivations occurred, whereas significant activations did not. In contrast, the predominantly acute pain grouping was associated with a mixture of activations and deactivations. For the comparison between the predominately deqi sensation grouping and the acute pain sensation grouping (deqi > pain contrast), only negative Z value voxels resulted (mainly from deactivations in the deqi grouping and activations in the pain grouping) in the limbic/sub-cortical structures and the cerebellum regions of interest. Our results show the importance of collecting and accounting for needle sensation data in neuroimaging studies of acupuncture.
Keywords: Functional magnetic resonance imaging; Acupuncture; Needling sensation
Corresponding author. Senior Research Fellow, Department of Health Sciences, Area 3, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK. Fax: +1904 321388.
Brain Research
Volume 1315, 22 February 2010, Pages 111-118
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Acupuncture for Hot Flashes in Breast Cancer Patients

January 3rd, 2010 No comments

Hot Flashes.  Night Sweats.  Decreased energy levels.  Discomforts felt by many but made worse in breast cancer patients.  Symptoms also recognized as both a yin (five palm heat and night sweats) and qi (decreased energy levels) deficiencies.  Both improved by acupuncture.

Yet another study (and the skeptics say there aren’t any… pshaw!), this time in the Journal of Clinical Oncology (you mean these studies are in REAL medical journals? wow!) states what TCM practitioners have known since before Moses parted the Red Sea – that acupuncture and Chinese medicine can treat hormone imbalances.  The western medicine method of treating hormone imbalances can be summarized in two statements: a) suppress what is excessive and b) replace what is missing.

The Chinese medicine way is to try to see where the system isn’t working right and correct THAT.

But on to the article, found on Webmd.  Yes, webmd (http://www.webmd.com/breast-cancer/news/20091231/acupuncture-may-help-ease-hot-flashes)

Acupuncture May Help Ease Hot Flashes
Study Shows Acupuncture Offers Relief to Breast Cancer Patients With Hot Flashes
By Jennifer Warner
WebMD Health News
Reviewed by Louise Chang, MD

Dec. 31, 2009 — Acupuncture not only cools hot flashes that occur as a result of breast cancer treatment but may offer a host of other benefits to boost women’s well-being.

A new study shows acupuncture was as good as drug therapy with Effexor (venlafaxine) at easing hot flashes in breast cancer patients, but it also improved sex drive, energy levels, and clarity of thought.

“Acupuncture offers patients a safe, effective and durable treatment option for hot flashes, something that affects the majority of breast cancer survivors. Compared to drug therapy, acupuncture actually has benefits, as opposed to more side effects,” researcher Eleanor Walker, MD, division director of breast services in the department of radiation oncology at Henry Ford Hospital in Detroit, says in a news release.
According to the National Cancer Institute, one in eight women will develop breast cancer in her lifetime. Typical treatment for breast cancer involves chemotherapy and five years of hormone therapy that often causes unpleasant side effects, such as hot flashes, night sweats, and decreased sex drive and energy levels.

Researchers say these side effects of breast cancer treatment significantly decrease a woman’s quality of life and may cause some women to discontinue treatment.

Acupuncture has already been shown to reduce hot flashes in menopausal women, but researchers say this is the first study to compare acupuncture to drug treatment in easing hot flashes in breast cancer patients. The results appear in the Journal of Clinical Oncology.

Fifty breast cancer patients were randomly assigned to receive either acupuncture or drug treatment for 12 weeks. The acupuncture group received acupuncture treatments twice per week for the first four weeks and then once a week for the remaining eight weeks; the drug group received 37.5 milligrams of Effexor each night for the first week and then 75 milligrams per night for the remaining 11 weeks.

I can almost hear the randomized clinical trial robots going: but it isn’t double blinded? DUH.

All participants stopped their treatment after 12 weeks and kept a diary to record the number and severity of hot flashes; they were surveyed about their overall physical and mental health for one year.

Both groups experienced a 50% decline in hot flashes and symptoms of depression, but the acupuncture treatment appeared to have more lasting effects with fewer side effects.

For example, two weeks after the treatments stopped, the drug therapy group experienced an increase in hot flashes; the acupuncture group did not experience any increase in the frequency of their hot flashes until three months after treatment.

Okay this is worth commenting on: The endocrine system is a complex system of feedback mechanisms.  Positive feedback means that more of a particular substance causes increased secretion of a hormone.  Negative feedback means that less of a particular substance causes the increase.  It’s the body’s self regulation system in a nutshell.  When using hormone replacement therapy, there is a tendency for this system to go out of whack.  It’s precisely why people on steroids should not be on them too long and have the steroids tapered off instead of stopped suddenly.  Too long and the adrenals start thinking that the high level of steroids is normal, and you can have worse endocrine disorders like Addison’s Disease.  If stopped suddenly, there might be a sudden rebound of symptoms due to the sudden change in the amount of available hormone or precursors.  That’s precisely what happened when hormone therapy was discontinued after 12 weeks – sudden rebound.  With acupuncture, though, there was no backlash, and the symptoms came back slowly but not on the same levels as before treatment.  This is typical acupuncture results by the way.

In addition, the Effexor group reported 18 instances of negative side effects, including nausea, dry mouth, dizziness, and anxiety, compared with no adverse side effects reported among the acupuncture group.

Let’s repeat that statement, boys and girls.  NO ADVERSE SIDE EFFECTS.  NO ADVERSE SIDE EFFECTS.  Wait.  Didn’t the article earlier say FEWER side effects?  What’s the difference between a SIDE effect and and ADVERSE effect anyway?

Most breast cancer patients treated with acupuncture also reported an improvement in their energy, clarity of thought, and sense of well-being. About 25% of women in the acupuncture group also reported an increase in their sex drive.

Once again, if acupuncture is a placebo, I’ll take that placebo!

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