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Posts Tagged ‘insomnia’

The Sour Dating Game

August 22nd, 2010 No comments

Last time, I talked about Suan Zao Ren Tang and mentioned some things about the main ingredient, Suan Zao Ren (Sour Date Seed).  I now present to the reader some excerpts from a 2002 study:

Chen, et al.  Prescriptions of Chinese Herbal Medicines for Insomnia in Taiwan in 2002. eCAM Advance Access published online on April 1, 2009.
eCAM, doi:10.1093/ecam/nep018 (
http://ecam.oxfordjournals.org/cgi/content/full/nep018)

Let’s go specifically into the part on Suan Zao Ren.

The second most commonly used Chinese herb for subjects with insomnia in our study was Suan-zao-ren (Z. spinosa). It is the chief ingredient in the formula of Suan-zao-ren-tang. In an animal model, Peng et al. (29) reported that Suan-zao-ren had a sedative effect at higher doses and an anxiolytic effect at lower doses. In addition, Zhang et al. (30) indicated that Jujuboside A, one of the components of Suan-zao-ren, produced its sedative–hypnotic effects through effecting the actions of anti-calcium-binding proteins and it inhibited the glutamate-mediated excitatorysignaling pathway in the hippocampus. Jiang et al. (31) also reported that saponins, the main bioactive components of Suan-zao-ren, could prolong the sleeping time induced by barbiturates. In addition, Ma et al. (32) revealed that sanjoinine A, an alkaloid compound of Suan-zao-ren, might regulate GABAergic neurons and further increase the sleeping time and decrease the sleep latency induced by pentobarbital. Notably, there was a case report indicating that Suan-zao-ren could interact with the antidepressant, venlafaxine (Efexor), thereby leading to an acute serotonin reaction (33).

So nice to see that traditional Chinese Medicine is being STUDIED and PROVEN to work.  Here are the research papers cited by Chen et al:

  1. Peng WH, Hsieh MT, Lee YS, Lin YC, Liao J. Anxiolytic effect of seed of Ziziphus jujuba in mouse models of anxiety. J Ethnopharmacol ( 2000;) 72:: 435–41. 
  2. Zhang M, Ning G, Shou C, Lu Y, Hong D, Zheng X. Inhibitory effect of jujuboside A on glutamate-mediated excitatory signal pathway in hippocampus. Planta Med ( 2003;) 69:: 692–5. 
  3. Jiang JG, Huang XJ, Chen J. Separation and purification of saponins from Semen Ziziphus jujuba and their sedative and hypnotic effects. J Pharm Pharmacol ( 2007;) 59:: 1175–80. 
  4. Ma Y, Han H, Eun JS, Kim HC, Hong JT, Oh KW. Sanjoinine A isolated from Zizyphi Spinosi Semen augments pentobarbital-induced sleeping behaviors through the modification of GABA-ergic systems. Biol Pharm Bull ( 2007;) 30:: 1748–53. 
  5. Stewart DE. Venlafaxine and sour date nut. Am J Psychiatry ( 2004;) 161:: 1129–30.

The other herbs in the formula include Chuanxiong, Fuling, Zhimu and Gancao.  The effects of each material seems obvious at first.  From a Chinese pharmacologic point of view, Chuanxiong regulates liver blood and clears blood stasis, Zhu Mu clears deficiency heat and nourishes yin, Gan Cao harmonizes, but what about Fu Ling?  Fu Ling is known for draining dampness, but it should be noted that it enters the Heart meridian as well and thus, has an effect of tranquilizing the mind and calming the spirit.

I had read somewhere that the formula as a whole lowers epinephrine levels, but have yet to find the actual research stating such.

This formula was first noted in Zhang Zhongjing’s “Essentials from the Golden Cabinet”, around 208 AD.  Truly a brilliant man.

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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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Insomnia: Chinese Medicine Better than Counting Sheep

October 29th, 2009 2 comments

Okay, I meant that as a joke.  What isn’t a joke is that so many people have sleep problems and are reliant on western drugs that sometimes counting sheep is the only apparent alternative option.  Just today, after our weekly conference at the University of the Philippines College of Medicine Dept. of Family and Community Medicine, a colleague asked me to treat her with acupuncture for her jet lag.

How fitting, it seems, that I then stumble on this news article a few hours later:

Traditional Chinese Medicine Effectively Treats Insomnia <http://www.naturalnews.com/027348_medicine_insomnia_Chinese.html>

Melissa Sokulski starts:

Acupuncture, which actually treats the person, not the disease, helps to balance the body’s energy, strengthening weak areas and moving energy where it’s stuck…

Insomnia can have many causes; figuring out the cause is an important part of diagnosis and treatment. For instance, pain can cause insomnia because the person is not able to get into a comfortable position for sleeping and the pain wakes them up. In that case acupuncturists treat the pain.

Okay, “balancing body energy” isn’t exactly accurate, but it’s not that far off either.  What she did hit right on the point (pun intended) was the importance of treating the CAUSE and not just the symptom.  Of course, for western medicine, cause means “what biological agent is missing or excessive” whereas for us cause means “what’s causing the imbalance” whether internal or external…

countingsheep 300x239 Insomnia: Chinese Medicine Better than Counting Sheep

Is Counting Sheep the Gold Standard for Insomnia?

The rest of the article is so good I’ll just reprint it here, but it ends with some points and formulas that can be used and I discourage people from taking these over the counter – it is still best to be evaluated by a professional:

Eating late at night is a common cause of insomnia. When people stop eating after 7 pm, sleep often comes much more easily and is more peaceful. According to the Chinese Clock, digestion is the strongest in the morning, between 7 am and 9 am for the Stomach, and 9 am to 11 am for the Spleen/Pancreas. Twelve hours later (7 pm to 11 pm) digestion is the weakest, and eating at this time will cause gas, bloating and indigestion, making it difficult for one to fall asleep easily. Other causes of insomnia according to Traditional Chinese Medicine are yin deficiency, an imbalance of yin and yang, heart imbalance, spleen deficiency and stagnant liver qi.

In my practice, Spleen Deficiency is the most common cause of insomnia.  It leads to decreased production of Blood and thus, the Mind has no place to rest.  Thus, sleep is inefficient.  EVERYONE these days seemingly has some form of liver qi stagnation.  I believe it affects sleep by affecting Blood as well.  (In TCM, the Liver stores Blood.)

Acupuncturists take a detailed history, which includes questioning, pulse analysis and tongue diagnosis, to give a complete picture of the patient as a whole. Even if it is determined that two different patients have insomnia as a result of yin deficiency, their treatments may still be different, depending on each person’s constitution (strength and type of overall body and health) and other factors.

This is what makes acupuncture so individualized and effective: there is no one prescription for a condition. Each time a patient comes in, they are re-evaluated, and each treatment is specifically selected. This is also why it is so common to see all sorts of symptoms clear up – not just the one someone has come in to treat. Rarely do acupuncturists just work on one symptom alone; in every treatment, the whole person is being addressed and treated.

Again, an emphasis is put on customized treatment for an individual person.  Sure, by picking points and formulas symptomatically, you can treat symptoms.  But that is not the same as effecting a long term solution.  It does sound weird, though when I question an insomniac lady about her menses and poo-poo in great detail…

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