A crash course in Chinese herbology for the psychopharmocological prescriber.
Exp Clin Psychopharmacol. 2009 Dec;17(6):384-95
Authors: White KP
Given the unparalleled popularity of botanicals in the United States, it is safe to say that almost every psychopharmacological prescriber will see some patients using Chinese herbs. Data show that between 36% and 42% of Americans use complementary and alternative medicine (CAM) each year and that persons suffering from depression and anxiety (67%) use CAM services significantly more than do their nonanxious and nondepressed counterparts (39%). This article gives an overview of several classical Chinese medical single herbs and herbal formulas commonly used for persons with psychiatric disorders and discusses some of the herbs that have the potential to interact with various pharmaceutical drugs. In addition, the article reviews scientific evidence and, at times, the lack thereof to validate the use of Chinese herbs and formulas in treating psychiatric conditions. Overall, the article seeks to prepare the pharmacological prescriber for working with patients concomitantly taking psychiatric medications and Chinese herbs. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Dr.Steve’s BOTTOM LINE: If you want a quick 411 article on Chinese psychoactive herbology (e.g. anxiety, depression etc) which is pretty readable and is well referenced, this is it. It’s not comprehensive even for this area of interest, so don’t think that if something it missing that it must not work. They did a great job, but the study of herbs is VERY broad and this is simply a great start about the “best” stuff as far as scientific evidence is concerned for psychoactive herbs.
Effect of sodium ferulate on the hyperalgesia mediated by P2X(3) receptor in the neuropathic pain rats.
Brain Res. 2009 Dec 4;
Authors: Zhang A, Gao Y, Zhong X, Xu C, Li G, Liu S, Lin J, Li X, Zhang Y, Liu H, Linag S
Neuropathic pain usually is persistent and no effective treatment. Activation of P2X(3) receptor subtype in primary sensory neurons is involved in neuropathic pain. Sodium ferulate (SF) is an active principle from Chinese herbal medicine and has anti-inflammatory activities. This study observed the effects of SF on the hyperalgesia mediated by P2X(3) receptor of rats after chronic constriction injury (CCI). Mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were measured and the expression of P2X(3) receptor immunoreactivity and protein in dorsal root ganglion (DRG) neurons was analyzed by immunohistochemistry and western blotting. CCI rats treated with SF, the MWT and TWL were increased compared with CCI rats treated with normal saline. The expression of P2X(3) receptor in DRG neurons was increased after CCI. In CCI rats treated with SF, the up-regulated expression of P2X(3) receptor in DRG neurons was reduced. SF may reduce the thermal and mechanical hyperalgesia in CCI rat model by decreasing the pain transmitting of primary afferant neurons mediated by P2X(3) receptor during the chronic neuropathic pain injury.
Dr.Steve’s BOTTOM LINE: Neuropathic pain is experienced by up to 10% of people with 5% being reported as severe. Examples are pain suffered by diabetics, those afflicted with Herpes Zoster (or Simplex in some cases), and in some cancer and HIV patients. The P2X(3) receptor is one which is increased in number with this kind of pain. In this laboratory rat model, the receptor was “stimulated” to increase in number artificially (upregulation) and then blocked effectively with sodium ferulate, reducing the mechanism for pain transmission. This is very promising work and may help explain how certain Chinese anti-inflammatory and anti-pain herbs work at the molecular level. Human studies are needed but this means there is a plausible scientific explanation for how some Chinese herbs work to reduce pain and inflammation.
Use of Chinese herbal medicine among menopausal women in Taiwan.
Int J Gynaecol Obstet. 2009 Dec 5;
Authors: Chen LC, Wang BR, Chen IC, Shao CH
OBJECTIVE: To assess the patterns of use of Chinese herbal medicine (CHM) used by women in Taiwan to treat menopausal symptoms. METHODS: A retrospective review of the records of women who received CHM therapies for menopausal symptoms at the Traditional Medicine Center, Veterans General Hospital, Taipei, between January 2003 and December 2006. The average number of therapies per prescription, dosage, and duration of the prescription were recorded. The most commonly prescribed herbs and formulae were also recorded. Data were analyzed using descriptive statistics. RESULTS: The records of 3432 women who were administered a total of 19370 CHMs to treat symptoms of the menopause were reviewed. The average number of drugs per prescription was 5.64. Most of the prescriptions (97.1%) were prescribed to be taken 3times a day. The most commonly prescribed Chinese herb was Leonurus heterophyllus. Jia-Wey-Shiau-Yau-San was the most commonly prescribed Chinese herbal formula. CONCLUSION: CHM is commonly used in Taiwan for the treatment of menopausal symptoms. The efficacy and safety of CHM drugs used for the management of menopausal symptoms require further study.
Dr.Steve’s BOTTOM LINE: While this study does not really prove anything, it certainly tells us that herbal treatment of menopausal hot flashes and other symptoms is alive and well and extremely popular in Taiwan. Both of these are one of the 50 fundamental herbs in traditional Chinese medicine (TCM) and there is published evidence that they can relieve vasomotor or “flushing” symptoms. The question is, exactly how well do they work….. and this remains an unanswered question.
IS CHIOS MASTIC GUM EFFECTIVE IN THE TREATMENT OF FUNCTIONAL DYSPEPSIA? A PROSPECTIVE RANDOMISED DOUBLE-BLIND PLACEBO CONTROLLED TRIAL.
J Ethnopharmacol. 2009 Dec 1;
Authors: Dabos KJ, Sfika E, Vlatta LJ, Frantzi D, Amygdalos GI, Giannikopoulos G
BACKGROUND: Herbal remedies are increasingly popular for the treatment of functional dyspepsia. Chios mastic gum is a resinous exudate from the stem of Pistacia lentiscus var.chia. It is a traditional natural remedy used throughout the eastern Mediterranean. The aim of this study was to assess the efficacy of Chios mastic gum in patients with functional dyspepsia. METHODS: One hundred and forty eight patients fulfilling Rome II criteria for functional dyspepsia were randomly assigned to receive either Chios mastic gum 350mg three times daily or placebo. After three weeks of treatment the change from baseline in the severity of symptoms of functional dyspepsia was assessed using the Hong Kong index of dyspepsia. Patients’ global assessment of efficacy was also evaluated. RESULTS: The symptom score after treatment was significantly lower in the Chios mastic gum than in the placebo group ((14,78+/-1,78) vs (19,96+/-1,83)) (p<0,05). There was a marked improvement of symptoms in 40% of patients receiving placebo and in 77% of patients receiving Chios mastic gum (p<0.02). Individual symptoms that showed significant improvement with Chios mastic gum were: Stomach pain in general, stomach pain when anxious, dull ache in the upper abdomen and heartburn (<0.05 for all four symptoms). CONCLUSION: Chios mastic gum significantly improves symptoms in patients with functional dyspepsia compared to placebo.
Dr.Steve’s BOTTOM LINE: In case you’re wondering, functional dyspepsia is the medical term for indigestion. While it is technically not heartburn, the two conditions overlap and this herbal gum helps most or all of indigestion symptoms, including heartburn. It has been widely used in Mediterranean and Mideast countries for at least 3,000 years. Other studies show that it has antimicrobial, antacid and protective effects on the stomach lining or mucosa. So, since it has some significant scientific proof, consider it. However, make sure you check with your doctor to make sure you don’t have something more serious going on, like ulcers and precancerous changes in your esophagus.
Ganoderma lucidum Extracts Inhibited Leukemia WEHI-3 Cells in BALB/c Mice and Promoted an Immune Response in Vivo.
Biosci Biotechnol Biochem. 2009 Dec 7;
Authors: Chang YH, Yang JS, Yang JL, Wu CL, Chang SJ, Lu KW, Lin JJ, Hsia TC, Lin YT, Ho CC, Wood WG, Chung JG
Ganoderma lucidum (G. lucidum) is a medicinal mushroom having biological effects such as immunomodulation and anti-tumor actions. In China and many other Asian countries, G. lucidum is used as a folk remedy to promote health and longevity. Although many studies have shown that G. lucidum modulates the immune system, including, for example, antigen-presenting cells, natural killer (NK) cells, and the T and B lymphocytes, the effects of G. lucidum on the WEHI-3 leukemic BALB/c mice are unclear. We attempted to determine whether G. lucidum would promote immune responses in BALB/c mice injected with WEHI-3 leukemia cells. The effects of G. lucidum on the survival rate of WEHI-3 leukemia cells injected into BALB/c mice were examined. It increased the percentages of CD3 and CD19, but decreased the percentages of Mac-3 and CD11b markers, suggesting that differentiation of the precursor of T and B cells was promoted but macrophages were inhibited. It decreased the weight of spleens as compared with control mice. It also promoted phagocytosis by macrophage from peripheral blood mononuclear cell (PBMC) and it also promoted natural killer cell activity. It decreased the percentage of leukemia cells in the spleens of mice before they were injected with WEHI-3 cells. Apparently, G. lucidum affects murine leukemia WEHI-3 cells in vivo.
Dr.Steve’s BOTTOM LINE: Otherwise known as Reishi mushroom or Ling Zhi, this is a fungus that has been used in oriental medicine for thousands of years as a “fix it all” kind of approach. This laboratory animal study shows that the anticancer effect that has been suggested for eons really has some scientific plausibility to it. This is likely not the magic bullet but joins a long list of herbal and natural anti-cancer substances that need more investigation. In the end, we want to know what works better than the next substance. This goes for drugs and natural substances since one does not want to waste time with less effective treatments when they have an aggressive cancer growing insider of them.
Polysaccharide-containing Macromolecules in a Kampo (Traditional Japanese Herbal) Medicine, Hochuekkito: Dual Active Ingredients for Modulation of Immune Functions on Intestinal Peyer’s Patches and Epithelial cells.
Evid Based Complement Alternat Med. 2009 Dec 4;
Authors: Kiyohara H, Nonaka K, Sekiya M, Matsumoto T, Nagai T, Tabuchi Y, Yamada H
A traditional Japanese herbal (Kampo) medicine, Hochuekkito (Bu-Zhong-Yi-Qi-Tang in Chinese, TJ-41) is a well-known Kampo formula, and has been found to enhance antigen-specific antibody response in not only local mucosal immune system in upper respiratory tract, but also systemic immune system through upper respiratory mucosal immune system. Although this immunopharmacological effect has been proposed to express by modulation of intestinal immune system including Peyer’s patches and intestinal epithelial cells, active ingredients are not known. TJ-41 directly affected the production of bone marrow cell-proliferative growth factors from murine Peyer’s patch immunocompetent cells in vitro. Among low molecular, intermediate size and macromolecular weight fractions prepared from TJ-41, only fraction containing macromolecular weight ingredients showed Peyer’s patch-mediated bone marrow cell-proliferation enhancing activity. Anion-exchange chromatography and gel filtration gave 17 subfractions comprising polysaccharides and lignins from the macromolecular weight fraction of TJ-41, and some of the subfractions showed significant enhancing activities having different degrees. Some of the subfractions also expressed stimulating activity on G-CSF-production from colonic epithelial cells, and statistically significant positive correlation was observed among enhancing activities of the subfractions against Peyer’s patch immunocompetent cells and epithelial cells. Among the fractions from TJ-41 oral administration of macromolecular weight ingredient fraction to mice succeeded to enhance antigen-specific antibody response in systemic immune system through upper respiratory mucosal immune system, but all the separated fractions failed to enhance the in vivo antibody response in upper respiratory tract.
BOTTOM LINE: Peyer’s patches are part of your immune system. Since you take in potentially disease producing organisms and other antigens, these patches are part of the immune surveillance mechanism to guard your body from what you eat. They contain macrophages, dendritic cells, B-lymphocytes, and T-lymphocytes. This highly technical laboratory study shows that some fractions of Hochuekkito ( a mixture of raw Japanese herbs) are capable of enhancing this immune response and boosting your protection. Studies of this kind are necessary to figure out what parts of what actually work vs. being just fluff or potentially dangerous fractions. As noted before, philosophically this is anti-naturopathic because it is likely that various parts of plants/herbs act together to creates a synergy or enhanced effect. The problem is that this is not always the case and some fractions may actually decrease the overall effectiveness of a plant/herb extract. So, what we do with the information can be argued, but getting information such as this is potentially very helpful.
