Can TCM Treat Covid-19?

Traditional Chinese medicine for COVID-19 treatment

1. Summary
The current 2019-nCoV outbreak is moving rapidly [1], the cumulative number of confirmed cases in mainland China has reached 80151, with 47,204 (58.89 %) cured cases and 2943 (3.67 %) deaths as of 2-Mar-2020, and no specific Meds has been discovered for Coronavirus Disease 2019 (COVID-19). However, a number of clinical practice results showed that traditional Chinese medicine (TCM) plays a significant role in the treatment of COVID-19, bringing new hope for the prevention and control of COVID-19.

can TCM treat Covid-19

TCM has a long history and played an indispensable role in the prevention and treatment of several epidemic diseases. During the SARS epidemic in 2003, the intervention of TCM has also achieved remarkable therapeutic effect. During the treatment period of COVID-19, more than 3100 medical staff of TCM were dispatched to Hubei province, and TCM scheme was included in the guideline on diagnosis and treatment of COVID-19 [2], and TCM experts fully participate in the whole rescue process. The decoction, Chinese patent medicine, acupuncture and other characteristic therapy of TCM was comprehensively employed, mainly treated based on syndrome differentiation. Specific TCM wards were set up and established the designated hospital, moreover, TCM team participates in treatment collectively. Currently, the total number of confirmed cases treated by TCM has reached 60,107 [3]. In 102 cases of mild symptoms treated with TCM, the clinical symptom disappearance time was shortened by 2 days, the recovery time of body temperature was shortened by 1.7 days, the average length of stay in hospital was shortened by 2.2 days, the improvement rate of CT image was increased by 22 %, the clinical cure rate was increased by 33 %, 27.4 % reduction in the rate of common to severe cases and 70 % increase in lymphocyte.3 In addition, in the treatment of severe patients with TCM, the average length of stay in hospital and the time of nucleic acid turning negative has been shortened by more than 2 days.

From current treatment results, TCM based on over-all symptoms of 2019-nCoV pneumonia patients has suggested prescribing prescription that is likely to be effective, such as qingfei paidu decoction (QPD), gancaoganjiang decoction, sheganmahuang decoction, qingfei touxie fuzheng recipe, etc. QPD which consisted of Ephedrae Herba, Glycyrrhizae Radix et Rhizoma Praeprata cum Melle, Armeniacae Semen Amarum, Gypsum Fibrosum, Cinnamomi Ramulus, Alismatis Rhizoma, Polyporus, Atractylodis Macrocephalae Rhizoma, Poria, Bupleuri Radix, Scutellariae Radix, Pinelliae Rhizoma Praepratum cum Zingibere et Alumine, Zingiberis Rhizoma Recens, Asteris Radix et Rhizoma, Farfarae Flos, Belamcandae Rhizoma, Asari Radix et Rhizoma, Dioscoreae Rhizoma, Aurantii Fructus Immaturus, Citri Reticulatae Pericarpium, and Pogostemonis Herba, has been promoted as a general prescription in the diagnosis and treatment plan of COVID-19 in China [2]. Among the 701 confirmed cases treated by QPD, 130 cases were cured and discharged, clinical symptoms of 51 cases disappeared, 268 cases of symptoms improved, and 212 cases of stable symptoms without aggravation [3]. The effective cure rate of QPD against COVID-19 is over 90 %. According to the theory of TCM, the target organ location of COVID-19 is the lung, and the etiology attribute is “damp and toxin plague”. The network pharmacology analysis showed that QPD has an overall regulatory effect via multi-component and multi-target. The primary site of pharmacological action is the lung, as 16 herbs to lung meridian, which indicated that the decoction is mainly specific for lung diseases. In addition, it can play the role of dehumidification through the rise and fall of the spleen and stomach and exhibited the protection for heart, kidney and other organs. Among the potential targets screen, most of them co-expressed with ACE-2, the receptor of COVID-19, indicating the potential improvement of COVID-19. It can inhibit the replication of COVID-19 by acting on multiple ribosomal proteins. COVID-19 can lead to a strong immune response and inflammatory storm [4]. Functional enrichment analysis showed that QPD could inhibit and alleviate excessive immune response and eliminate inflammation by regulating immune-related pathway and cytokine action related pathway [5]. Furthermore, through the prediction of molecular docking, it was found that patchouli alcohol, ergosterol and shionone in the formula had a better anti−COVID-19 effect, which provided new molecule structures for new Meds development [6].

Here, we take one highly suspected COVID-19 patient treated with TCM as a case example to show its effectiveness [7]. The male patient was on a business trip in Wuhan for several days before the onset of the disease. During the admission period, fever and cough were repeated, and respiratory rales of both lungs were not obvious. Western medicine was used firstly, including orally take oseltamivir phosphate capsule, intravenous infusion of ganciclovir, aerosol inhalation of recombinant human interferon a1b, etc. Although the nucleic acid test was negative, the results of chest CT showed that the fusion of two lung ground glass shadows was enlarged and the density was increased, which was more advanced than that of admission (Fig. 1a-1c). As the serious illness, combined with the patient’s performance of damp-heat syndrome, and the heat is more serious than damp, QPD was added for treatment. On the night of administration, the body temperature dropped to 36.2 ℃ and then tended to be normal. After 6 days of treatment, a chest CT was better than before, the tracheobronchial shadow was normal, and inflammation was obviously absorbed (Fig. 1d). The patient had no fever or asthenia, coughing occasionally, and the rales of two lungs were weaker than before. After discharge, continue to take 7 doses of the prescription, occasional cough, no special discomfort was found. The clinical symptoms and imaging examination of the patients improved significantly after the treatment, reflecting the advantages of TCM.

TCM has its own characteristics such as holistic concept, the balance of Yin and Yang, syndrome differentiation and treatment, strengthening the body resistance to eliminate pathogenic factors. TCM has thousands of years of experience in regulating the body and enhancing the resistance to epidemic diseases, with unique insights and prevention and control experience. For mild and common patients, the early intervention of TCM can effectively prevent the disease from transforming into the severe and critical disease. In severe cases, TCM has won time for rescuing them by improving symptoms (http://www.scio.gov.cn/xwfbh/xwbfbh/wqfbh/42311/42560/index.htm).

Treatment practice of COVID-19 showed that early intervention of TCM is an important way to improve the cure rate, shorten the course of the disease, delay disease progression and reduce the mortality rate. Furthermore, the reason why TCM works is not only to inhibit the virus, but might block the infection, regulate the immune response, cut off the inflammatory storm, and promote the repair of the body. Moreover, the prevention and control measures of COVID-19 fully reflect the ideology of “preventive treatment of disease”. Apart from the epidemic diseases recorded in the Han Dynasty should be isolated, the preventive measures of TCM also include psychology, sports, diet, medication, etc.

In the next prevention and control work of COVID-19, it should give full play to the advantages of TCM in syndrome differentiation and the whole therapeutic effect, reduce the complications as well as the death rate. Besides, the scientific research should also be carried out on the TCM with definite curative effective of COVID-19, to comprehensively evaluating its action mechanism and in-depth understanding COVID-19.

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References
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View Abstract

Coronavirus: Researchers claim TCM herbal remedy could ‘inhibit’ Covid-19

Coronavirus: Researchers claim TCM herbal remedy could ‘inhibit’ Covid-19

In an example that communication is proving as difficult as containment in the current coronavirus outbreak, China’s state media reported, to increasing scepticism, traditional Chinese medicine (TCM) oral liquid could inhibit the new coronavirus.

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On Jan. 31, China’s state press Xinhua published an article that claims that the Shanghai Institute of Materia Medica (SIMM, under the Chinese Academy of Sciences) and the Wuhan Institute of Virology had discovered that the Shuanghuanglian oral liquid could be used to “inhibit” Covid-19.

Made from a blend of honeysuckle, Chinese skullcap and forsythia, Shuang Huang Lian is believed to be antiviral, antibacterial and good for the immune system; thus, it is often used to relieve symptoms such as fever, cough and sore throat. The report caused panic buying of the TCM both online and in brick-and-mortar pharmacies in the country. However, the statement was also met with a wall of scepticism from both the general public and doctors. To address their concerns, SIMM released a statement on Feb. 1 to verify the Xinhua report, while saying that the conclusion is based on “the results of the laboratory in vitro studies” and “further clinical studies are needed to confirm it.”

“I think it’s very irresponsible for a research institute to release a statement only based on a simple in vitro test where they would put the extracted viruses in Shuang Huang Lian liquid and check their survival rate afterwards,” said Shi Lichen, founder of Beijing Dingchen Pharmaceutical Management Consulting Center. “Because there are so many reasons why virus couldn’t survive – being away from a host, for example, could lead to the natural death of the virus – so how do we know that it was the TCM that was actually working?”

“Plus the content of TCM is much more complicated,” he told BioWorld. “There are so many ingredients in Shuang Huang Lian, how would we know which ones are actually working?”

She noted that the result of in vitro tests should not be regarded as a guideline for clinical research. The only way to confirm the efficacy of a Meds is by its clinical performance.

“The central government is working on collecting clinical data and they should release a nationwide statement soon,” he said.

“And it should always be the central government that releases a statement like this instead of an individual local institute.”

She said that there is yet to be sufficient evidence to prove that any herbal remedy could kill viruses, but this is not the first time TCM is linked to the cure for a deadly virus.

In 2003, SIMM took the lead in confirming that Shuanghuanglian oral liquid has anti-SARS coronavirus effect. And in the decade following the SARS outbreak, a team from the institute conducted numerous researches and confirmed the TCM’s efficacy against influenza virus (H7N9, H1N1, H5N1), SARS-CoV and Middle East respiratory syndrome coronavirus (MERS), reporting obvious antiviral effects.

In the paper, titled “Study Progress on Antiviral Activities and Mechanisms of Flavonoids in Traditional Chinese Medicine and Natural Medicines,” authored by researchers from the Department of Pharmacy at Tongji Hospital, which is affiliated to Tongji Medical College of Huazhong University of Science and Technology in Wuhan, it is also mentioned that flavonoid extracted from litchi seeds can inhibit the proteinase activity of SARS-CoV3CL for its viral protein synthesis, which makes it a potential treatment for SARS.

“People are starting to go to TCM because there are no Western Meds available yet,” said He Gongxin, former chief representative of the Shanghai office at Gilead Sciences Inc., whose NUC inhibitor, remdesivir, had just entered a phase III trial in China for fighting the Covid-19.

“I’m not against Shuang Huang Lian. You can drink it; I don’t think it’s harmful to you because it’s just sugar water,” said He.
In another article on Feb. 3, Xinhua said that eight patients infected with the novel coronavirus (2019-nCoV) had been “cured by TCM or a combination of TCM and Western medicine in Jinyintan Hospital in Wuhan, epicentre of the coronavirus outbreak.” It goes on to say that this is the first batch of patients, of whom six were in critical condition, cured by such treatment.

Xinhua reported that the patients were treated by TCM doctors from Beijing’s Xiyuan and Guang’anmen hospitals, both under the China Academy of Chinese Medical Sciences, who have been looking after patients in Wuhan since Jan. 28.

Alcohol and Cancer

Alcohol and Cancer

Many of us don’t know that drinking alcohol increases the risk of developing cancers of the mouth, upper throat, voice-box, food-pipe, bowel, liver and breast (in women). Also, there is some evidence that alcohol increases the risk of stomach and pancreatic cancer.

If you combine smoking with drinking, your risk of cancer will increase significantly.

Our recommendations on alcohol are based on good quality evidence. We recommend that: you limit your alcohol intake or not drink alcohol if you want to reduce your risk of developing cancer.
Young people do not drink alcohol or delay drinking alcohol for as long as possible if they choose to drink.
Our Government and councils introduce policies that meaningfully reduce the amount of alcohol available and the amount of alcohol advertising.

How does alcohol cause cancer?
As yet we don’t have a definitive answer but good quality evidence tells us that alcohol (ethanol) may cause cancer in the following ways:
our body breaks ethanol down into smaller substances that are absorbed into our bloodstream. One of these substances is called acetaldehyde. Acetaldehyde can bond with our DNA (the genetic information in every cell) to increase the risk of cell mutations (damage to cells) and disrupts normal cell replication (how cells normally copy themselves) which may increase the risk of cancer.
ethanol comes into contact with our tissue by irritating the moist tissue that lines our digestive tract (mucosa). This irritation makes it easier for substances linked to cancer (carcinogens) to cause damage to our cells ethanol acts as a solvent (a thinner) so our body is more at risk of absorbing other carcinogens ethanol increases our oestrogen levels. This may add to the increased risk of breast cancer in women drinkers. Studies have found oestrogens to have a carcinogenic effect on breast tissue.
ethanol causes cirrhosis (scarring) of the liver, which increases the risk of liver cancer.

What is a safe level of drinking?
No level of alcohol intake is safe in terms of cancer risk. The cancers where alcohol has a strong link are, cancers of the mouth, throat (pharynx), voice box (larynx), food pipe (oesophagus), bowel (colorectal), breast (in women) and liver. There is some evidence that heavy drinking also increases the risk of stomach (gastric) cancer and pancreatic cancer.
Cancer risk increases with the amount of alcohol drunk.

Much research is being done on how acupuncture can help relieve some of the symptoms of cancer and side effects of cancer treatment. Acupuncture has been shown to help relieve fatigue, hot flashes, nausea, vomiting, and pain.

In a French study published in 2003, acupuncture was examined in the treatment of cancer-related pain. Patients treated with acupuncture had a 36% reduction in pain after 2 months of acupuncture treatments. Study at Memorial Sloan-Kettering Cancer Center, acupuncture was shown to reduce post-chemotherapy fatigue by 31% in people with various types of cancer.

Acupuncture Facial Paralysis

Acupuncture Reverses Facial Paralysis

Acupuncture is effective for the treatment of facial paralysis and improves patient outcomes for patients taking medications.
Hospital researchers find acupuncture effective for the treatment of facial paralysis. Across multiple hospital investigations, researchers document effective acupuncture protocols that yield significant positive patient outcomes for facial paralysis patients. In addition, acupuncture, infrared therapy, and moxibustion demonstrate the ability to significantly improve positive patient outcome rates for patients taking pharmaceutical medications.

Acupuncture and infrared heat therapy are effective for the treatment of facial paralysis. Researchers from the Third People’s Hospital in Chongqing determined that combining acupuncture and infrared heat therapy with conventional facial paralysis medications improves the rate of positive patient outcomes for the treatment of this condition. Facial paralysis is a disorder in which the facial muscles are dysfunctional, causing immobility, and it may occur in any age demographic. In the Third People’s Hospital investigation, facial paralysis patients who received supplementary infrared heat therapy and acupuncture reported a 91.67% total treatment effective rate while those in the control group reported a 60.42% total treatment effective rate. The addition of acupuncture and infrared therapy increased the effectiveness by 31.25%.

The study involved 96 patients with facial paralysis. Onset was within 6 days of treatment. Of the 96 patients, there were 46 males and 50 females. Patient ages ranged from 46 to 65 years old. The patients were randomly divided into 2 groups: the treatment group and the control group with 48 patients in each group. The control group was given conventional facial paralysis medications: vitamins, hormones, brain glycosides, carnosine and antiviral Meds. The treatment group underwent acupuncture therapy and infrared heat therapy in addition to receiving the same conventional medications as the control group. The total treatment duration was 2 weeks.

For acupuncture, the principles for the treatment of facial paralysis focused on restoring nerve function via improving local blood circulation, eliminating edema, and reducing facial nerve inflammation. The selection of acupoints for facial paralysis treatment largely involves the Yangming and Taiyang meridians. The acupoints include Zusanli, Hegu, Fengchi, Yifeng, Taiyang, Jiache, Dicang, Zanzhu, and Xiaguan. The Zusanli and Hegu acupoints improve qi and blood circulation and eliminate excess wind (Feng). The Fengchi, Yifeng and Taiyang acupoints eliminate wind (Feng) and pernicious influences (Xie). The Jiache, Dicang, Zanzhu and Xiaguan acupoints are selected based on the symptoms presented by the individual patient.

Infrared heat therapy utilizes the red spectrum of visible light, which has photochemical effects including activating catalase in cell mitochondria, increasing glycogen concentration, strengthening cell metabolism, improving adenosine triphosphate decomposition, and protein generation. These processes culminate in accelerated cell synthesis and regeneration, improved local blood microcirculation to the skin and nerves in the affected area, as well as improved metabolism and overall immunity. The net effect on the afflicted facial region is the reduction of nerve tissue inflammation therapy alleviating paralysis.

Standard acupuncture was administered on these acupoints once daily for 14 consecutive days. Infrared therapy was administered using the Carnation33 high power infrared light therapy device with a 640 nm wavelength (+/- 10 nm). The unit was manufactured by the Shenzhen Universal Gate Science and Technology Co. The affected site of paralysis received infrared heat from a distance of 30 to 35 cm and skin surface temperature was maintained at 40 degrees Celsius, or the highest temperature within the patient’s tolerance zone. The infrared heat therapy was conducted for 20 minutes at a time, 2 times daily, for 14 consecutive days.

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Acupuncture for the Relief of Arthritis Pain

Acupuncture for the Relief of Arthritis Pain

By Laura L. Eckland

Acupuncture is one of the oldest medical procedures in the world, with its origins dating back to China more than 2,000 years ago. When properly administered, it can have an amazing ability to naturally relieve arthritic conditions: pain and inflammation of the joints.

Traditional Chinese medicine is based on the belief that an essential like force call “qi”(pronounced “chee”) flows through the body along channels called meridians. These Meridians are like rivers that irrigate the body and nourish the tissues. Any obstructions (called “bi”) along these channels is like a dam that blocks vital energy flow, creating pain and diseases. Acupuncture is a very effective form of pain control in that it can relieve soreness in three ways. First, it causes the body to produce chemicals called endorphins, which inhibits the perception of pain naturally. Second, it blocks the transmission of pain signals to the brain through the nervous system. Thirdly, it deactivates trigger points. Trigger points are tender and extremely reactivate areas that develop within muscles. The result of acupuncture is a widespread relaxation of both mind and body.

Acupuncture for the Relief of Arthritis Pain

Arthritis is a pervasive disease that causes pain and inflammation in joints and can be widely spread throughout the body. Arthritis isn’t just one disease, it is a complex disorder that comprises more than 100 distinct conditions and can affect people at any stage of life. The common thread among arthritis symptom is persistent joint pain and inflammation of the joints. While arthritis pain and inflammation cannot be avoided as the body ages, with the aid of acupuncture and Oriental medicine the pain can be managed to a greater degree and improve functioning.

Acupuncture treatment points for arthritis are located all over the body, not just directly over the affected area. During the treatment, tiny needles are placed along the patient’s legs, arms, shoulders and even toes. These needles are so tiny that multiple acupuncture needles can fit inside a human hair. The needles stay in the area for a set amount of time and then removed. Most people relax and even fall asleep during the treatment. The length, number and frequency of treatments will vary according to the intensity of the pain, and its severity and pervasiveness with the patient.

The relief of arthritis pain through acupuncture has been studied many times. Results indicate that the use of acupuncture and Oriental medicine can be an effective form of pain management. Many studies throughout the world have been given on a range of arthritis sufferers- from patients awaiting full-hip replacements, to knee surgery patients, as well as people suffering from the effects of rheumatoid and osteoarthritis. In most studies, the patients are split into groups- one group participating in acupuncture and Chinese medicine treatments in conjunction with a self-help course for managing their condition and conventional therapy; the other group receiving only the conventional therapy and self-help course information. The studies indicated that between 25-40 per cent who received acupuncture in conjunction with the conventional and self-therapy had a decrease in pain and a noted improvement in the function of arthritic joints.

The latest study by the US National Institutes of Health (NIH) is one of the largest and longest clinical trials to show such conclusive effects and patients who underwent acupuncture treatment reported a 44% average reduction in pain and a 40% improvement in mobility.

Combining acupuncture with standard meds therapy can relieve pain and improve movement in people with arthritis of the knee, according to a new study conducted by Dr Brian Berman, from the University of Maryland School of Medicine in Baltimore, and was funded by the National Center for Complementary and Alternative Medicine (NCCAM) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

In the trial, Dr Berman and his colleagues studied 570 patients with an average age of 65 who had osteoarthritis of the knee. Participants were randomly assigned to receive one of three treatments for 26 weeks, in addition to standard care such as anti-inflammatory medications and pain relievers:

Acupuncture – inserting thin needles into certain body points to stimulate improved health.
Sham acupuncture – patients feel some sensation from a needle but it isn’t actually inserted.
A self-help course for managing pain.
Throughout the 26 week trial, participants continued to receive their normal standard medical care, including anti-inflammatory meds and pain relievers.

By the eighth week, acupuncture patients showed a significant increase in function compared with both the sham treatment and self-help groups. By week 14, they were also experiencing a significant decrease in pain. By the end of the trial overall pain was reduced by about 40% and function improved by almost 40% in the volunteers receiving acupuncture.

The popularity of acupuncture as a treatment for arthritis continues to grow because more and more people have found significant relief from Oriental Medicine without the negative effects that sometimes accompany conventional Western medicine. The best results for a drastic reduction in pain and inflammation caused by arthritis is seen by combining conventional medicine with Oriental medicine- acupuncture, herbs, and therapeutic massage. Herbal medicine strengthens the body and enhances the immune system. Massage increases circulation in affected areas and helps to deactivate painful trigger points.

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Acupuncture for Low Libido in Men

Low libido, or low sex drive, is something that will affect most people at some stage.
Whether it is due to a stressful lifestyle, relationship difficulties, a medical condition or simply getting older, finding that you have a reduced sex drive can be worrying.
There are many reasons why you might be finding it more difficult than usual to get in the mood. Some of the most common causes of low libido in men are:
Relationship difficulties
Stress
Depression
Age
Lack of sleep
Being overweight
Erectile dysfunction or ejaculation problems
Medical conditions such as diabetes, underactive thyroid, heart disease or cancer
Medication side effects
Smoking, alcohol

Acupuncture works by using fine needles placed at specific points on the body to maintain both physical and emotional health as well as treating disease.
Acupuncture can help with low libido in a number of different ways. Your exact treatment will depend on what is causing the issue. This will be determined at your initial consultation.
Firstly, acupuncture is an extremely relaxing treatment which is known to reduce stress. It triggers the release of endorphins, the body’s natural “feel good” chemicals, which help to relieve the anxiety associated with low libido and leave you feeling calm and positive. It also increases circulation to the sexual organs. This is especially important if you are suffering from erectile dysfunction. Finally, it has a balancing effect on your hormone levels, making it a great way to improve your libido naturally.
While low libido, erectile dysfunction and ejaculation problems might be sensitive subjects, you can rest assured that your acupuncturist is well trained to deal with these conditions. Anything you say in the clinic will be treated with the strictest confidence, so there is no need to be concerned.
Whatever the cause of your low libido, acupuncture is a fantastic way to relax, relieve stress and look after your health at any age.

Call 09 3601229 for more information.

http://www.cityacu.net/blog/acupuncture-for-low-libido-in-men

Acupuncture Insomnia

Acupuncture Beats For Insomnia Treatment

Acupuncture outperforms a benzodiazepine medication for the treatment of insomnia.

Researchers find acupuncture more effective for the relief of insomnia than estazolam, a benzodiazepine pharmaceutical. Using Pittsburgh sleep quality index (PSQI) scores as a basis of comparison, acupuncture outperformed estazolam for the improvement of “sleep quality, efficiency disturbance and daytime dysfunction.” The researchers note that the acupuncture protocol used to achieve the treatment results included a specialized order for inserting the acupuncture needles and that the “sequence of acupuncture points” plays an important role.

The investigation explored the efficacy of the Governor Vessel (GV) unblocking protocol developed by Prof. Gao Yu-Chun. The researchers provide the Traditional Chinese Medicine (TCM) basis for the protocol. The GV unblocking approach to care for the treatment of insomnia focuses on calming the mind by nourishing kidney water to “submerge liver yang and harmonize heart-mind by stimulating the three Yuan-Primary points Shenmen (HT7), Taichong (LR3) and Taixi (KI3).” The protocol also focuses on harmonizing the spleen and stomach. According to TCM principles, ascending “turbid qi or insufficient qi and blood due to dysfunctions of the spleen and stomach may either cause or aggravate insomnia.” To address these concerns, the following acupoints were included:

Zhongwan (CV12)
Tianshu (ST25)
Yinlingquan (SP9)

The researchers note that the harmonizing functions of CV12, ST25, and SP9 combined with the Yuan acupoints help to regulate the Zang-fu organs, benefit the spleen and stomach, and improve sleep. The GV unblocking protocol of Prof. Gao Yun-Chun adds GV acupoints to the point prescription for several reasons. The researchers note that the GV connects directly with the brain, governs all yang meridians, and connects the five Zang and six Fu organs either directly or indirectly. According to TCM theory, obstruction of qi and blood flow in the GV may cause yin, yang, and Zang-Fu imbalances resulting in insomnia. Consequently, needling the GV focuses on clearing obstructions impeding the free flow of qi in the meridians, dispersing yang qi, and facilitating the distribution of nutrients.

The researchers note that the guiding treatment principle for the GV acupoint choices is to “harmonize yin and yang and improve sleep.” Baihui (GV20) is selected because it is a meeting acupoint of the Bladder Foot-Taiyang channel with the GV. GV20 functions to “tranquillize the mind.” Shenting (GV24) is chosen for its specific function to treat both insomnia and palpitations. GV24 is notable as the meeting point of the GV with the Bladder Foot-Taiyang and Stomach Yangming channels. The research indicates that the combination of GV20 with GV24 harmonizes Ying and Wei qi (nutrient and defensive qi), tranquillizes the mind, strengthens kidney qi and jing (essence), and more strongly treats insomnia. To reinforce the functions of these acupoints, Anmian (EX-HN14), Sishencong (EX-HN1), and Fengchi (GB20) are added.

The researchers cite the work of Jiang et al., noting that the “sequence of acupuncture points” is an important aspect of the treatment protocol. They add that it is a “key part” and may be a “decisive factor of the treatment effect.” Step one is to needle CV12 and ST25 to activate yang qi in the spleen, stomach, and entire body. Next, GV acupoints are needled to “unblock meridian qi and tranquillize the mind.” Step three is to needle the Yuan (source) acupoints. This assists in regulating the heart, liver, and kidneys. The researchers add that Yuan acupoints help to settle the rising liver yang and to “harmonize the heart and mind.”
The acupoint prescription had greater positive patient outcomes than estazolam for the improvement of sleep quality. Also, the total recovery rate and marked effect rate were greater in the acupuncture group than in the estazolam group.

The recovery rate was determined by a PSQI reductive rate of ≥75% and a global PSQI score of <11 points.
The marked effect rate was determined by a PSQI reductive rate of ≥ 50% and<75%.
Signs of improvement were registered at a minimal level with a PSQI reductive rate of ≥ 30% and <50%.

The total effective rate combined the recovery, marked improvement, and minimal improvement rates. As a result, acupuncture and estazolam scored at approximately the same levels when taking into account minimal improvements. However, using only the recovery and marked effect rate, the research demonstrates that acupuncture produces significantly greater positive patient outcomes when considering significant clinical improvements.

Estazolam equalled acupuncture in one parameter. Both estazolam and acupuncture had an equal effect on sleep onset latency. This is a measure of time from wakefulness to sleep. Sleep onset latency typically measures the time it takes to go from full wakefulness to a light stage of non-REM sleep.

Patients in the estazolam group were administered 1 mg oral doses, once per day, for a total of four weeks. Patients in the acupuncture group did not receive any medications. Acupuncture points were needled with sterile, disposable 0.30 x 40 mm filiform acupuncture needles. Needles were retained for 15 – 20 minutes per acupuncture session for patients diagnosed with deficiency syndromes. For patients with a diagnosis of excess syndromes, needles were retained for 30 –40 minutes. Acupuncture was administered once per day, five times per week, for a total of four weeks.

Step one involved the insertion of acupuncture needles into the following acupoints:
Tianshu (ST25)
Zhongwan (CV12)
Yinlingquan (SP9)
Step two involved the following acupoints:
Baihui (GV20)
Shenting (GV24)
Sishencong (EX-HN1)
Anmian
Step three involved the following acupoints:
Shenmen (HT7)
Taichong (LR3)
Taixi (KI3)

The research team provided background information to their study. Worldwide, over 35% of people in the Occident and 42% in the Orient are affected by insomnia. A combination of TCM and biomedical parameters were used for the inclusion and exclusion criteria. Patients admitted to the study had a primary complaint of insomnia combined with at least five of the following symptoms: headaches, dizziness, dream disturbed sleep, poor memory, fatigue, palpitations. These diagnostic criteria account for the TCM principle that insomnia involves both lack of sleep and consequent dysfunction.

Biomedical parameters for inclusion involves several parameters. Patients must have had a primary complaint of sleep disturbances at least three times per week for no less than one month. Patients were unable to maintain sleep, experienced poor sleep quality, or had difficulty falling asleep. The sleep issue caused excessive worrying about insomnia consequences and the sleep issue must have caused social or occupational impairment.

Exclusion criteria sorted for insomnia secondary to an illness including Parkinson’s or Alzheimer’s disease, mental illness, or systemic disorders. Patients with complications due to heart, liver, kidney, or blood disorders were also excluded from the study.

Also, patients receiving other forms of therapy were excluded. Patients were randomly divided into the medication group and the acupuncture group.

The researchers (Wang et al.) conclude that acupuncture is safe and effective for the treatment of insomnia. Further, acupuncture produces greater positive patient outcomes than estazolam intake. Based on the recovery and marked effect rate, the researchers add that acupuncture is a reliable treatment modality for patients with insomnia. As a result, the GV unblocking method is recommended by the researchers.

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References:
Wang YJ, Zhang LH, Han YX, Li PP. Efficacy observation on Governor Vessel-unblocking and mind-calming acupuncture for insomnia. Journal of Acupuncture and Tuina Science. 2016 Jul 1;14(4):274-8.
Jiang S, Di Z, Fu WB. On the sequence of acupuncture points in acupuncture treatment. Zhongyi Zazhi, 2012, 53(7): 620-622.
Expert consensus panel on definition, diagnosis and therapy for insomnia. Expert consensus (draft) on the definition, diagnosis and therapy for insomnia. Chin J Neurol, 2006, 39(2): 141-143.