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Copyright 1994, AIDS Project Los Angeles. We encourage you to share these
fact sheets with others. Permission is granted for reproduction in full,
and copies must be provided free of charge.
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The information in these fact sheets is not medical advice. It is intended
to help people with HIV/AIDS make informed choices. Please consult with a
physician before making any decisions regarding treatment.
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TRADITIONAL CHINESE MEDICINE
Prepared by Jason Heyman
Spring 1994
The little research that has been done on traditional Chinese medicine for
the treatment of HIV and AIDS shows promise in a number of areas that
Western medicine has been unsuccessful in treating. A combination of
different medical approaches may be the most effective way to treat
conditions, such as AIDS, that no one system has been able to cure.
Western, or allopathic, medicine tends to view the body as a war zone where
battles against invading organisms are fought, and won or lost. Therapeutic
approaches are usually based on our intellectual ability to understand the
nature of the battle being fought, and to employ an effective arsenal of
weapons.
Many diseases have been effectively cured or subdued in this fashion, but
some illnesses have eluded Western medical treatment, including most viral
infections (such as HIV), genetic defects, and cancer. In the case of AIDS,
some Western treatments for opportunistic infections are effective, such as
the use of antibiotics in fighting PCP, while treatments for Kaposi's
Sarcoma have generally failed.
Different cultures' theories about the cause, pathogenesis, and outcome of
disease, form the foundation for their medical practices. Western medicine
relies upon the belief that there is a physical cause for most medical
problems, such as a bacterium, virus, or genetic trait, and that destroying
or neutralizing that agent will return a patient back to a state of health.
One aspect that most non-Western cultures share is a belief in holism -- the
idea that the physical body is inseparable from the mind, emotions and
spirit (or soul). Differing views of death also affect whether a culture
chooses to use medicine to fight death, or uses medicine to make a limited
life span as comfortable as possible.
The prognosis of a disease is affected by these different philosophical
approaches, as are its actual course and outcome. The results of a well
known study of women with breast cancer at Stanford University depicts one
aspect of holism -- that emotional support has a direct impact on health.
In this study women who were involved in a support group with other patients
benefited from the emotional support of the other women and had an increased
life span of two years.[1]
TRADITIONAL CHINESE MEDICINE
In traditional Chinese medicine (TCM), health is understood to be a balance
between a variety of constantly changing variables. An imbalance is usually
seen as the result of a variety of factors. This methodology is explained
in the book AIDS and Chinese Medicine:
"Eight principles are used to summarize clinical symptoms: yin or yang,
exterior or interior, hot or cold, and deficiency or excess. In addition to
these principles, there are analytical rules: three etiologies (external,
internal, and neither external or internal factors), differential diagnosis
by analysis of the state of five solid organs, and analysis and
differentiation of the diseases according to the state of vital energy (qi)
and blood."
"First and foremost, TCM emphasizes treatments which enhance the body's
natural immunities so that it may more effectively resist disease.
Specifically, the fundamental principles of TCM for the treatment of
infectious diseases are: fu zheng (supporting the body's natural order,
i.e. enhancing immunity), and quxie (eliminating external evil, i.e.
reducing the potency of the pathogen)."[2] Treatment consists of a tea
distilled from a combination of medicinal herbs, and acupuncture, but may
include breathing exercises (qi gong), and massage. Acupuncture and qi gong
are believed to increase the circulation of qi, and acupuncture is often
used to control pain.
A study of acupuncture for the treatment of HIV-related peripheral
neuropathy showed a small improvement in "quantitative sensory testing"
(which is a test of sensitivity to applied stimulation in the hands and
feet). There was also improvement in quality of life as assessed by self-
administered questionnaires.[3] These findings are preliminary, but they do
attempt to study the effects of a treatment that is difficult to measure by
Western medical standards.
CHINESE HERBS
Some of the herbs most commonly used in Chinese medicine for the treatment
of immune disorders are, astragalus, Eleutherococcus senticosus, and Panax
notoginseng. The mode of action of these herbs in unknown, and there has
been some speculation, as a result of in vitro studies, that they could be
dangerous for people with HIV and AIDS.[4]
Misha Cohen, L. Ac., OMD, director of the Quan Yin Chinese Herbal Clinic, in
San Francisco, explained that the combination of herbs employed in
traditional Chinese medicine has a balancing effect on the immune system
that is not apparent in laboratory studies, but can be seen in a clinical
setting. She cautioned that herbs can be very potent -- as dangerous, in
some cases, as any pharmaceutical drug - and anybody who is considering
using Chinese herbal medicine should see a qualified Chinese herbalist.[5]
The mechanism of action of most herbs is unknown. According to Subhuti
Dharmananda, of the Institute for Traditional Medicine, in Seattle,
Washington, "some of the herbs which are used to treat depressed immunity
also appear to successfully treat auto-immune diseases (which in Western
medicine are treated by inhibiting rather than enhancing immune function).
This suggests that the complex herbal ingredients effectively modulate or
regulate the immune functions instead of simply stimulating them."[6]
HERBAL FORMULAS
To counteract unwanted side effects, and to increase their efficacy, herbs
are used in combinations from formulas that are often centuries old.
Traditionally the whole herbs are cooked slowly and the resulting decoction
is drunk as a tea. This process can be time-consuming and the tea is often
unpleasant to drink. In the past few years practitioners have developed
standardized herbal formulas in the form of pills that are easier to use.
In 1986, Cohen and Dharmananda created one of the first herbal formulas for
AIDS. This compound, known as Astra Eight, was based on a traditional
Chinese formula that is used to treat immune deficiency in people undergoing
chemotherapy for cancer.
In 1988 researchers systematically tested Chinese herbs for antiviral
activity against HIV in vitro.[7] This work lent some credibility to the
herbal compounds since many of the herbs being employed were found to have
inhibitory activity against HIV and other viruses. Eleven herbs were found
to be active against HIV. The three most active were Viola Yedoensis,
Arctium lappa, and Andrographis paniculata.
One of the herbs found to have anti-HIV qualities, Hypericum japonicum, has
been used as an alternative AIDS treatment in an extracted form known as
hypericin. Other plants from Chinese medicine have been used in this
manner, such as Trichosanthes Kirilowii (compound Q), Shiitake mushroom
(lentinan), and Momordica charantia (bitter melon).
In the past few years two particular formulas have become popular in the
treatment of HIV and AIDS, these are Enhance (created by Cohen) and
Composition A (created by Dharmananda). There are approximately thirty
ingredients in these compounds, including; Ganoderma, Isatis, Astragalus,
Ginseng, and Licorice. The main difference between these two formulas is
that Composition A contains deer antler and Enhance does not. Deer antler
is understood in Chinese medicine to activate bone marrow, and has been
shown in a laboratory study to have anti-inflammatory qualities.[8]
There is some disagreement among traditional Chinese practitioners as to
whether these herbal formulas work as well as the traditional cooked herbs,
claiming that the strength of Chinese medicine lies in its ability to treat
each patient as an individual.[9] Unlike cooked herbs, herbal formulas do
not vary from person to person. Instead, practitioners prescribe a
combination of formulas to suit a patient's needs.
RESEARCH ON HERBAL FORMULAS
Over the years a number of observational studies have been done on the
effects of Chinese herbal formulas on patients with HIV and AIDS. These
studies show large improvements in symptoms, but since they are unblinded
and without control groups, the results have to be viewed with some
skepticism.[10, 11, 12, 13]
San Francisco General Hospital recently concluded the first double-blinded,
controlled clinical trial of a Chinese herbal compound for the treatment for
AIDS at a major research institution.[14] Cohen formulated the compound and
collaborated with Western-trained researchers in this ground-breaking study.
The formula was tested against a placebo which had been manufactured to look
and taste the same. Thirty subjects were recruited, with t-helper counts
between 200 to 500, who were experiencing symptoms but did not have an AIDS
diagnosis. Participants took 28 pills per day for a period of twelve weeks.
The pilot study showed that there was a statistically significant
improvement in the areas of "life satisfaction", fatigue, gastrointestinal
symptoms, and neurological symptoms, all of which were measured by
standardized questionnaires. These four outcome variables are all areas
that Western medicine has been particularly unsuccessful in treating.
The small sample size limits the scope of these findings. But if future
research, undertaken on a larger scale, can reproduce these results than
they could have a serious impact on the standard of care in AIDS treatment.
This kind of cooperation, between practitioners of traditional Chinese
medicine and Western-trained medical personnel, could in itself lead to
significant advances.
REFERENCES
1. Spiegel D et al. Effect of psychosocial treatment on survival of
patients with metastatic breast cancer. The Lancet. October 14, 1989; pages
888-891.
2. Zhang Q, Hsu H. AIDS and Chinese Medicine, Applications of the Oldest
Medicine to the Newest Disease, 1990. OHAI Press.
3. Tosches W et al. A pilot study of acupuncture for the symptomatic
treatment of HIV associated peripheral neuropathy. Community Research
Initiative of New England. Published in the proceedings of; HIV, AIDS and
Chinese Medicine, First International Conference. San Francisco State
University, San Francisco, CA. June 18-20, 1993.
4. Caulfield C, Goldberg B. Chinese Herbs for HIV: A Critical Review. The
San Francisco Sentinel, September 15, 1993. Pages 22-23.
5. Personal Communication, September 27, 1993.
6. Dharmananda S. "Commonly asked questions about Chinese herbal therapies
for HIV, some answers from Institute for Traditional Medicine." Institute
for Traditional Medicine brochure, June 1989.
7. Chang R, Yeung H. Inhibition of growth of Human Immunodeficiency Virus
in vitro by crude extracts of Chinese medicinal herbs. Antiviral Research
#9, 1988, pages 163-176.
8. Zhang Z, et al. Purification and partial characterization of anti-
inflammatory peptide from pilose antler of Cervus nippon Temminck. Yao
Hsueh Hsueh Pao Acta Pharmaceutica Sinica, 27(5),1992, pages 321-324.
9. Weibo L. Oral presentation at the Satellite workshop; "Evaluation of
Case Studies of Alternative Treatments." IX International Conference on
AIDS in Berlin, June 6-11,1993.
10. Young M. Chinese herbal therapies and HIV infection, a clinical
report. Published in the proceedings of; HIV, AIDS and Chinese Medicine,
First International Conference. San Francisco State University, San
Francisco, CA. June 18-20, 1993.
11. James J. Chinese fu zheng therapy: the Immune Enhancement Project.
AIDS Treatment News #25, February 13, 1987.
12. Hawkins M et al. Use of a Chinese herbal composition for the treatment
of Human Immunodeficiency Virus -- a descriptive study. Published in the
proceedings of; HIV, AIDS and Chinese Medicine, First International
Conference. San Francisco State University, San Francisco, CA. June 18-20,
1993.
13. The San Francisco AIDS Alternative Healing Project. Quan Yin
Publications, San Francisco, CA. 1987.
14. Burack J, Cohen M, Hahn J, Abrams D. Chinese herbal treatment of HIV-
associated symptoms. Abstract PoB 29-2191 from the IX International
Conference on AIDS in Berlin, June 6-11, 1993.
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This article was reprinted with permission from GMHC "Treatment Issues"
Vol. 7, No. 11/12, page 23-25, Special Winter 1993/1994. |
