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Chinese Herbal Medicine

by Hans R. Larsen, MSc ChE

Hans Larsen Effect of Chinese herbs on cancer cells
Chinese Herbal medicine includes more than 3200 herbs that are used to help treat a variety of ailments, restore balance to the body and provide relief from pain.

Herbal medicine is one of numerous complementary modalities that can be added to a cancer therapy regimen. It is not uncommon to find many of China's herbs in local whole food and health stores. Although it is not claimed that Chinese herbs cure cancer, certain herbs may help ease cancer therapy side effects, control pain, boost immune functions, improve quality of life, and, in some cases, reduce tumor growth.

A study published in Cancer Chemotherapy and Pharmacology in 2002 examined the effect of Chinese herbs and extracts in lung cancer cells. The authors of the study concluded, "The Chinese herbal medicine extracts OLEN, SPES and PC-SPES are cytotoxic to both drug-resistant and drug-sensitive lung cancer cells, show some tumor cell specificity compared to their effect on normal cells, and are proapoptotic as measured by DNA breaks and gene expression. The reaction of the tumor cells to these extracts was similar to their reaction to conventional chemotherapeutic drugs".

In February of 2002 PC-SPES was removed from the market and its production halted due to contamination. However, the Chinese herbs that were effective in the study have been used in new formulas that focus on their demonstrated benefits. Some of the Chinese herbs in the original PC-SPES are: chrysanthemum, Ganoderma lucidum, isatis, Panax pseudo-ginseng, Rabdosia rubescens, licorice, saw palmetto, and skullcap. The American Cancer Society reports that new formulas contain the following: magnesium, sterolins, quercetin, Reishi, Baikal skullcap, Rabdosia, dyer's woad, mum[Is this chrysanthemum?], saw palmetto, San-Qi ginseng, and licorice. Studies continue to monitor the affect of PC-SPES and other Chinese supplements on cancer cells, focusing on the benefits of the active herbal ingredients.
Sadava, David, Julie Ahn, Mei-Lin Pang, Jane Ding, and Susan E. Kane. Effects of four Chinese herbal extracts on drug-sensitive and multidrug-resistant small-cell lung carcinoma cells. Cancer Chemotherapy and Pharmacology 49 (2002): 261-66

Chinese herb proven in arthritis therapy
DALLAS, TEXAS. A team of researchers from the University of Texas and the National Institutes of Health reports that an extract of the Chinese herbal remedy Tripterygium wilfordii Hook F (TWHF) has proven effective in the treatment of severe rheumatoid arthritis. TWHF has been used for centuries in China to treat rheumatoid arthritis, ankylosing spondylitis, psoriasis, and IgA nephropathy. Preliminary studies in animals have shown that TWHF extracts have anti- inflammatory and immunosuppressive effects comparable to those of prednisone.
The researchers prepared their extract by extracting finely ground powder obtained from peeled TWHF roots with ethanol (alcohol) and ethyl acetate. The ethyl acetate extract was dried and put in capsules each containing 30 mg of the extract yielding a total of 9.9 micrograms of the active components triptolide and tripdiolide.
Thirteen patients with long standing rheumatoid arthritis participated in the trial. The initial dosage was 30 mg/day; this was gradually increased to 570 mg/day over a 12-18 month period. Nine of the patients went through the whole program. The patients all experienced marked improvement and one went into complete remission on a dose of 390 mg/day. Morning stiffness was the first symptom to improve. At baseline it lasted an average of 265 minutes. On a dose of 390 mg/day it reduced to 10 minutes. ESR (erythrocyte sedimentation rate) went from 55 mm/hour to 22 mm/hour on a dose of 480 mg/day. Sixty per cent of the patients experienced significant (more than 20 per cent) improvement on a dose of 180 mg/day. A dose of 300-480 mg/day was required for maximum benefit. This is comparable to the dosages used in China and was found to be entirely safe. The researchers are currently conducting a much larger, double- blind, controlled study to confirm the benefits of TWHF extracts.
Tao, Xuelian, et al. A phase I study of ethyl acetate extract of the Chinese antirheumatic herb Tripterygium wilfordii Hook F in rheumatoid arthritis. Journal of Rheumatology, Vol. 28, October 2001, pp. 2160-67

Chinese herb alleviates rheumatoid arthritis
DALLAS, TEXAS. Extracts of the roots of Tripterygium wilfordii Hook F (TwHF) have been used for centuries in China to treat rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), ankylosing spondylitis, psoriasis, eczema, scleroderma, and other autoimmune and inflammatory diseases. Originally, a hot water extract of the plant was used, but this approach had many adverse effects. In the 1970s two new extracts were developed; one is an ethyl acetate extract while the other, now known as T2, is a chloroform-methanol extract.

One randomized, double-blind trial involving 70 patients with RA compared the effect of 20 mg of T2 taken three times daily with a placebo. Approximately 90 per cent of the patients treated with T2 experienced significant improvement. Trials involving several hundred patients with SLE have shown significant beneficial effects of T2 and a much reduced need for prednisone. Favourable results have also been reported in the treatment of systemic sclerosis and various kidney disorders.

Although highly effective in many cases, T2 can have adverse effects especially on the gastrointestinal tract. Says Drs. Tao and Lipsky of the University of Texas "Treatment with extracts of TwHF is effective in most patients with rheumatic disease; however, close medical supervision is essential in order to avoid serious adverse effects." [117 references]
Tao, Xuelian and Lipsky, Peter E. The Chinese anti-immunosuppressive herbal remedy Tripterygium wilfordii Hook F. Complementary and Alternative Therapies for Rheumatic Diseases II, Vol. 26, No. 1, February 2000, pp. 29-50

Ancient Chinese herb rediscovered
GENEVA, SWITZERLAND. The World Health Organization has come out in support of the use of wormwood extract (from the qinghao plant) in the fight against malaria. Malaria affects over 250 million people and kills over 2 million children annually in the tropical world. The use of qinghao for medicinal purposes was first reported in 168 B.C. In the early 70's Chinese scientists rediscovered the herb and by 1979 they had conducted extensive clinical studies which proved its effectiveness in combatting malaria. Western pharmaceutical companies have now spent 13 years in trying to synthezise the active component of wormwood. Their synthetic product has yet to undergo human testing with the result that this life-saving drug is still not available outside of China and Vietnam. The Chinese have proven the efficacy and safety of wormwood for over 2000 years; yet the U.S. Food and Drug Administration still classifies it as dangerous.
The Lancet, March 14, 1992, pp. 649-50

Chinese herbal therapy combats dermatitis
LONDON, ENGLAND. Doctors at the Royal Free Hospital in London have completed an evaluation of an ancient Chinese remedy for dermatitis. The combination used consisted of a mixture of 10 herbs and was first described in the Inner Classic of the Yellow Emperor "published" between 300 and 100 BC. 40 adult patients with longstanding, widespread, atopic (genetically predisposed) dermatitis participated in the trial which lasted 5 months. Each patient was randomly allocated to receive either the herbal remedy or a placebo of similar taste and texture for an 8- week period. Followed by a 4-week wash-out period, the group originally receiving the herbal remedy received the placebo for 8 weeks and vice versa. The active herbs (and the placebo herbs) were prepared as a decoction each day and 200 ml of it consumed while still warm. 31 of the patients completed the study. Both groups showed a rapid and continued improvement in the extent of erythema (redness of the skin) and surface damage during the time they consumed the Chinese herbal remedy. The authors of the study conclude that the remedy is effective in treating adult atopic dermatitis, but warns that further experiments are needed to ensure its safety especially in patients suffering from liver or kidney complications.
The Lancet, July 4, 1992, pp. 13-17

Chinese herbs implicated in kidney failure
BRUXELLES, BELGIUM. Belgian doctors are warning that the use of two Chinese herbs, Stephania tetrandra and Magnolia officinalis may cause kidney failure. The doctors report on 48 women experiencing renal failure. They traced all the patients to a Belgian medical clinic which provides slimming treatments using the two herbs. The doctors caution however, that exact identification of the disease causing components in the slimming regimen is very difficult and that the herbs may have been adulterated with other compounds.
Vanherweghem, Jean-Louis, et al. Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs. The Lancet, Vol. 341, February 13, 1993, pp. 387-91

Some Chinese medicines may be toxic
ASHLAND, OREGON. Investigators at the U.S. National Fish and Wildlife Forensics Laboratory report that they have found potentially toxic levels of arsenic and mercury in Chinese herbal balls. Herbal balls are a mixture of medicinal herbs and honey and are dissolved in warm wine or water and then drunk as a tea. The investigators analyzed the balls as part of their effort to prevent the importation of products from endangered species. They found that the mercury content in the 32 balls tested varied between 7.8 and 621.3 mg per ball while the arsenic content varied between 0.1 and 36.6 mg. The most contaminated preparation was An Gong Niu Huang Wan from the Tung Jen Tang Pharamaceutical Factory in Nanjing. These balls contained between 3.21 and 36.6 mg of arsenic and between 80.7 and 621.3 mg of mercury, most likely in the form of sulfides. The investigators warn that chronic poisoning has been reported in people ingesting as little as 10 mg per day of arsenic sulfide and among people ingesting approximately 260 mg per day of mercury sulfide.
Espinoza, Edgard O., et al. Arsenic and mercury in traditional Chinese herbal balls. The New England Journal of Medicine, Vol. 333, No. 12, September 21, 1995, pp. 803-04

Chinese herb proves effective against malaria
HO CHI MINH CITY, VIETNAM. It is estimated that about two million people die every year from malaria. Since 1981 between 20 and 40 million people have died from the disease - this compares to about 2.5 million deaths caused by the AIDS virus in the same period. Malaria is caused by a parasite, Plasmodium falciparum, and is usually treated with quinine or quinidine. Unfortunately, it appears that P. falciparum is developing resistance to quinine making this drug less effective. Chinese scientists discovered 25 years ago that extracts from the herb qinghaosu (wormwood) are highly effective in treating malaria. These extracts have been used in China and Vietnam for several years as an alternative to quinine. Now teams of Vietnamese and Dutch researchers report that the wormwood extract artemether is as effective as quinine in treating severe malaria in adults and cerebral malaria in children. As a matter of fact, the artemether cleared the parasites from the blood quicker than did quinine and resulted in significantly lower mortality rate. So far the quinine-resistant parasites have only surfaced in Asia, but they are expected to become established in Africa within five years and at that time malaria deaths in Africa are estimated to rise to seven million a year. Dr. Piero Olliaro of the Tropical Diseases Research Program in Geneva believes that the use of artemether could avert the crisis, but that people in Africa may not be able to afford the $20 cost of the treatment that could save their lives. Dr. Olliaro goes on to say that "drug firms have been slow to develop artemether, because they cannot apply for patents on a drug that is already used in traditional Chinese medicine...."
Van Hensbroek, Michael Boele, et al. A trial of artemether or quinine in children with cerebral malaria. New England Journal of Medicine, Vol. 335, No. 2, July 11, 1996, pp. 69-75
Tinh Hien, Tran, et al. A controlled trial of artemether or quinine in Vietnamese adults with severe falciparum malaria. New England Journal of Medicine, Vol. 335, No. 2, July 11, 1996, pp. 76-83
Hoffman, Stephen L. Artemether in severe malaria - still too many deaths. New England Journal of Medicine, Vol. 335, No. 2, July 11, 1996, pp. 124-25
Day, Michael. Malaria falls to herbal remedy. New Scientist, July 13, 1996, p. 4

Herbal medicines - Are they safe?
EXETER, ENGLAND. Dr. Edzard Ernst, MD, Professor of Complementary Medicine at the University of Exeter has just released a major report on the safety of herbal medicines. Dr. Ernst surveyed the medical literature between 1992 and 1996 for reports concerning adverse effects of herbal remedies. Among his findings are:

  • Royal jelly has been linked to several cases of severe bronchospasm;
  • Twenty-two cases of severe toxic effects involving pennyroyal have been reported;
  • Germander has been linked to 30 cases of acute liver failure;
  • Chaparral, comfrey and skullcap have all been linked to liver problems and the shiitake mushroom has been associated with dermatitis;
  • Chinese herbal medicines have been linked to a host of adverse effects and are often contaminated, especially with heavy metals;
  • Siberian ginseng can interact with digoxin, licorice with prednisone, and some Chinese herbal preparations with warfarin;
  • Four per cent (108) of 2695 patients admitted to a Taiwanese hospital had drug-related problems. Herbal medicines ranked third among the categories of medicines responsible for causing adverse effects;
  • Out of 1701 patients admitted to a Hong Kong hospital three were admitted because of adverse reactions to Chinese herbal drugs;
  • The London-based National Poisons Unit received a total of 1070 enquiries relating to herbal and other traditional medicines between January 1983 and March 1989.

Dr. Ernst concludes that the following herbal medicines are safe: camomile, garlic, Ginkgo biloba, peppermint, sabal, saw palmetto, and St. John's wort. He also points out that herbal remedies often are safer than the corresponding pharmaceutical drugs. For instance, St. John's wort has fewer side effects than synthetic antidepressants. Herbal remedies for prostate problems are as effective and significantly safer than the popular drug Finasteride and a mixture of fennel, peppermint and wormwood is more effective and far safer then metoclopramide. Editor's note: More than 80 per cent of the world's population rely on herbal medicines to cure their illnesses and annual sales in Europe and the United States exceed $8 billion. Dr. Ernst's exhaustive study documents a total of 37 fatalities and less than 200 other adverse effects involving herbal remedies during a five-year period. That works out to an average of 7 fatalities and less than 40 adverse events per year ascribable to the use of herbal medicines. Considering that in the United States alone more than 7500 people die every year from taking nonsteroidal anti-inflammatory drugs and over 750,000 people experience an adverse drug event within American hospitals every year it is clear that herbal medicines are actually remarkably safe.
Ernst, Edzard. Harmless herbs? A review of the recent literature. American Journal of Medicine, Vol. 104, February 1998, pp. 170-78

Herb/drug interactions
AMARILLO, TEXAS. As herbal remedies grow in popularity it becomes increasingly important that users and their health care practitioners know of the potential interactions between herbs and pharmaceutical drugs. Many herbs have powerful effects which may be increased or counteracted by pharmaceutical drugs and vice versa. Dr. Lucinda Miller, a pharmacist at the Texas Tech University, has just published a comprehensive report listing the most common interactions. Among her main findings are the following:

  • Echinacea, if used for more than eight consecutive weeks, could cause liver toxicity and therefore should not be used with drugs such as anabolic steroids, amiodarone, and methotrexate which are toxic to the liver.
  • NSAIDs (nonsteroidal anti-inflammatory drugs) should not be used when feverfew is taken for migraine headaches.
  • Feverfew, garlic, ginger, ginseng, and Ginkgo biloba all affect bleeding time and should not be taken by patients using warfarin.
  • Until more data is available, St. John's wort should not be taken with monoamine oxidase inhibitors or selective serotonin reuptake inhibitors like Prozac and Paxil.
  • Licorice, plantain, hawthorn, and ginseng may interfere with digoxin therapy and valarian root should not be taken when barbiturates are used.
  • Evening primrose oil and borage are contraindicated in patients taking anticonvulsants and licorice can offset the pharmacological effect of the potassium-sparing diuretic spironolactone.
  • Immunostimulants such as Echinacea and zinc should not be given with immunosuppressants such as corticosteroids (prednisone, etc.) and cyclosporine and are contraindicated in patients suffering from rheumatoid arthritis and systemic lupus erythematosus.

Dr. Miller points out that more than 60 million Americans now use herbal remedies, but that 70 per cent of them do not tell their physician or pharmacist that they do so. She recommends that physicians when taking a patient's medical history pay just as much attention to what herbs they are taking as to what drugs they are taking. (171 references)
Miller, Lucinda G. Herbal medicinals. Archives of Internal Medicine, Vol. 158, November 9, 1998, pp. 2200-11

Chinese medicine alleviates irritable bowel syndrome
CAMPBELLTOWN, AUSTRALIA. It is estimated that 10-20 per cent of the population of the United States and Australia suffers from irritable bowel syndrome (IBS). This chronic or recurrent condition is characterized by abdominal pain, bloating, and constipation or diarrhea. Traditional Chinese herbal remedies are routinely used in China to treat the condition, but so far have not been generally accepted by conventional Western medicine. This may now change as medical researchers at the University of Sydney have just released a report showing that Chinese herbal medicine (CHM) is indeed effective in the treatment of IBS. Their year-long, randomized, double-blind, placebo- controlled trial involved 116 patients with IBS diagnosed by gastroenterologists. The patients were randomized into three groups. The first group of 38 patients received individualized CHM (prescribed by Chinese herbalists), the second group of 43 patients received a standard CHM for IBS (supplied by Mei Yu Imports, Sydney, Australia), and the third group of 35 patients received a placebo. All participants took five capsules three times daily during the 16-week treatment period. At the end of the treatment there was a significant improvement among the patients who had received CHM. According to evaluations carried out by gastroenterologists 59 per cent of the patients in the standard CHM group had markedly improved their condition as compared to 40 per cent in the individualized CHM group and 19 per cent in the placebo group. Patients receiving CHM also reported that the treatment had resulted in the IBS causing less interference in their lives. The patients were re-evaluated 14 weeks after the end of the treatment. At this time, only the patients who had received individualized CHM still showed significant improvement. The researchers conclude that Chinese herbal medicines can be effective in the management of irritable bowel syndrome.
Bensoussan, Alan, et al. Treatment of irritable bowel syndrome with Chinese herbal medicine. Journal of the American Medical Association, Vol. 280, November 11, 1998, pp. 1585-89

Lower your cholesterol naturally
LOS ANGELES, CALIFORNIA. A high cholesterol level is generally believed to be associated with an increased risk of atherosclerosis and heart disease. Cholesterol levels can be lowered through dietary changes or by prescription drugs. Now researchers at the UCLA School of Medicine report that a natural supplement based on Chinese red-yeast-rice is highly effective in lowering cholesterol levels. Red yeast rice is a fermented rice product on which a red yeast (Monascus purpureus) has been grown. It was first described in 800 AD and has been widely used in China for many years. The UCLA double-blind, placebo-controlled study involved 83 healthy men and women with elevated cholesterol levels. The participants were randomly assigned to receive either four red-yeast-rice capsules daily (containing a total of 2.4 grams of the yeast-rice) or four placebo capsules. All participants were following a diet similar to the American Heart Association Step I diet (less than 30 per cent of energy from fat, less than 10 per cent of energy from saturated fat, and less than 300 mg cholesterol daily). Blood samples for cholesterol analysis were drawn at the start of the study and after 8, 9, 11 and 12 weeks when the study ended. After eight weeks the average total cholesterol level in the red-yeast-rice group was almost 50 mg/dL (1.19 mmol/L) lower than in the placebo group and after 12 weeks the cholesterol level in the rice-yeast group had dropped by 40 mg/dL (1.03 mmol/L) as compared to a 5 mg/dL (0.13 mmol/L) drop in the placebo group. Average low density cholesterol (LDL) concentrations dropped by over 20 per cent after eight weeks (1.0 mmol/L or 39 mg/dL) in the rice-yeast group while no change was observed in the placebo group. The level of high density cholesterol (HDL) did not change in either group. No adverse effects of the red-yeast-rice were observed. The researchers conclude that red-yeast-rice is a safe and effective supplement for lowering cholesterol levels and point out that it is almost 10 times cheaper than conventional cholesterol-lowering drugs. NOTE: This study was supported in part by Pharmanex Inc., the manufacturer of the red-yeast-rice supplement Cholestin.
Heber, David, et al. Cholesterol-lowering effects of a proprietary Chinese red-yeast-rice dietary supplement. American Journal of Clinical Nutrition, Vol. 69, February 1999, pp. 231-36
Havel, Richard J. Dietary supplement or drug? The case of Cholestin. American Journal of Clinical Nutrition, Vol. 69, February 1999, pp. 175- 76

Ginger and turmeric fight cancer
KUALA LUMPUR, MALAYSIA. Ginger, turmeric and other members of the Zingiberaceae family of rhizomes have a long history of use in Malaysian traditional medicine. Ginger, for example, is widely used in the treatment of stomach problems, nausea, vomiting, epilepsy, sore throat, cough, bruises, wounds, childbirth, sore eyes, liver complaints, rheumatism, asthma, and many other disorders. Researchers at the Forest Research Institute of Malaysia now report that several members of the Zingiberaceae family effectively block the promotion of cancerous tumors. They tested 11 different species and found that seven of them had strong anti-tumor properties. Their test involved a short term assay of the inhibitory effect of extracts of the rhizomes (roots) on human cancer cells. They found that turmeric (Curcuma domestica) extracts (turmeric root extracted with petroleum ether, chloroform or ethanol) completely inhibited further growth of the cancer cells. Ginger (Zingiber officinale) extracts, especially the chloroform extract, also inhibited further growth, but the concentration of extract was more critical than for the turmeric extracts. The researchers conclude that turmeric, ginger and other Zingiberaceae rhizomes may be useful in preventing the promotion of cancer and that populations with high risks of cancer should be encouraged to include them in their diet. Further work is now underway to isolate the active components in the plants.
Vimala, S., et al. Anti-tumour promoter activity in Malaysian ginger rhizobia used in traditional medicine. British Journal of Cancer, Vol. 80, No. 1/2, April 1999, pp. 110-16

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