by Bob Flaws

During the last 5-6 years, I have done a lot of translating for books on the Chinese medical treatment of Western medical diseases in general and on diabetes, cardiology, and psychiatry in particular. In the course of that research, reading literally hundreds of Chinese clinical trials, I have become convinced that the future belongs (or at least should belong) to integrated Chinese-Western medicine 中西医结合. This means the simultaneous treatment of a condition with Western and Chinese medicines. To date, all my research suggests that such a combination of the two gets better therapeutic effects in serious and/or recalcitrant disease than either alone.

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However, recent converts to Chinese medicine, like all converts, tend to be "holier than thou," or, in this case, "purer than thou," meaning that they think Chinese medicine is the best medicine in the world and use of anything else is a moral fall from grace. Because such converts are usually actively turning away from modern Western medicine, this purist attitude is often accompanied by overt antipathy to modern Western medicine. Since most students of Chinese medicine in the West are in their 20s and early to mid 30s, they can afford the luxury of these illusions. However, once one is into their 50s, 60s, and beyond, the "cheap miles" are over, and the likelihood of having to use at least some Western medicine becomes greater and greater. For instance, recently on Facebook, one acupuncturist was saying how bad Western medicine is while another acupuncturist told of how Western medicine had saved his life from a heart attack. Needless to say, the second writer was markedly older than the first.

Unfortunately, because the overwhelming majority of Western students and practitioners cannot read the Chinese medical literature in Chinese, most have no idea of the prevalence and efficacy of integrated Chinese-Western medicine in China. Therefore, I'd like to share a summary of an article found on page 502 of issue 7, 2009 of the Zhejiang Journal of Chinese Medicine. This article was authored by Drs. Hu and Chen and is a report on a clinical trial involving 52 cases of anovulatory infertility.

Cohort description:

All 52 cases were diagnoses via ultrasound. Their median age was 27.60 plus/minus 2.75 years. Their median course of disease was 3.56 plus/minus 1.06 years. There were 30 cases of primary onset infertility, and 22 cases of secondary onset infertility. In addition, there were 18 cases of polycystic ovarian syndrome, 10 cases of hyperprolactinemia, and 24 cases of other causes of anovulation. These 52 cases were randomly divided into two groups of 26 cases each which were judged statistically comparable in terms of age, disease duration, and reproductive history. In terms of Chinese medicine, all were diagnosed as suffering from infertility, and all were discriminated as presenting a kidney vacuity pattern.

Treatment method:

All members of the comparison group were administered 50 milligrams of clomiphene per day beginning day five of their cycle. This was continued for five days. If, after two weeks, ovulation had not occurred, their dose was raised to 100-150 milligrams. All members of the treatment group received this same dose of clomiphene. However, beginning on the first day of the cessation of menstruation, they were also administered Si Er Wu Tang (Four Two Five Decoction) which consisted of:

Xian Mao (Rhizoma Cuculiginis)
Che Qian Zi (Semen Plantaginis)
Bai Shao (Radix Alba Paeoniae)
Dang Gui (Radix Angelicae Sinensis)
Chuan Xiong (Rhizoma Chuanxiong)
Chuan Niu Xi (Radix Cyathulae), 10 each
Xian Ling Pi (Herba Epimedii)
Gou Qi Zi (Fructus Lycii)
Fu Pen Zi (Fructus Rubi)
Shu Di Huang (cooked Radix Rehmanniae), 15g each
Wu Wei Zi (Fructus Schisandrae), 5g
Tu Si Zi (Semen Cuscutae), 20g

One packet of these medicinals was decocted in water and administered two times per day a half-hour after meals. This was continued for 20 days.

Modifications:

If there was yin vacuity internal heat, then Sheng Di Huang (uncooked Radix Rehmanniae), Nu Zhen Zi (Fructus Ligustri Lucidi), and Mu Dan Pi (Cortex Moutan) were added.

If there was phlegm dampness, Ban Xia (Rhizoma Pinelliae) and Yi Yi Ren (Semen Coicis) were added.

If there was liver depression, Chai Hu (Radix Bupleuri) and Zhi Qiao (Fructus Aurantii) were added.

If there was blood stasis, Tao Ren (Semen Persicae) and Dan Shen (Radix Salviae Miltiorrhizae) were added.

If there was polycystic ovarian syndrome, Kun Bu (Thallus Algae), Zhe Bei Mu (Bulbus Fritillariae Thunbergii), and Shi Chang Pu (Rhizoma Acori Tatarinowii) were added.

If there was hyperprolactinemia, Chai Hu (Radix Bupleuri) and uncooked Mai Ya (Fructus Germinatus Hordei) were added.

If estrogen was low, Zi He Che (Placenta Hominis) and Gui Ban Jiao (Gelatinum Plastri Testudinis) were added.

Two menstrual cycles equaled one course of treatment, and three such courses were administered before analyzing outcomes.

Study outcomes:

Cure was defined as complete disappearance of symptoms plus ovulation confirned by ultrasound or pregnancy. Marked effect was defined as partial or complete disappearance of symptoms with ultrasound showing
follicular development but failure to ovulate. Some effect was defined as partial disappearance or decrease in symptoms with ultrasound again showing follicular development but failure to ovulate. No effect was defined as no disappearance or decrease in clinical symptoms and no follicular development. Based on these criteria, in the treatment group treated with integrated Chinese-Western medicine, 20 cases were cured, two got a marked effect, one got some effect, and three got no effect. Thus the cure rate was 76.9%. In the comparison group treated solely with Western medicine, 12 cases were cured, six cases got a marked effect, four cases got some effect, and four cases got no effect. Hence the cure rate in this group was only 46.2%. Further in the treatment group, there were 16 pregnancies and two miscarriages. Therefore, the pregnancy rate was 61.5% and the miscarriage rate was 12.5%. In the comparison group, there were eight pregnancies and four miscarriages, for a pregnancy rate of 30.8% and a miscarriage rate of 50%. In the treatment group, there were 110 menstrual cycles, 98 of which were ovulatory. Therefore, the rate of ovulation in this group was 89.1%. In the comparison group, there were 70 menstrual cycles, 50 of which were ovulatory, for an ovulation rate of 71.4%.

Therefore, it is safe to say that, in every parameter studied, the integrated Chinese-Western medical protocol out-performed the pure Western medical protocol. From reading hundreds of these kinds of comparative studies, I can say that these outcomes are the norm rather than the exception. Thus, in the treatment of serious or recalcitrant conditions, I highly recommend using a combination of Western and Chinese medicines. That's what I do in terms of my own health care.

Copyright Blue Poppy Press, 2009. All rights reserved.