Jul
9
Chinese herbal medicine vs gestrinone for endometriosis
Posted by admin in Chinese herbs, Chinese medicine, endometriosis, infertility
Chinese herbal medicine for endometriosis
Flower A, Liu JP, Chen S, Lewith G, Little P
Chinese herbs for endometriosis
Endometriosis is a common gynaecological condition causing menstrual and pelvic pain. Treatment involves surgery and hormonal drugs, with potentially unpleasant side effects and high rates of reoccurrence of endometriosis. This review suggests that Chinese herbal medicine (CHM) may be useful in relieving endometriosis-related pain with fewer side effects than experienced with conventional treatment. However, the two trials included in this review are of poor methodological quality so these findings must be interpreted cautiously. Better quality randomised controlled trials are needed to investigate a possible role for CHM in the treatment of endometriosis.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 3, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Flower A, Liu JP, Chen S, Lewith G, Little P. Chinese herbal medicine for endometriosis. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD006568. DOI: 10.1002/14651858.CD006568.pub2
This version first published online: July 08. 2009
Abstract
Background
Endometriosis is characterized by the presence of tissue that is morphologically and biologically similar to normal endometrium in locations outside the uterus. Surgical and hormonal treatment of endometriosis have unpleasant side effects and high rates of relapse. In China, treatment of endometriosis using Chinese herbal medicine (CHM) is routine and considerable research into the role of CHM in alleviating pain, promoting fertility, and preventing relapse has taken place.
Objectives
To review the effectiveness and safety of CHM in alleviating endometriosis-related pain and infertility.
Search strategy
We searched the Menstrual Disorders and Subfertility Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library) and the following English language electronic databases (from their inception to the present): MEDLINE, EMBASE, AMED, CINAHL, NLH on the 30/04/09.
We also searched Chinese language electronic databases: Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Sci & Tech Journals (VIP), Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), and Chinese Medical Current Contents (CMCC).
Selection criteria
Randomised controlled trials (RCTs) involving CHM versus placebo, biomedical treatment, another CHM intervention, or CHM plus biomedical treatment versus biomedical treatment were selected. Only trials with confirmed randomisation procedures and laparoscopic diagnosis of endometriosis were included.
Data collection and analysis
Risk of bias assessment, and data extraction and analysis were performed independently by three review authors. Data were combined for meta-analysis using relative risk (RR) for dichotomous data. A fixed-effect statistical model was used, where appropriate. Data not suitable for meta-analysis are presented as descriptive data.
Main results
Two Chinese RCTs involving 158 women were included in this review. Both these trials described adequate methodology. Neither trial compared CHM with placebo treatment.
There was no evidence of a significant difference in rates of symptomatic relief between CHM and gestrinone administered subsequent to laparoscopic surgery (95.65% versus 93.87%; risk ratio (RR) 1.02, 95% confidence interval (CI) 0.93 to 1.12, one RCT). The intention-to-treat analysis also showed no significant difference between the groups (RR 1.04, 95% CI 0.91 to 1.18). There was no significant difference between the CHM and gestrinone groups with regard to the total pregnancy rate (69.6% versus 59.1%; RR 1.18, 95% CI 0.87 to 1.59, one RCT).
CHM administered orally and then in conjunction with a herbal enema resulted in a greater proportion of women obtaining symptomatic relief than with danazol (RR 5.06, 95% CI 1.28 to 20.05; RR 5.63, 95% CI 1.47 to 21.54, respectively).
Overall, 100% of women in all the groups showed some improvement in their symptoms.
Oral plus enema administration of CHM showed a greater reduction in average dysmenorrhoea pain scores than did danazol (mean difference (MD) -2.90, 95% CI -4.55 to -1.25; P < 0.01).
Combined oral and enema administration of CHM showed a greater improvement, measured as the disappearance or shrinkage of adnexal masses, than with danazol (RR 1.70, 95% CI 1.04 to 2.78). For lumbosacral pain, rectal discomfort, or vaginal nodules tenderness, there was no significant difference either between CHM and danazol.
Authors’ conclusions
Post-surgical administration of CHM may have comparable benefits to gestrinone but with fewer side effects. Oral CHM may have a better overall treatment effect than danazol; it may be more effective in relieving dysmenorrhea and shrinking adnexal masses when used in conjunction with a CHM enema. However, more rigorous research is required to accurately assess the potential role of CHM in treating endometriosis.
Feb
10
Systematic review: Acupuncture and IVF: Acupuncture improves rates of pregnancy and live birth
Posted by admin in ART, Chinese herbs, Chinese medicine, IVF, acupuncture, female infertility, infertility, male infertility, polycystic ovaries, stress/anxiety
Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta-analysis
Eric Manheimer, research associate1, Grant Zhang, assistant professor1, Laurence Udoff, assistant professor2, Aviad Haramati, professor3, Patricia Langenberg, professor and vice-chair4, Brian M Berman, professor1, Lex M Bouter, professor and vice chancellor (rector magnificus)5
1 Center for Integrative Medicine, University of Maryland School of Medicine, 2200 Kernan Drive, Kernan Hospital Mansion, Baltimore, MD 21207, USA, 2 Department of Obstetrics, Gynecology and Reproductive Services, University of Maryland School of Medicine, 3 Department of Physiology and Biophysics and Medicine, Georgetown University School of Medicine, Washington, DC, 4 Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, 5 VU University Amsterdam De Boelelaan 1105, 1081 HV Amsterdam, the Netherlands
Correspondence to: E Manheimer emanheimer@compmed.umm.edu
Objective To evaluate whether acupuncture improves rates of pregnancy and live birth when used as an adjuvant treatment to embryo transfer in women undergoing in vitro fertilisation.
Design Systematic review and meta-analysis.
Data sources Medline, Cochrane Central, Embase, Chinese Biomedical Database, hand searched abstracts, and reference lists.
Review methods Eligible studies were randomised controlled trials that compared needle acupuncture administered within one day of embryo transfer with sham acupuncture or no adjuvant treatment, with reported outcomes of at least one of clinical pregnancy, ongoing pregnancy, or live birth. Two reviewers independently agreed on eligibility; assessed methodological quality; and extracted outcome data. For all trials, investigators contributed additional data not included in the original publication (such as live births). Meta-analyses included all randomised patients.
Data synthesis Seven trials with 1366 women undergoing in vitro fertilisation were included in the meta-analyses. There was little clinical heterogeneity. Trials with sham acupuncture and no adjuvant treatment as controls were pooled for the primary analysis. Complementing the embryo transfer process with acupuncture was associated with significant and clinically relevant improvements in clinical pregnancy (odds ratio 1.65, 95% confidence interval 1.27 to 2.14; number needed to treat (NNT) 10 (7 to 17); seven trials), ongoing pregnancy (1.87, 1.40 to 2.49; NNT 9 (6 to 15); five trials), and live birth (1.91, 1.39 to 2.64; NNT 9 (6 to 17); four trials). Because we were unable to obtain outcome data on live births for three of the included trials, the pooled odds ratio for clinical pregnancy more accurately represents the true combined effect from these trials rather than the odds ratio for live birth. The results were robust to sensitivity analyses on study validity variables. A prespecified subgroup analysis restricted to the three trials with the higher rates of clinical pregnancy in the control group, however, suggested a smaller non-significant benefit of acupuncture (odds ratio 1.24, 0.86 to 1.77).
Conclusions Current preliminary evidence suggests that acupuncture given with embryo transfer improves rates of pregnancy and live birth among women undergoing in vitro fertilisation.
Oct
31
Acupuncture and Chinese Medicine for Chronic Pelvic Inflammation
Posted by admin in Chinese herbs, Chinese medicine, acupuncture, chronic pelvic inflammation
Hospital of Integrated Traditional and Western Medicine Affiliated to Zhejiang College of TCM, Hangzhou 31000, China.
OBJECTIVE: To observe the therapeutic effect of acupuncture and moxibustion on chronic pelvic inflammation. METHOD: Thirty-six cases of chronic pelvic inflammation were treated with acupuncture, the ancient recipe of Long Dan Xie Gan Tang ([symbol: see text] Decoction of Radix Gentianae for Purging the Pathogenic Fire of the Liver) and medicinal cake moxibustion. RESULT: The treatment resulted in cure in 9 cases, obvious effect in 16 cases, effect in 7 cases and no effect in 4 cases. CONCLUSION: Acupuncture, moxibustion and the ancient recipe Long Dan Xie Gan Tang used together can enhance the therapeutic effects on chronic pelvic inflammation.
Jun
16
Chinese herbal medicine – higher success rates of pregnancy, no side-effects
Posted by admin in Chinese herbs, Chinese medicine, female infertility, infertility
Measuring the Effectiveness of Chinese Herbal Medicine in Improving Female Fertility
By: Trevor A. Wing & Elke S. Sedlmeier
Keywords: Infertility, Chinese herbal medicine, ultrasound, hormone levels.
Aim: To determine the relationship between female fertility indicators and the administration of
Chinese herbal medicine (CHM).
Design: A prospective cohort clinical study to measure accepted bio-medical
factors that affect female fertility and to determine if CHM can improve these factors as well as pregnancy outcome.
Setting: A private practice specialising in treating infertility with traditional Chinese medicine (TCM). The study took place between November 2003 and December 2004. Patient(s): Fifty women with the Western medical diagnosis of unexplained infertility.
Interventions: One monitored menstrual cycle measuring pre-treatment fertility factors, followed by treatment with Chinese herbal medicine and subsequent measurement of the changes in the same fertility factors.
Results: Significant differences were observed between the two time points for the majority of factors measured. Pregnancies in the sample group recorded 6 months after commencement of the last treatment were 28, with 11 live births and 7 miscarriages.
Conclusion: The study outcome demonstrates that using Chinese herbal medicine results in higher success rates of pregnancy, with no patient side-effects and a reduction in the category of patients conventionally classified as having unexplained infertility.
Introduction
The research question this study seeks to answer is “Does administering Chinese herbal medicine (CHM) improve the physiological factors affecting human female fertility?†The hypothesis is that administering CHM improves the main physiological factors affecting human female fertility and therefore also the pregnancy
rate. These factors are ovarian follicle number and size, uterine endometrium thickness, uterine artery
haemodynamics, serum follicle stimulating hormone (FSH), serum progesterone levels and corpus luteum
vascularity.
Research aims and objectives
1. Establish a sample group of 50 new patients registering for fertility treatment at a London natural health fertility clinic.
2. Test and record a predetermined group of twelve measurements prior to treatment during one menstrual cycle.
3. Administer CHM in capsule form for one menstrual cycle.
4. Re-test the same parameters in the third cycle of treatment, continue to administer CHM for six months (or until pregnancy is achieved if this occurs in less than six months). Follow up six months after the beginning of the last patient’s treatment
5. To determine the number of pregnancies achieved.
6. Analyse results and discuss findings.
7. Draw conclusions and make recommendations for further practice and study.
Methodology
The challenge for any investigative method when applied to traditional Chinese medicine (TCM) is that
in everyday practice, the same disease in different patients will have a different treatment principle
and herbal prescription. The information collected from the traditional Chinese examination and
assessment determines a diagnosis based on pattern differentiation and hence a treatment principle and
formula which is individualised for each patient. In our treatment of infertility there is, in addition,
a weekly modification of each patient’s formula. As there is thus no standardisation of formulae for
patients it is not appropriate to discuss the formulae themselves in this study, but rather to simply study
the effects of Chinese herbal medicine treatment on female fertility.
The method chosen was a prospective cohort primary study using a sample group of patients registered
with the clinic for TCM infertility treatment.
Patients were selected for the study on the basis that they had no Western medical condition which might have affected their fertility. In other words they were described in Western medical terms as having unexplained infertility. They also entered the study on the condition that data obtained in the course of their treatment could be used in the study anonymously.
May
20
Effect of Chinese medicinal herbs on sperm membrane of infertile male
Posted by admin in Chinese herbs, male infertility
Effect of Chinese medicinal herbs on sperm membrane of infertile male
[Article in Chinese]
Liu XD.
Shandong Institute of Traditional Chinese Medicine and Materia Medica, Jinan.
The authors carried on the quantitative analysis of fluorescence polarization degree and fluorescent intensity on wheat germ agglutinin (WGA) receptor in sperm membrane surface and protein macromolecule 1-Anilinonaph thalene-8-suphonic acid salt (1,8-ANS) of sperm membrane to the patients with infertility and adult male with normal fertility, with the method of ultraviolet microspectrofluorometer (SMP, type: 05, made in West Germany). The results were as follows: the patient’s WGA receptor in sperm membrane surface was decreased (P less than 0.001), and the 1, 8-ANS of fluorescent intensity in hydrophobic area of protein macromolecule of sperm membrane was increased (P less than 0.05). After the treatment of Shenjing Zhongzitang, WGA receptor was increased obviously and 1, 8-ANS of fluorescent intensity was changed to be almost normal. It showed that the Chinese medicinal herbs mentioned above have certain influence upon the constitution of WGA receptor and protein macromolecule of sperm membrane.
Zhong Xi Yi Jie He Za Zhi. 1990 Sep;10(9):519-21, 515.
May
11
Chinese herbs – higher success rates of pregnancy (unexplained infertility)
Posted by admin in Chinese herbs, female infertility, infertility
Measuring the Effectiveness of Chinese Herbal Medicine in Improving Female Fertility
By: Trevor A. Wing & Elke S. Sedlmeier
Aim: To determine the relationship between female fertility indicators and the administration of
Chinese herbal medicine (CHM).
Design: A prospective cohort clinical study to measure accepted bio-medical
factors that affect female fertility and to determine if CHM can improve these factors as well as pregnancy outcome.
Setting: A private practice specialising in treating infertility with traditional Chinese medicine (TCM). The study took place between November 2003 and December 2004. Patient(s): Fifty women with the Western medical diagnosis of unexplained infertility.
Interventions: One monitored menstrual cycle measuring pre-treatment fertility factors, followed by treatment with Chinese herbal medicine and subsequent measurement of the changes in the same fertility factors.
Results: Significant differences were observed between the two time points for the majority of factors measured. Pregnancies in the sample group recorded 6 months after commencement of the last treatment were 28, with 11 live births and 7 miscarriages.
Conclusion: The study outcome demonstrates that using Chinese herbal medicine results in higher success rates of pregnancy, with no patient side-effects and a reduction in the category of patients conventionally classified as having unexplained infertility.
Introduction
The research question this study More »
May
11
Combination of western and Chinese medicine is the most effective method in treating tubal obstruction
Posted by admin in ART, Chinese herbs, IVF, female infertility, infertility
FALLOPIAN TUBE DYSFUNCTION AND CHINESE HERBAL MEIDCINE
A study was carried out in Guangzhou, China, to find an effective treatment for tubal obstruction. The results of 120 women divided into three treatment groups were compared. One group received a combination of Western medical treatment and Chinese herbal medicine, one group received Chinese herbal medicine only and another group received Western medical treatment only. After treatment, the fallopian tube patency rate 86.7% and the pregnancy rate 85.0% in the TCM/ WM group, 66.7% and 63.3% in the TCM group and 53.3% and 50% in the WM group respectively. The effectiveness in the combination group was significant. The authors conclude that the combination of western and Chinese medicine is the most effective method in treating tubal obstruction.
Kang JL, XIa W, He QY.’[Clinical study on treatment of oviduct obstruction by integrative traditional Chinese and Western medicine]. Zhongguo Zhong Xi Yi Jie He ZaZhi. 2001, 21 (6): 416-8.
May
10
Male infertility: acupuncture and herbs regulate antisperm antiboy antisperm antibody (AsAb)
Posted by admin in Chinese herbs, Chinese medicine, acupuncture, infertility, male infertility
Effects of the combined therapy of acupuncture with herbal drugs on male immune infertility–a clinical report of 50 cases.
Fu B, Lun X, Gong Y.
Department of Acupuncture, Second Guangdong Provincial Worker’s Hospital, Guangzhou 510720, China.
To study the clinical effects of the combined therapy of acupuncture with herbal drugs on male immune infertility and on antisperm antibody (AsAb), 100 male cases of infertility with positive AsAb were divided randomly into two groups, each consisting of 50 cases. The acupuncture-drug group was treated with acupuncture on Ganshu (BL 18), Shenshu (BL 23), Taichong (LR 3), Taixi (KI 3), Xinshu (BL 15), Geshu (BL 17), Shenmen (HT 7), and Xuehai (SP 10), combined with oral medication of Liuwei Dihuang Wan (Bolus of the Six Drugs Including Rehmanniae). The control group was treated with oral prednisone. The clinical therapeutic effects and the impact on AsAb were observed in the two groups. The results showed that the total effective rate in the acupuncture-drug group was 90%; while that of the control group was 64%, the comparison showing a statistically significant difference (P<0.05). The positive rate of blood serum and/or AsAb in both the two groups decreased in varying degrees, but the negative-turning rate of AsAb in the acupuncture-drug group was more obvious, the comparison showing also a significant difference (P<0.05). CONCLUSION: The combined therapy of acupuncture with herbal drugs has definite therapeutic effects on male immune infertility, which can regulate AsAb and raise the immunity of the patients.
J Tradit Chin Med. 2005 Sep;25(3):186-9.
Feb
20
Effects of ferulic acid on fertile and asthenozoospermic infertile human sperm motility, viability, lipid peroxidation, and cyclic nucleotides.
Posted by admin in Chinese herbs, Chinese medicine, infertility, male infertility
Effects of ferulic acid on fertile and asthenozoospermic infertile human sperm motility, viability, lipid peroxidation, and cyclic nucleotides.
Zheng RL, Zhang H.
Department of Biology, Lanzhou University, P.R. China.
The capacity of human sperm fertilization principally depends on sperm motility and membrane integrity. Reactive oxygen species, such as superoxide anion and hydrogen peroxide, are known to impair sperm motility and membrane integrity by inducing membrane lipid peroxidation (LPO). Ferulic acid (FA), an effective constituent in various medicinal herbs, has recently been shown to scavenge oxygen free radicals and increase the intracellular cAMP and cGMP. The aim of this study is to investigate the effects of FA on human sperm motility, viability, lipid peroxidation, and cyclic nucleotides in fertile and asthenozoospermic infertile individuals in vitro. The sperm samples were obtained from 10 fertile volunteers and 10 asthenozoospermic infertile patients. Washed spermatozoa were incubated at 37 degrees C in Ham’s F-10 medium with 0, 0.1, 0.2, 0.4, 0.8, or 1.6 mM of FA. Samples were analyzed for viability, determined by eosin-Y dye exclusion method at 0, 1, 2, 3, 5, and 6 h of incubation; motility, determined by the trans-membrane migration method within 2 h of incubation; LPO, determined by thiobarbituric acid (TBA) method at 3 h of incubation and the intracellular cAMP and cGMP, determined, respectively, by 3H-cAMP and 125I-cGMP radioimmunoassay at 3 h of incubation. The results showed: in both fertile and infertile spermatozoa, the viability, trans-membrane migration ratio (TMMR) and the levels of intracellular cAMP and cGMP in FA-treated spermatozoa were significantly higher than those of spermatozoa in control groups, while TBA-reactive substances contents in treated spermatozoa were significantly lower than those in control spermatozoa. The effects of FA on these processes were concentration dependent. These data suggested that FA is beneficial to sperm viability and motility in both fertile and infertile individuals, and that reduction of lipid peroxidative damage to sperm membranes and increase of intracellular cAMP and cGMP may be involved in these benefits. It is possible that FA may be used for cure of asthenozoospermic infertility.
Free Radic Biol Med. 1997;22(4):581-6.
Jan
19
Combination of Chinese herbs and hormones could lower the NO (nitric oxide) level in semen and improve the quality of sperm
Posted by admin in Chinese herbs, Chinese medicine, male infertility
Clinical observation on effect of combination of zhuanyindan and hormone in treating male infertility with positive antisperm antibody
[Article in Chinese]
Yu AL, Zhang FZ, Zhang FX.
Taishan Medical College, Shandong 271000.
OBJECTIVE: To explore the therapeutic effect of combination of Zhuanyindan (ZYD, a Chinese herbal preparation) and hormone in treating male infertility with positive antisperm antibody and its influence on nitric oxide (NO) level. METHODS: Eighty-two patients were randomly divided (according to the digital list) into the WM group (n = 20, treated with prednisone), the TCM group (n = 28, treated with ZYD) and the ICWM group (n = 34, treated with prednisone plus ZYD). The clinical effect, negative converting rate of antisperm antibody, changes of NO level in semen and various parameters of sperm motion before and after treatment were observed. RESULTS: The total effective rate in the ICWM group was 88.2%, that in the TCM group 75.0% and in the WM group 65.0%. Significant difference was seen in the ICWM and TCM group before and after treatment in NO level, sperm motion parameters, including linear motion speed, linearity, propulsion, whip frequency, sperm vitality and mean moving angle, and quality of semen (P < 0.05 or P < 0.01). In the WM group, significant difference in comparison before and after treatment was seen in NO level, propulsion, whip frequency, mean moving angle and quality of semen, including vitality and survival rate (P < 0.01).
CONCLUSION: Combination of Chinese herbs and hormone could lower the NO (nitric oxide) level in semen and improve the quality of sperm.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2004 Mar;24(3):223-6.