Acupuncture Continuing Education

Acupuncture & Herbs Heal Colitis

New research confirms that acupuncture and herbal medicine relieve chronic ulcerative colitis. Chinese herbal medicine heals colitis. Herbal MedicineThis disorder is an inflammatory disease of the intestines that most commonly affects the innermost lining of the large intestine and rectum. It is a contiguous expanses of inflamed tissue that may spread deeply into affected regions. Biomedical treatments include anti-inflammatory drugs, immunosuppression and surgical removal of parts of the intestines. In Traditional Chinese Medicine (TCM), a combination of acupuncture and herbs are used to treat this disorder.

TCM case histories for the successful treatment of chronic ulcerative colitis date back over 1,000 years. This new research confirms what has been included in standard Chinese Medicine texts for millennia. The approach taken in this recent study was to combine an herbal enema with standard acupuncture therapy. The herbal enema was comprised of a Bai Tou Weng and Ku Shen decoction. A control group was given only sulfasalazine, an antibiotic used in the treatment of ulcerative colitis and Crohn’s disease.

The researchers discovered two major findings. First, the acupuncture combined with herbal medicine group had significantly better patient outcomes than the drug group. Second, the acupuncture combined with herbal medicine group seldom had any side effects whereas the drug group experienced adverse effects from the antibiotic treatment. All results were taken from a sample size of 62 patients with chronic ulcerative colitis that were randomly divided into the acupuncture-herb group and the sulfasalazine antibiotic group. This study was recently published in the Clinical Journal of Chinese Medicine.

Historically, Traditional Chinese Medicine documents a great many successes in the treatment of ulcerative colitis using internal herbal tea decoctions for oral consumption as a medicinal beverage. The use of the formulas is based on a differential diagnosis of a patient’s condition. The following is a short list of common herbal formulas used in TCM clinics for the treatment of chronic ulcerative colitis: Bai Tou Weng Tang, Bai Zhu Shao Yao San, Bu Zhong Yi Qi Tang, Dang Gui Bu Xue Tang, Fu Zi Li Zhong Wan, Ge Gen Huang Lian Huang Qin Tang, Ge Gen Qin Lian Tang, Huai Hua San, Jian Pi Wan, Shao Yao Tang, Tong Xie Yao Fang, Zhen Ren Huo Ming Yin.

The medicinal functions of these formulas varies enormously and a skilled licensed acupuncturist trained in herbal medicine is able to determine the appropriate choice given a patient’s specific condition. Severe infectious stages of chronic ulcerative colitis may require an anti-toxin formula such as Bai Tou Weng Tang whereas chronic stages characterized by patient fatigue may require a tonifying herbal formula such as Bu Zhong Yi Qi Tang.

Clinical Highlights
Traditional treatment of subacute flare-ups and acute stages is often guided by the treatment principle of clearing the Large Intestine damp-heat. In TCM, damp-heat is a term often referring to inflammatory conditions characterized by redness, swelling, pain, heat, pus, mucous and other types of fluid congestion. Shao Yao Tang and Bai Tou Weng Tang are often appropriate herbal formulas in these more extreme clinical scenarios.

Shao Yao Tang is generally chosen when there is an equal amount of blood and pus in the stool whereas Bai Tou Weng Tang is chosen when there is more blood than pus in the stool. The chief ingredient of Bai Tou Weng Tang, Bai Tou Weng, has very strong properties. It clears heat, toxins and poisons and also cools the blood and binds the intestines. It is often used in cases where there is severe diarrhea from acute amoebic or bacterial dysentery. Bai Tou Weng Tang, in general, applies to the treatment of more severe, acute presentations.

The clinical scenarios shift from these subacute and acute stages to very cold, deficient chronic cases. In those situations, anti-toxin formulas like Shao Yao Tang and Bai Tou Weng Tang may not provide any relief. Fu Zi Li Zhong Wan represents a formula used on the othe side of the clinical spectrum for the treatment of chronic ulcerative colitis. It functions to warm the middle jiao, expel the cold and to tonify the Spleen Qi. It shares symptoms with more acute presentations such as abdominal pain, bloating and diarrhea but this is where the similarities begin to wane. The patients are often exhausted, have a watery stool, belch, have a cold sensation of the lower abdomen or whole body and have a very low appetite. The treatment principle is to warm the interior. From the fiery presentations of Large Intestine Damp-Heat to the chilling presentations of cold and dampness, chronic ulcerative colitis presents many challenges to treatment.

The new research did not focus on herbal decoctions as beverages but instead combined herbal decoction enemas with acupuncture. In some states, herbal enemas are not within the scope of practice of a licensed acupuncturist. Outside of this legal restriction, this treatment modality is a widely accepted and well documented approach. Acupuncturists are also well versed in Chinese Medicine dietetics. Dietary modifications may be necessary to prevent exacerbation and aggravation of colitis. The acupuncture component helps to speed the recovery process significantly.

Acupuncture exerts a synergistic effect on the body thereby enhancing the efficaciousness of herbal medicine approaches. In an interview with Prof. J. Pang, L.Ac., he notes that acupuncture helps to open the acupuncture channels thereby potentiating the herbal formulas. Prof. Pang is a provider of acupuncture continuing education courses for acupuncture CEU credit at the Healthcare Medicine Institute (HealthCMi) and is the department chair of herbal medicine, dietetics and theory at Five Branches University located in San Jose and Santa Cruz, California.

Clinical observation on treating chronic ulcerative colitis with retention enema by Baitouweng Kushen decoction and acupuncture, Clinical Journal of Chinese Medicine, 1674-7860, 2013.