Acupuncture is perhaps the best known aspect of Traditional Chinese Medicine (TCM) in America. But an important branch of TCM is its highly developed approach to herbal medicine. While acupuncture is rightly famous for its effectiveness in treating pain and trauma, the primary focus in TCM herbology is on internal medicine.
In TCM, the herbs, as well as the diseases, are classified according to their various characteristics. As a simple example, a patient whose illness causes signs of heat and dryness (such as fever, sore throat, dry mouth and dark urine) might be treated with herbs that are considered cooling and moistening. The “cooling” effects of an herb may be understood by modern medicine to be the result of its anti-infective properties, but there is less focus on biochemistry in the traditional concepts.
An herbal prescription or formula in TCM commonly contains 10 or 12 different herbs. These would not be simply a bunch of herbs with similar properties. Instead, herbs are chosen to play a particular role within the formula. Each herb would have a specific purpose, such as treatment of the primary complaint, treatment of secondary complaints, moderation of other harsh ingredients, “guiding” the formula to affect specific parts of the body, or harmonizing the actions if dissimilar herbs. The formula is also developed with one of eight traditional treatment methods in mind. For example it might be designed to tonify, reduce, warm, or clear away heat.
The following case study reviews the successful treatment of a Blastocystis hominis infection with Chinese herbs. Traditional Chinese names are given for the herbs, using the standard pinyin transliterations.
Blastocystis hominis is a common microscopic parasitic organism (a single-cell protazoan) found throughout the world. Infection is common; many infected people are asymptomatic. Symptoms can include loose stools, diarrhea, abdominal cramping or pain, anal itching, weight loss, and flatulence. It can remain in the intestines for years, and is typically not treated if there are no symptoms. Infection rates are higher in developing areas, and in places with inadequate sanitation and poor personal hygiene.
Standard treatments include the antibiotic metronidazole (Flagyl), a combination of sulfamethoxazole and trimethoprim (e.g. Bactrim, Septra) and the antiprotozoal iodoquinol (e.g. Yodoxin). Response to medication for blastocystosis varies greatly, and symptoms may not improve, even with elimination of the parasite.
The patient in this case was a 51 year old female in overall good health, physically fit, with an athletic build. In the course of trying to discover the cause of her intermittent abdominal pain (particularly in the lower left quadrant) she was diagnosed with blastocystosis. She may have contracted the infection during a visit to India. As the patient was reluctant to take the course of Flagyl that was suggested by her medical doctor, she sought alternative treatment.
She was evaluated according to Traditional Chinese Medicine principles, but her positive diagnosis of B. hominis infection was also taken into consideration. A classic TCM herbal formula (Shao Yao Tang) was chosen as the basis of her prescription, but this was modified according to input from modern research. An important influence was the study In vitro response of Blastocystis hominis against traditional Chinese Medicine conducted by the Department of Parasitology, Shanghai University of Traditional Chinese Medicine, P.R.C.. In this study of 20 crude extracts of Chinese herbals, the extracts of Coptis chinensis [Huang Lian] and Brucea javanica [Ya Dan Zi] were found to be most active against B. hominis.
The patient was treated for one week with the following herbal formula. The quantities refer to grams of concentrated (5:1) powdered herbal extracts.
bai shao 14 g dang gui 7 g gan cao 7 g haung lian 14 g huang qin 7 g da huang 3 g mu xiang 4 g zhi shi 3 g rou gui 4 g ya dan zi 14 g
Dosage was 3.5 g, 3 times daily for one week. After one week, the patient reported improvement in the abdominal pain, but ongoing problems with constipation. The formula was modified slightly as follows:
bai shao 13 g dang gui 6 g gan cao 6 g haung lian 13 g huang qin 6 g da huang 5 g mu xiang 4 g zhi shi 3 g rou gui 3 g ya dan zi 13 g huo ma ren 5 g
Dosage for the second week was again 3.5 g, 3 times daily for one week.
About two weeks after completing the herbal treatment, the patient was retested and found completely clear of B. hominis. This concluded the successful treatment with Chinese herbs of a verifiable digestive tract infection. TCM is often noted for its usefulness against so-called functional diseases such as Irritable Bowel Syndrome, where there is no known organic cause of the dysfunction. This case offers an example of how effective Chinese herbal treatments can be against verifiable microbial infections as well.