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Post-menopausal Osteoporosis & TCM

 

By Bob Flaws

Keywords: Chinese medicine, Chinese herbal medicine, gynecology, menopause, osteoporosis

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Numerous clinical trials have been carried out over the last 20 years on the effects of Chinese medicine on osteoporosis. In general, these studies show that Chinese herbal medicine can increase bone density in post-menopausal women. Below is an example of this research. It was originally published on page 32 of issue #6, 2004 of Zhong Yi Yan Jiu (Chinese Medical Research). The article was authored by Zhang Chun-yan and was titled, "The Treatment of 58 Cases of Post-menopausal Osteoporosis by the Methods of Supplementing the Kidneys & Strengthening the Bones." A summary of this article is presented below.

[ILLUSTRATION OMITTED]

Cohort description

All 58 women in this clinical trial were seen as outpatients in the gynecology department of the Xin Yang Municipal Chinese Medical Hospital in Henan province. These women were 46-80 years of age, with an average age of 60. All were post-menopausal by 1-25 years, and all presented the Chinese medical pattern of kidney vacuity. Twenty-nine presented with kidney yang vacuity, 10 presented with kidney yin vacuity, and the remaining 19 presented with yin and yang dual vacuity. Criteria for Chinese medical pattern discrimination was based on the pattern differentiation contained in (Zhong Yao) Xin Yao Lin Chuang Yan Jiu Zhi Dao Yuan Ze (Guiding Principles to the Clinical Research of [Chinese Medical] New Medicines). Criteria for the Western medical diagnosis of osteoporosis were based on those developed by a Japanese person (whose name I was not able to translate from Chinese). Those patients with osteoporosis secondary to other disease were excluded from this study.

Treatment method

All 58 patients received Bu Shen Zhuang Gu Tang (Supplement the Kidneys & Strengthen the Bones Decoction), which consisted of:

Ba Ji Tian (Radix Morindae Officinalis), 10g

Xian Ling Pi (Herba Epimedii), 6g

Zi He Che (Placenta Hominis), 3g

Huang Qi (Radix Astragali Membranacei), 10g

Bai Zhu (Rhizoma Atractylodis Macrocephalae), 10g

Ci Wu Jia (Radix Eleuthrococci Senticosi), 10g

Dan Shen (Radix Salviae Miltiorrhizae), 20g

Sheng Di (uncooked Radix Rehmanniae Glutinosae), 12g

Shan Yao (Radix Dioscoreae Oppositae), 20g

Long Gu (Os Draconis), 9g

Mu Li (Concha Ostreae), 20g

One packet of these medicinals was decocted in water and administered orally in two doses per day. Typically, three months equaled one course of treatment. Patients whose pattern discrimination leaned toward kidney yang vacuity had Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli), Rou Cong Rong (Herba Cistanchis Salsae), Xian Mao (Rhizoma Curculiginis Orchioidis), and Du Zhong (Cortex Eucommiae Ulmoidis) added to their formula. Those who leaned toward kidney yin vacuity had Nu Zhen Zi (Fructus Ligustyri Lucidi), Huang Jing (Rhizoma Polygonati), Gou Qi Zi (Fructus Lycii Chinensis), and Mai Men Dong (Tuber Ophiopogonis Japonici) added to their formula. Those who presented with both kidney yin and yang vacuity had Fu Zi (Radix Lateralis Praeparatus Aconiti Carmichaeli), Gui Ban Jiao (Gelatinum Plastri Testudinis) or Lu Jiao Jiao (Gelatinum Cornu Cervi), and Shan Zhu Yu (Fructus Corni Officinalis) added to their formula.

Study outcomes

Outcomes were based on 1) blood, urine, liver, and kidney function examinations, and 2) associated symptoms, bone mineral content, and bone density before and after treatment. Marked effect was defined as marked improvement in any back pain or low back and knee soreness and limpness, a subjective feeling of more generalized strength, good appetite, and an increase in bone density of 0.06g/[cm.sup.2]. Some effect was defined as marked improvement in any back pain, the existence of some low back and knee soreness and weakness, some remaining lack of strength, and no change in bone density. No effect was defined as the presence of back pain, no improvement in low back and knee soreness and limpness, and no change in bone density. Based on these criteria, 40 patients were judged to have experienced a marked effect, 13 got some effect, and five got no effect for a total effectiveness rate of 91.3%. The following table shows changes in mean bone density, mineral content, and kidney vacuity severity rating scale.

Before             After
                      treatment          treatment         P value

Bone mineral content
  (g/[cm.sup.2])       0.60[+ or -]0.09  0.65[+ or -]0.10  P<0.05
Bone density
  (g/[cm.sup.2])       0.52[+ or -]0.07  0.58[+ or -]0.08  P<0.05
Kidney vacuity
  severityrating      14.35[+ or -]1.29  4.10[+ or -]0.39  P<0.01

As the above mean values demonstrate, this protocol resulted in statistical increases in mean bone mineral content and bone density as well as marked improvement in the clinical signs and symptoms of kidney vacuity. In addition, no abnormalities in blood, urine, kidney, or liver function were found after treatment, nor were any side effects from this treatment apparent.

Discussion

Dr. Zhang rationalizes her treatment protocol with the oft-repeated Chinese medical syllogism: The kidneys rule the bones and engender the marrow. The kidneys also sore essence and are the former heaven root. The low back is the mansion of the kidneys. Therefore, the growth and development of the bones as well as their strength is closely connected with the exuberance or decline of kidney essence. If the kidney essence is full and sufficient, the source of engenderment and transformation of the bones and marrow have a source. The bones and marrow obtain nourishment and thus are fortified, strong, and forceful. The opposite of this easily leads to osteoporosis. In women, "at seven times seven (years of age, i.e., 49), the channels and vessels are vacuous, the supreme chong or penetrating vessel declines, the tian gui (or kidney yin) is exhausted, and the earthly pathways are not freely flowing." Thus women experience menopause at around 49 years of age. The implication of this Chinese medical logic is that menopause and post-menopause osteoporosis are due to the vacuity and decline of kidney essence. Therefore, to promote bone growth and density, one should mainly prescribe Chinese medicinals which supplement the kidneys and, hence, strengthen the bones.

For instance, the leading medicinal in the above formula is Ba Ji Tian. According to Chinese medical theory, this medicinal supplements the kidneys and invigorates yang, boosts the essence and blood, strengthens the sinews and bones, and relieves impediment or joint pain. Pharmacological research has shown that this medicinal is capable of increasing the secretion of luteinizing-releasing hormone (LRH) from the pituitary and luteinizing hormone (LH) from the ovaries, thus increasing the rate of bone transformation. In Chinese medicine, Xian Ling Pi supplements the kidneys and invigorates yang, strengthens the sinews and fortifies the bones. Modern pharmacological research has demonstrated that it can increase the production of bone cells' osteoblastosis and inhibit their osteoclastosis. Zi He Che (human placenta) contains many types of hormones and is known to control osteoclastosis. Ci Wu Jia (so-called Siberan ginseng) supplements the center and boosts the essence, hardens the sinews and strengthens the bones. It is known to be an immune-booster and general adaptogen as well as a central nervous system stimulant. This medicinal is also well known for its ability to combat taxation and fatigue. Dan Shen quickens the blood and transforms stasis, moves the qi and stops pain. In modern scientific terms, it is known to improve the microcirculation. Huang Qi and Bai Zhu fortify the spleen and boost the qi. They are also able to improve the function of the gastrointestinal tract. Sheng Di, Shan Yao, and Huang Jing supplement the kidneys, engender marrow, and fortify the bones. Shan Yao is also said to "foster the bones and marrow, grow the muscles and flesh, engender the essence and blood, and supplement the five viscera." It is known to empirically treat post-disease lower limb soreness and pain. Long Gu and Mu Li both contain large amounts of the minerals used to build bone tissue. Therefore, they act as essential nutrients for providing the building blocks of the bones. When all these medicinals are used together, their effect is to supplement the kidneys and boost the essence, strengthen the bones and engender marrow, quicken the blood and supplement the qi. This goes along with the fact that most modern Chinese medical protocols for the treatment and prevention of osteoporosis consist of kidney yang supplements, spleen qi supplements, and blood-quickening medicinals.

abstracted & translated by Bob Flaws, LicAc, DiplAc & CH, FNAAOM

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TAG: gynecology menopause osteoporosis
 

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