CM NEWS – The results of a new analysis have provided good evidence to suggest that Tai Chi is beneficial for arthritis. Specifically, it was shown to decrease pain with trends towards improving overall physical health, level of tension and satisfaction with health status.
Musculoskeletal pain, such as that experienced by people with arthritis, places a severe burden on the patient and community and is recognized as an international health priority. Exercise therapy including such as strengthening, stretching and aerobic programs, have been shown to be effective for arthritic pain. Tai Chi, is a form of exercise that is regularly practiced in China to improve overall health and well-being. It is usually preformed in a group but is also practiced individually at one’s leisure, which differs from traditional exercise therapy approaches used in the clinic.
Recently, a new study examined the effectiveness of Tai Chi in decreasing pain and disability and improving physical function and quality of life in people with chronic musculoskeletal pain. The study is published in the June issue of Arthritis Care & Research. Led by Amanda Hall of The George Institute in Sydney, Australia, researchers conducted a systematic review and meta-analysis. They analyzed seven eligible randomized controlled trials that used Tai Chi as the main intervention for patients with musculoskeletal pain. The results demonstrate that Tai Chi improves pain and disability in patients suffering arthritis.
The authors state, “The fact that Tai Chi is inexpensive, convenient, and enjoyable and conveys other psychological and social benefits supports the use this type of intervention for pain conditions such as arthritis.”
“It is of importance to note that the results reported in this systematic review are indicative of the effect of Tai Chi versus minimal intervention (usual health care or health education) or wait list control,” the authors note. Establishing the specific effects of Tai Chi would require a placebo-controlled trial, which has not yet been undertaken.
CM NEWS – A famous TCM arthritis drug and expensive mushroom lingzhi have analgesic effects for rheumatoid arthritis, but the long-claimed anti-inflammatory and immunity boosting functions are yet to be substantiated, a new study says. Read more
CM NEWS - Triptolide, an extract of the famous toxic Chinese herb lei gong teng, has the ability to suppress inflammation and cartilage destruction in collagen-induced arthritis mice, a Beijing study reveals.
The study was completed at the Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences in Beijing. Read more
In an analysis of 9 clinical trials from the past 15 years, researchers found that acupuncture generally seemed to improve knee arthritis sufferers’ pain and stiffness in the short term. The patients had osteoarthritis, a degenerative joint disease associated with age, as opposed to arthritis associated with an autoimmune disorder.
However, a closer look showed that the benefits were limited to trials that compared acupuncture with doing nothing or with “usual care,” such as anti-inflammatory medication.
In trials that compared acupuncture with “sham” acupuncture, on the other hand, there was no clear evidence that the real therapy was more effective.
Sham acupuncture is accomplished by using non-penetrating needles, or inserting needles only into the superficial layer of skin, at random sites rather than the specific points used in real acupuncture. In studies that evaluated electro-acupuncture, the sham version involved phony electrodes and “mock” electrical stimulation of acupuncture points.
The point is to keep study participants from knowing whether they were receiving the real or the placebo treatment. This helps separate the specific effects of a therapy from any placebo effects — where people feel better simply because they believe they’ve been treated.
However, that doesn’t mean acupuncture is not worthwhile, according to the researchers, led by Eric Manheimer of the University of Maryland School of Medicine in Baltimore.
Research does suggest that acupuncture has a “genuine biological effect,” and there was evidence in some studies that the real therapy resulted in somewhat better short-term effects than sham acupuncture, the researchers note.
For their study, Manheimer and his colleagues combined the results of nine clinical trials conducted in Europe, the U.S. and Thailand. The trials included a total of more than 3,500 subjects.
Each trial included a patient group that received acupuncture for knee arthritis, as well as a “control” group. In some studies, control patients were placed on a waiting list for acupuncture, while in others they received some standard therapy that acupuncture patients did not. Control patients in other studies received sham acupuncture.
In general, the Manheimer’s team found, only studies that pitted acupuncture against doing nothing, or against standard care, showed clear benefits. The results of the sham-controlled trials were too mixed to show any benefits, according to the researchers.
The investigators do not, however, dismiss the potential benefits of acupuncture for knee arthritis. Indeed, they note, a possible explanation for the mixed results is that sham acupuncture had some actual biological effects.
Given the overall safety of acupuncture, the researchers conclude, patients can still consider it as one option in a “multidisciplinary approach” to treating knee arthritis.
Little scientific evidence supports the efficacy of herbal medicines in the treatment of degenerative arthritis of the knee. The purpose of this study is to evaluate both the efficacy and safety of a finished Chinese herbal preparation Duhuo Jisheng Tang in reducing symptoms of degenerative osteoarthritis of the knee.
A prospective follow-up study was carried out in two hospitals in Taipei between April and October 2005. 68 osteoarthritis patients, with symptoms diagnosed by radiologists, received DJT at a rate of 2.5 g, twice daily for four weeks. Baseline scores were measured on the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, followed by further measures at the end of weeks 1, 2 and 4.
The World Health Organization Quality of Life (WHOQOL) assessment was undertaken as a secondary outcome, with pattern identification questionnaires being adopted. Regression models were constructed to explore the score differences between the baseline and at weeks 2 and 4 by various determinants including age, gender, body mass index (BMI), severity at baseline, use of rescue medication, aversion to cold and flaccidity of the lower back and knees.
Among the 68 participants, there were statistically significant reductions in the WOMAC index scores for pain, stiffness and physical functioning in the second and fourth weeks, with effects first appearing during week 2.
By week 4, the mean WOMAC index scores had fallen from 22.2 (+/-19.2) to 16.1 (+/-16.2) for pain, from 28.1 (+/-24.9) to 18.5 (+/-20.3) for stiffness, and from 22.6 (+/-18.0) to 18.2 (+/-17.8) for physical functioning, while the global score for pain under the visual analogue scale (VAS) was reduced from 38.7 (+/-21.5) to 27.8 (+/-19.8).The researchers conclude that in the treatment of degenerative osteoarthritis of the knee, a 4-week therapy with the Chinese herbal preparation DJT reduced pain and stiffness and improved physical functioning, but it was less effective in treating flaccidity and aversion to cold.
February 13, 2007
Filed under arthritis
CM NEWS – A group of Chinese researchers find that a TCM herb radix linderae (wu yao, 烏藥; aka 矮樟、香桂樟、白葉柴) could be used in treating rheumatoid arthritis because radix linderae is found to be able to suppresses inflammation and protects joints from destruction.
The study was done by scientists at the Department of Pharmacology of Chinese Materia Medica, China Pharmaceutical University, Nanjing, China.
Radix linderae, the dry roots of Lindera aggregata (Sims) Kosterm., is frequently used in traditional Chinese medicine. It contains alkaloids, volatile oils and sesquiterpene esters.
What are contained in radix linderae? A nets aporphinoid alkaloid, trivially named linderaline (1), along with eight known isoquinoline alkaloids as (-)-pallidine (2), protosinomenine (3), laudanosoline 3′,4′-dimethyl ether (4), boldine (5), norisoboldine (6), laurolitsine (7), pronuciferine (8) and reticulline (9) were isolated from ethanol extract of the dried root of Lindera aggregata (Sims) Kosterm. Their structures were established on the basis of the spectral analysis. Compounds 2, 3, 4, 6, 8 were found from the plant for the first time.
In the present study, researchers investigated the therapeutic potential and underlying mechanisms of the total alkaloids from Radix Linderae (TARL) on collagen II-induced arthritis in mice.
The results indicated that TARL (50, 100 and 200mg/kg), orally administered on the same day of an antigen challenge for 20 consecutive days, alleviated disease severity in a dose-dependent manner, while it did not significantly affect body weights.
Researchers also found that the TARL treatment reduced the serum level of anti-CII IgG (IgG is the most abundant form, or class, of antibody in the blood), and suppressed the delayed type hypersensitivity.
What is hypersensitivity? Hypersensitivity refers to undesirable (damaging, discomfort-producing and sometimes fatal) reactions produced by the normal immune system. Hypersensitivity reactions require a pre-sensitized (immune) state of the host.
What is delayed type hypersensitivity? This is the only class of hypersensitive reactions to be triggered by antigen-specific T cells, which are linked to inflammation. This type of hypersensitivity is often called “delayed type” as the reaction takes two to three days to develop. Unlike the other types, it is not antibody mediated but rather is a type of cell-mediated response. T cells belong to a group of white blood cells known as lymphocytes and play a central role in cell-mediated immunity. Antigen-specific T cells provides the immune system with “memory” against past infections.
TARL also protected joint destruction based on the evidence of reducing the histopathological scores (which are the total scores based on the sum of peribronchial, perivascular, interstitial, and alveolar inflammation).
The researchers thus conclude that TARL is a potential therapeutic agent for rheumatoid arthritis that suppresses inflammation and protects joints from destruction.
[J Ethnopharmacol. 2006 Dec 13]