Wen-Long Hu

Chinese Herbal Products for Ischemic Stroke

Traditional Chinese herbal products (CHPs) have been described in ancient medicine systems as treatments for various stroke-associated ailments. This study is aimed to investigate the prescription patterns and combinations of CHPs for ischemic stroke in Taiwan. Prescriptions of CHPs for ischemic stroke were obtained from the National Health Insurance Research Database (NHIRD) of Taiwan. Every prescription with a leading diagnosis of ischemic stroke made during 2000-2010 was analyzed. Descriptive statistics were applied to the pattern of co-prescriptions. Multiple logistic regression models were used to assess demographic and risk factors that are correlated with CHP use. The dataset of inpatient claims data contained information on 15,896 subjects who experienced ischemic stroke from 2000 to 2010. There was an average of 5.82 CHPs in a single prescription for subjects with ischemic stroke. Bu-yang-huan-wu-tang (BYHWT) (40.32%) was by far the most frequently prescribed formula CHP for ischemic stroke, and the most commonly used combination of two-formula-CHP was BYHWT with Shu-jin-huo-xue-tang (SJHXT) (4.40%). Dan Shen (16.50%) was the most commonly used single CHP for ischemic stroke, and the most commonly used combination of two single CHPs was Shi Chang Pua with Yuan Zhi (4.79%). We found that BYHWT and Dan Shen were the most frequently prescribed formula and single CHP for ischemic stroke, respectively. These results provide information about individualized therapy and may contribute to further pharmacologic experiments and clinical trials.

Laser Acupuncture Therapy in Patients with Treatment-Resistant Temporomandibular Disorders

Objective To investigate the clinical effects of laser acupuncture therapy for temporomandibular disorders (TMD) after ineffective previous treatments. Methods A retrospective observational study was conducted in 29 treatment-resistant TMD patients (25 women, 4 men; age range, 17–67 years). Subjects were treated 3 times per week for 4 weeks with the Handylaser Trion (GaAlAs laser diode, 810 nm, 150 mW, pulsed waves), which delivered 0.375 J of energy (5 s) to ST7, ST6, and LI4 and 3 J (40 s) to each Ashi point, 7.5–26.25 J/cm2 in total. The visual analog scale (VAS) and maximal mouth opening (MMO) were evaluated before and after treatment. Results VAS analysis showed that the patients were free of pain at rest (endpoint) after 5.90±6.08 sessions of laser acupuncture for acute TMD and after 16.21±17.98 sessions for chronic TMD. The VAS score on palpation of the temporomandibular joint reduced to 0.30±0.67 for patients with acute TMD (p = 0.005) and to 0.47±0.84 for those with chronic TMD (p<0.001). The MMO significantly increased in patients with acute TMD (7.80±5.43 mm, p = 0.008) and in patients with chronic TMD (15.58±7.87 mm, p<0.001). Conclusions Our study shows that laser acupuncture therapy improves the symptoms of treatment-resistant TMD. Further studies with a more appropriate design, involving long-term follow-up examinations in a larger patient sample, are needed to evaluate its efficacy.

Adjuvant Chinese Herbal Products for Preventing Ischemic Stroke in Patients with Atrial Fibrillation.

Objective Chinese herbal products (CHPs) are widely used for atrial fibrillation (AF) in Taiwan. We investigated the effect of adjuvant CHPs in preventing ischemic stroke in patients with AF. Methods Taiwanese patients in the Health Insurance Database newly diagnosed with AF during 2000–2011 were enrolled. Medication treatment with/without CHPs was administered within 7 days after the AF diagnosis. The clinical endpoint was an ischemic stroke. The Chi-square test, Fisher’s exact test, and Student t test were used to examine differences between the traditional Chinese medicine (TCM) and non-TCM cohorts. Cox proportional hazard regression was used to assess the risk for ischemic stroke between two cohorts. Results Three hundred and eleven patients underwent TCM treatment and 1715 patients did not. Compared to non-TCM users, TCM users had a lower incidence of stroke (12.59% vs. 1.93%, respectively) and lower risk of stroke [CHA2DS2-VASc score = 0–2 (hazard ratio = 0.20; 95% confidence interval = 0.06–0.65)]. Compared to non-TCM users, the stroke risk was significantly lower in TCM users with AF who were female or younger than 65 years, but not in males, people more than 65 years old, or people with comorbidities. Compared to TCM users, non-TCM users who received conventional treatment had a higher ischemic stroke risk. The risk for AF-related hospitalization was significantly lower in TCM users (0.64%) than in non-TCM users (38.1%). Conclusions Users of TCM with AF have a lower risk of new-onset ischemic stroke. Therefore, adjuvant CHP therapy may have a protective effect and may be used in AF patients to prevent ischemic stroke.

Acupuncture helps regain postoperative consciousness in patients with traumatic brain injury: A case study

OBJECTIVE This report of one case illustrates the potential effect of acupuncture therapy in addition to Western medicine for regaining postoperative consciousness in patients with traumatic brain injury (TBI). CLINICAL FEATURES A 65-year-old man experienced a TBI after being involved in a motor vehicle accident. His initial Glasgow Coma Scale (GCS) score was E1V1M2, and brain computerized tomography showed a right-sided subdural hemorrhage. He received emergency medical treatment and underwent craniotomy to remove the lacerated portions of brain as well as subtemporal decompression, followed by a decompressive craniectomy the following day to remove an intracerebral hematoma due to late-onset temporo-parietal rebleeding. Twelve days after surgery, the patient remained in poor condition due to serious complications and the GCS was E2VeM4. His family then underwent counseling and he subsequently received acupuncture treatment. INTERVENTION AND OUTCOME This patient was treated with acupuncture three times each week, consisting of strong stimulation at GV26 (Shuigou) and the 12 Well points using the half-needling technique. After 3 weeks of consecutive treatment, his GCS score improved to E4VtM6. In addition, he regained consciousness and could tolerate rehabilitation programs. CONCLUSIONS We believe that an experienced physician may use acupuncture as complementary therapy in patients with TBI who fail to regain consciousness postoperatively.

Chinese Herbal Products for Female Infertility in Taiwan: A Population-Based Cohort Study

AbstractFemale infertility and low birth rate are significant public health issues with profound social, psychological, and economic consequences. Some infertile women resort to conventional, complementary, or alternative therapies to conceive. The aim of this study was to identify the Chinese herbal products (CHPs) most commonly used for female infertility in Taiwan.The usage of traditional Chinese medicine (TCM) and the frequency of CHP prescriptions to infertile women were determined based on a nationwide 1-million randomly sampled cohort of National Health Insurance Research Database beneficiaries. Descriptive statistics and multiple logistic regression analysis were employed to estimate the adjusted odds ratio (aOR) for TCM usage and potential risk factors.In total, 8766 women with newly diagnosed infertility were included in this study. Of those, 8430 (96.17%) had sought TCM treatment in addition to visiting the gynecologist. We noted that female infertility patients with risk factors (e.g., endometriosis, uterine fibroids, or irregular menstrual cycle) were more likely to use TCM than those without TCM medication (aOR = 1.83, 1.87, and 1.79, respectively). The most commonly used formula and single CHP were Dang-Gui-Sha-Yao-San (17.25%) and Semen Cuscutae (27.40%), respectively. CHP formula combinations (e.g., Dang-Gui-Sha-Yao-San plus Wen-Jing-Tang 3.10%) or single Chinese herbal combinations (e.g., Semen Cuscutae plus Leonurus japonicus 6.31%) were also commonly used to treat female infertility. Further well-conducted, double-blind, randomized, placebo-controlled studies will be needed to evaluate the efficacy and safety of these CHP combinations for female infertility.

Explore Laser Acupuncture’s Role

Acupuncture has been widely used in the treatment of many diseases for over 2000 years. It is traditionally performed by inserting thin needles into acupuncture points in human body; this is known to affect the functions of various organs. According to the theory of traditional Chinese medicine, energy (or Qi) flows through the body along specific paths known as meridians. Any disturbance in this Qi results in an energy imbalance in the body; this imbal‐ ance may in turn result in disease. Acupuncture attempts to regulate and restore energy balance by stimulating specific acupoints along the meridians and thereby treat the underlying disease. In 1979, the World Health Organization (WHO) identified 43 conditions that might benefit from acupuncture. In 1996, WHO confirmed 64 indications for acupuncture treatment.

Acupuncture for Disorders of Consciousness - A Case Series and Review

The lives of numerous patients in critical condition have been saved since the development of neuro-intensive care medicine in the 1960s. However, an unfortunate outcome of this development is the existence of a pool of surviving patients with unresponsiveness. This previously rare condition has been a new challenge for the medical community. After decades of medical development, a general framework of diagnosis and treatment of unresponsiveness has gradually been established, although the current knowledge is mainly derived from personal experience, and consensus is lacking for well-defined and effective diagnostic and treatment procedures (Liang, 2008). Disorders of consciousness mainly include coma, vegetative states (VSs), and minimally-conscious states (MCSs) (Bernat, 2006). The causes of consciousness disorders are mainly traumatic brain injury and cerebrovascular diseases, but they may also include hypoxia resulting from cardiac arrest and resuscitation, shock, and carbon monoxide (CO) poisoning. The lesions are predominantly found in the cerebral cortex, hypothalamus, and midbrain (Povlishock & Christman, 1995; Kampel et al., 1998). Consciousness emerges from interactions of the reticular activating system between the two cerebral hemispheres and the brain stem. Any factor interfering with these delicate processes may decrease alertness. The cerebral cortex lacks any intrinsic mechanism to promote responsiveness, which instead requires subcortical structures to generate and maintain consciousness. External stimuli are transmitted to the brain stem through the sensory organs, subsequently relayed to the thalamus, and eventually delivered to the cerebral cortex. The hypothalamus also plays a crucial role during this process, especially in controlling periodic rhythms. Different etiological factors of consciousness disorders result in differences in neuropathology. This is exemplified by studies of nerve electrophysiology showing that short-term brain hypoxia mainly affects the cerebral cortex; however, as the duration of hypoxia extends, deeper structures are also compromised (Hoesch et al., 2008). The pathology of VS is divided into three categories: large-scale damage to the cerebral cortex, injury to links (e.g., thalamus)

Acupuncture Anesthesia for Complicated Dental Extractions in Patients with Lidocaine Allergy

Clinical presentation of the soft tissue abscess and periodontitis of the buccal gingiva of the upper right first molar after the metal crown was removed.

Reduction in postpartum weight with laser acupuncture: A randomized control trial.

Background:Gestational weight gain and weight retention at 1 year after delivery are associated with long-term obesity. We aimed to investigate the effect of laser acupuncture therapy on postpartum weight control. Methods:We randomly assigned 66 subjects with postpartum weight retention to a laser acupuncture group and control group. The subjects were treated at acupoints including the stomach and hunger points of the ear, ST25, ST28, ST40, SP15, CV9, and SP6 by using verum or sham laser acupuncture over 5 sessions per week. After 12 treatment sessions, the differences in the body mass index (BMI), body fat percentage (BFP), and waist-to-buttocks ratio (WBR) of the patients were analyzed and compared between the laser acupuncture and control groups via analysis of variance, chi-square tests, and stepwise regression tests. Results:The characteristics of the patients did not significantly differ between the laser acupuncture and control groups. Analysis of repeated measures data between the laser acupuncture and control groups indicated the presence of significant differences in postpartum BMI (P < 0.001) and BFP (P < 0.001); however, no significant difference was observed for WBR (P = 0.09). Conclusion:Laser acupuncture reduces postpartum weight retention by improving BMI and BFP, but does not impact the WBR following short-term treatment.

Electrodermal Screening of Biologically Active Points for Upper Gastrointestinal Bleeding

The purpose of this case-control study was to investigate the relationship between the electrical resistance of the skin at biologically active points (BAPs) on the main meridians and upper gastrointestinal bleeding (UGIB). Electrical resistance to direct current at 20 BAPs on the fingers and toes of 100 patients with (38 men, 12 women; mean age [range], 58.20 ± 19.62 [18-83] years) and without (27 men, 23 women; 49.54 ± 12.12 [22-74] years) UGIB was measured through electrodermal screening (EDS), based on the theory of electroacupuncture according to Voll (EAV). Data were compared through analysis of variance (ANOVA), receiver operating characteristic (ROC) curve analysis, and logistic regression. The initial readings were lower in the UGIB group, indicating blood and energy deficiency due to UGIB. Significant differences in indicator drop values were observed at nine BAPs (p < 0.05) on the bilateral small intestine, bilateral stomach, bilateral circulation, bilateral fibroid degeneration, and right lymph meridians. The area under the ROC curve values of the BAPs on the bilateral small intestine and stomach meridians were larger than 0.5, suggesting the diagnostic accuracy of EDS for UGIB on the basis of the indicator drop of these BAPs. Logistic regression revealed that when the indicator drop of the BAP on the left stomach meridian increased by one score, the risk of UGIB increased by about 1.545-3.523 times. In conclusion, the change in the electrical resistance of the skin measured by EDS at the BAPs on the bilateral small intestine and stomach meridians provides specific information on UGIB.