East-West Integration, Rewards of Using Herbs with Drugs

Theory

There has been much written about the threat of herbs interacting with drugs. In China, this is often the goal.

Beneficial interactions end up being called “integration”. Using herbs together with drugs has a number of positive outcomes including the following:

1. Reduce side effects, as in the chemo/herb integration.
2. Side effect reduction is potentiated by Chinese medical theory as shown in the chart that compares the outcomes of modified and unmodified formulas.
3. Improved clinical outcomes as in the integrated treatment using corticosteroids along side Chinese herbs.
4. Improved tolerance of side effects using antibiotics along side Chinese herbs.

Chemo+Herbs = Less Side-Effects

The use of Chinese herbal medicine makes a lot of sense for patients undergoing chemotherapy, as you can see from the chart below. The left column’s numbers are lower suggesting that those on chemotherapy have less of the listed side-effects than those who are not taking the herbs.

Groups Chemotherapy plus herbs: 534 cases (100%) Chemotherapy only (control): 86 cases (100%) P Value
Nausea 138 (25.8%) 70 (81.4%) <0.01
Vomiting 103 (19.2%) 64 (74.4%) <0.01
Abdominal distension 108 (20.2%) 54 (62.8%) <0.01
Diarrhoea 39 (7.3%) 20 (23.3%) <0.01
Stomach haemorrhage 21 (3.9%) 7 (8.1%) <0.05
Tiredness 113 (21.2%) 72 (83.7%) <0.01
Leucopenia 182 (34.1%) 65 (75.6%) <0.01
Anaemia 86 (16.2%) 32 (37.2%) <0.01
Trichomadesis 24 (4.5%) 25 (29.1%) <0.01
Liver damage 32 (6.0%) 15 (17.5%) <0.01
Kidney damage 14 (2.6%) 5 (5.8%) <0.05
Myocardial damage 7 (1.3%) 8 (9.3%) <0.05
Immune inhibition 52 (9.7%) 31 (36.0%) <0.01
Source:Interactions Between Chinese Herbal Medicinal Products and Orthodox Drugs
(Chan, Cheung 2000)

Individualized modifications provide improved outcomes.

The chart below describes the benefits of customizing an herbal formula to the specific presentation of the chemotherapy patient. Many herbal formulas that are mass-marketed do not offer this type of formula modification. As an example, there are many different herbs for nausea, however there are some that would be better for me, and others that would be better for you.

Groups Chemotherapy plus FZJPT: 40 cases (100%) Chemotherapy plus modified FZJPT: 40 cases (100%)
Nausea 11 (27.5%) 9 (22.5%)
Vomiting 10 (25.0%) 7 (17.5%)
Abdominal distension 11 (27.5%) 7 (17.5%)
Diarrhoea 5 (12.5%) 4 (10.0%)
Stomach haemorrhage 3 (7.5%) 1 (2.5%)
Tiredness 8 (20.0%) 6 (15.0%)
Leucopenia 14 (35.0%) 12 (30.0%)
Anaemia 9 (22.5%) 7 (17.5%)
Trichomadesis 5 (12.5%) 1 (2.5%)
Liver damage 1 (0.0%) 0 (0.0%)
Kidney damage 0 (0.0%) 0 (0.0%)
Myocardial damage 0 (0.0%) 0 (0.0%)
Immune inhibition 8 (20.0%) 5 (12.5%)
Source:Interactions Between Chinese Herbal Medicinal Products and Orthodox Drugs
(Chan, Cheung 2000)

FZJPT is “Fu Zheng Jian Pi Tang” which translates to “Rectify Patterns by Nourishing the Spleen Decoction”. Don’t get all caught up in the word “Spleen”. The CM Spleen is a wide number of digestive and metabolic processes in Western medicine.

It is unknown if the formula modifications were the addition of herbs or modifications of the dosages. Dosages for the following herbs were not provided in the source text.  “Fu Zheng Jian Pi Tang” included the following herbs:

  1. Huang Qi (Rx. Astragalus)
  2. Dang Shen (Rx. Codonopsis)
  3. Bai Zhu (Rz. Atractylodis Macrocephalae)
  4. Fu Ling (Poria)
  5. Gan Cao (Rx. Glycyrrhizae)
  6. Shu Di Huang (Rx. Rehmanniae Preparata)
  7. Gou Qi Zi (Fr. Lycium)
  8. He Shou Wu (Rx. Polygoni Multiflori)
  9. Huang Jing (Rz. Polygonati)
  10. Nu Zhen Zi (Fr. Ligustri Lucidi)
  11. Sha Shen (Rx. Glehniae)
  12. Ji Xue Teng (Caulis Spatholobi)
  13. Mai Men Dong (Rx. Ophiopogonis)
  14. Qian Shi (Semen Euryales)
  15. Shan Yao (Rz. Dioscoreae)

Drugs + TCM Herbs = “Success”

This graphic describes the benefits of East-West integration on two different metrics. One is the clinical outcome and the other is side-effects. With the integrated approach, the “success” rates improved 29%, while the side-effects were strongly mitigated, by 33%.

nephrotic East West Integration, Rewards of Using Herbs with Drugs

Observations on the Integrated Treatment of Adult Primary Nephrotic Syndrome

Unfortunately, the outcome measurements that define “success” and “side-effects” were not available in the English abstract. Source: Chinese Journal of Integrated Traditional and Western Medicine

Drugs + TCM Herbs = Improved Tolerance of Side-Effects

The following chart describes a patient population that reports intolerance of a particular antibiotic. Among those who reported this problem, 80% reported improvement when taking streptomycin with gancao.

strep.gancao East West Integration, Rewards of Using Herbs with Drugs

Reduction of Streptomycin Side-Effects by Gancao* (Rx. Glycyrrhiazae)

Patients who demonstrate an intolerance of Streptomycin, can better handle this antibiotic when taking with gancao.  Source: Chinese Journal of Modern Developments in Traditional Medicine 3(7). 137.

* there is no relationship between the researched herb “gancao” (Rx. Glycyrrhiazae) and the name of this website (gancao.net) although the herb name was the inspiration for the domain name.

Chemo Drugs + TCM Herbs = Improved Efficacy

This next chart describes the efficacy of a chemotherapeutic drug, a single Chinese herb called San Qi (Rx. Notoginseng), and finally the affects on a particular kind of colorectal cancer when using both together.

sanqi.chemo  East West Integration, Rewards of Using Herbs with Drugs

Notoginseng enhances anti-cancer effect of 5-fluorouracil on colorectal cancer cells.

I note also that this research looked into mechanisms behind the effects and found the 5-fluorouracil and notoginseng to be working via different mechanisms. Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2657471/

Last modified: March 18, 2010  Tags: ,  ·  Posted in: Theory