Emerson Ecologics – Chinese Herbal Medicine and Parkinson’s Disease
By Lise Alschuler, N.D.
Parkinson’s Disease (PD) is a neurodegenerative disease that affects up to 1% of the population over 60 years old living in Western countries. The neurological degeneration of PD manifests as resting tremors, muscle rigidity, impaired balance, gait instability, and slowed movements (bradykinesia). PD, and its treatments, also cause additional symptoms such as insomnia, constipation, depression, nausea and pain. Parkinson’s disease results from damage to the majority of dopamine-secreting nerve cells. Dopamine produces smooth muscle movements, so its lack causes irregular and spasmodic muscle contractions, manifesting as tremors, rigidity and imbalance. The onset of PD is typically gradual and develops over years. The focus of Western medicine is symptom control. Levodopa is the mainstay of treatment; however its longterm use is associated with dyskinesia (involuntary muscle tics and diminished voluntary muscle movements). Given both the lack of a curative therapy as well as serious side effect profile of PD treatments, many people affected with PD seek integrative treatment.
In addition to seeking acupuncture, herbal medicine is a popular form of alternative treatment used by PD patients. There are a very small number of randomized clinical trials on the use of TCM in Parkinson’s Disease. This trial by Wan Fung Kum and colleagues out of Honk Kong Baptist University is a compelling contribution to evidence base for using CHM in PD. According to TCM theory, Parkinson’s Disease is seen as spleen and stomach Qi deficiency. Classic TCM formulas such as Jia Wei Liu Jun Zi Tang, also known as Six Gentlemen formula or Liu Jun Zi Tang tonify spleen and stomach Qi and have long been used in traditional Chinese herbal medicine to treat symptoms consistent with the Western diagnosis of Parkinson’s Disease. Kum and colleagues conducted a prospective, randomized, double-blinded placebo-controlled pilot study of 55 PD patients with dual TCM diagnosis of Spleen and Stomach Qi deficiency. The subjects were randomized to receive either 24 weeks of active herbal formulation (granule-based decoction formulation of Jia Wei Liu Jun Zi Tang) or placebo with each dose of their levodopa.
Patients were evaluated using the 39-item Parkinson’s Disease Questionnaire, Unified PD Rating Scale, Short Form-36 Health Survey, Geriatric Depression Scale and Deficiency of Splenic Qi Scale. The use of Six Gentlemen formula resulted in a significant improvement in the Unified PD Rating Scale score when compared with placebo at 12 weeks (P = 0.039) and 24 weeks (P= 0.034). This scale assesses gastrointestinal disorders, sleep disturbances, and imbalance. In addition, patients in the Chinese herbal medicine group experience improvement in communication at 12 weeks (P=0.024) and 24 weeks (P=0.047) when compared with the placebo group according to Parkinson’s Disease Questionnaire scores. The only adverse effect noted was one case of mild diarrhea in the Chinese herbal medicine group. These findings suggest that the use of this TCM spleen and stomach Qi tonifying formula may improve non-motor complications of conventional therapy and improve communication abilities in patients with PD. The Chinese herbal medicine formula did not affect the motor symptoms associated with PD. Jia Wei Liu Jun Zi Tang is also known as Six Gentlemen formula or Liu Jun Zi Tang.*