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52ALTERNATIVETHERAPIESjulaug2011VOL.17NO.4MenopauseTraditionalChineseMedicinevsHormoneTherapystudyinthedecreaseinkuppermanscorebyacupunctureandHTbutdoesnotconOrmitwithregardtoE2.FurthermorenosigniO-cantdifferencebetweenHTgroupandacupuncturegroupwasiden-tified.AstudybyTianandzhangshowedbetterresultsforacombinationofherbsandacupuncture97vsHT73whichdoesnotcoincidewiththeresultsofthisstudyindicatingthesameefOcacyforbothofthesegroups.22InChinesemedicinemenopausalproblemsarefundamentallyduetoadeclineofidneyessencewhichcantaetheformofidneyyinidneyyangoracombineddeOciencyofidneyyinandidneyyang.Inthisstudyonlypatientswithasyndromeofdeclineintheyinofidneyandliveraccompaniedbyhyperactivityandrisingofliveryangwereadmittedasparticipants.Thissyndromeischaracter-iHedbyredtonguewithoutfur.AccordingtotraditionalprinciplesoftreatmentthesepatientsneededtoreceiveherbstonourishtheiryinofidneyandliversubduetheyangofliverandcalmthemindsotheformulationofkBWwaschosen.kBWhasbeenformulatedonthebasisoftheclassictheoriesoftraditionalChinesemedicineandpreviousanimaleFperiments.IntheformulaofkBWFructusx0Ligustrix0LucidiRadixx0Paeoniaex0Lacti-oraeandRadixx0Rehmanniaewerechosenasthemonarchdrugsmeanttonourishtheyinofliverandidney.26-28Flosx0Chrysanthemix0MorifoliiandRadixx0Scutellariaex0Baicalensishelptosubdueliveryang.Semenx0Zizyphix0Spinosaesubduestheyangofliverandcalmsthemind.26-28NewresearchabouttheprimaryherbsshowstheirvariousbeneOtsforwomeninperi-andpostmenopause.ManyrecentstudiessuggestthatFructusx0Ligustrix0Lucidi29-33andRadixx0Paeoniaex0Lacti-orae34areusefulasanalternativemedicineforimprov-ingcalciumbalanceandpreventingosteoporosisinpostmenopausalwomenwhichisinaccordancewiththetraditionalChinesemedi-cinetheoryonnourishingtheidneyyin.TheeFtractofFructusx0Ligustrix0Lucidix0improvescalciumbalancemodulatesthecalciotropichormonelevelandincreasesvitaminDx13dependentcalciumtrans-portinagedovariectomiHedrats.30WhereasFructusx0Ligustrix0Lucidididnotshowestrogeniceffectsintheresearchbyzhaoetal35Radixx0Rehmanniaeisreportedtohavecertainphytoestrogeniceffectsinonestudy.36Moreinvestigationsarenecessarytoclarifytheseeffects.ThisstudyfoundasigniOcantdecreaseinclinicalsymptomsasrePectedinthedecreaseoftotalkuppermanscoringandnumberofsymptomsinallthreetherapieswithnosignificantdifferencebetweenHTandtheothertwotraditionaltreatmentssuggestingthatherbaltreatmentandacupuncturemayofferasmuchbeneOtastheconventionaltreatmentHTwithoutposingtherissthatHTdoes.Howeverthegrouptreatedwithacupunctureinconjunctionwithherbalmedicinepresentedsignificantlybetterresultsthanthosereceivingherbalmedicinealoneincontrollingsymptoms.HerbaltreatmentalonefailedtodecreasethelevelofFSH.Thismaysuggestthattheunderlyingmechanismofthisformulationofmedic-inalherbsshouldnotbeestrogeniceffectsasuppositionthatdimin-ishesconcernsabouttherisofthephytoestrogenicpropertiesoftheseherbs.Ofcoursethismatterdeservesmorerigorousinvestiga-tion.OntheotherhandthedeclineinFSHresultingfromtheACUCHMtreatmentsuggestsarealphysiologiceffectinthisgroup.Onehypothesisstatesthattheeffectivenessofacupunctureinrelievingmenopausalsymptomsmaybeduetothetriggeringofthereleaseofhypothalamic-endorphinanotherhypothesispointstothereleaseof5-HTP.Adecreaseintheactivityofhypothalamic-endorphinandadecreaseinthelevelofbloodserotoninareconsideredtwopresumedpathwaysinthepathophysiologyofmenopausalvasomo-torsymptoms.HypothesesconcerningtheacupuncturemechanisminalleviatingmenopausalsymptomsneedtobeeFploredbyfuturestudies.Alsofurtherstudieswithmorecontrolgroupsarerecom-mendedinordertobetterclarifyandcomparetheeffectsofherbalmedicineandacupunctureegaclinicaltrialwithacupunctureshamacupunctureherbalmedicineandHTgroups.CONCLUSIONSThisstudyrevealsthattheapplicationofacombinationofCHMandacupunctureisaseffectiveasHTinthetreatmentofmenopause-relatedsymptomsandthatitworsbetterthanherbalmedicinealone.ChineseherbstogetherwithacupuncturemaybeausefulalternativetreatmentforwomensufferingfrommenopausalsymptomsandwhoareunableorreluctanttoreceiveHT.AcknowledgmentsAuthorsofthisarticlethanYunHhiChenPhDxiaoyanDouMScLuLiuMScMuhammadAliRasaeeandAmirHosseinSabouriMDfortheirsincerehelpaswellasthepatientswhocontrib-utedintheresearch.HodaAHiHiisthanfultoIranx19sMinistryofHealthandMedicalEducationforitssupportbypresentingascholarshiptoherfordoctoralworattheBeijingUniversityofChineseMedicine.SheisalsogratefultoBeijingUniversityofChineseMedicineforsupportingherdoc-toralthesisgrant2001201051550-10.REFERENCES1.Noauthorslisted.NIHstate-of-the-scienceconferencestatementonmanagementofmenopause-relatedsymptoms.NIHx0Consensx0Statex0Scix0Statements.20052211-38.2.CobinRHFutterweitWGinHburgSBetalAACEMenopauseGuidelinesRevisionTasForce.AmericanAssociationofClinicalEndocrinologistsmedicalguidelinesforclinicalpracticeforthediagnosisandtreatmentofmenopause.Endocrx0Pract.2006123315-337.3.NorthAmericanMenopauseSociety.Estrogenandprogestogenuseinperi-andpost-menopausalwomenMarch2007positionstatementofTheNorthAmericanMenopauseSociety.Menopause.2007142168-182.4.BouletMJOdden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