Healing on All Levels: Spiritual/ Mental/ Emotional and Physical

When healing the body, it’s hard to look at the root cause without looking at the spiritual and emotional component. What came first? the chicken or the egg. The beauty and miracle of our body is that it does not have separate parts the way western medicine divided it up. It’s all One.
When I work with clients, it’s a co creative process.
We look at everything that is happening on every level.
I use medical intuition to help get our left brain out of the way and tune into the client’s higher self to find out what kind of healing is needed. Often there are limiting belief systems under all of our difficulties and we work on clearing on those with acupuncture techniques, shamanic techniques and any herbal remedies or supplements that the body is asking for. I use a muscle testing system to find out the remedies needed at that time.This is all information that our intuitive body has available for us to access. You are your own healer and I have tools to help us get there.

Treating Viruses and Flus with Chinese Herbal Medicine

Chinese Medicine has been treating viruses and flus for as long as it has been in existence, at least 2,000 years.
As this article explains below, Corona virus is also being treated with herbal formulas with much success.
The information disseminating about this novel illness seem to be that people with pre-existing health conditions are more at risk of getting sicker than the healthy, younger population.
Reports have already shown that the virus looks like a regular flu in a healthy person: some symptoms are a fever, dry cough, fatigue, sputum production, shortness of breath, muscle pain or joint pain, sore throat, headache, chills, nausea or vomiting, nasal congestion and diarrhea. It seems to rarely cause a runny nose.
There are many anti-viral and anti-bacterial herbs in the Chinese herbal pharmacopeia. And when treating with herbs from this standpoint, we treat and differentiate based on symptoms and what the clients internal landscape is and then how the virus/bacteria meet that landscape. Some of the actions that herbs have is to clear heat, warm, drain damp, transform phlegm, moisten, vent instead of suppress, tonify organs in the body and more. They have many different healing actions and can create health in a different way than pharmaceuticals. Pharmaceuticals have their place in health and healing obviously and integrated with Chinese herbal formulas, we can find a different level of health.

This pandemic is definitely a stressful situation and these are very strange times…

We have all been hearing about the best ways to stay healthy and these include:

1) Meditate or whatever works for you to stay grounded. Staying grounded is key and trying not to get lost in the panic.
2) Keep your immune system strong…

Eat healthy, Get good sleep, Keep your distance as needed, Wash hands, take Vitamin C and Vitamin D to keep your immune system strong.

3) Call me if you are sick and would like a herbal consult.
It will take about 30 min and I will leave an herbal formula for pick up on my porch.

Everyone in my family takes Chinese herbal formulas as needed when down with a cold or flu and I am extending this to the community… I have stocked up as much as possible on needed herbs.
Hope I can help!
Stay healthy,
Molly

If you are interested in the research I mentioned please read on below, the case studies from this doctor in China is fascinating. It follows her treatment of very sick patients and their recovery and the formulas that she used in addition to western medicine.

Fear Comes from Ignorance, Redemption Comes from Chinese Medicine.
Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19
by Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang
Compiled and Translated by John K. Chen, Pharm.D., PhD., OMD, LAc
Editors: Debra Nash-Galpern, L.Ac., DiplOM, Robert Chu, L.Ac.,OME, Lorraine Wilcox, L.A.c, Rina Sasmita, Donna Chow, L.Ac., DiplOM
Today, I want to share my experience treating 30 COVID-19 patients from the beginning to the end with you. I treated every single patient from admission to discharge, and I hope my experience can provide some insights for you.
One of the similarities of these 30 patients is that the time of onset of their illness is relatively close. Admission date for all of these patients was February 4, 2020, except for a few patients who were admitted on February 5, 2020. Through my observations of the course of their illness, I hope to provide a small clinical group study.
When I first started treating COVID-19 patients, my approach was multifaceted since I had read and considered the excellent presentations by many of my teachers. Luckily, Dr. Zhang Ying Liang and Dr. Zhang Chang were able to give me specific guidance and assurance that I believe made a significant difference.
©2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 2
I specialize in difficult-to-treat conditions. Hence, when I first started seeing COVID-19 patients, naturally I was prepared to consider many different factors, including individual patient constitution, the state of their Qi and blood, 8 principles, and Zang Fu differential diagnosis. Yet, more than usual, these patients seemed to share similar presentations to one another, therefore I was able to generally determine a common treatment plan.
THE PRINCIPLE SIMILARITY AMONGST THE THIRTY PATIENTS
What I noticed is that virtually all of these patients had a fever, and those who did not, had chills. Furthermore, most patients presented with cold extremities; while some had perspiration, others did not have any perspiration. Additionally, patients experienced headache, nausea, a bitter taste in the mouth, and dry throat. The most common symptom they all shared was a dry cough. Of these 30 patients, only a few could expectorate phlegm.
I observed an intriguing detail in most cases. Their tongue coatings were thick, white, and greasy, while my teacher from Changsha, a different geographical region located 300 kilos away, detected a different tongue coating. The question arose as to whether tongue coatings were different due to geography and weather, or because most of my teacher’s patients received more treatment prior to admission than my patients.
Please see the photos below of my patients’ tongues. These pictures were taken on the first or second day of their admission to the hospital.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 3
To track their tongues over time, I set up a WeChat group for each patient and asked them to send a picture of their tongue each morning. Along with their tongue photo, I asked them to report their symptoms, energy level, sleep, appetite, urination, defecation, aversion to cold, cold sensation in the extremities or the back, perspiration, including whether they had hot or cold sweat, and if the amount of perspiration was profuse, scanty, or oily. I also asked them to report their facial complexion and what medications they were using, and if they were having any positive or negative reactions to those medications.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 4
As “necessity is the mother of invention”, this WeChat format actually became our method of intake for these patients. This has become the method that we now communicate with all our patients. My colleagues and I compiled and analyzed all this information, including daily photos, and we came to the conclusion that the majority of these 30 patients had the diagnosis of Cold-Damp Invading the Lungs.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 5
TYPES OF WESTERN MEDICATIONS AND HERBS USED DURING TREATMENT PERIOD
As this is an Integrative TCM and Western medicine hospital, our approach to the COVID-19 virus, was to utilize both types of medicine. The Western medicine route offered oral antiviral drugs such as Oseltamivir and Abidol. The critically ill patients were given supportive therapy. IV fluids were strictly monitored. If they were still able to eat, we generally did not administer fluids, as we felt they were getting enough. From the Chinese medical perspective, we had to make a differential diagnosis before prescribing herbs. Integrative therapy seemed like it would provide better results. Furthermore, this provided the rare opportunity to fully embrace the essence of the Shang Han Lun. I knew then that my understanding of COVID-19 was deepening, and that it would leave a lasting impression on me.
As most patients had the diagnosis of Cold-Damp in the Lungs, they primarily received the oral antiviral medications, Oseltamivir and Abidol. We observed that some patients required IV fluids. The primary Chinese medicine formulas used with these medications were:
• Xiao Chai Hu Tang (Minor Bupleurum Decoction)
• Chai Hu Gui Zhi Tang (Bupleurum and Cinnamon Twig Decoction)
• Ma Huang Fu Zi Xi Xin Tang (Ephedra, Asarum, and Prepared Aconite
Decoction)
• Gua Lou Xie Bai Ban Xia Tang (Trichosanthes Fruit, Chinese Chive, and Pinellia
Decoction)
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 6
Almost All Patients Required Ma Huang (Herba Ephedrae)
Throughout the entire treatment process, regardless of which formula was used,
Ma Huang (Herba Ephedrae) was found to be an essential adjunct to treatment. Initially, there was a great deal of dispute regarding the use of Ma Huang (Herba Ephedrae), but those debates were quickly put to rest when we saw how effective it was.
When COVID-19 started around mid-January, 2020, I began to receive many calls daily from patients. While my colleagues and I analyzed their x-rays, we did not pay too much attention to the gravity of the illness, until we were actively working with patients.
What I noticed was that while many patients were experiencing symptomatic relief, their CT scans were showing the progression of the disease. It showed the worsening of lung conditions as the white area in the scan continued to show expansion. Surprisingly, the
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 7
patient’s sleep, appetite, energy level, etc. were, by and large, improving. At first, I was baffled and tried to explore possible explanations for this phenomenon. Hence, I asked my senior colleague whether he thought it was possible that phlegm was unsuspectingly lodging in the lungs of patients.
What my patients reported was that once they expectorated the sputum, their respiration felt much more open. This was especially the case for patients with a dry cough, for the 30 patients I was overseeing. They all experienced the same thing: difficult inhalation, but normal exhalation. So, with that in mind, I insisted on using Ma Huang (Herba Ephedrae) for all my patients from that time forward.
Throughout the entire treatment period from February 4, 2020 through February 20, 2020, most of the critically ill patients became mild cases and most mild cases were released out of the hospital with this integrative approach to care. From this, we learned that Ma Huang (Herba Ephedrae) was pivotal in achieving exceptional results for these 30 patients.
Following this experience, I now highly recommend the use of Chinese herbs to treat COVID-19, in all of its stages. Though the use of herbs is non-invasive with relatively mild side effects, it is not only effective to treat mild and mid-stages of this illness, it can also help prevent patients from moving into the more critical stages of this disease. However, I cannot stress the importance of achieving accurate diagnosis and regularly updated herbal prescriptions for the particular stage of illness. Below, please find a few case studies, with explanations for each one.
CASE 1
A female patient in Bed #4, was admitted to the hospital on 2/4/20, with a high fever of approximately 41°C (105.8°F), nucleic acid detection (+). She also exhibited severe chest pain, dyspnea, respiratory difficulty, and her blood oxygen saturation level was 97%. Furthermore, she was unable to get out of bed, had insomnia due to chest pain, with an inability to eat. She was served one bowl of porridge and she could not even finish that. This patient was barely able to talk, and when she did, she had a very feeble
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 8
voice. I noticed that each time she tried to speak, her words were shortened due to the need to inhale mid-sentence. However, it did not seem that her exhalation was affected. The patient also could not sleep due to the pain, and she expressed that she felt all her ribs were going to break. She did not feel that she had COVID-19, rather, she felt her ribs were broken. She was emotional, understandably, and very fragile.
Modified Ma Huang Xia Zhu Tang and Gua Lou Xie Bai Ban Xia Tang (Trichosanthes Fruit, Chinese Chive, and Pinellia Decoction) were prescribed. On 2/7/20 her temperature was under control and chest pain, and dyspnea improved. On 2/20/20 the patient
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 9
had only a moderate cough with phlegm and no other symptoms. Nucleic acid test (-). Tongue is shown here for comparison.
The Western medicines, Ofloxacin and Ribavirin, were prescribed. I insisted on not giving her steroids because of the large area of ground-glass opacity (GGO). Steroids would cause further spreading of the infection and make recovery more difficult. Therefore, she was only given Chinese herbs.
By 2/7/20, her temperature was under control and her chest pain and dyspnea were somewhat better. However, what worried me was that her cough was worse. I was a bit nervous especially since I am a Western Medical doctor who learned Chinese medicine on my own, so my intuition to avoid the use of steroids raised a lot of questions amongst my peers. When the patient said her cough worsened after taking the herbs, I asked her, “Do you feel worse, or do you feel that your chest is tight after you cough?” She said, “No, after I cough, I feel better, especially if I can cough out some sputum. I feel the chest is more open.” After hearing that, I was very confident I was on the right path. After her temperature was normal, we did not give her any more Ma Huang Fu Zi Xi Xin Tang (Ephedra, Asarum, and Prepared Aconite Decoction). Instead, I used a modified version of Gua Lou Xie Bai Ban Xia Tang (Trichosanthes Fruit, Chinese Chive, and Pinellia Decoction) and added a large amount of Zi Su Zi (Fructus Perillae), Jiang Can (Bombyx Batryticatus), Di Long (Pheretima), Fu Ling (Poria), and more. The key was to open her congested chest and help her expectorate the phlegm.
After taking 3 more doses, following 9 days of herbs, her situation improved dramatically. Previously, she was only able to lie down and was not able to get out of bed. Sometimes, the nurse had to help feed her meals. But on 2/13/20, her voice was robust and she was able to get out of bed. However, she said she still felt a little bit of pain in her chest when she coughed or moved.
After that, the subsequent formulas were relatively easy to discern. I used Gua Lou Xie Bai Ban Xia Tang (Trichosanthes Fruit, Chinese Chive, and Pinellia Decoction).
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 10
Below, please find her CT scans over time.
In this CT scan, it is clear that her infection is very severe. A quarter of her lungs were covered with ground-glass opacity (GGO). Her initial clinical manifestation corresponded precisely with the CT result.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 11
On 2/19/20, her CT showed that much of GGC had dissipated. Furthermore, both of her nucleotide tests were negative. Yet, as regulations are strict from our headquarters, we were not yet allowed to discharge the patient.
The main herbal formulas I used for this patient throughout the treatment were Ma Huang Jia Zhu Tang (Ephedra Decoction plus Atractylodes) and Gua Lou Xie Bai Ban Xia Tang (Trichosanthes Fruit, Chinese Chive, and Pinellia Decoction).
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 12
CASE 2
The next case is regarding a male patient in Bed #14. This patient is 57 years old and contracted the COVID-19 virus at home through a family gathering. Along with most of his relatives, they are all in the hospital and experiencing severe symptoms. This patient had a cough and fever 9 days prior to being admitted to the hospital. His fever was not so high, so he took some over-the-counter drugs at home first. When he was a confirmed case and admitted to our hospital on 2/4/20, his fever was as high as 39°C (102.2°F). His presentation was more severe than the previous patient. For this patient, we decided to put him on the steroid, Methylprednisolone. Previously, I felt steroids would be inappropriate, but didn’t fully realize the side effects in COVID-19 patients, until this patient. His CT clearly displayed slowed absorption. In other words, he would need to stay in the hospital much longer than others.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 13
The difference I noticed with this patient is that, unlike others who were relatively comfortable speaking, he didn’t want to talk to anyone and his spirits were very low. He said he felt chest congestion and did not wish to get out of bed. I asked him if he had dry mouth and he said that he did not, but that he had aversion to cold. Reportedly, he felt cold everywhere in the body but had no perspiration. His neutrophils, amyloid, and calcitonin levels were all abnormal. His transaminase level was abnormal and his urine protein was 1+. At the time, his blood oxygen saturation was only 93%, so I thought the test results and his mental condition and symptoms were consistent.
This patient had aversion to cold, chills, preference to continuous sleep, poor spirits, and a low energy level. As he reported an absence of thirst, I gave him Ma Huang Fu Zi Xi Xin Tang (Ephedra, Asarum, and Prepared Aconite Decoction) with a little bit of Ren Shen (Radix et Rhizoma Ginseng). Furthermore, given his high temperature and his low energy, 80 mg of Methylprednisolone, a steroid, was administered, by the attending physician that evening. The next day, his temperature normalized, but his blood oxygen levels remained at 93%.
On 2/9/20, the patient still had chest congestion, dry cough, and no desire to move. I had initially thought it was because he was more petite and weak, but his son-in-law told me that the patient does physical work and was usually very healthy and strong. So, I tried to convince my supervisor to stop using the steroids.
I was against administrating gamma globulin. I could not understand why it was necessary to use it in this case. So on 2/9/20, I insisted we stop the steroids and my supervisor agreed. We also took out the gamma globulin. By then, the patient’s temperature had already returned to normal with the steroid use.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 14
2/9/20 I prescribed Ma Huang Fu Zi Xi Xin Tang (Ephedra, Asarum, and Prepared Aconite Decoction) and added Dang Shen (Radix Codonopsis) and Sheng Sai Shen (dried ginseng). I also added Zi Su Zi (Fructus Perillae), Jiang Can (Bombyx Batryticatus), Cang Zhu (Rhizoma Atractylodis), Fu Ling (Poria). Please note that all the herbs I used this time were extracted granules. I found that both extract granules and decoctions yielded similar results.
After the patient took the formula for a few days, on 2/12/20, we astonishingly found that he was able to get out of bed. Not only did he get out of bed, but he was talking to others and eating normally without help! Between 2/4/20 and 2/9/20 he could only eat porridge and nothing else because he said he did not feel hungry and he could barely swallow the porridge.
On 2/12/20, he wanted to order a box lunch from the set menu, and I was ecstatic. The patient expressed through WeChat that his chest congestion was better, but that he was still coughing severely, and the white phlegm could easily be expectorated. He no longer felt his chest was congested with phlegm because it had loosened up. Given his overall recovery, I modified the formula and gave him Ma Huang Fu Zi Xi Xin Tang (Ephedra, Asarum, and Prepared Aconite Decoction) with San Ren Tang (Three-Nut Decoction).
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 15
Below, please find his CT result.
This was the first scan when he was administered on 2/5/20. You can see his lungs were severely damaged. It was my opinion, the alveoli were severely compromised.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 16
As you can see from the following CT result, on 2/9/20, there is an improvement. Correspondingly, this is when he stated that his symptoms were improving as well.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 17
On 2/24/20, the medical team on the entire floor was very happy for him and his family because his CT scan showed that the lungs were obviously clearing significantly. As members of his family were all healing in the same unit, it would have been tragic, and may have potentially affected their healing, if he had worsened and not improved.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 18
On 2/20/20, the patient felt generally great and had very little to no symptoms. He had an occasional mild cough, but no sputum. We recommended that the patient remain in the hospital for a few more days before going home.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 19
MY CONCLUSION AFTER REVIEWING PATIENT’S CT RESULTS
Through my observation of CT scans thus far, I concluded the following:
If the CT of the recovered patients showed very clear dark spots, I would ask the patient “How was your body constitution prior to contracting the COVID-19?” Most would answer very good. I would then ask, “Did you feel you were easily tired or would perspire easily?” Most would say no.
However, if the markings in the lungs looked thicker than the rest and the dark area is not as bright and clear, these patients would tell you that they had difficulty breathing prior to contracting COVID-19 and exhibited frequent fatigue and easy perspiration.
So, with this in mind, I discussed with my colleagues the concept of whether or not we could diagnose Lung Qi deficiency through CT results. As this is just a hypothesis, I am uncertain if it is accurate, however, in reviewing the patient in bed #14 it is clear to see that in a matter of 15 days from the initial CT to the last CT, there were great improvements.
All Patients Discharged No Longer Had a Thick, White, Greasy Tongue Coating
Below, please find pictures of Case #2 both on 2/4/20 and on 2/20/20. Please note the immense difference in the images. At first, I questioned whether it was a scan of the same person, or if the camera was defective because there was such a dramatic change. To be certain, I requested the photo be taken again (see below).
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 20
After compiling all information about these 30 patients, including the recordings of how their tongues had changed, they were ready to be discharged.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 21
The following is a compilation of all the tongue photos, and it is clear that none of the patients had the thick, white, greasy tongue coating anymore. I cannot say they are all normal tongue coatings but the patients told me that the state of their current tongue after my treatments was the same as what it looked like prior to contracting the COVID-19 virus.
Continue Phlegm Eliminating Herbs Throughout the Course of Treatment
I also recognized a similar pattern among all my patients. All the patients had a worsening of symptoms around 1/31/20, the last one being 2/2/20. Most patients had their CT scans on 2/2/20 or 2/3/20. What I discovered was that on 2/8/20, the CT results all appeared to be more severe.
• However, despite CT results being more severe on 2/8/20, the patient’s subjective symptoms were all improving
• 3/2/20-3/12 or 13, all patient’s CT results showed absorption
• IconcludedthatthepeakofCOVID-19isroughlyatdays7-8,whichcoincides
with the presentation of other types of viral pneumonia.
I asked many experts about why patients improve before their CT scans show improvement. Many of them agree that the CT results seem to improve after the patients’ subjective feeling is better. Hence, I conclude that the CT results lag behind patient presentation.
My personal feeling is that even though the patient experiences relief from cough, fever, nausea, etc, the retained phlegm in the lungs has not been addressed. Most patients present with high fever so most doctors would focus on reducing the fever without addressing the phlegm.
Furthermore, my ward primarily used TCM treatment, whereas others may strictly use Western medicine. I noticed that some patients, when admitted, had very few symptoms. However, after 3-4 days, they would start to develop dyspnea and respiratory
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 22
obstruction. After discovering this pattern, I urged my colleagues to start using phlegm eliminating herbs EVEN before the patient starts to show symptoms. Five of the herbs that I used the most were Zi Su Zi (Fructus Perillae), Jie Zi (Semen Sinapis), Jiang Can (Bombyx Batryticatus), Cang Zhu (Rhizoma Atractylodis) and finally Ma Huang (Herba Ephedrae). Ma Huang (Herba Ephedrae) was something that I used throughout the entire course of the treatment. It’s a key herb that must NOT be left out. Most of our patients were using Ma Huang (Herba Ephedrae) from February 8, 2020 – February 20, 2020.
This group of patients, especially the 15 who were released on 2/25/20 showed complete absorption without leaving a trace. So, I suppose this theory is accurate.
On 2/18/20, I read a pathology report about COVID-19, and one doctor pointed out that fibrosis develops in the lung, mucus secretions, pulmonary edema, hyaline membrane formation, and more. My understanding is that there is a presence of these secretion or mucus, and it is what we consider to be damp-phlegm in Chinese medicine. So, what we learned is that it is vital for recovery to dispel this phlegm in order to avoid further complications and burden on the lungs.
MY OBSERVATION OF THE CHARACTERISTICS OF COVID-19
The most noticeable characteristics of COVID-19 are:
FIRST: The patient enters peak severity in terms of symptoms, at approximately 1-week into the virus. Whether it is cough, mucus, or any other complaints, approximately 7 days from the onset of infection is when the patient will exhibit the most serious symptoms.
1. Within 1-week, the symptoms peak in severity
2. Excessive use of rectal antipyretic medications, heat-clearing detoxifying herbs, or IV fluids will lead to afternoon fever or spike of fever at night, but not during the day.
3. Afterthefeversubsides,thecoughworsens.Thepatient’sconditionimproves
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 23
if the patient is able to expectorate sputum, with the help of Chinese herbs.
SECOND: I noticed that all patients had a fever, and were reflexively given Lopinavir and Lian Hua Qing Wen capsules (herbs) for 3 days. I noticed that these patients then developed nausea and absence of appetite, and diarrhea. Two-thirds of these patients went on to develop liver dysfunction. I am unsure whether these symptoms are part of the COVID-19 infection, or if they were side effects from the Lopinavir or Lian Hua Qing Wen capsules. Both are considered cold in nature.
Another observation is that out of the 20 patients admitted on 2/4/20, if the patient was repeatedly given antipyretic medication rectally to treat their high temperature, the fever came down, but repeatedly spiked back up again. It seems to take around 3-5 days for the temperature to stabilize.
If antipyretic medications were avoided in favor of herbs to reduce the fever, the duration of fever seemed to shorten to 0.5-2 days. As this may have been unconventional, we had to explain to the patients that they should remain calm and not worry about high fever worsening their conditions, that it would, in fact, shorten the duration of fever. This in turn, can help the patient sleep well and get much needed rest for recovery.
My supervisor and I decided that IV fluids would only be used when absolutely necessary and that we would limit it to 2 different types.
Ma Huang (Herba Ephedrae) DOSAGE AND FORMULAS
Some of you may ask what dose of Ma Huang (Herba Ephedrae) is most appropriate. To be honest, I was not very confident about the dosing at first. My colleague suggested using around 10 grams of Ma Huang (Herba Ephedrae), 15-20 grams of Gui Zhi (Ramulus Cinnamomi), 15-20 grams of Ku Xing Ren (Semen Armeniacae Amarum) and 10 grams of Gan Cao (Radix et Rhizoma Glycyrrhizae).
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 24
Why Do All Patients Need Ma Huang Fu Zi Xi Xin Tang (Ephedra, Asarum, and Prepared Aconite Decoction)?
When national TCM experts came to our hospital, they asked why I was using Ma Huang Fu Zi Xi Xin Tang (Ephedra, Asarum, and Prepared Aconite Decoction) for all the patients and I explained my rationale to them this way. Along with Dr. Zhang Chang and Zhang Ying Dong, we learned from an old man who is an expert in Five Elements and Wu Yun Liu Qi (Five Movements and Six Climates) that 2019 is a year that is deficient in the Earth Element. That means it is not a good year to do anything that would hurt the digestive system, namely the Spleen and the Stomach. So, during the spring of 2019, when I treated kids with sudden onset of fever due to a cold, I would use his recommendation of Fu Zi Li Zhong Wan (Prepared Aconite Pill to Regulate the Middle). It worked exceptionally well each time.
Furthermore, in the summer of 2019, I told all my Spleen Qi deficient patients to avoid or minimize the consumption of raw fruits and vegetables, and to avoid cold water. This is especially important for the children. I asked the parents to always give their kids warm or hot drinks even during the summer. I know it was difficult for some of them, but most parents were compliant. Also, in October of 2019, I intentionally added 10-15 g of Fu Zi (Radix Aconiti Lateralis Praeparata) to all my patient’s formulas. And what I was surprised to learn was that my patients, who followed my dietary guidelines, were not infected with COVID-19. I have about 3600 patients and 60% of them worked in Wuhan and they were not infected!
My conclusion is that the patients who were admitted on 2/4/20 with high fever did not “preserve” themselves enough in the winter. It is hard to explain Huang Di Nei Jing (Yellow Emperor’s Inner Classic) to Western doctors or to patients, but the results seemed to show that if someone did not take care of their body in the wintertime, Springtime diseases can easily develop. What I did in the winter for my patients was to tonify and “preserve” their Yang and then in the Spring, I had them use ventilating herbs, such as Ma Huang (Herba Ephedrae) and Xi Xin (Radix et Rhizoma Asari), to treat any exterior invasions.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 25
Before prescribing Ma Huang Tang (Ephedra Decoction) and Ma Huang Fu Zi Xi Xin Tang (Ephedra, Asarum, and Prepared Aconite Decoction) to the patients, we doctors drank these formulas for 3 full days first.
What I noticed is that even though these formulas normally dispel the exterior by inducing sweating, neither I nor my colleagues had any sweating after we drank the formula. We used up to 30g of Ma Huang (Herba Ephedrae) and 45g of Gui Zhi (Ramulus Cinnamomi). The three of us did not experience any sweating nor did we notice any discomfort or side effects. Therefore, we decided to use the same formulas on our patients.
After giving the patients the herbs, I noticed that only a small amount of perspiration
occurred with patients with high fever. Furthermore, their fever would subside after sweating occurred. Later after the fever has passed, when I administered any formula with Ma Huang (Herba Ephedrae), I did not notice any sweating.
I asked my teacher, Dr. Zhang Ying Dong, about the rationale for the absence of sweat. He recommended two very valuable research articles to me, which answered many of my questions. I noticed that I only remembered Ma Huang (Herba Ephedrae) as a diaphoretic herb to expel the exterior and induce sweating, yet I forgot about the rest of its functions. I suddenly remembered that in my teacher Dr. Huang Shi Pei’s lecture, Ma Huang (Herba Ephedrae) can even be used for an elderly patient who had unconsciousness due to the usage of Diazepam.
THE SIGNIFICANCE OF Ma Huang (Herba Ephedrae) IN TREATING THIS EPIDEMIC
In my opinion, the two greatest benefits of Ma Huang (Herba Ephedrae) for treatment of this epidemic are: FIRST – it opens the ENTIRE chest cavity; SECOND – it opens the water passageway up above the lungs, by increasing urine output, leading to the dissipating accumulated fluids and dampness from the Lungs. Case after case, I saw patients increase urine output, without experiencing thirst. Furthermore, they expressed feeling lighter and more energetic. Hence, I gained much more confidence in prescribing Ma Huang (Herba Ephedrae) as time went on.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 26
THE RELATIONSHIP BETWEEN BODY CONSTITUTION BEFORE AND AFTER INFECTION
Since I specialize in treating mixed or difficult-to-treat conditions, it is imperative to balance the patient’s body constitution by treating conditions that have not yet manifested. This means I have to not only consider the symptom but the root cause of it. In this way, we can correct the imbalance of the body before they present as health concerns.
However, after admitting so many patients to the hospital with COVID-19 infection, I suddenly wondered if this epidemic is just one big accident? If so, does it really matter if the patient is strong or weak, young or old? If it is something that comes on quickly, when are we able to eradicate this “accident,” wouldn’t everything be back to normal? What we found is that if the duration of the disease did not drag on for too long or if the patient’s Zheng (upright) Qi remained intact because he or she had not been too damaged by the virus or the medications, we were able to arrest it very quickly. Therefore, theoretically, there may be no deficiency after the patient recovers.
Out of the 30 patients, only 4 were elderly and critically ill. For those who averaged over 60 years of age, I would add some Dang Shen (Radix Codonopsis) and Huang Qi (Radix Astragali) to their formula. For the rest of the patients, I didn’t add tonics. All patients seemed to respond well to the Ma Huang (Herba Ephedrae) based formulas.
I also observed that, upon being admitted to the hospital, 7 of the patients could only eat porridge for the first five days. They could not eat bread, rice, or anything else. Up until yesterday, between the 30 patients, they ordered 40 lunch boxes per day. Why? Some of the patients were young men and they were still hungry after finishing one lunch box! I saw this as a very good sign that their health was returning.
In conclusion, when the appetite returns in a patient, this means the Spleen and Stomach functions have returned to normal and that they are at the end of the misery they endured.
Thank you for reading about my thoughts, observations, and process in regard to these 30 COVID-19 patients.
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Chen Juan, Huang Di, Wang Shi Qi, Cai Xiang • Medical Records from a Young and Brave Female Traditional Chinese Medicine (TCM) doctor on Fighting the COVID-19 27
Disclaimer: This article is compiled and translated by John Chen from references below to inform the readers how COVID-19, the 2019 novel coronavirus, is currently treated in China. For readers who may have such an infection, contact and consult your primary physician, go to the nearest emergency room or the hospital immediately. For additional information, please contact the World Health Organization (WHO), the Center of Disease Control (CDC) and the Food and Drug Administration (FDA).
Reference 1 :http://www.nhc.gov.cn/yzygj/s7653p/202002/8334a8326dd94d329df351d7da8aefc2/files/ b218cfeb1bc54639af227f922bf6b817.pdf
Reference 2 : https://mp.weixin.qq.com/s/lmnJnfJYoQ3dW5kG9XJ9nQ
Reference 3 : The following is the Guidance for Corona Virus Disease 2019 from the People’s Medical Publishing House
(6th version in English): https://mp.weixin.qq.com/s/nOAmosQ4YqkXHKdJbBE9GA
© 2020 Lotus Institute of Integrative Medicine eLotus.org

Applied Kinesiology, Microbes, Food Sensitivities, Metal Toxicity and Your Health

Happy New Year! I wish you a Happy New Year full of robust health, happy times, Peace and Love.

The New Year has been a mixture of bright, beautiful days and cozy snowfall here in Boulder, I am grateful for the beauty and community connection of this town and so grateful for a happy home, busy clinic and for life’s simple pleasures.

I am also writing to update you on some new wellness therapies in the clinic.
This past fall, I trained with Dr. Michael Lebowitz DC and adopted his applied kinesiology system that he has developed over 30 years of practice. The focus is on the more complex client and addressing the underlying cause of illness and well being (treating the Root, in addition to the Branch). 

The treatment addresses your underlying microbes (virus, bacteria, parasites, fungus, biofilms), metal toxicity and food sensitivities. When the underlying microbes are removed and resolved, the metals detoxified from the system, the untolerated foods are removed from the diet, then the gut can heal and the sensitivities lessen. This all leads to a healthier gut and a healthier body.

Some symptoms that can be alleviated with this system:
Adrenal Fatigue
Allergies
Anxiety/Depression
Arthritis
Autoimmune Disorders
Brain Fog/Difficulty concentrating
Chemical/Food Sensitivities
Chronic Infections (ear, throat)
Fatigue
General Wellbeing 
Hormonal Issues
H.Pylori/Ulcers
Irritable Bowel Syndrome/Reflux/GERD
Lymes
Mononucleosis
Parasites
Perimenopausal Symptoms
Respiratory Infections
Sleep
SIBO
Sinus
Skin Rashes
Thyroid 
Weight Gain
Yeast Infections
Treatment is not limited to these symptoms, 
please email or call me with questions or for a consultation.

As always, my treatments will continue to include as needed: 
Acupuncture 
Chinese Herbal Medicine  
Plant Spirit Medicine 
Shamanic practice
NAET
Cupping 
Shonishin (needle less system for children)

Wishing you all the best in the New Year!

Wellness into the Winter months: Herbal formulas to keep in the medicine cabinet/ processing grief for a healthier winter

Autumn, the time where the energy of the lungs is at its height… respiratory illnesses come to the forefront, whether they are chronic issues or acute colds and flus.
The emotion associated with Autumn and the lungs is grief. We may be feeling this emotion more intensely at this time of year. Creating ceremony around grief and processing it will help as you enter the winter, the strength of the lungs will be stronger.Ceremony could look like creating a sacred space around a fire, allowing yourself to feel the emotion that may be coming through by offering it to the fire and allowing yourself to grieve and process. This will help usher in the depths of winter in a more grounded way and not get overwhelmed by the intensity of the quiet. Winter is the time for inward reflection and with unresolved grief, the water element of winter could overwhelm with fear. The season of the Lung/Grief gives the opportunity for this processing because it is at the surface, the most exposed during Autumn.

That being said, when respiratory illnesses do hit your household, make sure to have
Yin Qiao San in your medicine cabinet (many companies make this with names like, Cold Nip, Cold Snap etc.) This formula is important to have on hand because as soon as you have that first symptom of a “cold” (we call it wind- cold or wind- heat), begin taking the formula every couple hours. The herbal formula has the ability to stay ahead of the viral replication if you take it frequently and immediately. Make sure to cover your head and back of neck on winter or windy days, do not sit outside in cold or wind after exercising, pores are open and vulnerable.
If you have “cold” that starts with a cough, it’s better to take Sang Ju Yin.
And at that point, if the cold is not under control and cough is not responding or bronchitis or asthma symptoms are acting up, come in for a session… Herbal medicine differentiates for different patterns that may be happening… for example, not all coughs are the same: there could be dryness, phlegm, heat, damp, cold. Chinese medicine is nuanced enough to combat it from different perspectives.
Kang ning wan or curing pills are also vital for the medicine cabinet to combat stomach flu or other stomach upsets.
Lastly, if you are well and want to stay well, Jade windscreen (yu ping feng san) is a wonderful immune tonic. Take regularly to avoid colds and flus. Please connect if you are sick, Chinese herbal formulas can work wonders for acute illnesses.

Shamanic work/ Plant Spirit Healing and Five Element Acupuncture

Shamanic sangha offering:
1st Sunday of the month
1:30-4:30
$45
We will practice journeying to live drumming with the help of our power animals and spirit guides.

My journey into this complementary medicine has allowed me to continue down some amazing paths of healing and learning and seeing the world as a spiritual place that is fully accessible to all of us.
I had the great fortune of studying with Marlow Brooks, she studied with J.R.Worsley, the godfather of Five Element Chinese Medicine and Plant Spirit Healing for many years.
I have appreciated adding the Five Element style into my practice… it allows me to treat acupuncture points on the spirit level compared to Traditional Chinese Medicine, which operates more on both the physical and emotional levels.Treating the spirit level allows for greater shifts in constitutional healing.
I believe that the access to the spirit level through needling and the Five Element tradition, most likely brings in the spiritual access of the medicine that existed in this oral tradition of medicine passed down from Doctor to apprentice prior to the Cultural Revolution in China.
Studying with Marlow, also lead to learning about Shamanic journeying to plant spirits and accessing them for healing.
Shamanism, also an ancient tradition in many cultures, is the ability to access a connection to the spirit world through journeying to a drumbeat and creating a state of being that allows access to the highest self and subconscious. We ARE our own healers and this tool gives us the ability, anyone can access this tool… it is a tradition that has been passed through Shamanic cultures for many generations. I continued my studies with Michael Harner’s Foundation for Shamanic studies and learned about soul retrievals, extractions and dying and beyond. I feel so fortunate! It has been a gift for my soul journey.

Goat Milk Formula for Infants

Formula #1: Goat Milk Base

1 quart goat milk, 200 mcg folic acid (drops), 1-2 mg B complex (if you can’t get drops, dissolve a 50 mg tablet in a 1 oz dropper bottle and use 1 dropperful each day in formula), 1/4 tsp fish oil (flax oil may be used if vegetarian), 1 drop Vit E (micellized), 1 drop mixed carotenes, 1/2 tsp bifidus factor, 1 tsp maple syrup or agave (optional).

The formula listed above was developed by Dr. William Mitchell of Seattle. Dr. Mitchell, one of the co-founders of Bastyr University has instructed and mentored countless naturopathic physicians. These formulas will supply a baby’s nutritional needs until the child is ready to start on solid foods.

Food Allergies in Infants and Children

Milk and soy allergies are particularly common in infants and young children. These allergies sometimes do not involve hives and asthma, but rather lead to colic, and perhaps blood in the stool or poor growth. Infants and children are thought to be particularly susceptible to this allergic syndrome because of the immaturity of their immune and digestive systems. Milk or soy allergies in infants can develop within days to months of birth. Sometimes there is a family history of allergies or feeding problems. The clinical picture is one of a very unhappy colicky child who may not sleep well at night. The doctor diagnoses food allergy partly by changing the child’s diet. Rarely, a food challenge test is used. If the baby is on cow’s milk, the doctor may suggest a change to soy formula or exclusive breast milk, if possible. If soy formula causes an allergic reaction, the baby may be placed on an elemental formula. These formulas are processed proteins (basically sugars and amino acids). There are few if any allergens within these materials. The doctor will sometimes prescribe corticosteroids to treat infants with severe food allergies. Fortunately, time usually heals this particular gastrointestinal disease. It tends to resolve within the first few years of life. Exclusive breast feeding (excluding all other foods) of infants for the first 6 to 12 months of life is often suggested to avoid milk or soy allergies from developing within that time frame. Such breast feeding often allows parents to avoid infant- feeding problems, especially if the parents are allergic (and the infant therefore is likely to be allergic). There are some children who are so sensitive to a certain food, however, that if the food is eaten by the mother, sufficient quantities enter the breast milk to cause a food reaction in the child. Mothers sometimes must themselves avoid eating those foods to which the baby is allergic. By delaying the introduction of solid foods until 6 months, and of certain foods much longer, it is possible to delay or prevent food allergies.

The Real Food Stoplight (Tara Littman)

StopLight

Children and Food Sensitivity

Food Sensitivities

Why do so many kids have food sensitivities?

Food sensitivities and food allergies are becoming an alarming norm in the United States. Gluten- free, dairy- free, soy- free… these are products we see in grocery stores all the time and we all probably know someone in our lives who adheres to one of these diets. I know that in my pediatric aspect of my practice, most children I see with chronic illness, have a food sensitivity. If it has not been diagnosed yet, the parent and I work together to decipher which foods or food group may be creating such a negative impact on a child. Ways to decipher this vary, saliva tests, blood tests (which have mixed results and don’t seem to be as accurate), biofeedback and simply elimination diets. I understand that this is not easy. It’s difficult on the parent, it’s difficult on the child, it is just a disruption. Especially, when getting healthy food into children can be a difficulty to begin with. Add that to being exhausted, working parents and it all feels overwhelming.

The unfortunate element that I have found with food sensitivities is that if we don’t remove the offending food, the child’s immune system is constantly being bombarded by something that is making it sick and inflammation ensues. At this point, this child is immuno- compromised and chronically getting sick. Whether it is a skin reaction, a chronic cough, fatigue, gastrointestinal illness, brain fog, achy joints or muscles, sleeplessness or chronic nasal congestion or runny nose. An example of this is a child that I recently had in my office this winter. This little girl was 18 months old and had a chronic wheeze associated with an upper respiratory infection and chronic cough. We deciphered from biofeedback that this child had a dairy sensitivity. This was difficult for this mom to institute, but she did it and the cough started to clear up. The dairy example is confusing because we are told culturally that dairy is the only way to get calcium into the body. 1) This makes it difficult to institute the change because parents are always trying to do best for their child and 2) from what I have seen a child will not absorb or assimilate the calcium anyway because the dairy sensitivity is creating inflammation and the body is rejecting it.

Often a child will “grow” out of a food sensitivity, but the cause of inflammation needs to be removed in order to heal the gut lining. After that is instituted for a period of time, often the child can “grow” out of the sensitivity or just not be quite as sensitive avoiding a constant state of distress.

Preventing Food Allergies

One cause of food allergies may be related to “hygiene hypothesis” —our children are raised in an environment that is ‘too clean’ .

A second cause of food sensitivities may be related to the exposure to chemical toxins in our food: pesticides, genetically modified organisms and general environmental toxicity.

“Because 70% of our immune system is found in our digestive tracts, the foods that we eat and the chemicals that they contain can have a significant impact on our health.

As these chemicals in foods work through a child’s digestive system, they can corrode his or her “pipes” in much the same way that chemical toxins corrode plumbing! This “chemical corrosion” of the digestive tract can leave a child vulnerable to a host of auto-immune disorders, including allergies, asthma, Celiac’s disease and other conditions.” (source: allergykids.com)
“Because of the risks that these chemicals may present, mothers in most developed countries are advised to avoid exposure to chemical toxins during the first twelve weeks of pregnancy given the role that these toxins play in the development of:

Autism
Allergies
Asthma
ADHD
Gestational diabetes.

A mother’s exposure to pesticide during pregnancy has been linked to both:

Autism
Gestational diabetes (Source: Organic Center)” (allergykids.com).

In the last 20 years,

400% increase in allergies,
300% increase in asthma,
400% increase in ADHD
and an increase of between 1,500 and 6,000% in the number of children with autism-spectrum disorders.

Most likely, these increases are related to environmental toxins. I believe the best way to counter this is to do your best to avoid pesticides, antibiotics, hormones and chemicals in food, GMOs, xenoestrogens (from plastics) during pre pregnancy, pregnancy and during your child’s life in at least the first 7 years.

The approach is simple:

Eat a whole foods organic diet the best that you can.

There is the adage to follow, “If your grandmother would not have had the ingredient in her pantry, don’t eat it.”
There are many great sources for this type of diet, a place to start is:
Nourishing Traditions, by Sally Fallon.

Pre Pregnancy Health and Acupuncture

Acupuncture and Herbs protect pregnancy and prevent miscarriages

Acupuncture and herbal formulas can help balance a woman’s system prior to getting pregnant and therefore, be in the healthiest state possible before pregnancy to ensure a healthy pregnancy.

New research published by the Oregon College of Oriental Medicine demonstrated the efficacy of acupuncture and Chinese herbal medicine for the treatment of recurrent pregnancy losses. A team of acupuncturists combined Traditional Chinese Medicine (TCM) therapies in a clinical study of a 42 year old female in Bellevue, Washington suffering from chronic, recurrent pregnancy losses.

Acupuncture and herbs prevent miscarriages.

TCM Protects Pregnancy. The outcome of the study suggests that a combination of acupuncture and herbal medicine enhances fertility and prevents miscarriages. The clinical study tracked the progress of the patient from six months prior to conception to the successful delivery of a healthy boy at full term using Traditional Chinese Medicine as the therapeutic modality to achieve a positive clinical outcome. As a result of these findings, the researchers suggest more research to confirm the level of effectiveness of the procedures.

According to Traditional Chinese Medicine theory, chronic miscarriages may be due to a variety of differential diagnoses including: kidney deficiency, Qi and blood deficiency, heat in the blood, trauma and disorders of the Dai, Chong and Ren channels. While there is overlap with biomedical diagnoses, there are many differential diagnostics in the TCM system not found in conventional biomedicine. Several herbal formulas throughout history have been indicated in the TCM system for the protection of the fetus to full term. Shou Tai Wan (Fetus Protecting Pill) is a classic TCM formula for the treatment of kidney deficiency. Tai Yuan Yin (Decoction for Fetus and Essence) is indicated for the treatment of Qi and blood deficiency. Bao Yin Jian (Yin Protecting Decoction) is a classic herbal formula for the treatment of heat in the blood. Si Wu Tang, perhaps one of the most common herbal formulas in TCM, is indicated for the treatment of trauma affecting a fetus. The aforementioned herbal formulas are indicated for a threatened abortion and also for colporrhagia, hemorrhaging from the vagina, during pregnancy. Bu Shen Gu Chong Tang (Kidney Reinforcing and Chong Channel Consolidating Decoction) is also a common herbal formula for the treatment of women suffering from chronic miscarriages.

Given the positive outcome of this recent study on the benefits of acupuncture and herbal medicine in protecting pregnancies, today’s spotlight is on Bao Yin Jian. This herbal formula is comprised of Sheng Di Huang, Shu Di Huang, Bai Shao, Shan Yao, Xu Duan, Huang Qin, Huang Bai and Gan Cao. The Traditional Chinese Medicine function of the formula is to nourish Yin, cool the blood, clear heat and calm the fetus. Indications for use of this formula are bright red colored bleeding during pregnancy, red cheeks and lips, a feeling of excessive heat in the palms & soles, concentrated urination, dry mouth, dry throat and scanty urination. The tongue is usually red with a dry, yellow coating and the pulse is typically slippery and rapid.

Reference:
Hullender Rubin, Lee, Dara Cantor, and Benjamin L. Marx. “Recurrent Pregnancy Loss and Traditional Chinese Medicine.” Medical Acupuncture (2013).

Acupuncture and Infertility

Acupuncture and Chinese herbal medicine have potent effects in reversing infertility.

A new clinical study concludes that acupuncture and Chinese herbal medicine have potent effects in reversing infertility. Several types of patients suffering from infertility participated in the study including those using IVF, IUI and those using no biomedical assistance. All types showed significantly improved successful pregnancy rates. Pregnancy

The researchers cited prior investigations measuring the biological mechanisms by which acupuncture enhances fertility. The researchers note that beta-endorphins and related neurotransmitters stimulated by acupuncture causes the secretion of gonadotropin-releasing hormone (GnRH). This exerts a regulatory effect on the menstrual cycle and ovulation. Acupuncture has been shown to enhance the micro-circulation of blood in the uterus through the inhibition of excess sympathetic nerve activity in the uterus. The researchers also note that their research is consistent with another investigation finding acupuncture successful in improving IVF outcomes.

The researchers note that the success rate of IVF is 24% (for 4 or more embryos transferred) as a standalone therapy. The combination of IVF with acupuncture has a significantly higher success rate of 42.5%. They note that the improved success rate is both indicates a safe and economical way to assist women undergoing fertility treatments. A total of 52.38% of women in the study conceived with acupuncture and/or herbal medicine without biomedical assistance. Another 9.52% conceived with acupuncture and/or herbs combined with IVF (in vitro fertilization) and 4.76% conceived with IUI (intrauterine insemination) combined with acupuncture.

Most women conceived within the first 12 months of the clinical trial. Measurements were made up to two years from the onset of acupuncture therapy. Several women did not complete the full 2 year course of the study. The study’s success rate may have been higher if all participants completed the full 2 year treatment regime. The women in the study consisted of 85.7% with primary infertility and 14.3% with secondary infertility. No adverse events were reported as a result of acupuncture and herbal medicine treatments.

Acupuncture was the primary treatment method in this current investigation. Chinese herbal medicine supplemented acupuncture in several cases. Based on a Traditional Chinese Medicine (TCM) differential diagnosis, herbal formulas Chai Hu Shu Gan San and Tao Hong Si Wu Tang were used. These formulas were added in cases wherein the TCM diagnostics indicated liver qi stagnation and blood stasis in the uterus respectively. We’ll take a look at the exact acupuncture points used in the study but first a quick look at the inclusion criteria.

Patients were admitted to the study if they met 5 inclusion criteria and did not meet 6 exclusion criteria. Patients had to be of child bearing age and between 21 and 45 years of age. Patients were required to be married with no conception after a least one year of unprotected sex during the fertile phase of the menstrual cycles. Patients had to be non-smokers and non-alcoholics. Patients needed to be willing to receive acupuncture and/or Chinese medicinal herbs and the husband had to have a healthy sexual activity ability and sperm analysis was required to be normal.

Patients with major heart, kidney, respiratory, liver function disorders and HIV were excluded. Women using illicit and investigational drugs were also excluded. If a patient used Traditional Chinese Medicine recently, they too were not able to participate in the study. Additionally, patients with any illness or issue that would impair compliance with the treatment schedule were excluded.

Acupuncture Treatment
Initially, acupuncture was administered 2-3 times per week following menstruation. During ovulation, acupuncture was administered on 3 consecutive days. This typically landed on days 12, 13 and 14. During the luteal phase, acupuncture was administered at a rate of approximately 2-3 times per week. The acupuncture needles were sterile, disposable needles of gauge 0.22 X 25mm and were inserted to a depth of 10-20mm. Deqi was stimulated at each point twice and the needle retention time was 25 minutes.

The acupuncture point selection was based on a TCM differential diagnosis. The primary point selection consisted of the following:

EX-CA1 (Zigong)
M-CA-23 (Sanjiaojiu, Qipang: bottom 2 points only)
SP6 (Sanyinjiao)
CV6 ( Qihai)
CV4 (Guanyuan)
CV3 (Zhongji)

Secondary points used in the study were:

CV12 (Zhongwan)
SP10 (Xuehai)
ST36 (Zusanli)
LR3 (Taichong)

The CV6, CV4, CV3 combination reflects a choice used classically by luminaries of the field. This combination powerfully nurtures the dantien, translated as the elixir field, sea of qi or energy center. Zigong is another point widely used in TCM for the treatment of infertility. Overall, the acupuncture point combinations reflect best practice choices within the TCM system.ST25CV6

The researchers provided a general overview of the study’s relevance and focus. They note that approximately 15% of women in the child bearing years experience infertility. There are a broad range of issues leading to infertility. The causes range from dysfunction of the uterus, fallopian tubes and ovulation to hormonal imbalances. The researchers note that studies show that acupuncture regulates the hypothalamic-pituitary-ovarian axis and therefore menstruation. Additional research demonstrates that acupuncture regulates endocrine system functions and therefore addresses hormonal disorders. In TCM, the diagnoses of blood stasis and liver qi stagnation were common to many of the participants. Based on these principles, the focus of the treatments were to enhance circulation in the uterus and ovaries to improve fertility.

The researchers note that “acupuncture shows promising success in treating female infertility as compared with IVF (in vitro fertilization) alone without acupuncture….” They also note that acupuncture and herbal medicine show a “positive effect” on treating several types of female infertility. They note that acupuncture with or without herbal medicine supplementation shows promise in the treatment of female infertility.

Similar Acupuncture Points
A recent meta-analysis concurs with this new study on the effectiveness of acupuncture for the treatment of infertility and the effectiveness of the acupuncture point selection. The researchers determined common acupuncture points across multiple studies demonstrating effectiveness in promoting fertility. The comprehensive analysis of fertility treatments revealed that four key acupuncture points were significantly effective. Acupuncture points SP6 (Sanyinjiao), CV4 (Guanyuan), CV3 (Zhongji) and Zigong (Ex-CA1) demonstrated clinical efficacy.

Comparative Acupuncture Points
Another study of acupuncture points compared women receiving infertility treatments versus women receiving acupuncture for other concerns. A cross sectional study of 48 women consisted of two groups. Group 1 consisted of 24 women who were treated for infertility. Group 2 consisted of 24 women who were fertile and received acupuncture for other concerns. The acupuncture points common to both groups were K3, LV3 and SP6. The women receiving infertility treatments more often received the acupuncture points CV4, CV3 and ST29. For group 2, they received needling at SP3 more often than the women receiving treatment for infertility.

Pregnancy and Live Birth Rates
Researchers conclude that acupuncture improves both the pregnancy and live birth rates of women receiving in vitro fertilization and embryo transplantation (IVF-ET). During the investigation, researchers uncovered a biochemical mechanism by which acupuncture enhances fertility. In addition, the researchers compared successful IVF-ET rates with Chinese medicine differential diagnoses and made an interesting discovery.Infant

The researchers found that electroacupuncture increases blood levels of HLA-G (human leukocyte antigen) “and the level of HLA-G secreted in embryos for the patients in the process of IVF-ET.” Presence of the HLA-G protein is predictive of higher pregnancy and live birth rates according to modern research conducted at the Department of Obstetrics and Gynecology, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada.

The researchers compared the Chinese medicine differential diagnostics for the women in the study. There were 82 kidney deficiency, 74 liver qi stagnation and 54 phlegm-dampness cases. The HLA-G levels were significantly higher during embryo transplantation as a result of electroacupuncture treatment for the kidney deficiency and liver qi stagnation groups. This corresponded to differences in the “high-quality embryo rate” with the kidney deficiency group having a 73 percent yield, the liver qi stagnation group having a 70 percent yield and the phlegm dampness group having a 54 percent high-quality yield. Of interest, all three groups had similar improvements in fertilization and pregnancy rates following the application of electroacupuncture. The researchers concluded that, due to electroacupuncture, “the pregnancy outcome and the pregnancy rate are improved.”

Anovulation Infertility
Additional research concludes that acupuncture is successful for the treatment of infertility. A clinical trial was conducted at the Department of Acupuncture and Moxibustion at Ruikang Hospital, an affiliate of Guangxi University of Chinese Medicine. A total of 40 cases were invested using a standard treatment protocol of electroacupuncture combined with moxibustion. The effective rate for the treatment regime was 85% based on the pregnancy rate documented in follow-up visits.

The researchers measured the effects of acupuncture and moxibustion on anovulatory infertility, a type of infertility caused by the lack of ovulation. Following the treatment regime, FSH, LH and E2 levels improved. In addition, the thickness of the endometrium increased and the follicle diameter increased. The higher pregnancy rates and objective testing resulted in the research team finding acupuncture and moxibustion successful in enhancing fertility for women with anovulatory infertility.

Electroacupuncture and moxibustion were applied to Zigong (EX-CA-1), CV4 (Guanyuan) and Zhongji (CV3). An additional choice of acupuncture points was made with the Ling Gui Ba Fa method. Ling Gui Ba Fa, translated as the eightfold method of the sacred tortoise, is a method for choosing effective acupuncture points selected from the eight confluent points of the eight extraordinary vessels based on the time of day. This method is based on the theory of the nine palaces and eight trigrams to determine acupuncture points that are most effective for a given period of time.

The earliest account of the Ling Gui Ba Fa method is found in the Zhen Jiu Zhi Nan, A Guide to Acupuncture and Moxibustion, written by Dou Hang-qing in the Jin dynasty. The eight confluent points, which are the palette of point selection, are SP4, PC6, SI3, UB62, GB41, TB5, LU7 and KI6. More conventional methods employ the standard use of differential acupuncture channel diagnoses and indications to select from these acupuncture points.

PCOS
In other research, investigators concluded that acupuncture was able to improve “menstrual frequency and decrease circulating androgens in women with polycystic ovary syndrome (PCOS).” Infertility is an unwanted complication associated with some forms of PCOS, polycystic ovarian syndrome, and acupuncture showed significant clinical improvements in the women studied.

Another study published in the American Journal of Physiology – Endocrinology and Metabolism concludes that low frequency electroacupuncture improved menstrual frequency and balanced sex steroid levels in women with PCOS. The study measured improvements in a wide range of endocrine variables such that the researchers concluded that electroacupuncture may help induce ovulation in women attempting to conceive since participants showed significant improvements in monthly menstrual frequency. There are similarities in the acupuncture point selection in this study with the study of women with anovulatory infertility.

Acupuncture was applied to CV3, CV6, ST29, SP6, SP9, LI4 and PC6. All needles were stimulated manually until deqi arrived. Thirty minutes of 2Hz electroacupuncture was applied to CV6, CV6, ST29, SP6 and SP9 for each treatment. LI4 and PC6 were manually stimulated every 10 minutes to evoke sensation. Needle length ranged from 30 to 50mm and the diameter was 0.32mm. Needle depth ranged from 15 to 35mm. Acupuncture was administered twice per week for two weeks, one time per week for six weeks and once every other week for eight weeks for a total of 14 acupuncture treatments over a 16 week period.

ART
Additional research demonstrates a consensus among acupuncture experts on best practice treatment protocols for acupuncture enhancement of assisted reproductive technology (ART) fertility treatments. ART includes all fertility treatments in which both the eggs and sperm are handled. ART includes in vitro fertilization (IVF) and intrauterine insemination (IUI). In this study, researchers set out to determine if a consensus exists on high priority acupuncture points for the enhancement of ART.Pregnancy

ART has been used in the USA since 1981. Although acupuncture and Chinese medicine for the treatment of infertility is a time honored practice, the combination of acupuncture with ART has emerged in recent years as an effective approach for improving pregnancy and live birth rates. In this study, researchers administered 3 rounds of questionnaires to 15 international acupuncture fertility experts to determine if a consensus exists on best practice protocols.

The investigation revealed that several key components are central to acupuncture in combination with ART. The timing of an acupuncture treatment in relation to the menstrual cycle is of great importance. An acupuncture treatment administered between day 6 and 8 of the “stimulated ART cycle” is optimal. In addition, it is ideal to have two acupuncture treatments “on the day of embryo transfer.” Pre-transfer acupuncture points of high priority are SP8, SP10, LV3, ST29 and CV4. Post-transfer points include GV20, KI3, SP6, PC6 and KI3. Auricular acupuncture points Shenmen and Zigong were also determined to be of high priority.

Pharmaceuticals and Acupuncture
New research demonstrates higher ovulation and pregnancy rates for women receiving acupuncture combined with clomiphene (clomifert, clomid) compared with women receiving clomiphene only. Clomiphene is a selective estrogen receptor modulator. It inhibits hypothalamus feedback to stimulate production of gonadotropins, hormones that affect fertility including FSH (follicle stimulating hormone) and LH (luteinizing hormone).

The study measured a control group of 19 women and an acupuncture group of 17 women. The control group received 50mg of oral clomiphene at a rate of once per day for a total of 50 menstrual cycles. The acupuncture group received the clomiphene at the same dosage and rate plus regular acupuncture treatments. The researchers measured changes in ovulation, endometrial thickness, cervical mucus, pelvic fluid, and follicular development. The acupuncture group showed a significantly higher rate of both ovulation and conception than the group receiving medication only.

In another recent study of 5,807 women, it was demonstrated that acupuncture improves clinical pregnancy rates and live birth rates for women receiving IVF (in vitro fertilization). A study published in the American Journal of Reproductive Immunology shows that the application of acupuncture to acupoints ST36 and SP6 was shown to prevent egg implantation failure and another study of 309 women concluded that electroacupuncture “significantly improved the clinical outcome of ET (embryo transfer).”

A recent study measured the biochemical mechanisms by which acupuncture increases IVF success rates. In a randomized controlled study, it was concluded that, “Acupuncture could improve the poor receptive state of (the) endometrium due to mifepristone by promoting Th2 cytokines secretion and inhibiting Th1 cytokines to improve blastocyst implantation.”

Sperm Motility and Acupuncture
Male infertility is also of major concern. Researchers conclude that acupuncture restores sperm motility. Laboratory experiments measured the effects of electroacupuncture on infertility by stimulating acupoints located on the scalp, abdomen and legs.Sperm and Egg The researchers measured “a trend of improved motility and increased number of motile epididymal spermatozoa in the H+EA (electroacupuncture) group.” The researchers note that electroacupuncture enhances “cell proliferation through improvement of Sertoli cell functions.” Sertoli cells are activated by follicle-stimulating hormone and are located in the convoluted seminiferous tubules, the anatomical structure in the testes where spermatozoa are produced.

Researchers disrupted spermatogenesis using a scrotal heat-treated rat model. Electroacupuncture was applied to GV20 (Baihui), CV4 (Guanyuan), ST36 (Zusanli) and SP6 (Sanyinjiao) for a total of ten acupuncture sessions. After 79 days following the heat treatment, motile spermatozoa were found in the heat-treated group that received electroacupuncture. No motile spermatozoa were found in the rats that did not receive electroacupuncture. The electroacupuncture group also showed a significant increase in PCNA-positive cells and inhibin B levels. In addition, the electroacupuncture group demonstrated a higher Johnsen’s score through day 56. As a result of these findings, the researchers conclude that electroacupuncture “may facilitate the recovery of spermatogenesis and may restore normal semen parameters in subfertile patients.”

Comfort In The Clinical Setting
Another team of researchers took a less utilitarian approach. Their research concludes that acupuncture reduces anxiety in women undergoing IVF (in vitro fertilization). A randomized-controlled study of 43 women undergoing IVF measured changes in anxiety levels.

A total of four acupuncture treatments over a period of four weeks at a rate of once per week were administered. The acupuncture group received acupuncture at acupoints Yintang, HT7 (Shenmen), PC6 (Neiguan), CV17 (Shanzhong) and DU20 (Baihui). The control group received needle stimulation at non-acupuncture points near the areas of the true acupuncture points (sham acupuncture).

The true acupuncture group showed a significant reduction in anxiety while the sham acupuncture group did not. The researchers concluded that acupuncture reduces anxiety and psychological strain for women undergoing IVF. This research focuses on the integration of acupuncture with modern medical practices and represents a trend in modern investigations.

HealthCMi
At the Healthcare Medicine Institute (HealthCMi), we follow this type of research very closely. Positive clinical outcomes for the treatment of female infertility is a consistent trend in modern reserach. Take a look at this video of recent Acupuncture CEU/PDA course on the treatment of pelvic inflammatory disorder, a major cause of infertility. This course is ABORM (American Board of Oriental Reproductive Medicine) approved.

A prominent acupuncturist specializing in the treatment of infertility is Dr. Ting Ting Zhang. Members of the Healthcare Medicine Institute attended a conference at the American College of Traditional Chinese Medicine (ACTCM) in San Francisco, California where she covered some of her latest advances in the field. Dr. Zhang is the Gynecology Department Chair of Yue Yang Hospital at the Shanghai University of TCM.

Dr. Zhang presented new ultrasound and hormone testing research revealing that certain Chinese herbal medicines promote ovulation and egg development, increase sperm motility and count and prevent miscarriage. Further, biomedical data confirms that Chinese herbal medicine greatly increases the conception rate of women undergoing artificial insemination.

Dr. Zhang opened up the conference with some basic statistics. A recent study of 500 child bearing age women who were NOT treated with Chinese herbal medicines resulted in a 60-70% conception rate given regular sexual intercourse. At 6 months, the rate increases to 75-80%. At 1 year, the rate increases to 80-90%.

From age 30 to 34, 1 in 7 women experience infertility. Between the ages of 35 and 40, 1 in 5 women are infertile and between the ages of 40 and 44, 1 in 4 women experience difficulties with infertility. In up to 55% of cases, infertility is caused by a female reproductive disharmony. In 25-40% of cases, infertility is caused solely by a male reproductive issue. In 20% of all cases, infertility is caused by both the male and female partners.

Dr. Zhang’s clinical outcomes demonstrated a very high rate of clinical success in reversing infertility. Dr. Zhang noted that “infertility is a symptom, not a disease.” She posits her great success to the teachings of the great Dr. Tai.

Dr. Zhang presented Chinese medicine differential diagnostics in relation western medical findings. Basal body temperature (BBT) charts were revealed to express a process of emerging yin essence in the first 12 days of a menstrual cycle followed by a powerful yang stage. A direct reading of the BBT chart translates into an exact Chinese medicine diagnosis. In addition, Dr. Zhang introduced methods for analyzing hormone tests. For example, high FSH is linked to yin deficiency and high LH is linked to yang deficiency.

A multitude of ways to view BBT, ultrasound, sexual hormone tests and other western related data were correlated into the Chinese medicine theoretical framework. Dr. Zhang closed the divide between biomedical medical data and Chinese medicine differential diagnostics in her presentation. Acupuncturists can now read the biomedical data, make a Chinese medicine differential diagnosis and choose from the correct herbal medicines to promote conception and a healthy pregnancy.

Common conditions leading to infertility are kidney yin and yang deficiency, liver qi stagnation and blood stasis. For women, the main concern is to harmonize the menstrual cycle. Dr. Zhang presented important herbal formulas to address many clinical scenarios and included special herbs to promote ovulation and nourish the fetus.

Dr. Zhang presented herbal remedies to prevent anti-sperm antibodies such as AsAb and other autoimmune system disorders from leading to infertility. Dr. Zhang covered the topic of uterine fibroids, their exact relationship to infertility and how to overcome any impediments they may present. This requires, at the very minimum, an ultrasound test of existing fibroids to determine their exact placement and size. Surgical removal of fibroids may be required in some cases.

Dr. Zhang presented step-by-step methods to take an abnormal BBT charted cycle to one that follows a healthy pattern from follicular phase through ovulation to luteal phase and menstruation. The herbal medicines restore the normal ovulation window, optimize the fertility cycle and enhance the process of a healthy pregnancy and fetus. Dr. Zhang detailed the exact herbs needed to promote egg maturation and those needed to facilitate uptake and transport of eggs into and through the fallopian tubes. Further, she presented a detailed herbal medicine regime to optimize the window of opportunity for patients undergoing IVF and IUI. In cases where artificial insemination has previously failed, adding Chinese herbs balances the health of the patient such that artificial insemination becomes successful.

Adam White, L.Ac. is the CEO of the Healthcare Medicine Institute. He notes that “Dr. Ting Ting Zhang has managed to fully integrate the biomedical model for the treatment of primary and secondary infertility into the Chinese medicine system. We now have a fully integrated understanding of biomedical medical test data in terms of Chinese medicine theory and we have a new understanding of herbs that promote the various stages of conception. Dr. Zhang and her colleagues at Shanghai University of TCM have employed biomedical testing methods to measure the effects of herbal medicines on processes such as ovum development and release, fallopian tube function, and fetal development. Thanks to Dr. Zhang, the clinical efficacy of Chinese medicine in the treatment of infertility has advanced tremendously.”
References:
Chui, Shiu Hon, Fung Chun Chow, Yim Tong Szeto, Kelvin Chan, and ChristopherWK Lam. “A Case Series on Acupuncture Treatment for Female Infertility with some cases supplemented with Chinese Medicines.” European Journal of Integrative Medicine (2014).

Fan Qu, Jue Zhou, Mark Bovcey, Giovanna Franconi, Kelvin Chan, Caroline Smith et al. Does acupuncture improve the outcome of in vitro fertilization? Guidance for future trials. European Journal of Integrative Medicine 2012; 4(3): e234 – e244.

Eric Manheimer, Grant Zhang, Laurence Udoff, Aviad Haramati, Patricia Langenberg, Brian M Berman et al. Effects of acupuncture on rates of pregnancy and live birth among women undergoing in vitro fertilisation: systematic review and meta- analysis. British Medical Journal 2008;336;545-549.

Exploration of clinical regularities in acupuncture-moxibustion treatment for infertility. Qin-feng Huang. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE, Volume 10, Number 2. (2012), 72-76, DOI: 10.1007/s11726-012-0574-0.

Acupunct Med 2012;30:12-16 doi:10.1136/acupmed-2011-010089. Traditional Chinese medicine patterns and recommended acupuncture points in infertile and fertile women. Oddveig Birkeflet, Petter Laake2, Nina Vollestad.

XU, Yin, and Miao ZHANG. “Efficacy observation on 40 cases of anovulatory infertility treated by acupuncture and moxibustion.” World Journal of Acupuncture-Moxibustion 23, no. 1 (2013): 40-43.

Electrical and manual acupuncture stimulation affects estrous cyclicity and neuroendocrine function in a DHT-induced rat polycystic ovary syndrome model. Yi Feng1,2, Julia Johansson1, Ruijin Shao1, Louise Mannerås Holm1, Håkan Billig1, Elisabet Stener-Victorin1,3 . Experimental Physiology. DOI: 10.1113/expphysiol.2011.063131.

Elizabeth Jedel, Fernand Labrie, Anders Odén, Göran Holm, Lars Nilsson, Per Olof Janson, Anna-Karin Lind, Claes Ohlsson, and Elisabet Stener-Victorin. Impact of electro-acupuncture and physical exercise on hyperandrogenismand oligo/amenorrhea in women with polycystic ovary syndrome: a randomized controlled trial. Am J Physiol Endocrinol Metab 300: E37–E45, 2011.

BMC Complementary and Alternative Medicine 2012, 12:88 doi 10.1186/1472-6882-12-88. 7 July 2012. Development of an acupuncture treatment protocol by consensus for women undergoing Assisted Reproductive Technology (ART) treatment. Caroline A Smith, Suzanne Grant, Jane Lyttleton and Suzanne Cochrane.

Zhongguo Zhen Jiu. 2012 Feb;32(2):113-6. Effects of electroacupuncture on embryo implanted potential for patients with infertility of different symptom complex]. Kong FY, Zhang QY, Guan Q, Jian FQ, Sun W, Wang Y. Department of Reproduction, The Second Affiliated Hospital of Shandong University of TCM, Jinan, China.

Fertil Steril. 2005 Jan;83(1):30-6. Secretion of human leukocyte antigen-G by human embryos is associated with a higher in vitro fertilization pregnancy rate. Yie SM, Balakier H, Motamedi G,