Being Alive; January 1994
Jin-Lin Wang, LAC, MD (China)
At the Oriental Medical Center, we began treating people with HIV/AIDS in 1986. Our approach was to use a treatment combination of Chinese herbs, specifically formulated for their antiviral and immune enhancing effects, and acupuncture. Since we began this program, we have kept records on 201 patients who were continuously treated for from six months to over five years.
The Study Groups
For the purposes of evaluation, we divided our 201 patients into two groups. The first group (Group A) used only acupuncture and Chinese herbs. The second group (Group B) added Western medicine to their treatment regimen.
The first group included 103 adults (101 men and 2 women). At the beginning of their treatment program, 11 had CD4 counts of less than 200, 63 were in the 200-500 range, and 29 had CD4 over 500.
The second group consisted of 98 adults (95 men and 3 women). In this group, 57 had initial CD4 less than 200, 32 were in the 200-500 range, and only 9 had CD4 greater than 500. As you can see, the average initial CD4 for Group A was a good deal higher than for Group B.
The Treatment Program
Treatment included both acupuncture and Chinese herbs. Acupuncture was administered once or twice a week. For those who understand such things, the basic points were: LI-4, ST-36, RE-6, Ear-Spleen. Additional points were used as individually indicated.
The Chinese herbs consisted of two basic formulas. An immune enhancer was taken twice daily (three capsules each time), and an antiviral three times daily (also three capsules each time). Additional herbs were prescribed as specific cases indicated.
Standards of Evaluation
Only twelve years have passed since the first cases of AIDS were diagnosed in 1981. We do not yet completely understand the natural progression of this disease. Some research indicates that 50% of HIV+ people will progress to AIDS within five years. Other research reports that 35% of HIV+ people can survive more than 10 years with normal CD4 counts. Thus, we believe that to evaluate the effects of a treatment, both its short term effects and long term survival must be observed.
To evaluate the short term effects of treatment, the CD4 count is used. The CD4 count is the standard used by the FDA to evaluate the effect of antiviral drugs. The CD4 count is also generally accepted internationally as an indicator of the condition of the human immune system. There is some disagreement about this; however, because of its general acceptance, we use the CD4 count as a surrogate marker.
The CD4 count fluctuates daily. We apply a classification to minimize confusion caused by fluctuations. We classify someone as Improved if CD4 count is up 50 points or more from the original level. Someone is Stable if CD4 count is plus or minus 1 to 49 points from their initial count. Finally, we call someone Decreased if CD4 drops 50 points or more from the original level.
To determine the long range value of the treatment program, we look at the three year survival rate, as well as the rate of progression to AIDS among the study subjects.
Results for Group A
Sixty-eight people (or 66% of the group) improved during the treatment program (according to the criterion noted above). At the start of the program, average CD4 count for the Improved was 435; at the end of the evaluation period, average CD4 stood at 616.
Twenty-five people in Group A were Stable, while only 10 (or 9.7% of the group) were classified as Decreased.
In Group A, 23 patients were observed for from two to five and a half years. None of these patient either progressed to AIDS or died.
Two cases from this group are good examples. One man began treatment in June of 1988 with an initial CD4 count of 317. He was treated continuously for four and a half years. During this time, his CD4 count rose to 661, and he remained free of symptoms. Another man began treatment in January of 1987 and started with a CD4 level of 300. Results were even more dramatic. After four and a half years of continuous treatment, his CD4 count increased to 710 and he stayed asymptomatic.
Results for Group B
Group B, which combined Chinese and Western treatments, began the treatment program with an average CD4 count lower than Group A. Results for this group were somewhat less successful. Only 29 people or 30% of the cases could be classified as Improved. However, 44 or some 45% remained Stable. Twenty-five patients in Group B decreased.
Thirteen cases in Group B were observed during continuous treatment of from two to four and a half years, Of this subgroup, four of the thirteen died.
Using Only Chinese Herbs and Acupuncture
We find that it is very difficult to get the CD4 count to return to normal range once it has dropped below 200. The best indication for sole use of traditional Chinese medicine is when the CD4 count is still above 300.
The Concorde study reports that AZT is not as beneficial for early HIV infection as previously believed. Our purpose with acupuncture and Chinese herbs is to slow or stop the average annual loss of T-cells and to keep the patient's immune system intact until a cure is discovered.
Some research indicates that the CD4 count will drop 70-80 points annually. Our results indicate that 66% of the 103 patients treated solely with traditional Chinese medicine showed a CD4 increase instead of a decrease. Twenty of the 103 patients whose CD4 counts were in the abnormal/low range increased into the normal range.
Combining Chinese and Western Treatments
Research demonstrates that traditional Chinese medicine may strengthen immune function and inhibit the HIV virus. Our clinical practice and results support these findings. Acupuncture and Chinese herbs have the additional advantages of cost effectiveness and general lack of side effects. However, it is our opinion that traditional Chinese medicine cannot cure HIV infection at this time. Thus, it is vital to recognize when Western medications are indicated and useful for the protection of the patient.
Because AIDS suppresses the immune system, the patient may be susceptible to infection. Western medications can prevent opportunistic infections as exemplified by the use of Bactrim to prevent PCP. We are testing Chinese herbs to prevent opportunistic infections. At this time, however, we do not have a Chinese herbal replacement for such medications as Bactrim.
The Value of Acupuncture
The mechanism of acupuncture can increase the endorphin level. Endorphins are recognized as pain relievers. Within the last three years, studies of endorphins also demonstrate that they increase T-cell count and natural killer cell activity, as well as inducing the body to form interferon.
Continuous Treatment Enhances Benefits
Our work during the past seven years indicates that there are clear benefits to the continuous use of Chinese herbs and acupuncture. When a patient seeks treatment for only a short time or on an intermittent basis, the value of the Chinese approach is diminished.
Two cases illustrate this important point. One man began treatment in April of 1987; his initial CD4 count was 430. He was treated continuously with only Chinese herbs and acupuncture for three years. At the end of this period, his CD4 had risen to 530 and his p24 antigen had gone from positive to negative. The patient chose to discontinue treatment. When he returned almost three years later, his CD4 count was only 55 and his p24 antigen was again positive.
Another man began treatment in early 1988 with a CD4 count of 443. He continued with regularly scheduled treatments for almost three and a half years. At the point that he discontinued treatment, his CD4 stood at 500. Only a year and a half later, he had an attack of shingles and returned for treatment. His CD4 count had dropped to 150.
When you compare these two cases to the ones reported in our Group A results, you can see that uninterrupted treatment seems more effective. If an HIV+ patient does choose to discontinue treatment, we strongly recommend that they check their CD4 count every three months.
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