Recent Chinese medical research on the treatment of ADHD - Chinese Medicine Update

Townsend Letter for Doctors and Patients,  Oct, 2003  by Bob Flaws

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Keywords: Chinese medicine, Chinese herbal medicine, acupuncture-moxibustion, attention deficit-hyperactivity disorder (ADHD)

In the last 10 years, there has been a growing interest in the Chinese medical treatment of attention deficit-hyperactivity disorder in the People's Republic of China (PRC). My assumption is that, with the adoption of a more Western diet (and especially an increase in sugars and sweets) as well as a more Western lifestyle (TV, video games, and the overuse of antibiotics), there has been an increase in ADHD in the PRC, not just an increased awareness of this condition. The main symptoms of attention deficit hyperactivity disorder as described in the Chinese medical literature correspond to the traditional Chinese disease categories of irritability (yi nu, duo nu), insomnia (bu mian), profuse dreams (duo meng), oppressive ghost dreams (meng yan), vexation and agitation (fan zao), and impaired memory (jian wang). The main disease mechanism of ADHD is the presence of some sort of heat evils which harass and stir (dong) the heart spirit. In Chinese, hyperactivity is translated as duo dong, excessive stirring, and stirring mostly is the result of an excess of yang qi, whether that excess be a true excess or only a relative excess. The main types of heat evils present in ADHD are depressive heat transformed from liver depression qi stagnation, phlegm heat or phlegm fire, and yin vacuity internal heat. In the case of all three of these types of heat evils, spleen vacuity failing to nourish and construct the heart spirit with sufficient qi and blood also typically plays a part. Below are summaries of a number of recently conducted studies from the PRC on the treatment of ADHD with Chinese medicine.

Study #1

"The Treatment of 30 Cases of Pediatric Hyperactivity with Gui Zhi Tang (Cinnamon Twig Decoction)" was published by Zhao Qi-ran and Peng Hong-xing in the Hu Bei Zhong Yi Za Zhi (Hubei Journal of Chinese Medicine), issue #3, 1994, on page 33. All the patients in this clinical audit were seen as out-patients. There were 21 boys and 9 girls. They ranged in age from 2-13 years old. The course of their disease was as short as five days and as long as four years. Gui Zhi Tang (Cinnamon Twig Decoction) was composed of: Ramulus Cinnamomi (Gui Zhi), 6g, Radix Albus Paeoniae Lactiflorae (Bai Shao), 15g, mix-fried Radix Glycyrrhizae (Zhi Gao), 4g, uncooked Rhizoma Zingiberis Officinalis (Sheng Jiang), 4 slices, Fructus Zizyphi Jujubae (Da Zao), 4 pieces. These were the amounts for children around five years of age. They were decocted in water and one packet was administered per day, with seven days equaling one course of treatment.

Complete cure consisted of complete disappearance of the patient's signs and symptoms in 2-3 courses of treatment. Marked improvement was defined as obviously improved sleep and bodily control over twitching. A change for the better meant that the child's twitching was diminished and their sleep somewhat improved. No result was that there was no change for the better in either twitching or sleep. Based on the above criteria, eight cases were cured, 17 markedly improved, three took a change for the better, and two experienced no results. Thus the total amelioration rate was 93.3%. The six cases whose course of disease had lasted two months or less were cured. Of the 11 cases whose course of disease had lasted for less than a half year, two were cured and nine were markedly improved. The cases which registered no results from using this protocol were those children whose course of disease had lasted for three years or more.

Study #2

Zhang Yi-mei and Zhang Xiao-ling, writing in Hu Nan Zhong Yi Za Zhi (Hunan Journal of Chinese Medicine), #9, 2000, on pages 22-23, describe their treatment of 41 cases of pediatric attention deficit hyperactivity disorder with a combination of acupuncture and internally administered Chinese herbal medicine as compared to 46 cases of ADHD who received acupuncture alone. Of the 41 children in the treatment group, 34 were male and seven were female. The youngest was four and half years old and the oldest was 15. In the comparison group, there were 37 males and nine females who ranged in age from 4-12 years. All had been diagnosed as suffering from ADHD based on the criteria set forth in the DSM-IV. In addition, neurological diseases resulting in disturbances of intelligence were excluded.

The so-called comparison group received the following acupuncture treatment. The main or ruling points consisted of several named groups of points. Zhi San Zhen (Intelligence Three Needles) was comprised of Qian Ding (GV 21) located on the midline and unnamed points located three inches to either side. Zhu Yi Li San Zhen (Attention Power Three Needles) consisted of Yin Tang (M-HN-3) and Tai Yang (M-HN-9) needled bilaterally. The last group of ruling points was Si Shen Cong (M-HN-1). Auxiliary points included: He Gu (LI 4), Shou Zhi Zhen (Hand Intelligence Needles, i.e., Nei Guan, Per 6, Shen Men, Ht, and Lao Gong, Per 8), Zu San Zhen (Foot Three Needles, i.e., Zu San Li, St 36, San Yin Jiao, Sp 6, and Tai Chong, Liv 3), Shen Mai (Bl 62), and Zhao Hai (Ki 6). One inch 30 gauge fine needles were used. Needles on the head were needled transversely approximately one inch. The Si Shen Cong were needled towards Bai Hui (GV 20). Points on the four extremities were needled perpendicularly to standard depths. Even supplementing-even draining hand technique was used with the needles being twirled once every 10 minutes. The needles were retained for a total of 30 minutes per treatment, with one treatment per day.