by
Bob Flaws, Dipl. Ac. & C.H., FNAAOM
Anxiety disorders are the most common class of psychiatric disorder. Some of the specific subtypes of anxiety disorders include: generalized anxiety disorder (GAD), acute stress disorder, substance-induced anxiety disorder, posttraumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), social phobia, other specific phobias, and panic attacks with or without agoraphobia. However, GAD accounts for half or more of all anxiety disorders. Recently, Meng Zhao-rong and Yi Xiao-ying published an article in Si Chuan Zhong Yi (Sichuan Chinese Medicine, #1, 2001, p. 27-28) titled, "The Treatment of 40 Cases of Phlegm Fire Pattern Generalized Anxiety Disorder Treated by Qing Xin Di Tan Tang (Clear the Heart & Flush Phlegm Decoction)." Drs. Meng and Yi say that they tried using this Chinese medical formula because of the side effects of Western anti-anxiety drugs (i.e., benzodiazepines) which commonly include somnolence, fatigue, dry mouth, and constipation.
Cohort description:
Altogether, 77 patients were seen between 1998 and 2000. All were diagnosed as suffering from generalized anxiety disorder based on criteria appearing in CCMD-2-R (the Chinese equivalent of the DSM-IV-R). These patients were rated according to the Hamilton Anxiety Rating Scale. Other examinations before commencement of therapy included blood analysis, urine analysis, liver and kidney function, and ECG. These 77 patients were then divided into two groups, a so-called treatment group and a comparison group. The treatment group was comprised of 40 patients, 14 men and 26 women, with a mean age of 30±5.7 years and a mean disease duration of 11±5.78 years. In the comparison group of 37 patients, there were 12 men and 25 women, with a mean age of 29±6.1 years and a mean disease duration of 10±6.34 years. Therefore, there was no significant statistical difference between these two groups (P , 0.05) in terms of their age, sex, or disease duration.
Treatment method:
The treatment group were given the following Chinese medicinal formula: Rhizoma Coptidis Chinensis (Huang Lian), Radix Bupleuri (Chai Hu), Fructus Gardeniae Jasminoidis (Zhi Zi), and bile-processed Rhizoma Arisaematis (Dan Nan Xing), 15g each, Radix Scutellariae Baicalensis (Huang Qin), Rhizoma Acori Graminei (Shi Chang Pu), and Semen Zizyphi Spinosae (Suan Zao Ren), 20g each, Radix Polygalae Tenuifoliae (Yuan Zhi), 10g, and Magnetitum (Ci Shi), 30g. One ji of these medicinals was decocted in water per day and administered in three divided doses.
The comparison group received 1mg of Valium TID.
Treatment outcomes:
Cure was defined of a 90-100% reduction in Hamilton Anxiety Rating Scale score. Marked effect meant a 60-90% reduction. Some effect meant a 30-60% reduction, and no effect meant that any reduction in this rating scale score was less than 30%. Based on these criteria, of the 40 cases in the treatment group, eight were judged cured, 11 got a marked effect, 13 got some effect, and eight got no effect, for a marked effectiveness rate of 47.5% and a total effectiveness rate of 80%. In the comparison group of 37 patients, nine were judged cured, eight got a marked effect, 14 got some effect, and six got no effect. In this group, the marked effectiveness rate was 45.9% and the total effectiveness rate was 83.8%. In terms of changes in Hamilton Anxiety Rating Scale, the mean score before treatment in the treatment group was 25.12±3.522. After treatment it was 10.23±6.127. The mean score before treatment in the comparison group was 24.36±3.109, and the mean score after treatment was 9.78±5.390.
In terms of side effects, 11 patients reported fatigue in the treatment group. This was the only side effect with this treatment method. In the comparison group, 19 patients reported fatigue, 12 reported a dry mouth, and eight reported constipation. This means that, although the Chinese medicinals were slightly less effective than the Western anti-anxiety drug, they also caused markedly less adverse reactions.
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