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http://dx.doi.org/10.7231/jon.2017.28.2.095

A Review on Treatment of Essential Tremor in Traditional Chinese Medicine  

Shin, A-Ri (School of Korean Medicine, Pusan National University)
Bae, Yeong-Long (School of Korean Medicine, Pusan National University)
Lim, Jae-Yu (School of Korean Medicine, Pusan National University)
Lee, Seung-Hwan (Department of Neuropsychiatry, Pusan National University Korean Medical Hospital)
Kim, Sang-Ho (Department of Neuropsychiatry, Pohang Oriental Hospital of Daegu Haany University)
Lim, Jung-Hwa (Department of Neuropsychiatry, School of Korean Medicine, Pusan National University)
Publication Information
Journal of Oriental Neuropsychiatry / v.28, no.2, 2017 , pp. 95-107 More about this Journal
Abstract
Objectives: This study was performed to review studies on Essential Tremor (ET) in Traditional Chinese medicine (TCM). Methods: We reviewed papers in the China National Knowledge Infrastructure (CNKI) from 2007~2016. Search keywords were 原发性震颤, 特发性震颤, essential tremor and idiopathic tremor, and excluded non-clinical studies, non-related to ET or TCM studies, theses for degrees and non-Randomized Controlled Trial (RCT). The quality of the articles was assessed by Jadad scale and the Risk of Bias (RoB). Results: Thirteen studies were selected. 'Criteria for the diagnosis of ET' was most frequently used as diagnostic criteria. 'Tremor rating scale' was primarily used for outcome measurement. Meta-analysis of nine trials revealed the effective rate of acupuncture and Western medicine (WM+Acu) groups was significantly higher compared to the WM group (RR: 1.48, 95 percent CI: 1.20 to 1.82, p=0.0002, $I^2=0$ percent) and tremor rating scale was also significantly decreased in the treatment group (MD: -1.35, 95 percent CI: -2.17 to -0.54, p=0.001, $I^2=0$ percent). Also, effective rates of Electro-acupuncture (EA) and Chinese herbal medicine (CHM) groups were significantly higher than that of the WM group {(RR: 1.53, 95 percent CI: 1.22 to 1.92, p=0.0003, $I^2=0$ percent) in EA vs. WM and (RR: 1.35, 95 percent CI: 1.16 to 1.57, p<0.0001, $I^2=0$ percent) in CHM vs. WM}. However, the quality of selected clinical studies was poor. Conclusions: Treatment of ET in TCM may be more effective and safe than in Western medicine. Therefore, we hope this study will lead to further clinical research on treatment of ET in Korean medicine.
Keywords
Essential Tremor; Idiopathic Tremor; Traditional Chinese Medicine;
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Times Cited By KSCI : 5  (Citation Analysis)
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1 Korean Neurological Association. Neurology. Seoul: Koonja. 2007:438-43.
2 Louis ED, Ferreira JJ, How common is the most common adult movement disorder? Update on the worldwide prevalence of essential tremor. Mov. Disord. 2010;25(5): 534-41.   DOI
3 Busenbark KL, Nash J, Nash S, Hubble JP, Koller WC. Is essential tremor benign? Neurology. 1991;41(12):1982-3.   DOI
4 Auff E, Doppelbauer A, Fertl E. Essential tremor:functional disability vs subjective impairment. J Neural Transm Suppl. 1991;33:105-10.
5 Metzer WS. Severe essential tremor compared with Parkinson's disease in male veterans:diagnostic characteristics, treatment, and psychosocial complications. South Med J. 1992;85(8):825-8.   DOI
6 Koller WC, Busenbark K, Miner K. The relationship of essential tremor to other movement disorders:report on 678 patients. Essential Tremor Study Group. Ann Neurol. 1994;35(6):717-23.   DOI
7 Diaz NL, Louis ED. Survey of Medication Usage Patterns Among Essential Tremor Patients:Movement Disorder Specialists vs General Neurologists. Parkinsonism Relat Disord. 2010;16(9):604-7.   DOI
8 Wang G, et al. Hwangjenaegyeongsomungeumseog(黃帝內經素問今釋). Seoul:Seongbosa. 1983:439.
9 Heo J. Dong-uibogam(東醫寶鑑). Seoul:Namseongdang. 1981:299.
10 Cho SY, Shim SR, Rhee HY, Park HJ, Jung WS, Moon SK, Park JM, Ko CN, Cho KH, Park SU. Effectiveness of acupuncture and bee venom acupuncture in idiopathic Parkinson's disease. Parkinsonism Relat Disord. 2012; 18(8):948-52.   DOI
11 Toosizadeh N, Lei H, Schwenk M, Sherman SJ, Sternberg E, Mohler J, Najafi B. Does integrative medicine enhance balance in aging adults? Proof of concept for the benefit of electroacupuncture therapy in Parkinson's disease. Gerontology. 2015;61(1):3-14.   DOI
12 Kim HM, Ko TS, Moon HN, Hong CY. Early Onset - Essential Tremor 1 case. Journal of Korea child neurology society. 1994;2(1):218-23.
13 Ryu SH, Chae JW. A. Case Report of Early Onset - Essential Tremor. The journal of Korean oriental pediatrics. 2013;27(1):1-6.
14 Hwang MH, Lee YK, Kim JS, Lee HJ, Lim SC. A Clinical case study about the patient of Essential Tremor Treated by Taegeuk Acupuncture. Journal of The Association of the Spine & Joint Korean Medicine. 2015;12(1):77-81.
15 Min KJ, Kim SH, Jung IC, Lee SR. The clinical study on 1 case of essential tremor patient. Institute of Oriental Medicine Journal. 2007;16(2):281-8.
16 Noh JS, Kim YB, Lee U, Park CW, Ahn SK, Kang DS. Clinical Analysis of Stereotactic thalamotomy for Medically Intractable Essential Tremor. Journal of Korean Neurosurgical Society. 1996;25(1):99-105.
17 Yang DH, Lee KY, Shin HS, Jo SH, Lim CS, Lim JH, Yun SH, Lee H. Case Reports :Clinical Observation of Improvement Made by Prescription of Liver Supplementation on a Case of Essential Tremor Patient Who was Operated DBS(Deep Brain Stimulation). Journal of Korean acupuncture & moxibustion medicine society. 2010;27(6):123-31.
18 Ko IS, Ryu HS, Park SJ, Ahn HJ. A Case Report of a Essential Tremor Patient Aggravated by Hwa-byung. The Korean Society of Oriental Neuropsychiatry. 2012;23(3): 129-41.
19 Oh HS, Lee SJ, Han IS, Lee DS, Son IB, Park HM, Lee WC, Sun SH. Case Report of Essential Tremor Treated with GwiBiTang and Gagambang. Acupuncture and Moxibustion. Korean Journal of Oriental Physiology & Pathology. 2012;26(5):760-4.
20 Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ, McQuay HJ. Assessing the quality of reports of randomized clinical trials:Is blinding necessary. Controlled Clinical Trials. 1996;17(1):1-12.   DOI
21 Chen LH, Chen Q, Chen M. Clinical observation on combination of acupuncture with medication for treatment of spontaneous tremor. Journal of Chinese Acupuncture & Moxibustion. 2006;26(10):701-3.
22 Higgins JP, Green S, editors. Cochrane handbook for systematic reviews of interventions. Ver. 5.1.0. The Cochrane Collaboration. 2011.
23 Higgins J, Green S. Analysing and presenting results.Cochrane handbook for systematic reviews of interventions4.2.6 [updated september 2006]. Chichester,UK: John Wiley & Sons Inc. 2008:79-165.
24 National Evidence-based Healthcare Collaborating Agency. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. NECA. 2011: 65-78.
25 Elble RJ. Diagnostic criteria for essential tremor and differential diagnosis. Neurology. 2000;54(Suppl 4):S2-6.   DOI
26 Jiang BL, Sun YZ. Clinical Observation on Acupuncture Treatment of Idiopathic Tremor. Journal of Chinese Acupuncture & Moxibustion. 2008;24(4):22-3. (the title was translated from 针刺治疗特发性震颤临床疗效观察)
27 Qin LN. Clinical Observation on Electronic Acupuncture Treatment of Essential Tremor. Jilin Journal of Traditional Chinese Medicine. 2010;30(6):511-2. (the title was translated from 电针治疗特发性震顫的临床观察)
28 Bain P, Brin M, Deuschl G, Elble R, Jankovic J, Findley L, Koller WC, Pahwa R. Criteria for the diagnosis of essential tremor. Neurology. 2000;54(11 Suppl 4):S7.
29 Song ZL. Observation of catgut-embedding therapy on essential tremor. Hebei Journal of Traditional Chinese Medicine. 2010;32(8):1211-3.
30 Han CM. Neuropsychiatry. Beijing:Unsa medical and scientific publishers. 2006:332.
31 Wang WZ. Neurology. 5th. Beijing:People's Medical Publishing House. 2004:216.
32 Sui KM, Li X. Clinical observation on acupuncture combined with medication for treatmnet of essential tremor. Journal of Chinese Acupuncture& Moxibustion. 2010; 30(2):107-9.
33 Wang SG, Li JG. Clinical Observation on 40 Cases of Patients with Idiopathic tremor with Depression Syndrome Treated by Combination of Acupuncture and Medicine. Chinese Journal of Traditional Medical Science and Technology. 2011;18(2):148-9. (the title was translated from 针药结合治疗特发性震颤伴发 抑郁症状患者40例临床观察)
34 Ni W. 'Daejeongpungjugagam' treatment of 24 cases of essential tremor. Jiangxi Journal of Traditional Chinese Medicine, 2012:43(2):25. (the title was translated from 大定风珠加减治疗原发性震颤24例)
35 An DW. Differential diagnosis of nervous system diseases. 1st. Beijing:People's Medical Publishing House. 2000:218.
36 Xue HY, Wu XW. Observation on the Efficacy of Integrated Traditional Chinese and Western Medicine in Treating Idiopathic. Journal of Clinical Medicine in Practice. 2013;17(17):127-8. (the title was translated from 中西医 结合治疗特发性震颤的疗效观察)
37 Huang PZ. Chi XL, Sun GM, Qiu HL, Zhang XF. Clinical study of 'Shikfunghwalhyuljeongjeon-tang' in the treatment of idiopathic tremor of blood stasis pneumatic type, 2015:72(18):16. (the title was translated from 熄风活血定颤汤治疗血瘀风动型特发性震颤临床研究)
38 Tian DL. Chinese internal medicine. Beijing:People's Medical Publishing House. 2002: 287-9.
39 Tian CX. Nourishing Kindy and Tonifying Blood Prescription in the Treatment of Essential Tremor for 30 Cases. Chinese medicine modern distance education of china. 2015;13(14):51-2.
40 Yao D, Zou W. Therapeutic Observation of Ping Gan Xi Feng Tremor-ceasing Needling for Essential Tremor, Shanghai Journal of Acupuncture and Moxibustion. 2016;35(2):169-71.
41 Louis ED, Barnes L, Wendt KJ, et al. A teaching videotape for the assessment of essential tremor. Mov Disord 2001;16:89-93.   DOI
42 Wang HZ. Treatment of 66 Cases of Idiopathic Chatter by Pinggan Decoction. Shaanxi Journal of Traditional Chinese Medicine. 2016;37(6):701-3. (the title was translated from 平肝息风止颤汤治疗特发性震颤66例)
43 Zhang ZJ, Zang WP, Feng QA. Treatment of 40 cases of idiopathic tremor with multi -therapy. Traditional Chinese Medicinal Research. 2016;29(4):17-9. (the title was translated from 多联疗法治疗特发性震颤40例)
44 Louis ED, Ford B, Wendt KJ, Lee H, Andrews H. A comparison of different bedside tests for essential tremor. Mov Disord. 1999;14(3):462-7.   DOI
45 Elble RJ, Bain P, et al. Task Force Report:Scales for Screening and Evaluating Tremor Critique and Recommendations. Mov Disord. 2013;28(13):1793-800.   DOI
46 Liu DZ, Zhu J, Jin DZ, Zhang LM, Ji XQ, Ye Y, Tang CP, Zhu XZ. Behavioral recovery following sub-chronic paeoniflorin administration in the striatal 6-OHDA lesion rodent model of Parkinson's disease. J Ethnopharmacol. 2007; 112(2):327-32.   DOI
47 Lee JH. Doseolhanbang Lee Jae-hee's lecture of Herbology. Wonju:Yibang medical book. 2003:77-96, 485-8.
48 Hong JA, Chung SH, Lee JS, Kim SS, Shin HD, Kim H, Jang MH, Lee TH, Lim BV, Kim YP, Kim CJ. Effects of Paeoniae radix on the 5-hydroxytryptamine synthesis and the tryptophan hydroxylase expression in the dorsal raphe of exercised rats. Biol Pharm Bull. 2003;26(2): 166-9.   DOI
49 Jeon YI, Park CS, Park CG. An Experimental Study of Effect on Brain Damage and Neuroprotective Effect of Angelicae Gigantis Radix extract against Cerebral Ischemia in Rats. The Korea Journal of Herbology. 2003; 18(4):25-35.
50 Li L, Du J, Zou L, Xia H, Wu T, Kim Y, Lee Y. The Neuroprotective Effects of Decursin Isolated from Angelica gigas Nakai Against Amyloid ${\beta}$-Protein-Induced Apoptosis in PC 12 Cells via a Mitochondria- Related Caspase Pathway. Neurochem Res. 2015;40(8): 1555-62.   DOI
51 Kwon HS, Oh YS, Lee SY, Park CS, Park CG, Jang WS. The Neuroprotective Effects of Uncariae Ramulus et Uncus on focal cerebral ischemia in rats brains. The Journal of Korean Oriental Internal Medicine. 2003; 24(2):181-9.
52 Kim HC, Lee BN, Kim YS, Lee SI. Neuroprotective Effects of Gastrodiae Rhizoma on Dopaminergic Neuronal Cell Death in Parkinson's disease. The Korea Association of Herbology. 1999;14(1):103-9.
53 Son KH, Lee JH, Kim SS, Lee KC, Lee YM, Hong GY, Moon HB, Seo EA, Han DS, Shin MK, Song HJ, Park ST. Effect of Rhizoma Gastrodiae on Cultured Spinal Motor Neurons Damaged by Oxygen Radicals. Korean Journal of Oriental Physiology & Pathology. 2002;16(2):262-6.
54 Moon SG, Kim YS, Park SU, Jeong US, Go CN, Jo GH, Bae HS, Lee JD, Kim DY. The Effect of LI4-LI11 Electrical Acupuncture at Unaffected Limb on Cerebral Blood Flow in Ischemic Stroke Patients using SPECT. Journal of Korean acupuncture & moxibustion medicine society. 2004;21(1):111-8.
55 Lee HS, Cha Sj, Park HJ, Seo JC, Park JB, Lee HJ. Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture(STRICTA):extending the CONSORT Statement. Korean J of Acupuncture. 2010;27(3):1-23.
56 Na GH, Youn DH, Na CS, Chae WS. Anti-apoptotic and Neuroprotective effects of Gastrodiae Elata Pharmacopuncture at GB20 on focal brain ischemic injury induced by Intraluminal Filament insertion in rats. Journal of Korean acupuncture & moxibustion medicine society. 2008;25(1):1-14.
57 Liu CH, Wang R, Jin YB. Acupoint injection of kakkonein for early- or mid-stage Parkinson's disease: a multicenter randomized controlled clinical trial. Acupuncture research. 2015;40(1):56-60.
58 The Textbook Compilation Committee of Acupuncture & Moxibustion Medicine of oriental medical schools in nation. The Acupuncture & Moxibustion Medicine. 4th ed. Seoul:Hanmi Medical Publishment. 2016:255-64.
59 Lee TY, Lee SR. The Investigation into the Theoretical Basis of the Mechanisms of Scalp Acupuncture. Journal of Korean acupuncture & moxibustion medicine society. 1999;16(4):91-108.