Fellow Dupetryn's sufferers: I have had Dupetryn's for about eight years and it has gotten progressively worse over that time. My PhD is in pharmacology and I am quite familiar with Xiaflex, it benefits and deficits.
Over the past year, I have encountered a cheap, readily available topical/oral treatment that worked for me. It is the root of a plant known as Szechuan Lovage (chuanxiong) that is readily available cheaply both online and in the "Chinatown" neighborhood of major US cities.
I began taking this root as a tea in September (it tastes fine added to green tea) and then after discussing the decreasesed pain and cord size with my karate master, he suggested a wet plaster (in gauze taped to palm of my hand) overnight to get a more localized effect. I have drunk the tea everyday and applied the patch everynight since December.
Results: The cord is softer and smaller in height and width, the pain in my hand is gone, and the main lump of collagen has just about disappeared. I have not experienced any side effects.
Dec 5th, 2011 - Hand painful, swelling in palm, tense raised cord, can't lay hand flat Jan 6th, 2011 - No pain in hand, palm swelling reduced ~50%, cord relaxed and now small, hand fully flat on table
Tea: Put ~1 ounce of root in hot tap water (not boiling) and drink over ~1 hour. Hot tap water - run faucet on full hot for 1 minute
Patch: Put ~1/4 oz of root in enough hot tap water to cover bottom of coffe cup. Immerse gauze pad in liquid, put root pieces into the gauze, cover with plastic wrap and tape to palm with duct tape - go to sleep and remove in morning
Science behind it: The active ingredients extracted with hot water reduce the inappropriate production of collagen by inhibiting the TGF beta pathway and also increase production of collagenase by chondrocytes.
Best of Luck
Note: Spelling of Dupuytren's corrected in the title by moderator.
Chuan Xiong (Szechuan Lovage Root) - Chinese Herbal Medicine Chinese Name: Chuan Xiong English Name: Szechuan Lovage Root
Clinical Usage and Indications
Invigorate blood, promote movement of Qi - any blood stasis pattern, important for gynecological issues (amenorrhea, dysmenorrhea, difficult labor, lochioschesis). Expels wind and alleviates pain - headache (temporal, vertex), dizziness, painful obstructions, skin issues. Headache - moves qi upward and alleviates pain; headaches due to wind, heat, cold, blood deficiency.
Functional Groups (Click for Summary/Study Notes)
Herbs That Invigorate Blood
Dosage and Preparation Notes
Gall Bladder Liver Pericardium
Associated Temperature and Taste
Acrid Warm (Wen)
Cautions and Contraindications There are currently no contraindications listed. Staff Clinician Notes
Common Herbs for Headaches: Bai Zhi, Chuan Xiong, Gao Ben, Qiang Huo. All are warm, pungent - move qi, disperse dampness, qi and blood stagnation, dry dampness.
Herbal Formulas Which Include This Herb
Below you will find Traditional Chinese Medicine herbal formulas which contain this particular herb (in alphabetical order). You may click on the name of the formula for more details or click on any of the products from our store to read usage information or purchase a particular formula.
Dear Larry and Wach: Seeveral points to consider - Spelling is not everything - Google is not the font of all wisdom - I agree that my post is an extrapolation from my success - My intent is only to help other similarly affected - It is a topical treatment with more basis for rationale than the DMSO gels and other things I read about here - If you wish an FDA-approved therapy, refer to Xiaflex which was tested on only 374 Dupetryn's patients in pivotal studies
Seek out the following (articles too big to attach) Lu, Drug and Chemical Toxicology, 2010; 33(3): 310–315 for a mechanistic study of a Chuanxiong ingredient on TGFb. It is not on Dupuytren's but in another fibrotic disease and is in the rat since rarely are MoA studies conducted in man.
This study was conducted to investigate the effect of tetramethylpyrazine (TMP) on CCl4-induced fibrosis in rats and the possible roles of leptin, TGFbeta1, Smad3, and Smad7 in this process. Liver fibrosis in rats was induced by the subcutaneous injection of 60% CCl4 (0.3 mL /100 g body weight, biweekly ) for 12 weeks. Rats in TMP prevention and treatment groups were given TMP (10 mg /100 g body weight, daily) by gavage from days 1 and 31 after the start of CCl4 injection, respectively. The mRNA expression of leptin, OB-Rb, TGFbeta1, and TGFbeta-RII in the liver were detected by RT-PCR, whereas Smad3 and Smad7 protein were determined by Western blot. The results showed that hepatic cirrhosis was obviously alleviated in both TMP prevention and treatment groups. The mRNA expression of leptin, OB-Rb, TGFbeta;1 and TGFbeta-RII, and Smad3 protein were higher in the cirrhotic models. In TMP prevention and treatment groups, these markers of expression were higher, compared with that of the normal control, but were lower when compared with that of the cirrhotic model group. Smad7 protein expression was lower in the cirrhotic model group than in the normal control. Smad7 expression in TMP prevention and treatment groups was higher, compared with that in the cirrhotic model group. Liver collagen in the TMP prevention group was the lowest among all CCl4 injection groups. In conclusion, TMP can prevent and alleviate the development of liver fibrosis in rats. The possible mechanism could involve the downregulation of leptin, Ob-Rb, TGF-β1, TGF-βRII, and Samd3, and upregulation of Smad7.
For a case study in man with another TGFb inhibitor, refer to (although the dose is certainly too high) Dominguez-Malagon, Cancer 1992; 692478-2483. The proliferating cells in fibromatoses are myofibroblasts that produce abundant stromal collagen and contain intracellular native and widely spaced collagen fibers. To assess the clinical and cellular effects of colchicine in such tumors, this drug was administered to three patients, one with musculoaponeurotic desmoid fibromatosis, one with Dupuytren’s palmar fibromatosis, and one with Peyronie’s disease. All three patients had an excellent clinical response, with reduction of tumor size and improvement of contracture. Two cases were studied ultrastructurally; the main cellular changes detected were collapse of the rough endoplasmic reticulum cisternae, reduction of myofilaments, and disappearance of intracellular widely spaced collagen. The findings from this study indicate another probable application for colchicine and support the concept that collagen fibers can be formed intracellularly.
Case 2: A firm nodule in the center of the right palm of a 21-year-old woman increased in size over a 2-year period until it was 7 X 7 cm, progressively limiting movement of the fingers because of severe contracture. The clinical diagnosis of palmar fibromatosis (Dupuytren’s contracture) was confirmed by biopsy. Treatment with 3 mg/d of colchicine was initiated. By the seventh day, there was subjective reduction in the size of the tumor, and 1 week later movement of the fingers was improved considerably. Two weeks after this, opposition of the thumb was possible without discomfort. Treatment was continued with 1 mg/d of colchicine. Three months later, there was only a mild residual functional deficit, and the nodule measured 2 X 2 cm. The tumor was excised for histologic and ultrastructural study. A 1 mg/d maintenance dose of colchicine was instituted. Two years later, the patient is in clinical remission with no detectable tumor.
there have been several proposals to use TGFbeta inhibitors for treating Dupuytren's. An example is the application of tamoxifen http://www.dupuytren-online.info/dupuytr...s_research.html. So far this did not yield a therapy, although initial data by Degreef on adjuvant tamoxifen in combination with surgery are positive.
Tamoxifen is not without side effects. It would be great if a (hopefully not poisonous) Chinese tea would have the same effect. One paper I found in PubMed indicates a positive effect on hypertrophic scarring in rats. Nothing on Dupuytren's so far. If it helped you, please keep tracking it and report on the forum.
You attached two pics to your post, probably there was some treatment between the two pics. I have to admit that I have difficulties seeing progress. It might be due to the different illumination. If it helps the effect ought to be better visible after 6 months.
Dear Wach The progress which I have seen in my case is not readily seen in the pictures and I expect it will take 4-6 months, not the 4 weeks that have thus far passed. Here are some comments to clarify: There is swelling to the left and right of the major leasion near my fingers in both photos. In December, it was solid and bulging, now I can best describe it as an "empty tent" suspended by the central portion of the lesion which is smaller and softer, but not gone. The central cord was broad stiff, contracting and painful. Now it is not painful, about half as broad, half as high, soft and pliable. In the December photo, I could only approximate my palm surface to ~1 inch from a table surface, now I can easily press it flat without assistance from my left hand and can even flex my ring finger upward while the hand is flat. Great progress for something I thought would only cripple me and jeopardize my job in the coming years.
The tamoxifen effects on TGFbeta are part of the reason I mentioned the other approved comment in my post for which there is one case report of success.
Well, I'm willing to give this a try. Seems harmless even if it has no effect on the Dupuytren's. I won't be doing the wet plaster portion. It's just too onerous to stick to it for a long period of time. I can deal with making tea on a daily basis.
Some questions for the HWolfe.
Is there a reason you chose to use the root of the herb rather than a smaller amount of extract? Would you expect different results if using the extract (say 3-5 grams) rather than 1 oz of the root?
What's wrong with using boiled water instead of hot tap water? It would seem more sanitary to use cold water from the tap and boiling it rather than using hot tap water.
I don't know anything about the extract and am cautious about using a product with little or no quality control
If the root is authentic (i.e. from a Chinese apothecary store), I feel more confident about what I am using
I believe (but have not conducted an experiment to verify this) that hot water extracts primarily tetramethylpyrazine which is very water soluble, used in the US as a food flavoring and is on the FDA's Generally Recognized As Safe (GRAS) list.
However, Chinese literature (Bengcao Gungmu - Materia Medica) uses a wine extract of Liugusticum root for treatment of migraines and other "disorders or the head" as opposed to an aqueous decostion (tea) for other disorders. Ligusticum root also contains an ingredient known as Senkyunolide(s) which have central nervous system activity, are ethanol soluble and would be more soluble in boiling water than hot tap water. I am simply trying to minimize exposure to senkyunolide(s) since I feel a little fuzzy if I gulp a tea made with boiling water, but do't feel that way if I soak the root in hot tap water.
Guidance: Tap water - anywhere from room temp to hot and steep until the water is tan colored I sip an 8 ounce cup of this tea over a period of 3-4 hours (just leave it on my desk at work) With this approach, I have no side effects
You might note that tamoxifen, though effective in lab experiment on TGFbeta, so far has not been effective as treatment for Dupuytren's. Further to your own case, an initial swelling and later reduction of swelling is fairly typical for Dupuytren's without treatment.
Hwolfe:... The tamoxifen effects on TGFbeta are part of the reason I mentioned the other approved comment in my post for which there is one case report of success.