Si Wu Tang (Four Treasure Decoction) , a treasure for women.

Si Wu Tang (Four Treasure Decoction) is a very basic yet very powerful formula.

The main function of Si Wu Tang is for tonifying blood.

Blood in the definition in TCM means more than what flows inside the blood vessels. In TCM our body runs on the dynamic reaction of Yin and Yang like moon and Sun. All the substance and functions in the body can all be categorized into these two aspects. Yin and Yang depends on each other and at the same time controls each other.

Blood falls on the yin side. “Women  belong to yin . The physiological function of the women is based on the blood.” Because of our physiology of pregnancy , labor and menstrual flow, we experience more “excess in Qi , but deficient in blood.”

Thus Si Wu Tang is considered a major formula for women.

First  we look at the menstrual flow and its physiology in TCM.  In the monthly course of menstruation, blood needs to fill in the Chong and Ren meridian. In the case of blood deficiency , which usually accompanies excess of Qi, the menses can  be scanty and in consistent. Because in TCM , blood is stored in the liver and can be easily stagnant because of its yin nature.

The composition of Si Wu Tang is Dang Gui (Angelica sinensis), Bai Shao(White Peony Root) , Di Huang (Chinese Foxglove Root), Chuan Xiong (Szechuan Lovage Roo). The main herbs in this formula is Dang Gui as the emperor herbs that dominates the whole formula. Dang gui also has the name of ” the herbs promotes the  qi in the blood.”

When the blood is not filling up the meridian and vessels , it can show as no lust on the skin , weakness and fatigue , scanty menstruation. When the blood is deficient in the channel , like not enough water filling up the water pipe, nutrients can’t be delivered to the organs and then stagnation can occur. Any stagnation can lead to pain. That’s why a lot of time , women with blood deficiency can present with menstrual cramps. PMS can be one of the indication for Si Wu Tang , as blood related closely to liver and spleen.  When blood is not filled and stored in the liver, liver’s function as unobstructed force can be compromised. The emotion  dominated by the Liver is anger. That’s why a lot of time, anger and irritability can be a major symptoms in PMS.

Over all, Si Wu Tang is a very basic yet versatile formula as in women’s problem. In the differentiation of blood deficiency or liver deficiency , this formula can be a good help.

 

*Disclaimer: this article is served as a reference for TCM practitioner and herbalists. If you have any questions on this formula, please consult your specialists  , or leave us a comment below.

 

Painful menstruation , the cause and the treatment, a TCM perspective.

I believe most of us wit X chromosome, have a love and hate relationship with our monthly flow. It represent the fertility and health of a woman. But it also brings a lot of discomfort and sometimes pain.

Painful menstruation, or dysmenorrhea , is one of the most common clinical symptoms and complaints I got among my patients.

Women during our reproductive years often experience certain level of discomfort related to our monthly flow. But painful menstruation is a term reserved to symptoms that are preventing women from normal activities and require medical attention.

With painful menstruation, you may experience pain before or during menstrual flow. The scale of pain can be high enough to cause you to be bed ridden. Also there might be times that you will have pain as well as nausea , fatigue or diarrhea.

What cause the painful menstruation?

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There are three types of painful menstruation, primary with no organic cause, secondary with pathological cause and membranous cause with shedding of uterine membrane. There is also a type of painful menstruation caused by the IUD( intrauterine device) which needs immediate attention from your OB/GYN.

Studies have shown that for primary dysmenorrhea, the cause can be an increase of prostagladin. Prostaglandin can cause inflammatory response and  is stored in the uterine membrane , as the menstrual flow starts, prostaglandin can be released with shedding of membrane to the surrounding tissue like uterine muscle and blood vessel.

The increase level of prostaglandin can lead to abnormal contraction of uterine and decrease in blood flow which eventually lead to insufficient blood flow and oxygen to the uterine tissue.

When the prostaglandin enters the circulation of the body, it can cause systemic reaction like nausea, vomiting or diarrhea.

The  most common treatment  for painful menstruation is NSAIDs. There are times that your Ob/Gyn will prescribe you with antiprostaglandins , oral contraceptive or even suggest surgery to help with cervical dilation.

We know that acupuncture is effective for chronic pain , such as lower back pain and migraine headache. What’s the performance for acupuncture in treating painful menstruation?

An 2017 Australia based study[1] on manual acupuncture and electro-acupuncture in pain reduction for dysmenorrhea showed the manual acupuncture delivered the effect as peak pain reduction , and surprisingly showed a better outcome than electro-acupuncture.

The use of analgesic was not prohibited in this study, but this study also showed that both manual and electro-acupuncture provided a lower usage of pain medication.

In this study , the effect of acupuncture also showed a significant decrease in secondary menstrual symptoms which included mood changes, bloating and breast tenderness.

This finding is really encouraging because approximately 25% of women undergoing treatment of dysmenorrhea the conventional way has little to no relief.

For woman suffering from painful menstruation, without being dependent on medication, acupuncture can be a safe and effective treatment option.

[1]Armour, Mike, et al. “The role of treatment timing and mode of stimulation in the treatment of primary dysmenorrhea with acupuncture: An exploratory randomised controlled trial.” PloS one 12.7 (2017): e0180177.

 

 

 

 

 

 

 

 

Acupuncture , is it scientific or not?

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Many times in my years of practice, I have been asked this question by my patients and also by myself.

How does acupuncture actually work? Is there any science base to it?

To answer that questions, we have to take a look at what science require to meet its standard. When it meets the scientific standard, it means that a practice or an experiment was able to be replicated or the result can be reproduced.

As a practitioner in traditional Chinese medicine, I do find that the clinical outcome can be very effective but the method I use can vary from person to person.

A patient presenting with insomnia and anxiety can be deficient while another person with the same signs and symptoms but being excessive.

Chinese medicine look at the signs and symptoms as a result of imbalance. The imbalance can be from internal imbalance in the patient or the imbalance of a patient and the environment. A treatment in Chinese medicine is not a “cure”but a method to restore and regenerate the balance that was once disturbed.

As there are many researches that prove acupuncture works on many conditions effectively, I still think science can only explain a glimpse  how acupuncture works.

When western medicine does meet the standard in science, there are times that we don’t know how it exactly works. Take Lithium for example, it is an effective medication for bipolar depression ,however the mechanism of it is still unknown.

Human body is such a big mystery and a wonder. It’s wise to be modest and humble as we develop in medicine and the understanding of universe.

Categories: TCM

Case study : Blepharitis

A patient walked into the clinic today with swollen eye lid on both sides. Not presenting with pain but with itchiness and redness on the lesion. This patient had a history of allergy and hypertension and a chronic history of constipation.What could it be?

As a Chinese medicine practitioner, we can use medical diagnosis to help us in terms of treatment plan.

Unlike Stye, blepharitis is an inflammatory of the eye lid which may or may not involve with infection.  Blepharitis can involve with the eyelid skin , eye lashes and surrounded gland.

Treatment options for blepharitis include antibiotics , oral  and topical corticosteroids. All these options should be , according  Current medical diagnosis and treatment , should to restricted to short-term. However, clinically blepahritis can be a chronic condition that cause discomfort and inconvenience in patients’s lives.canstockphoto31186645

As a Chinese medicine practitioner, we should always ask ourselves: what can we provide for our patients and community ? What are their choices outside of medication that are also effective and safe?

Blepharitis was documented in ancient ophthalmology [Yin Hai Jin Wei], describing this condition was “wind-attack with underlying heat toxin on the stomach channel which manifested on the channel as rotten flesh.”

In TCM,eye and the surrounding tissue are on the pathway of Urinary channel ,stomach channel and large intestine channel, all of which are yang channels. Wind is the number one pathogens of all that attack easily on Yang Channels. With underlying heat and dampness on these Yang channels, heat and dampness can accumulated into toxins that lead to depleted  Qi on the pathway. Depleted Qi leads to weakness and like a door can’t be shut tight , wind pathogen can easily attack these channel and cause illness.

Blepharitis is usually a condition with wind, heat toxin and dampness.

In the treatment of TCM, we can use releasing method to clear the wind, clear heat and drain dampness.

Points to be used: we can choose St 44 , St45 , LI 1, LI2, or bleeding on UB2 to releasing the heat.

Formula of choice: Ge Gen Tang modified with Shi Gao . If blepahritis occurs repeatedly, we need to consider blood stasis as part of the pathogen. In this case . we can modify Ge Gen Tang with Chuan Xiong,  Da Huang (if a patient also suffers constipation).

Blepharitis is a condition that cause discomfort patients that can also be hepled by tradtional Chinese medicine. This would surely bring an alternative to paitent for their choice of health care.

 

Categories: TCM

Cervicogenic dizziness and acupuncture.

Have you ever complained about having “the floor or the roof spinning”? or “feeling tired all the time and feel like falling ” and meanwhile your neck hurts and have frequent headache?
You might be having cervicogenic dizziness.
What are the symptoms of cervicogenic dizziness?
The most common symptoms are of course, dizziness. And the cause of it is due to the decrease blood flow to the head. The decreased of blood flow can attribute to compression , tension and stenosis of the cervical vertebrae or the mal-alignment of the cervical spine.
Because of underlying cervical spondylosis , patients often times experience radiating neck pain , jaw pain or headache.
So how does TCM see this condition?
Channel theory is the principle of TCM as well as the balance theory.
Channel or meridians are the pathway for transporting and transforming to and from internal and external organs.
In order to treat a condition, first we need to look at the pathway of where the ailments are.
In TCM, the head is where all the Yang meridians converge. Any blockage of the Yang channel can impair the normal function.
The treatment principle for cervicogenic dizziness is mainly unblocking the channel and opening the orifice and tonifying the Yang aspect of the body.
There are many points of selection. The practitioners may select local points such as GB20, UB10 or distal points such as KI6, LV3.
A study on Zhu’s scalp acupuncture shows the effective rate of 93.33% in treating cervicogenic dizziness.This encouraging finding of acupuncture in treating cervicogenic dizziness can provide an alternative for patients who are not responding well to conventional treatment and provide them with care and relieves.
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Categories: TCM

Type 2 Diabetes as an inflammatory disease. A TCM perspective…

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Type 2 diabetes mellitus (T2DM) is a metabolic disease caused by cell surface not sensitive to insulin. Therefore after we eat , our body can’t convert sugar in the blood into energy for our cells to use.

Type 2 diabetes was studied widely in medical society. More and more researches support the pathology of  T2DM to systemic inflammation. Obesity is the #1 cause leading T2DM.  When a person starts gaining weight , the composition of cells also changed.  Obesity leads to an increase of B lymphocytes, mast cell, M1 macrophage , CD8+ and pro-inflammatory chemokines and TNF-.α which shift from anti-inflammatory state to pro-inflammatory state.[1.]

Through out the history of TCM, diabetes was documented as “Xiao-Ke”, meaning thirst and wasting disease.The name describes a more advanced state of diabetes with extreme wasting and extreme thirsts which includes polydipsia, polyphagia, polyuria.

So how does TCM define diabetes? TCM views the body energy with 2 relative force, Yin and Yang. “Xiao-ke” or diabetes is seen as deficiency of yin leading to the rising of yang. Imagine the sun kept blazing and the water was vaporized faster than normal.

As far as TCM treatment for T2DM goes, single herbs or a combination of Chinese herbs (Fang Ji) were being studied. One of the study shows berberine , a component found in a Chinese herbs, Huang Lian  (Rhozoma Coptidis) , can be a potent hypoglycemic agent.[2]

There are also study showing that some TCM formulas can be a potential supplemental treatment for T2DM. [3.] The benefits of Chinese herbs in the use of T2DM treatment can be a safe supplemental therapy with few side effects.

In the epidemic of diabetes , finding an supportive treatment option can be beneficial for our health care system.

1.Esser, Nathalie, et al. “Inflammation as a link between obesity, metabolic syndrome and type 2 diabetes.” Diabetes research and clinical practice 105.2 (2014): 141-150.

2. Yin, Jun, Huili Xing, and Jianping Ye. “Efficacy of berberine in patients with type 2 diabetes mellitus.” Metabolism 57.5 (2008): 712-717.

3. Yeh, Gloria Y., et al. “Systematic review of herbs and dietary supplements for glycemic control in diabetes.” Diabetes care 26.4 (2003): 1277-1294.

 

 

Categories: TCM

How can TCM help if you have cervical spondylosis?

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Cervical spondylosis is not uncommon nowadays. With our advanced iphone, ipad and working on the computer,  this age related problem has been diagnosed more in younger people. Women are at higher risk due to hormonal change , pregnancy and nursing.

By definition, cervical spondylosis is wear and tear condition in the neck causing pain and stiffness in the initial stage. As the conditions get worse, the space between cervical discs will become narrow and start compressing on the nerves coming out of the spinal cord. When at this stage , you may start experiencing weakness and tingling in the hands and fingers. In some advanced cases, we can see muscle wasting , loss of dexterity of the hands and even dizziness or headache.

Treatments available for people who are diagnosed with cervical spondylosis includes:

1.Medication: your doctors may prescribe medication includes . Types of medication includes :NSAIDs, Corticosteroids, muscle relaxant, anti-seizure medications, antidepressant and opioids.

2. Physical therapy :physical therapy helps stretch and strengthen neck muscles for pain relief. As the neck muscle gets stronger, posture will be improved and also prevent the further wear and tear.

3.Surgery:surgical intervention includes removal of the herniated disc or bone spurs, removing a part of the vertebrae and fuse a segment of the neck.

So how does TCM see cervical spondylosis?

1.Bi syndrome:

What is Bi syndrome? The immobility of muscle , tendon and bone with pain is called “Bi syndrome”. The cause of Bi syndrome in TCM is the “accumulation of pathogens includes wind, dampness and coldness in the meridian”.The accumulation leads to blockage of Qi and blood which fail to nourish the tissues and organ then cause pain and deformity.

The focus of TCM in treating Bi syndrome is to expel the pathogen , remove the blockage and replenish the Qi and blood.

2. Du meridian:

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The location of cervical spondyslosis is on Du meridian. Du meridian is the governing meridian of all Yang Channels. It also governs the Yang Qi (or the functional energy ) in our body. Women naturally are more deficient in Yang Qi than men. Thus in TCM , warming herbs or warming needles are usually applied to women with cervical spondylosis.

When treating cervical pain, TCM doesn’t only provide relief of pain but also provide a long-term solution which is safe and effective.

Categories: TCM