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Pattern Names

Alzheimer's Disease Damp and Phlegm Misting the Orifices • •

Classification
Category: Bio Med	Syndrome: Alzheimer's Disease

Symptoms

Tongue: pale, swollen tongue with wet/sticky, white coating

Pulse: soft, rolling

Indications: Heavy-headedness, a yellow, stagnant facial complexion, superficial edema, fatigue, lack of strength, sleepiness, phlegmy sounding respiration, slow reaction, lack of speech or confused speech, alternating sorrow and joy for no particular reason, no discrimination between good and bad, profuse mouth drool, abdominal distention, if severe, lack of sensitivity, inability to manage one’s activities by oneself.[34], [47]

BioMed: ★ Alzheimer's Disease (AD) is a neurodegenerative condition with an insidious onset and progressive impairment of cognitive and behavioral functions, including memory, comprehension, language, attention, reasoning, and judgment. AD is classified into different stages based on the level of cognitive impairment: preclinical or presymptomatic stage, mild cognitive impairment, and dementia stage, which is further divided into mild, moderate, and severe stages. ★ The neurodegenerative process in AD typically begins in the entorhinal cortex within the hippocampus and is characterized pathologically by the accumulation of abnormal neuritic plaques and neurofibrillary tangles in the brain. These pathological changes are accompanied by the loss of neurons, particularly cholinergic neurons in the basal forebrain and the neocortex. ★ Factors contributing to AD include genetic factors, age, cardiovascular diseases, obesity, and diabetes. On average, individuals aged 65 or older diagnosed with AD may have a life expectancy of about 4 to 8 years. ★ Treatment options for AD include Cholinesterase Inhibitors (donepezil, rivastigmine, and galantamine), partial N-Methyl D-Aspartate (NMDA) antagonist (Memantine), and disease-modifying therapies. [NIH-StatPearls]

Etiology: ★ In Chinese Medicine, Alzheimer's Disease (AD) is referred to as Chi Dai, Jian Wang, or Dai Zheng. Ancient Chinese medical literature has discussed memory and cognitive deficits associated with AD. ★ Pathologic mechanism: The gradual insufficiencies in yin blood and aging process can lead to a lack of essence transformation and insufficient nourishment for the sea of marrow (Brain). Moreover, yang qi deficiency may result in a loss of Shen. An unhealthy diet may contribute to the generation of damp phlegm, which can mist the orifices of the heart (mind) and brain, leading to mental confusion and aphasia. ○ In instances of liver depression qi stagnation, which is expected due to the frustration caused by this condition, blood stasis can occur. Additionally, faulty or impaired memory and difficulty with abstract thinking may be attributed to heart and /or Spleen blood deficiency. ★ Early-stage AD often presents as Kidney Essence Deficiency and Spleen Qi Weakness, resulting in mild memory impairment and brain fatigue. ★ Mid-stage AD frequently involves Heart Blood Deficiency, Liver Qi Stagnation, and Phlegm Obstruction, leading to agitation, confusion, speech difficulties, and emotional instability. ★ Late-stage AD is typically complicated by Blood Stasis and Phlegm Misting the Mind, causing severe cognitive dysfunction, apathy, and loss of communication abilities.[34],[47]

Treatment Principle

tonify Spleen, resolve dampness and phlegm, clear orifices and mind

Acupunture

DU20, Si Shen Cong, GB20, ST36, SP9, ST40, REN12, HT5, HT7 [34], [47]

Herbs

Xi Xin Tang: Ren Shen, Suan Zao Ren, Fu Shen, Ban Xia, Shi Chang Pu, Chen Pi, Shen Qu, Zhi Gan Cao, Zhi Fu Zi. If there is abdominal distention and scanty intake, remove Ren Shen, Zhi Fu Zi, and Suan Zao Ren and add Huo Xiang, Pei Lan, Hou Po, Lai Fu Zi, Zhi Ke, Mu Xiang, 9g each. ★ Extract of Huperzia serrata (Qian Ceng Ta) contains HupA, which is a potent, reversible, and selective inhibitor of cholinesterase, which helps increase acetylcholine levels in the brain, enhancing cognitive function. It reduces glutamate-induced toxicity in neurons by modulating glutamate-NMDA receptor interaction and Ca2+ ion channel passage. It has antioxidant properties too. ★ Ginkgo biloba: treats age related physical and cognitive disorders. It contains EGb 761 Extract which shows favorable effects on cerebral circulation, neuronal cell metabolism, the muscarinic cholinergic system, and exhibits antioxidant activity. It protects agains beta-amyloid and nitric oxide induced toxicity in vitro and reduces apoptosis both in vitro and in vivo. It also maintains calcium homeostasis by blocking abeta1-42. ★ Salidroside (Hong Jing Tian), traditionally used as a tonic and anti-aging agent in East Asia. It has neuroprotective activity and antioxidative effects. ★ Salvia miltiorrhiza (Labiatae), Dan Shen, official indications for the root include treatment of blood circulation disorders. It is neuronal protective by inhibiting neuronal cell death by preventing presynaptic glutamate release or nitric oxide formation. It potentially modifies ischemic cell changes by modulating somatostatin. It has antioxidant properties and cholinesterase inhibitory activity. [34], [47]

Notes

1. Qi Fu Yin (七福饮), a formula designed for dementia treatment, includes Ren Sheng, Shu Di Huang, Dang Gui, Da Zao, Zhi Gan Cao, and Yuan Zhi. This formula is considered the earliest known herbal therapeutic strategy for dementia globally and continues to be utilized for AD treatment. 2. According to the CDC's National Center for Health Statistics in 2023, Alzheimer's disease (AD) ranks as the 6th leading cause of death, accounting for nearly 120,000 deaths annually. AD predominantly affects individuals over 65 years old, increasing their susceptibility to complications that significantly impact their health and well-being. These complications encompass mental/behavioral challenges as well as physical difficulties. 3. Rehabilitation and physical activity play pivotal roles in the treatment and prevention of dementia. They can enhance cognitive function, particularly executive functioning, thereby reducing the risk of falls and improving the ability to perform daily activities. 4. Caregivers and healthcare teams are essential in ensuring continuous care and providing necessary support to dementia patients. 5. Certain traditional Chinese medicines show promise as potential anti-AD treatments. Herbs are relatively less toxic, can penetrate the blood-brain barrier effectively, and exhibit bioavailability, thus exerting multiple synergistic effects. 6. Research indicates that Qigong exercise significantly enhances neurocognitive function in aging individuals. It contributes to increased hippocampal volume and reduced peripheral IL-6 levels.[34], [47]