Patterns Comparisons
Abdominal Mass – Blood Stasis Stagnated in the interior
Tongue
purple
Pulse
choppy
Symptoms
Hard, immovable and painful masses in the abdomen, dark and withered complexion, feeling cold, amenorrhoea, painful periods.
Tongue: Purple. Pulse: Choppy. This is a condition of severe and chronic stasis of Blood with obvious masses. The dark and withered complexion reflects stasis of Blood and the cold feeling is due not to internal Cold, but to poor circulation of Blood.
[34]
Notes
★ Blood stasis is a common cause of fixed, palpable masses in the abdomen and often represents the result of a long-term pathogenic process. It is essential to recognize that Blood stasis does not arise spontaneously but instead develops from other underlying imbalances or pathogenic factors. ★ Primary Causes of Blood Stasis:
1. Qi stagnation: When Qi becomes stagnant, it impairs the smooth flow of Blood, leading to stasis. 2. Cold in the Blood: Cold slows circulation, causing the Blood to congeal and stagnate, often resulting in fixed and painful
masses. 3. Heat in the Blood: Heat can cause Blood to move erratically, leading to its thickening and eventual stagnation. ★ Secondary Causes of Blood Stasis: 1. Qi deficiency: Deficient Qi fails to circulate Blood effectively, resulting in stagnation over time. 2. Blood deficiency: Insufficient Blood can lead to poor flow and eventual stagnation, creating a condition of stasis. ★ Role of Phlegm: While Phlegm itself does not directly cause Blood stasis, it can aggravate it. The accumulation of Phlegm obstructs the channels and collaterals, further hindering the smooth movement of Qi and Blood, thereby intensifying stagnation. ★ Treatment principles of masses according to stage: 1. Beginning stages: primarily eliminate the pathogenic factor (i.e. move Qi and Blood, resolve Phlegm and dissolve masses). 2. Middle stages: eliminate the pathogenic factor and tonify the body’s Qi simultaneously. 3. Late stages: primarily tonify the body’s Qi and secondarily eliminate the pathogenic factor. ★ Treatment of Abdominal Masses from Blood Stasis: In cases of abdominal masses caused by Blood stasis, treatment requires not only the use of herbs to invigorate Blood but also stronger herbs that can “break” Blood. By incorporating softening herbs to disperse masses, complementing the action of herbs that invigorate or break Blood. [34]
Treatment
Eliminate blood stasis, soften hardness, dissolve masses, regulate Spleen and Stomach.
Etiology
In the ancient text, abdominal masses are called jī jù (积聚). Ji indicates actual abdominal masses that are fixed and immovable; Ju indicates abdominal masses that come and go, do not have a fixed location and are movable. Another name for abdominal masses was zhēng jiǎ (症瘕), Zheng being equivalent to Ji (i.e. actual, fixed masses) and Jia being equivalent to Ju (i.e. non-substantial masses from stagnation of Qi). The term Zheng Jia normally referred to abdominal masses occurring only in women, but, although these masses are more frequent in women, they do occur in men as well. ★ Etiology: 1. Emotional strain: Prolonged emotional stress can disrupt the flow of Qi, leading to stagnation. 2. Irregular diet: Poor dietary habits can impair digestion, weaken the Spleen, and contribute to the formation of Phlegm or stagnation of Qi and Blood. 3. External pathogenic factors: External Cold can invade the lower abdomen, impairing the circulation of Blood and eventually
leading to Blood stasis. ★ Pathology: Abdominal masses are primarily characterized by Qi stagnation or Blood stasis. In some cases, the accumulation of Phlegm may also play a role. Importantly, there is always an underlying deficiency of Qi in patients with abdominal masses, which compromises the body’s ability to resolve the condition. ★ Masses from Qi stagnation: These masses are movable upon palpation, come and go, and may shift location. Qi stagnation leads to a temporary and less defined mass due to the disrupted but dynamic flow of Qi. ★ Masses from Blood stasis:These masses are fixed in location, hard to the touch, and non-movable on palpation.Blood stasis causes a dense and stagnant mass that remains unyielding and firmly rooted.
★ Masses from Phlegm: These masses are soft to the touch, have a fixed location, and are usually painless. The accumulation of Phlegm results in a softer texture, as Phlegm is a fluid and viscous pathogenic factor.
Biomed
★ An abdominal mass refers to an abnormal, space-occupying growth, the nature of which requires thorough evaluation to determine its
origin, composition, and clinical significance. These masses can arise from a wide range of causes, including congenital malformations, infections, benign or malignant neoplasms, hematologic disorders, vascular abnormalities such as aneurysms, and trauma. Systemic conditions like tuberculosis, lymphoma, or other inflammatory diseases may also present as abdominal masses. Such growths can displace, compress, infiltrate, or impair the function of nearby organs and structures, leading to symptoms such as pain, distention, intestinal obstruction, urinary retention, or weight loss, depending on their size and location.
★ Abdominal masses can be categorized based on their anatomical location into three primary types:
1. Intraperitoneal – arising from structures within the peritoneal cavity such as the liver, spleen, gastrointestinal tract, or reproductive
organs.
2. Extraperitoneal – occurring outside the peritoneal cavity, either retroperitoneal (e.g., kidneys, adrenal glands, pancreas, lymph
nodes) or pelvic (e.g., reproductive organs, bladder, rectum).
3. Abdominal wall – originating from the musculature, fascia, or subcutaneous tissues of the abdominal wall.
★ Further diagnostic evaluation relies heavily on advanced imaging techniques, which play a pivotal role in determining the mass’s location,
size, composition, and relationship to adjacent structures. These techniques include:
1. Ultrasound (US): Often the initial imaging modality due to its non-invasiveness and ability to differentiate cystic from solid lesions.
2. US-guided core needle biopsy: Essential for obtaining tissue samples to confirm malignancy or infection.
3. CT scans with contrast: Provide detailed cross-sectional images, helping to identify vascular involvement, organ displacement, or
metastasis.
4. MRI: Particularly useful for soft tissue characterization, assessing pelvic masses, or distinguishing benign from malignant lesions. ○ PET scans: Used for evaluating metabolic activity, staging cancers, and detecting distant metastasis.
★ In some cases, additional laboratory tests, such as tumor markers (e.g., CA-125, AFP, CEA) or blood cultures, may be warranted to aid
diagnosis, especially when cancer, infection, or systemic conditions are suspected.
[34]
Acupunct
GB34, Ren6, SP4, PC6, SP10, BL17, ST29, LV3, SP6, LV8, ST36, BL20. (LV-8, ST-36 and BL-20 which should be reinforced.) With an underlying Qi deficiency, add Ren4, Ren8, BL23, KI3, LU7 and KI6. Moxa should be used on Ren4, Ren6 or Ren8
Herbs
FORMULAS:
➔ Ge Xia Zhu Yu Tang is specific to invigorate Blood,
eliminate stasis, stop pain and dissolve masses in the lower abdomen.
➔ Gui Zhi Fu Ling Wan invigorates Blood, eliminates
stasis and dissolves masses.
➔ To enhance the mass-dissolving effect, add San
Leng, E Zhu and Ze Lan.
Abdominal Mass – Liver Qi Stagnation
Tongue
body color may be normal or slightly Red on the sides
Pulse
wiry
Symptoms
Movable abdominal masses which come and go, abdominal distension and pain which come and go with the masses, a feeling of discomfort in the hypochondrium, depression, moodiness, irritability, alternation of constipation and diarrhoea. Tongue: the body colour may be normal or slightly Red on the sides. Pulse: Wiry/String taut.[34]
Notes
★ Blood stasis is a common cause of fixed, palpable masses in the abdomen and often represents the result of a long-term pathogenic process. It is essential to recognize that Blood stasis does not arise spontaneously but instead develops from other underlying imbalances or pathogenic factors. ★ Primary Causes of Blood Stasis:
1. Qi stagnation: When Qi becomes stagnant, it impairs the smooth flow of Blood, leading to stasis. 2. Cold in the Blood: Cold slows circulation, causing the Blood to congeal and stagnate, often resulting in fixed and painful
masses. 3. Heat in the Blood: Heat can cause Blood to move erratically, leading to its thickening and eventual stagnation. ★ Secondary Causes of Blood Stasis: 1. Qi deficiency: Deficient Qi fails to circulate Blood effectively, resulting in stagnation over time. 2. Blood deficiency: Insufficient Blood can lead to poor flow and eventual stagnation, creating a condition of stasis. ★ Role of Phlegm: While Phlegm itself does not directly cause Blood stasis, it can aggravate it. The accumulation of Phlegm obstructs the channels and collaterals, further hindering the smooth movement of Qi and Blood, thereby intensifying stagnation. ★ Treatment principles of masses according to stage: 1. Beginning stages: primarily eliminate the pathogenic factor (i.e. move Qi and Blood, resolve Phlegm and dissolve masses). 2. Middle stages: eliminate the pathogenic factor and tonify the body’s Qi simultaneously. 3. Late stages: primarily tonify the body’s Qi and secondarily eliminate the pathogenic factor. ★ Treatment of Abdominal Masses from Blood Stasis: In cases of abdominal masses caused by Blood stasis, treatment requires not only the use of herbs to invigorate Blood but also stronger herbs that can “break” Blood. By incorporating softening herbs to disperse masses, complementing the action of herbs that invigorate or break Blood. [34]
Treatment
Soothe the Liver, eliminate stagnation, move Qi and dissolve masses.
Etiology
In the ancient text, abdominal masses are called jī jù (积聚). Ji indicates actual abdominal masses that are fixed and immovable; Ju indicates abdominal masses that come and go, do not have a fixed location and are movable. Another name for abdominal masses was zhēng jiǎ (症瘕), Zheng being equivalent to Ji (i.e. actual, fixed masses) and Jia being equivalent to Ju (i.e. non-substantial masses from stagnation of Qi). The term Zheng Jia normally referred to abdominal masses occurring only in women, but, although these masses are more frequent in women, they do occur in men as well. ★ Etiology: 1. Emotional strain: Prolonged emotional stress can disrupt the flow of Qi, leading to stagnation. 2. Irregular diet: Poor dietary habits can impair digestion, weaken the Spleen, and contribute to the formation of Phlegm or stagnation of Qi and Blood. 3. External pathogenic factors: External Cold can invade the lower abdomen, impairing the circulation of Blood and eventually
leading to Blood stasis. ★ Pathology: Abdominal masses are primarily characterized by Qi stagnation or Blood stasis. In some cases, the accumulation of Phlegm may also play a role. Importantly, there is always an underlying deficiency of Qi in patients with abdominal masses, which compromises the body’s ability to resolve the condition. ★ Masses from Qi stagnation: These masses are movable upon palpation, come and go, and may shift location. Qi stagnation leads to a temporary and less defined mass due to the disrupted but dynamic flow of Qi. ★ Masses from Blood stasis:These masses are fixed in location, hard to the touch, and non-movable on palpation.Blood stasis causes a dense and stagnant mass that remains unyielding and firmly rooted.
★ Masses from Phlegm: These masses are soft to the touch, have a fixed location, and are usually painless. The accumulation of Phlegm results in a softer texture, as Phlegm is a fluid and viscous pathogenic factor.
Biomed
★ An abdominal mass refers to an abnormal, space-occupying growth, the nature of which requires thorough evaluation to determine its
origin, composition, and clinical significance. These masses can arise from a wide range of causes, including congenital malformations, infections, benign or malignant neoplasms, hematologic disorders, vascular abnormalities such as aneurysms, and trauma. Systemic conditions like tuberculosis, lymphoma, or other inflammatory diseases may also present as abdominal masses. Such growths can displace, compress, infiltrate, or impair the function of nearby organs and structures, leading to symptoms such as pain, distention, intestinal obstruction, urinary retention, or weight loss, depending on their size and location.
★ Abdominal masses can be categorized based on their anatomical location into three primary types:
1. Intraperitoneal – arising from structures within the peritoneal cavity such as the liver, spleen, gastrointestinal tract, or reproductive
organs.
2. Extraperitoneal – occurring outside the peritoneal cavity, either retroperitoneal (e.g., kidneys, adrenal glands, pancreas, lymph
nodes) or pelvic (e.g., reproductive organs, bladder, rectum).
3. Abdominal wall – originating from the musculature, fascia, or subcutaneous tissues of the abdominal wall.
★ Further diagnostic evaluation relies heavily on advanced imaging techniques, which play a pivotal role in determining the mass’s location,
size, composition, and relationship to adjacent structures. These techniques include:
1. Ultrasound (US): Often the initial imaging modality due to its non-invasiveness and ability to differentiate cystic from solid lesions.
2. US-guided core needle biopsy: Essential for obtaining tissue samples to confirm malignancy or infection.
3. CT scans with contrast: Provide detailed cross-sectional images, helping to identify vascular involvement, organ displacement, or
metastasis.
4. MRI: Particularly useful for soft tissue characterization, assessing pelvic masses, or distinguishing benign from malignant lesions. ○ PET scans: Used for evaluating metabolic activity, staging cancers, and detecting distant metastasis.
★ In some cases, additional laboratory tests, such as tumor markers (e.g., CA-125, AFP, CEA) or blood cultures, may be warranted to aid
diagnosis, especially when cancer, infection, or systemic conditions are suspected.
[34]
Acupunct
GB34, Ren6, LV3, SJ6, PC6, SP6, LU7, KI6. Qi and Blood stagnation: Add SP10, BL17, SP4
Herbs
FORMULAS:
➔ Xiao Yao San moves Liver-Qi, tonifies Spleen-Qi
and nourishes Liver-Blood.
➔ Chai Hu Shu Gan San moves Liver-Qi in the lower
abdomen and stops pain.
➔ Mu Xiang Shun Qi San moves Qi, resolves
Dampness and restores the descending of Stomach-Qi.
➔ Qi and Blood stagnation: Jin Ling Zi San and Shi
Xiao San together move Liver-Qi and Liver-Blood in the lower abdomen.
Abdominal Pain Blood Stagnation
Chinese
腹痛
Tongue
purple, stasis spots
Pulse
choppy, wiry
Symptoms
stabbing fixed abdominal pain, worse with pressure, purplish lips, dark rings around eyes, purplish vessels under tongue, female: irregular menses T: purple, stasis spots P: choppy, wiry
[41]
Treatment
Invigorate (Move) Blood, Stop Pain
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain
[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Acupunct
SP8, ST29, Zi Gong, SP10, LI4, LV3, UB17 [41]
Herbs
Shao Fu Zhu Yu Tang (Dang Gui-9, Yan Hu Suo-9, Mo Yao-6, Chi Shao-9, Chuan Xiong-9, Rou Gui-6, Pu Huang-9, Wu Ling Zhi-9, Xiao Hui Xiang-6, Pao Jiang-6) [41]
Abdominal Pain Cold Deficiency
Chinese
腹痛
Tongue
pale, thin white coat
Pulse
thin, deep, weak
Symptoms
chronic dull abdominal pain, likes warmth, pain before eating or when hungry, pain improved with eating, fatigue, SOB, cold extremities, poor appetite, loose stool T: pale, TWC P: thin, deep, weak
[41]
Treatment
Warm Interior, Benefit Spleen & Stomach, Stop Pain
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain
[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Acupunct
Ren12, Ren6, Ren4, ST36, SP4, PC6 [41]
Herbs
Xiao Jian Zhong Tang (Gui Zhi-9, Zhi Gan Cao-6, Bai Shao-9, Yi Tang-6, Sheng Jiang-3) [41]
Abdominal Pain Cold Excess
Chinese
腹痛
Tongue
white coat
Pulse
tight, wiry
Symptoms
acute abdominal pain, better with warm and pressure, chilled, cold extremities, nausea and vomiting, diarrhea, no thirst, clear urine T: white coat P: tight, wiry
[41]
Treatment
Warm Interior, Dispel Cold, Support Yang, Stop Pain
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain
[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Acupunct
Moxa-Ren4/6/12, SJ5, SP4, PC6, ST34 [41]
Herbs
Si Ni Tang (Fu Zi-9, Gan Jiang-9, Zhi Gan Cao-6) [41]
Abdominal Pain Food Stagnation
Chinese
腹痛
Tongue
thick greasy coat
Pulse
slippery, strong
Symptoms
abdominal pain, distention, worse with pressure and after eating, sour foul belching, vomiting with undigested food, acid reflux, constipation, foul smelling diarrhea T: thick greasy coat P: slippery, strong
[41]
Treatment
Relieve Food Stagnation, Stop Pain
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain
[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Acupunct
Ren12, LI10, ST40, ST44, ST25[41]
Herbs
Bao He Wan (Shan Zha-9, Lai Fu Zi-6, Shen Qu-9, Lian Qiao-9, Chen Pi-6, Ban Xia-12, Fu Ling-12)[41]
Abdominal Pain Liver Qi Stagnation
Chinese
腹痛
Tongue
red edges
Pulse
wiry
Symptoms
abdominal pain related to emotions, belching, hypochondriac pain, chest pain, cold fingers and toes, depression, anxiety, irritability T: red edges P: wiry
[41]
Treatment
Regulate Liver Qi, Smooth Liver, Stop Pain
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain
[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Acupunct
LV3, PC6, SJ6, LV14, GB34 [41]
Herbs
Chai Hu Shu Gan San (Chai Hu-9, Chuan Xiong-9, Bai Shao-9, Chen Pi-6, Zhi Shi-9, Gan Cao-6, Xiang Fu-6) → this formula helps with IBS [41]
Abdominal Pain Worm Accumulation
Chinese
腹痛
Tongue
pale with many red spots
Pulse
weak, wiry
Symptoms
Intermittent abdominal pain, usually around the umbilicus, abdominal distention, hunger or appetite loss, itchy anus/nose, grinds teeth at night, dark rings under eyes, scaly white spots on face, worms or worm eggs in stool T: pale with many red spots P: weak, wiry [41] • Roundworms (abdominal pain, vomiting worms, cold limbs), Hookworms (eat strange objects like soil, wax, uncooked rice, tea leaves), Pinworms (itchy anus, worse in the evening), Tapeworms (constant hunger).
Treatment
Dispel Worms, Stop Pain
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain
[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Acupunct
Ren 12, ST25, ST40, UB21, SP15, UB20, Bai Chong Wo [41]
Herbs
Wu Mei Wan (Wu Mei-24, Huang Lian-9, Zhi Fu Zi-6, Xi Xin-3, Huang Bai-9, Gan Jiang-6, Gui Zhi-6, Dang Gui-9, Ren Shen-9, Chuan Jiao-3)[41]
Abdominal Pain Yang Ming Heat
Chinese
腹痛
Tongue
red, yellow sticky coat
Pulse
strong, slippery, rapid
Symptoms
abdominal pain, fullness and distention, worse with pressure (firm palpation), fever, dry mouth, thirst, restlessness, constipation T: red, yellow sticky coat P: strong, slippery, rapid
[41]
Treatment
Clear Stomach Heat, Move Bowel, Stop Pain
Etiology
Etiology: 1)Attack of Evil Qi (Cold) → Middle Jiao Injury. 2)Yang Deficiency (Spleen) → Impaired T&T. 3)Excess Consumption of Cold and Uncooked Food → Dysfunction of Digestion. 4)Emotion → Liver Qi Attack. 5)Other (Parasites) → Abdominal Pain
[41]
Biomed
epigastric pain, acute appendicitis, dysentery, acute/chronic gastroenteritis, intestinal spasms, neurosis [41]
Acupunct
LI11, ST44, ST25, UB25, ST37 [41]
Herbs
Da Cheng Qi Tang (Da Huang-9, Hou Po-6, Mang Xiao-6, Zhi Shi-9) [41]
Acne Blood Stasis Phlegm Stagnation
Tongue
pale red, greasy coat
Pulse
soggy, slippery
Symptoms
repeated persistent eruptions on the cheeks and lower jaw, gradually enlarging to 3-5mm or larger, unevenly protruding, purplish red lumps that feel soft on palpation with pus and blood, or sticky yellow matter expelled with pressure, scars form after rupture T: pale red, greasy coat P: soggy, slippery
[41]
Treatment
Promote Blood Circulation, Remove Phlegm to Soften Lumps
Etiology
TCM Etiology: 1) Heat in the Blood and Lung Channel - affects the face. 2)Heat Accumulation in the Spleen and Stomach - due to uncontrolled diet and eating too much spicy, heavy, fatty foods. 3)Blood heat moves to the exterior and congests the vessels - common during adolescence when the body is growing rapidly.
4)Stagnation of Qi and Blood in the channels and network vessels - due to emotional disturbances (stress, depression, worry)
[41]
Biomed
acne is a disorder of the hair follicle sebaceous glands. It is most common during adolescence and occurs mostly on the face, chest, and back [41]
Acupunct
SP10, LI4, ST40, UB20, ST6 [41]
Herbs
Hai Zao Yu Hu Tang (Hai Zao-9, Zhe Bei Mu-9, Chen Pi-6, Qing Pi-6, Kun Bu-9, Ban Xai-12, Lian Qiao-9, Chuan Xiong-9, Xia Ku Cao-6, Long Gu-12, Mu Li-12, Dang Gui Wei-9)[41]
Acne Lung Heat
Tongue
red, thin yellow coat
Pulse
floating, rapid
Symptoms
Lesions are distributed over the cheeks and forehead, around the nose, manifesting as discrete pinpoint to 2mm red or pale red papules. Severe cases may involve lesions on the chest and back, blackheads may be seen on some lesions, greasy or thick yellow discharge, skin appears oil and shiny, dry mouth and nose T: red, thin yellow coat P: floating, rapid
[41]
Treatment
Clear Lung Heat
Etiology
TCM Etiology: 1) Heat in the Blood and Lung Channel - affects the face. 2)Heat Accumulation in the Spleen and Stomach - due to uncontrolled diet and eating too much spicy, heavy, fatty foods. 3)Blood heat moves to the exterior and congests the vessels - common during adolescence when the body is growing rapidly.
4)Stagnation of Qi and Blood in the channels and network vessels - due to emotional disturbances (stress, depression, worry)
[41]
Biomed
acne is a disorder of the hair follicle sebaceous glands. It is most common during adolescence and occurs mostly on the face, chest, and back [41]
Acupunct
LI4, LU7, Du14, LI11, SJ6 [41]
Herbs
Pi Pa Qing Fei Yin (Pi Pa Ye-9, Zhi Zi-9, Lian Qiao-9, Jin Yin Hua-9, Chi Shao-9, Sang Bai Pi-9, Huang Qin-6, Dong Gua Pi-9, Dan Pi-6, Hong Hua-9, Ling Xiao Hua-6, Dong Gua Ren-9)
[41]
Acne Qi Blood Stagnation
Tongue
dark red, stasis marks
Pulse
deep, thin, choppy
Symptoms
presents as red or dark red eruptions on the face for several years. In women eruptions are usually aggravated during menstruation and are alleviated after periods. Accompanying symptoms and signs from stress and disharmony between Ren and Chong - irregular menstruation, menstrual clots, abdominal pain T: dark red, stasis marks P: deep, thin, choppy
[41]
Treatment
Move Qi, Regulate Blood, Relieve Toxicity, Dispel Lumps
Etiology
TCM Etiology: 1) Heat in the Blood and Lung Channel - affects the face. 2)Heat Accumulation in the Spleen and Stomach - due to uncontrolled diet and eating too much spicy, heavy, fatty foods. 3)Blood heat moves to the exterior and congests the vessels - common during adolescence when the body is growing rapidly.
4)Stagnation of Qi and Blood in the channels and network vessels - due to emotional disturbances (stress, depression, worry)
[41]
Biomed
acne is a disorder of the hair follicle sebaceous glands. It is most common during adolescence and occurs mostly on the face, chest, and back [41]
Acupunct
LI4, LV3, LI11, SP10, Du12, SP8, ST29[41]
Herbs
Liang Xue Qing Fei Yin (Sheng Di -12, Huang Qin-9, Dan Pi-6, Bai Hua She She Cao-9, Zi Hua Di Ding-9, Jin Yin Hua-15, Yin Chen Hao-15, Yi Mu Cao-12, Zhe Bei Mu-12, Pi Pa Ye-6, Chi Shao-9, Tao Ren-9, Lian Qiao-9, Zhi Mu-12). Fu Fang Zhen Zhu An Chuang Pian (Zhen Zhu Mu-18, Jin Yin Hua-9, Pu Gong Yin-9, Tian Kui Zi-9, Ling Xiao Hua-9, Lian Qiao-9, Chi Shao-12, Dan Shen-12)
[41]
Acne Stomach Heat
Tongue
red, thick yellow coat
Pulse
slippery, rapid
Symptoms
overeating spicy, fatty, fried foods. Lesions are mainly distributed around mouth, foul breath, aversion to heat, thirst with desire for cold drinks, constipation, dark yellow urine T: red, thick yellow coat P: slippery, rapid
[41]
Treatment
Clear Heat from the YangMing
Etiology
TCM Etiology: 1) Heat in the Blood and Lung Channel - affects the face. 2)Heat Accumulation in the Spleen and Stomach - due to uncontrolled diet and eating too much spicy, heavy, fatty foods. 3)Blood heat moves to the exterior and congests the vessels - common during adolescence when the body is growing rapidly.
4)Stagnation of Qi and Blood in the channels and network vessels - due to emotional disturbances (stress, depression, worry)
[41]
Biomed
acne is a disorder of the hair follicle sebaceous glands. It is most common during adolescence and occurs mostly on the face, chest, and back [41]
Acupunct
ST44, LI11, LI4, ST25, SJ6 [41]
Herbs
Tiao Wei Cheng Qi Tang (Zhi Dan Huang-12, Zhi Gan Cao-6, Mang Xiao-12) [41]
Allergic Rhinitis Lung & Kidney Qi Deficiency
Symptoms
Afraid of cold, Pale complexion, weak back, propensity to catching colds, pale tongue, weak-deep pulse. [34][47]
Notes
1. For seasonal allergic rhinitis, symptoms are minimal or absent during the non-pollen season. Treatment
should focus on addressing the root cause. For perennial allergic rhinitis, symptoms persist throughout
the year. Treatment should focus on both the root cause and the symptoms.
• 2. If the rhinitis is seasonal, begin supplementing the root six weeks to three months before the offending season. For instance, one can use modifications of Huang Qi Ren Shen Tang for the prevention of fall season rhinitis. This formula is comprised of: Huang Qi, 15g, Dang Shen, 12g, Bai Zhu, Cang Zhu, Mai Men Dong, Huang Bai, Dang Gui, Wu Wei Zi, and Chen Pi, 9g each, Zhi Gan Cao and Shen Qu, 6g each, and Sheng Ma, 4.5g.
• 3. If allergic rhinitis transforms into acute sinusitis, then there can be a yellow nasal discharge. However, that then is a different disease diagnosis.[34][47]
Treatment
Treatment based on root and branches (treat root here)
Etiology
Bi Qiu: itchy nose, sneezing, profuse, white-watery nasal discharge and
stuffy nose. (Allergic rhinitis) • Bi Yuan: a purulent nasal discharge with a foul smell, a stuffed nose, a
runny nose, headache and sneezing. (sinusitis) • Primary mechanism: deficiency of Lung, Spleen & Kidney Wei Qi systems (root) and Wind attack with phlegm retention (Branch) • Affected Zang-fu Organs: LU, KD, SP • Spleen qi deficiency causes damp and phlegm. ○ Kidneys are responsible not only for breathing, due to their function of grasping Lung Qi, but also sneezing. • The Du Vessel emerges from between the Kidneys and flows up the spine to the top of the head and then down to the nose and lips. • Pathologic factors: wind, wind cold, wind heat, phlegm • The difference between seasonal and perennial allergic rhinitis, the latter occurs when there is a more severe Kidney deficiency.
Biomed
Allergic rhinitis refers to an atopic disease characterized by seasonal
(intermittent) or perennial (chronic) sneezing, rhinorrhea, postnasal drip, nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens.
• Frontal headache, irritability, anorexia, depression, and insomnia. Coughing and
asthmatic wheezing may develop if the condition is more severe.
• A result of the interaction between the inhaled allergen and allergen-specific
immunoglobulin E (IgE) adhering to mucosal mast cells in the nasal epithelium.
• Serum testing for allergen-specific IgE or allergy skin testing • Avoidance of allergen. Pharmacological options include antihistamines, intranasal
steroids, leukotriene receptor antagonists (LTRAs), and immunotherapy.
• Infectious rhinitis (viral or bacterial infections, most commonly seen in the
pediatric population); Nasal polyposis • The prevalence of allergic rhinitis peaks in adolescence and gradually decreases
with advancing age.[34][47]
Acupunct
Du4, Ren4 with moxa, BL23, KI3, BL13, Du12, Du24, Du23, GB20, Du14 with moxa, SI3 and BL62 (in women combined with LU7 and KI6) [34][47]
Herbs
Shen Qi Wan (modify): Shu Di Huang, Shan Yao, Shan Zhu Yu, Wu Wei Zi, Xin Yi Hua, Mu Dan Pi, Fu Ling, Ze Xie, Ge Jie, Xi Xin, Rou Gui[34][47]
Allergic Rhinitis Lung & Spleen Qi Deficiency
Symptoms
Fatigue, lack of strength, reluctant to speak and spontaneous sweating, tongue with teeth-marks, soft pulse [34][47]
Notes
1. For seasonal allergic rhinitis, symptoms are minimal or absent during the non-pollen season. Treatment
should focus on addressing the root cause. For perennial allergic rhinitis, symptoms persist throughout
the year. Treatment should focus on both the root cause and the symptoms.
• 2. If the rhinitis is seasonal, begin supplementing the root six weeks to three months before the offending season. For instance, one can use modifications of Huang Qi Ren Shen Tang for the prevention of fall season rhinitis. This formula is comprised of: Huang Qi, 15g, Dang Shen, 12g, Bai Zhu, Cang Zhu, Mai Men Dong, Huang Bai, Dang Gui, Wu Wei Zi, and Chen Pi, 9g each, Zhi Gan Cao and Shen Qu, 6g each, and Sheng Ma, 4.5g.
• 3. If allergic rhinitis transforms into acute sinusitis, then there can be a yellow nasal discharge. However, that then is a different disease diagnosis.[34][47]
Treatment
Treatment based on root and branches (treat root here)
Etiology
Bi Qiu: itchy nose, sneezing, profuse, white-watery nasal discharge and
stuffy nose. (Allergic rhinitis) • Bi Yuan: a purulent nasal discharge with a foul smell, a stuffed nose, a
runny nose, headache and sneezing. (sinusitis) • Primary mechanism: deficiency of Lung, Spleen & Kidney Wei Qi systems (root) and Wind attack with phlegm retention (Branch) • Affected Zang-fu Organs: LU, KD, SP • Spleen qi deficiency causes damp and phlegm. ○ Kidneys are responsible not only for breathing, due to their function of grasping Lung Qi, but also sneezing. • The Du Vessel emerges from between the Kidneys and flows up the spine to the top of the head and then down to the nose and lips. • Pathologic factors: wind, wind cold, wind heat, phlegm • The difference between seasonal and perennial allergic rhinitis, the latter occurs when there is a more severe Kidney deficiency.
Biomed
Allergic rhinitis refers to an atopic disease characterized by seasonal
(intermittent) or perennial (chronic) sneezing, rhinorrhea, postnasal drip, nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens.
• Frontal headache, irritability, anorexia, depression, and insomnia. Coughing and
asthmatic wheezing may develop if the condition is more severe.
• A result of the interaction between the inhaled allergen and allergen-specific
immunoglobulin E (IgE) adhering to mucosal mast cells in the nasal epithelium.
• Serum testing for allergen-specific IgE or allergy skin testing • Avoidance of allergen. Pharmacological options include antihistamines, intranasal
steroids, leukotriene receptor antagonists (LTRAs), and immunotherapy.
• Infectious rhinitis (viral or bacterial infections, most commonly seen in the
pediatric population); Nasal polyposis • The prevalence of allergic rhinitis peaks in adolescence and gradually decreases
with advancing age.[34][47]
Acupunct
BL13, BL20, Du23, GB20, ST36, ST40, SP6, REN6, KD3
[34][47]
Herbs
Yu Ping Feng San + Er Chen Tang (modify): Huang Qi, Bai Zhu, Dang Shen, Fang Feng, Fu Ling, Ban Xia, Chen Pi, Dang Gui, Zhi Gan Cao, Chai Hu, Sheng Jiang[34][47]
Allergic Rhinitis Wind Cold
Symptoms
Sneezing, profuse runny nose
with white-watery discharge, pale complexion, stuffy nose, slight headache, no thirst.
[34][47]
Notes
1. For seasonal allergic rhinitis, symptoms are minimal or absent during the non-pollen season. Treatment
should focus on addressing the root cause. For perennial allergic rhinitis, symptoms persist throughout
the year. Treatment should focus on both the root cause and the symptoms.
• 2. If the rhinitis is seasonal, begin supplementing the root six weeks to three months before the offending season. For instance, one can use modifications of Huang Qi Ren Shen Tang for the prevention of fall season rhinitis. This formula is comprised of: Huang Qi, 15g, Dang Shen, 12g, Bai Zhu, Cang Zhu, Mai Men Dong, Huang Bai, Dang Gui, Wu Wei Zi, and Chen Pi, 9g each, Zhi Gan Cao and Shen Qu, 6g each, and Sheng Ma, 4.5g.
• 3. If allergic rhinitis transforms into acute sinusitis, then there can be a yellow nasal discharge. However, that then is a different disease diagnosis.[34][47]
Treatment
Treatment based on root and branches (treat branches here)
Etiology
Bi Qiu: itchy nose, sneezing, profuse, white-watery nasal discharge and
stuffy nose. (Allergic rhinitis) • Bi Yuan: a purulent nasal discharge with a foul smell, a stuffed nose, a
runny nose, headache and sneezing. (sinusitis) • Primary mechanism: deficiency of Lung, Spleen & Kidney Wei Qi systems (root) and Wind attack with phlegm retention (Branch) • Affected Zang-fu Organs: LU, KD, SP • Spleen qi deficiency causes damp and phlegm. ○ Kidneys are responsible not only for breathing, due to their function of grasping Lung Qi, but also sneezing. • The Du Vessel emerges from between the Kidneys and flows up the spine to the top of the head and then down to the nose and lips. • Pathologic factors: wind, wind cold, wind heat, phlegm • The difference between seasonal and perennial allergic rhinitis, the latter occurs when there is a more severe Kidney deficiency.
Biomed
Allergic rhinitis refers to an atopic disease characterized by seasonal
(intermittent) or perennial (chronic) sneezing, rhinorrhea, postnasal drip, nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens.
• Frontal headache, irritability, anorexia, depression, and insomnia. Coughing and
asthmatic wheezing may develop if the condition is more severe.
• A result of the interaction between the inhaled allergen and allergen-specific
immunoglobulin E (IgE) adhering to mucosal mast cells in the nasal epithelium.
• Serum testing for allergen-specific IgE or allergy skin testing • Avoidance of allergen. Pharmacological options include antihistamines, intranasal
steroids, leukotriene receptor antagonists (LTRAs), and immunotherapy.
• Infectious rhinitis (viral or bacterial infections, most commonly seen in the
pediatric population); Nasal polyposis • The prevalence of allergic rhinitis peaks in adolescence and gradually decreases
with advancing age.[34][47]
Acupunct
BL12, BL13, LU7, LI20, Bitong,
Du23, GB20, Yintang
[34][47]
Herbs
Cang Er Zi San. For runny nose, add Huo Xiang (Herba
Pogostemonis), Bai Zhi (Radix
Angelicae Dahuricae) 9g each. For itchy eyes, add Chan Tui
(Periostracum Cicadae), Jing Jie (Herba
Schizonepetae) 9g each.
[34][47]
Allergic Rhinitis Wind Heat
Symptoms
Sneezing, runny nose with white and watery discharge, itchy throat, itchy-red eyes, slight thirst. [34][47] Itchy, skin hypersensitivity; eyes feel itchy, inflamed or stinging [42]
Notes
1. For seasonal allergic rhinitis, symptoms are minimal or absent during the non-pollen season. Treatment
should focus on addressing the root cause. For perennial allergic rhinitis, symptoms persist throughout
the year. Treatment should focus on both the root cause and the symptoms.
• 2. If the rhinitis is seasonal, begin supplementing the root six weeks to three months before the offending season. For instance, one can use modifications of Huang Qi Ren Shen Tang for the prevention of fall season rhinitis. This formula is comprised of: Huang Qi, 15g, Dang Shen, 12g, Bai Zhu, Cang Zhu, Mai Men Dong, Huang Bai, Dang Gui, Wu Wei Zi, and Chen Pi, 9g each, Zhi Gan Cao and Shen Qu, 6g each, and Sheng Ma, 4.5g.
• 3. If allergic rhinitis transforms into acute sinusitis, then there can be a yellow nasal discharge. However, that then is a different disease diagnosis.[34][47]
Treatment
Treatment based on root and branches (treat branches here)
Etiology
Bi Qiu: itchy nose, sneezing, profuse, white-watery nasal discharge and
stuffy nose. (Allergic rhinitis) • Bi Yuan: a purulent nasal discharge with a foul smell, a stuffed nose, a
runny nose, headache and sneezing. (sinusitis) • Primary mechanism: deficiency of Lung, Spleen & Kidney Wei Qi systems (root) and Wind attack with phlegm retention (Branch) • Affected Zang-fu Organs: LU, KD, SP • Spleen qi deficiency causes damp and phlegm. ○ Kidneys are responsible not only for breathing, due to their function of grasping Lung Qi, but also sneezing. • The Du Vessel emerges from between the Kidneys and flows up the spine to the top of the head and then down to the nose and lips. • Pathologic factors: wind, wind cold, wind heat, phlegm • The difference between seasonal and perennial allergic rhinitis, the latter occurs when there is a more severe Kidney deficiency.
Biomed
Allergic rhinitis refers to an atopic disease characterized by seasonal
(intermittent) or perennial (chronic) sneezing, rhinorrhea, postnasal drip, nasal congestion, itching, and often conjunctivitis and pharyngitis in response to airborne allergens.
• Frontal headache, irritability, anorexia, depression, and insomnia. Coughing and
asthmatic wheezing may develop if the condition is more severe.
• A result of the interaction between the inhaled allergen and allergen-specific
immunoglobulin E (IgE) adhering to mucosal mast cells in the nasal epithelium.
• Serum testing for allergen-specific IgE or allergy skin testing • Avoidance of allergen. Pharmacological options include antihistamines, intranasal
steroids, leukotriene receptor antagonists (LTRAs), and immunotherapy.
• Infectious rhinitis (viral or bacterial infections, most commonly seen in the
pediatric population); Nasal polyposis • The prevalence of allergic rhinitis peaks in adolescence and gradually decreases
with advancing age.[34][47]
Acupunct
BL12, BL13, LI4, LI11, LI20, Bitong,
Yintang, GB20
[34][47]
Herbs
Sang Ju Yin (modify): For more sneezing: add Cang Er Zi, Xin Yi Hua and Bai Zhi [34][47] • Cang Er Zi and Xin Yi Huan are mostly for sneezing. Bai Zhi will dry up the runny nose. [42]
Alzheimer’s Disease Damp and Phlegm Misting the Orifices
Tongue
pale, swollen tongue with wet/sticky, white coating
Pulse
soft, rolling
Symptoms
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]
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]
Treatment
tonify Spleen, resolve dampness and phlegm, clear orifices and mind
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]
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]
Acupunct
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]
Alzheimer’s Disease Heart and Spleen Deficiency
Tongue
pale, swollen tongue with thin white coating
Pulse
weak, thready
Symptoms
Confused, chaotic thinking, a predilection to sorrow and a desire to cry, excessive stillness, scanty speech, slow movement, lack of involvement in the outside world, lassitude, spontaneous sweat, lack of strength, emaciation, palpitations, susceptibility to fright, shortness of breath on slight exertion, lower food intake, lack of taste.[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]
Treatment
tonify and nourish Heart and Spleen Qi and blood, Calm and stabilize the Shen and Mind
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]
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]
Acupunct
BL15, BL17, BL20, BL52, DU20, Si Shen Cong, HT7, PC7, SP6. [47]
Herbs
Yang Xin Tang: Ren Shen, Mai Men Dong, Suan Zao Ren, Dang Gui, Sheng Di Huang, Shu Di Huang, Fu Ling, Bai Zi Ren, Wu Wei Zi, Zhi Gan Cao. If there is chaotic speech, add Shi Chang Pu, Long Chi, and Yu Jin, 9g each. If there is blood stasis, add Dan Shen 9g, and Hu Po 3g. [47] • ★ 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]
Alzheimer’s Disease Liver & Kidney Yin Deficiency with Phlegm Stasis
Tongue
dark red tongue with possible static macules and scanty coating
Pulse
string-taut, thready, rapid
Symptoms
A relatively long disease course, dizziness, vertigo, numbness, tingling of the hands and feet, loss of intelligence and coordination, decreased memory power, lack of Shen in both eyes, a stagnant, shallow facial expression, malar flushing, night sweats, possible emaciation, dry, scaly skin, a predilection for abnormal anger, trembling or spasms and contractions, if severe, difficult, encumbered movement, possible hemilateral paralysis and aphasia. [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]
Treatment
Nourish Liver and Kidney Yin, invigorate blood, resolve phlegm
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]
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]
Acupunct
BL18, BL23, BL52, DU20, Si Shen Cong, SP6, ST40, KD1, HT5
[47]
Herbs
Liu Wei Di Huang Wan (modify): Shu Di Huang, Fu Ling, Shan Zhu Yu, Mu Dan Pi, Ze Xie, Chi Shao, Chuan Xiong, Hong Hua, Tao Ren, Yuan Zhi, Shi Chang Pu. If there is dizziness, add Ci Shi 12g, Tian Ma, Gou Teng, and Nu Zhen Zi, 9g each. If there is hemiplegia or numbness of the hands and feet, add Ji Xue Teng and Dan Shen, 15g each, Dang Gui and E Jiao 9g each. [47] • ★ 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]
