TCM Management of Chronic Illnesses Brahm Centre 25 th June 2016 - PowerPoint PPT Presentation

TCM Management of Chronic Illnesses Brahm Centre 25 th June 2016 Hong Hai The Renhai Clinic (www.renhai.com.sg)

Comparing Western medicine (biomedicine) with TCM Biomedicine TCM Cause of Etiology (germs, Environmental Illness cell disorders, factors and body etc) imbalances Treatment Interventions Facilitation (help to (drugs, surgery) body to heal itself) Evidence Clinical trials Medical cases, studies of past data Method Reductionist (at Holistic, Heuristic cellular level) (experience)

Cardiovascular diseases (CVDs) (coronary heart disease [CHD], hypertension and stroke) • Is cholesterol the culprit? Latest thinking: blood serum cholesterol is not much influenced by diet, more by the body’s own liver functions Some cardiologists even place less emphasis on serum cholesterol, and more on chronic inflammation: “the mother of all illnesses”. A plant-based diet may be helpful towards reducing inflammation In TCM: – 2 main underlying syndromes for coronary heart disease are blood stasis （血瘀 ） and qi deficiency (weakness of heart-qi 心气虚 ) – Liver wind ( 肝风 ) is the main internal pathogen for hypertension and stroke, generated by hyperactivity of the liver 肝阳上亢

Treatment & Prevention for CVDs Western approach: Statins to reduce serum cholesterol and inflammation in arterial walls • Low (saturated) fat diet or low carbohydrate diet; plant-based diet • TCM : Aims to reduce blood stasis by promoting qi and blood flow and improving qi level • Acupuncture/acupressure, qigong and taiji improve qi level and flow and improve motor skills for post-stroke patients

Preventing Heart diseases (TCM) Plaque in arteries Reducing risk factors • Plaque formation can be slowed down by reducing blood stasis and sufficient heart qi for smooth blood flow • Stroke incidence can be reduced by avoiding hypertension and blood stasis • Some forms of hypertension can be avoided with preventing endogenous wind and reducing accumulation of phlegm 5

Reversing heart blockage with plant-based diet Coronary angiograms of the distal left anterior descending artery before and after 32 months of a plant-based diet without cholesterol-reducing medication Source: Esseyltyn, CB Prevent and Reverse Heart Disease , 2007

Herbs and foods for Preventing CVDs Foods • Diet rich in fibre with fresh fruit and vegetable helps to promote endothelial health e.g. pomegranate ( 石榴 ) juice improves arterial health • Bitter gourd, yellow ginger and black fungus help to reduce blood stasis • Beet juice, spinach, lettuce, cabbage, carrots, bananas, raisins, potatoes, and melons are thought to help control blood pressure. • Black fungus, celery, walnuts, fishes (salmons), cereals with high fibre content (e.g. rye bread, whole grain wheat) may help to achieve arterial health Herbs • Reduce blood stasis – danshen 丹参 , shanzha 山楂 , hongqumi 红曲米 (red yeast rice) , chuanxiong 川芎； • qi tonics - American ginseng, huaishan 淮山 and huangqi 黄芪 , ginseng, dangshen 党参 • Tianma 天麻 and gouteng 钩藤 are believed to help control blood pressure by calming liver yang and expelling liver wind.

Diabetes Mellitus (Type 2) • Insulin resistance; Poor insulin sensitivity with/without low insulin production • A high-carbohydrate diet rich in sugar and refined grains and a idle lifestyle • Chronic inflammation in the adipose tissues could be the leading cause for insulin resistance especially for obesity-related diabetes • Late stage: Emergence of complications such as retinopathy, neuropathy, cardiovascular disease, nephropathy etc

Diabetes Mellitus (Type 2) • Recorded as 消渴 xiao ke in Huangdi Neijing 黄帝内经 (The Yellow Emperor’s Canon of Medicine ) Main underlying problem: Yin deficiency with asthenic fire and dryness 阴虚燥热 • Depending on the symptoms presented, this illness can be categorised in relation to the dysfunctions of the three zang -organs: – 上消 Lung heat with dryness ( 肺热津伤 ) – 中消 Exuberance of stomach fire ( 胃热炽盛 ) Deficiency in spleen qi and yin ( 气阴亏虚 ) – 下消 Kidney yin deficiency ( 肾阴亏虚 ) Deficiency in both yin and yang ( 阴阳两虚 )

Treatments & Prevention for Diabetes Diet TCM Education Medicine Exercise

Herbs and food for diabetes • Food that have low (<55) or medium (56-69) glycemic index – Low: oatmeal , oat bran, sweet potato, corn, yam, beans, dark green leafy vegetables – Medium: Whole wheat, quick oats, brown or wild rice – High (>70): Melons, pineapples, russet potato, instant oatmeal, cornflakes • Ripeness, processing and cooking method can affect the glycemic index of a food. • Foods to avoid – Refined grains and processed food such as cereals, white bread, donuts, bagels; mashed potato – Sugary drinks such as fruit punches, smoothies, energy drinks – Red meat (beef, lamb) and processed meat (bacon, hot dogs) – High sugar fruits such as banana, peaches, nectarines (may not be true to everyone)

Chinese herbs that are believed to help control blood glucose level Huangqi 黄芪 Gegeng 葛根 Huaishan 山药 (Astragalus) (Kudzuvine Root) (Chinese yam) Machixian 马齿苋 Rougui 肉桂 Shanzhuyu （ Purslane ） 山茱萸 (Cinnamon bark)

Depression yuzheng 郁证 (the modern epidemic) • Western clinical depression ( Lack of motivation, no interest in enjoyment, loss of appetite and libido, restlessness, sadness, poor memory, insomnia, early morning awakenings ) is different from TCM yuzheng. • TCM yuzheng is an illness involving stagnation in qi flow brought about largely by emotional factors. • Ilardi: Depression is often the result of modern lifestyles (“radical environmental mutation”), when man changed from hunter-gatherers to manufacturers and farmers (“disease of civilization”)

Prevention and Therapies • Ilardi accords with TCM methods of avoiding depression through yangsheng – avoidance of excessive emotions, preference for the placid life, harmony with the environment, internal flow and balance. • Anti-depressant drugs among the best-selling in the market. Exercise may work better in some cases (e.g. Zoloft vs walking half hour a day) • Promotes qi flow by doing qigong/taichi exercises

Common syndromes in yubing Main therapy is to promote liver qi flow. If there is problem with sleeping, can add herbs such as lingzhi 灵芝 to soothe the mind. 1. Stagnation of liver qi 肝气郁结 Main symptoms: moodiness, chest oppression, sighing / Formulation: ( chaihushugan san 柴胡疏肝散 ) 2. Stagnation transforming to liver fire 气郁化火 Main symptoms : irritable, fiery temper, bitterness in the mouth, red eyes / Formulation: ( danzhi xiaoyaosan 丹栀逍遥散 ) 3. Confusion in the spirit 心神惑乱 Main symptoms : absent-minded and confused, unstable moods, paranoia / Formulation: (Decoction of liquorice, wheat and dates 甘麦大枣汤 ) 4. Deficiency of heart and spleen 心脾两虚 Main symptoms : excessive contemplation, insomnia, amnesia, poor appetite / Formulation: (Decoction for strengthening heart and spleen 归脾汤 )