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Traditional Chinese medicine (TCM) has thousands years history. It has unique basic theories and diagnostic methods. It is a very effective therapy in treating many chronic diseases and some acute diseases. If you are interested in TCM, welcome to pop in to this TCM forum, let's discuss on any topic about Chinese herbal medicine and acupuncture. If you have any health problem, you are welcome to visit my clinic Knowhow Acupuncture at No.1 Harley street, London. If you are far away from London, you can pop in my online clinic to get some help. If you like this blog please share it to your friends.

Tuesday, 14 September 2010

Crohn's disease and its Chinese medicine treatment

Tiejun Tang

The first time I encountered Crohn’s disease (CD) was at beginning of 1980’s. My teacher introduced us to this disease during our university western medicine lessons. I learnt that CD is an inflammatory disease of the intestine, which can affect any part of the gastrointestinal tract causing a wide variety of symptoms including abdominal pain, diarrhoea vomiting, weight loss, and tiredness. We were told the incidence of CD is higher in western countries and much lower in Asian countries including China. The aetiology of CD is not very clear. Genetics and environmental factors, immune system disorder and bacterial infection can play a role.

The first case of CD I met at Xijing Hospital in 1985. -- a leading hospital in China. I worked as a junior resident physician in the ward of gastrointestinal disease. I acquired much clinical experience relevant to the diagnosis and treatment of CD. We gave the patients sulphasalazine (SASP) as an anti-inflammatory and the steroid prednisone or another immunosuppressive drug. Most of patients improved a lot after treatment, but all the corticosteroids caused significant side-effects following long term use. When we tried to reduce the doses or encourage the patients to stop taking them, their symptoms always got worse. We hence often gave to the patients Chinese herbal decoctions to be taken orally or as an enema which invariably improved their condition. None of the CD patients I came across in my three month’s working experience at the gastrointestinal ward had to go to have surgery.

From 1989 to 1992, I spent three years for my master degree studies at the TCM department of the First Military Medical University. My major was focused on treating gastrointestinal disease with Chinese herbs patented pills. I have read many Chinese medicine classics texts about spleen deficiency. In TCM, the spleen does not refer only to the anatomical spleen of Western Medicine it also refers to the functions of the whole digestive system. According to the theory of traditional Chinese medicine most of digestion and absorption functions are attributed to the function of spleen. Causes of spleen deficiency will manifest as poor digestion and resemble the clinical manifestation of CD. The herbs which tonify the spleen will benefit the digestive functions and relieve the symptoms of CD. I attended the endoscopy clinic to observe the pathological changes of inflammatory bowel disease (IBD). There I observed the difference in histopathological changes between CD and ulcerative colitis (UC). I have measured intestinal local immune function in spleen deficiency patients and animal models. The results of this laboratory based research I undertook showed the local immune function to be significantly reduced in patients with spleen deficiency. After treating with a patented Chinese herbal mix drug, their immune function had been greatly improved greatly [1-4]. The clinical symptoms also improved. Over 100 cases of spleen deficiency were included in these studies. Diagnoses included chronic gastritis, colonitis, UC, and CD. The name of the patented Chinese herbal mix drug is Jianpi Yikang Wan (JPEK). Jianpi means to invigorate the spleen, Yikang means to benefit health, Wan means pill. This pill has a double layer structure, the first or outer layer is absorbed in the stomach and the inner layer in the intestine. The outer layer is composed by Huangqi, Danggui, Dangshen etc which benefit effect at stomach; the inner layer is composed by Baishao, Muxiang, Yanhusuo etc which benefit the intestine. The trade name of this pill called Bupi Yichang Wan. Presently it is the first choice of Chinese herbal remedy for the treatment of IBD.

In China most of IBD is UC, only small part is CD; but in western country CD became a major disease of IBD. The clinical symptoms are very similar between UC & CD. The treatment principle is the same. The herb pills selection is the same – Bupi Yichang Wan. If herb pill is not strong enough, we can prescribe herbal decoction according to different conditions of individual case. The basic prescription is modified Sijunzi Tang and Shenling Baizhu San. If there are mucus in the stool, add Baijiangcao and Baixiapi; if there are blood in the stool, add Baiji and Diyu; if patient have watery diarrhea add Yiyiren and Cheqianzi; if vomiting, add Banxia and Zhuru; if abdominal pain, add Yanhusuo, Chuanlianzi and Baishao etc The original prescription of JPEK is not from me, it’s from my master degree tutor professor Fulin Xu. He is a specialist of gastrointestinal disease in TCM, the dean of TCM department of the First Military Medical University at that time. All my experience is from my tutors. I would like to give many thanks to my tutors, without them I am nothing. A statistics report showed CD affects about 1 in 10,000 people. There are about 60,000 people in the UK with this disease. I practice in UK for five years now. I have met many patient suffer from very bad digestion, they have chronic diarrhea, abdominal pain or distension. Some patients have a scar at their belly. They had been diagnosed as CD. Some of them already had part of intestine removed. In many cases their symptoms often recur after operation. Another report showed CD is associated with an increased risk of small bowel and colorectal carcinoma, including bowel cancer[5]. I would like to tell CD patient Chinese medicine can help you go to better prognosis and avoid unnecessary surgery.

Reference

1. Tiejun Tang. The effect of JPYK pill on T cell subpopulation and immunological function of spleen asthenia mice. Pharmacology and Clinics of Chinese Materia Medica. 1992; 8 (Sep.): 181.

2. Tiejun Tang. The effect of JPYK pill on isoenzyme of rats. Chinese Journal of Integrated Traditional and Western Medicine. 1990; 10(Sep): 96.

3. Tiejun Tang. Quantitative analysis of sIgA in the intestinal juice of spleen deficiency patients. Traditional Chinese Medicine Research. 1993; 6(1): 24.

4. Tiejun Tang. Amylase activity change in the intestinal juice of mice caused by two different animal model of spleen deficiency. Journal of Traditional Chinese Medicine and Pharmacy. 1994; (3): 40.

5. Canavan, C. et al (2006). "Meta-analysis: colorectal and small bowel cancer risk in patients with Crohn's disease". Alimentary pharmacology & therapeutics 23 (8): 1097–104.

Tuesday, 7 September 2010

Acupuncture is a good solution for Repetitive Strain Injury

Tiejun Tang

Do you have a nice summer holiday? Do you back to you busy work again? Don’t work too hard, because RSI might trouble you at anytime.

In 29th June, I had been invited to give a speech at Central London RSI Support Group. The topic of my speech is Acupuncture is a good solution for Repetitive Strain Injury. This group is composed by many patients suffer from different kinds of RSI (Repetitive Strain Injury). They meet regularly in central London every month and exchange their experience of fighting RSI. Some people attended that meeting, but many people were absent, it might be due to the hot weather or an important match of the world cup at that night. I write my suggestion to RSI patients in here, hope you do not miss it again.

RSI is an injury of the musculoskeletal and nervous systems which is caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), or sustained or awkward positions. A study showed that 68% of UK workers suffered from some sort of RSI, with the most common problem areas being the back, shoulders, wrists, and hands.

Chinese medicine believes most of the pain and numbness of RSI is due to meridian blockage. These blockages can be due to Qi stagnation or blood stasis. Some cases can be due to blood deficiency or liver and kidney deficiency. Classic text of Chinese medicine said: There is an obstruction there is a pain. If the obstruction had been removed the pain will be gone. For those cases due to the deficiency of blood or kidney & liver, they need nourish blood or tonify kidney & liver. In TCM philosophy kidney dominate bone and liver dominate the tendons Joints and tendons are more easy to get overstrain when the liver and kidney deficiency. That mean strengthen liver & kidney is very important in the treatment of RSI.

How to remove the obstruction and how to invigorating the kidney & liver? Acupuncture needles, Tuina manipulation can do those. As for acupoints selection, different disease should use different local points and distance points. To name a few:

Carpal tunnel syndrome points: Baxie (UE22), Neiguuan (PC6), Waiguan (SJ5), Daling (PC7), Yangchi (SJ4), Wailaogong (E-UE24);

Tennis elbow points: Quchi (LI11), Shousanli (LI10), Chize (LU5), Xiaohai (SI8).

Frozen shoulder points: Jianyu (LI15), Jianjin (GB21), Jianliao(SJ14), Jianzhen (SI9), Tianzong (SI11), Binao (LI14).

Cervical spondylosis points: Fengchi (GB20), Jingbailao (E-HN30), Jianjing (GB21), Houxi (SI3), Laozhen (E-UE24), Huatuojiaji (neck).

Except acupuncture and Chinese Tuina massage, sometimes we combine cupping, moxibustion, electric acupuncture and Chinese herbal remedy to treat RSI. According to the diagnosis of each individual case we select 2-3 above therapy. It will always help after couple of sessions.

However, the most important thing is to prevent RIS happen. Modified your posture while you working. Adjust your chair, desk, keyboards, mouse and PC screen. Take a break and do some excise after long time working. Try some self massage when you feel strain and ache in some part of your body. Get your acupuncture treatment at the earlier stage of your disease. Hope you had chance to read my blog and keep RSI away.