20/10/2017 Chinese Medicine for Parkinson's Disease Dr. Suzanne Robidoux, L.Ac. Doctor of Chinese Medicine Specialist in Neurology Doctoral Tutor Content Morning Session = Importance of treating PD = Western understanding of PD ‘© Classical understanding of the symptoms of PD = Case Study with Treatment protocol Afternoon Session + Classical Chinese Medicine Understanding with Two Systems in ‘Chinese medicine © 6 syndrome Symptom Analysis in PD © Treatment Protocol according to the 6 Syndromes and the classical system for PD + Scalp lines and important points for PD ChineseMedicineTraveller.com 120/10/2017 S Understanding Chinese Medicine Two Systems Chinese Medicine Approach Two- System Treatment Focus © Three Dan Tians & » 6 Syndromes System Central Channel + Mental Clarity DU20, DUL6, DUI4, GB 8.Yin Tang Absorption of Nutrients RNI2, DUI, ST36, B34 Life span/quality DU4, RN4, UB23, UB25, Jiajits |. Location of disease 2. Disease progression 3.Treatment approach Life Energy and Balance ChineseMedicineTraveller.com 220/10/2017 Stages of PD and 3 Dan Tians SI When treating PD we need to treat it according to the stage of progression as well as the type and location of pathogen. However, in all stages of PD the function of the Central Chann« interrupted and isn’t working to its full capacity. Reinstating the connection is very important for healing neurological degenerative disorders. Using points that target the lower, middle and upper Dan Tian is essential to restore this connection in the body. Moxa and Needle Entry Points of Zhong Mai and 3 Dan Tians Upper Dan Tian: DU20, DUI6, DUI4, RN22,Yin Tang, GBS Middle Dan Tian: RN17, DUI1, SP21,RN12, RNIO, DU9, ST25, GB24 Lower Dan Tian: RN6, RN4, DU4, Extra point L5- S1,(RN3, ST28) Lower limbs: ST36, SP10, GB31, GB34, GB40, SP6, SP4, KI ChineseMedicineTraveller.com 320/10/2017 Stages of Disease vs Treatments (ate. e Early Stage: Slight trembling of limbs, vertigo, lack of balance and fatigue with slight mental or verbal slow response e Progression Stage Lack of balance, severe muscle cramping and tightness, severe trembling, severe gait issues, slow speech, mental confusion e Late Stage Severe muscle tightness and atrophy, weakness, inability to walk, slow speech or lack of speech, dementia Stages of Disease vs Treatments e Early Stage: Focus on pathogen and support the zhen qi, expel internal rheum and stagnation Progression Stage Focus on symptoms and support the zhen gi Move and nourish the blood and expel rheum e Late Stage Support the zhen qi and nourish body fluids and blood, move blood and break stasis ChineseMedicineTraveller.com 420/10/2017 Stages of Disease vs Prognosis 2 e Early Stage: Treatment of the symptoms to stop them completely and recover the normal bodily functions. Treatment needs to continue every week after recovery for 3 months to prevent recurrence by supporting the zhen qi and nourishing the central and peripheral nervous systems with moxibustion, scalp and movement therapy. Stages of Disease vs Prognosis Progression Stage Treatment of the symptoms to reduce the symptoms and improve the quality of life. Here diet and movement are extremely important and need to be strict for without phlegm forming food and increasing body fluids forming food. © Late Stage There is no full recovery from this stage due to the severe atrophy of the muscles and lack of nourishment on the muscular and organ level. Support the zhen qi and nourish body fluids and blood, move blood and break stasis. ChineseMedicineTraveller.com 520/10/2017 Symptoms Analysis and Treatment Exterior Syndrome Hee Tai yang and Shao yin ¢ Half exterior and Half interior re Shao yang and Jue yin Haff Interior Interior Syndrome Yang ming and Tai yin ChineseMedicineTraveller.com 6ChineseMedicineTraveller.com 20/10/2017 6 Syndrome- Symptoms Belonging to the Exterior Syndromes |. Tremors and twitches e 2.Muscle numbness and lack of sensation ¢ 3. Muscle stiffness lack of range of motion ¢ 4.Muscle weakness and atrophy ¢ 5. Posture and gait problems 6. Mental confusion, slow speech and memory loss 6 Syndrome- Symptoms belonging to internal rheum moving upward of the Ben Tun of excess type 7. Posture and gait problem 8. Dizziness and palpitation ¢ 9.Anxiety and blurry vision 10. Mental confusion ¢ 11. Slow speech20/10/2017 6 Syndrome- Symptoms Belonging to Blood depletion causing the Deficient type of Ben Tun e 12. Muscle cramps and twitches 13. Muscle weakness e 14. Muscle atrophy e 15. Lack of memory ° 16. Severe fatigue ¢ 17, Low speech ¢ 18. Lack of strength A Symptoms Analysis es |. Trembling or tremor ¢ This disorder is recorded over and over in the Shang Han Za Bing Lun and in the Bian Que Xin Shu to explain its mechanism Syndromes. 1.Tai yang Tai yin with internal rheum ~ Dampness on the exterior layers, excess 2.Tai yang Tai yin with blood depletion » Stirring of the blood vessels due to blood depletion ChineseMedicineTraveller.com20/10/2017 A Ben Tun syndrome: Exterior syndrome + internal rheum or internal depletion of blood Stirring blood vessels with twitching from clause 160 are identical to the body tremors discussed in clause 67. If left untreated, this disorder will also show signs of malnourishment of the muscle and atrophy. It falls under Ling Gui Zhu Gan Tang with or without Ling Gui Zdo Gan Tang to address the blood depletion. A Ling Gui Zhé Gan Tang Ss Shang Han Lun, clause 67: “Shang Han [syndrome], if after [applying] vomiting and purgation methods there is reversal fullness under the heart, the qi rushes upwards to the chest, there is dizziness when standing up, a deep and tight pulse, sweat promotion causes stirring of the vessels and body tremors, Fu Ling Gui Zhi Bai Zhu Gan Cdo Tang governs.” ChineseMedicineTraveller.com20/10/2017 A Indentifying & Treating Ben Tun Exterior symptoms Internal rheum » Sweating with * Loose stools, bloating after aversion to wind or eating, low appetite cold, heat sensation _ Blood depletion and chills Faint ; ati oe + Fainting, pale lips, palpitation, * Joint pain or muscle weakness Headache © Treatment: Both syndromes must be addressed at the same time e EXT: GB20, DUI4, SJ5, GB31, LI4,LV3 Rheum: ST40, SP9, ST25, UB22, UB25 ° Blood depletion: SP10, GB39, SP6, UB20, UBI7 Water Qi Syndrome also causes Tremors and Numbness SS Féing Ji Fi Ling Tang * Jin Gui Yao Lue - On Water Qi Disorders, line 22: “Skin water disease, the four limbs are swollen, water qi is in the skin, if the four limbs are slightly twitching, Fang Ji Fu Ling Tang governs. » Symptoms: Edema, heaviness, joint stiffness Ingredient: Fang Ji, Fu Ling, Gui Zhi, Huang Qi, Gan Cao. ChineseMedicineTraveller.com 1020/10/2017 Mechanism © Skin water disease with swelling or edema of the four limbs suggests deficiency to the exterior wei gi causing an accumulation of pathogenic water qi in the skin which is unable to expel. © Slight twitching of the limbs or mild jerking movements also reflects an accumulation of water qi under the skin. It is also common to see numbness of the limbs in the pattern. (ate. « Skin water and the four limbs are numb, twitching or have jerky movement, Fang Ji Fu Ling Tang is able to address it. Indentifying & Treating Water Qi Exterior symptoms Internal rheum * Joint pain and * Loose stools aversion to wind © Bloating after eating * Body heaviness and Low appetite edema. ee * Cold lower limbs © Purple feet (rheum transforming to blood stasis) * Treatment: Both syndromes must be addressed at the same time EXT: LII 1, SJ6, GB31, GB40, GB20 » Rheum: ST40, SP9, ST25, RN12, RN 10, UB20, UB25 ChineseMedicineTraveller.com 11Sensation Mechanism Rheum in the exterior layers blocking the flow » Accompanied with heavy limbs and severe fatigue due to the dampness seeping to the outside layers Mechanism |, Rheum are blocking the channels 2. Sometimes combined with blood stasis when there is pain 3. Body fluid depletion in the muscle layer when accompanied with cramping ChineseMedicineTraveller.com 20/10/2017 2. Muscle Numbness and Lack of Protocol ° Expel rheum from the outer layers by promoting sweating ¢ Warm the interior and expel rheum from the interior 3. Muscle Stiffness and Reduced Range of Motion Protocol Unblock the channel and activate Zhong Mai ¢ Warm the interior * Nourish body fluids and blood ¢ Move blood stasis 1220/10/2017 A Treatment for Muscle Stiffness « Neck and Shoulder: GB20, DU 16, DUI4, UB13, UBI5,T3 and TS Jia Ji, SII1, SI10 « Face and Speech: S]I7, DUI5, ST7, RN24, RN26, RN22, RNI7, ExHn!7 Jia Cheng Jiang (on chin), ExHn22 Shang Lian Quan x3. ° Lower back: L2-5 Jia Ji, UB23, UB25, UB32, GB30, UB54, ExB Yao Yan. Hands - wrist: ExUE9 Ba Xie, S]5 to PC6, LI4, ° Feet - ankles: ExLE10 Ba Feng, GB40, SP5, ST42, SP4, LV3. 4. Muscle Weakness and Atrophy Mechanism Protocol * The severe lack of ° Warm the interior body fluids and blood —_and nourish blood results in a lack of * Nourish body fluids nourishment causing. Expel the rheum and cramping, weakness Activate the channel. and eventually atrophy. ChineseMedicineTraveller.com 1320/10/2017 A Treatment for Muscle Weakness Acupuncture Moxibustion ° Points to nourish ° Moxa in this case Zhen qi and body needs to be done fluids are essential at lightly and according this stage such as to the case on ST36, SP10, SP6, LV3, UB20, GB34, SPIO, RN4, UB23, ST36, GB34. Du4. 5. Posture and Gait Disorders Mechanism Protocol Ben Tun creates a « Release the exterior severe gait issue due» Expel rheum to the upward rising of , Warm the interior qiand rheum ner « Promote urination « Internal rheum create Expel Stool heaviness and fatigue ° Expel Stools seen in the posture ¢ Strengthen the * Stasis of rheum and Zhong Mai blood. ° Fortify the GB channel. ChineseMedicineTraveller.com 1420/10/2017 Treatment for Gait Issues (ate. « Release the exterior: GB20, SJ5 » Expel rheum: ST40, GB39 « Warm the interior: Moxa on DU4, RN4 * Promote urination: ST36, SP9 » Expel Stools: ST25, ST37 © Strengthen the Zhong Mai: DU4, DU6, RNI2, RN6 « Fortify the GB channel: GB34, GB40, GB31 6. Mental Confusion and Memory Loss Mechanism Protocol * Rheum in the upper in * Dredge Channel permanence or due to Ben. Expel Rheum Tun syndrome. * Strengthen Zhen Qi , tow te lack of blood * Move & nourish blood Treatment » Dredge Channel: DU20 to DU24, Si Shen Cong » Expel Rheum: ST40, Frontal Lines * Strengthen Zhen Qi: RN4, RN6, UB23, UB25 » Move and Nourish blood: SPI 0, SP6, SP4, ST36, GB8 ChineseMedicineTraveller.com 1520/10/2017 Treatment Protocol and Expectations Summary Treatment Approach |. Expel pathogens according to symptoms with Scalp acupuncture and 6 syndromes 2. Nourishing Zhen qi is done according to the 3 Dan Tians and body fluid level with acupuncture, moxa and herbs 3. Expelling rheum and moving blood stasis are done with acupuncture, electro stimulation, movement and herbs ChineseMedicineTraveller.com 1620/10/2017 Summary Treatment Protocol ¢ |. Scalp with DU20 and lines 2. Body acupuncture according to the 6 syndromes and 3 Dan Tians 3. Electro stimulation in stagnation and excess is present e 4.Movement exercises for 20 minutes ¢ 5. Feet soaking in Ginger water 30 minutes 6. Daily herbal medicine (a Scalp Treatment 1. DU20-DU24 to bring yang qi up to the mind and stimulate Zhong Mai 2. Balance line and Vertigo line: gait issues, vertigo and lack of balance 3.Tremor lines and Liver lines 2: tremors 4, Motor lines: jerky movements of legs and arms 5. Sensory line: numbness or pain in the body 6. Foot motor line, Kidney lines: numbness under the feet 7.Speech form and 2” speech line: speech issues 8.Sound memory and Si Shen Cong: dementia 9. Frontal lines: depression and apathy 10. Foot motor line: incontinence ChineseMedicineTraveller.com 1720/10/2017 Treatment Plan e Daily treatment in the acute and severe stages are more effective ¢ Combining the acupuncture with moxa and herbal medicine is absolutely necessary ¢ Movement and speech therapy after every treatment is extremely important | acupuncture treatment a week with daily moxibustion, movement and herbal medicine in remission or stable stage Movement is effective © The most important aspect of the movement is to engage the body and brain together with the movement and have the limbs cross central line Dancing and moving with a rhythm has proven to reduce tremors and stiffness considerably Bicycling for over 5 minutes has proven to reduce the symptoms considerably Tai chi and yoga have also proven to reduce the symptoms considerably Crossing squats, smart exercise, twists and lifts and so on. Reduce the stiffness and balance ChineseMedicineTraveller.com 1820/10/2017 Expected Results (a ¢ The lighter the symptoms, the faster the resolution The treatments need to be appropriate to the situation e Patients who are not taking any medication respond much faster * Continued treatments in the remission stage for a minimum of three months once a week are recommended to avoid recurrence Thank youl Dr, Sazaune Robidour, L, re, ChineseMedicineTraveller@gmail.com ChineseMedicineTraveller.com, ChineseMedicineTraveller.com 19