CCCH9029 Contents

Common diseases: preventable, o Dementia

o Stroke
curable, or incurable? o Diabetes
o Asthma
Zhang-Jin Zhang (張樟進) o Constipation
Professor, School of Chinese Medicine, HKU
o Menstrual pain
o Migraine
November 18, 2020 o Nearsightedness (myopia)
o Eczema
1

The course of human life: 中醫哲學: 健康长寿，无疾而终

Chinese philosophy TCM philosophy: healthily aged
and die without suffering
o 上古之人，其知道者，法於陰陽，
生 老 病 死
be born, to grow old, to get sick, and to die 和於術數，食飲有節，起居有常，
不妄作勞。故能形與神俱，而盡終
其天年，度百歲乃去。

《素問•上古天真論》

1
 何謂天年，何謂夭折 (1)
Happy longevity & unexpected death
o 天年 (natural span of life): 天賦的壽命
o 天年: 120歲 (120 years) = 兩個甲子。
o 一甲子: cycle of sixty years
o 頤養天年 (peacefully and joyfully
getting old)：開心地活到老。
o 夭寿 (原意: 夭者，少也)：Die before 60
years old 未成年而亡。
The course of human life:
Chinese philosophy
生 老 病 死
be born, to grow old, to get sick, and to die
p Senile dementia 老年性癡呆
p Stroke 腦中風
何謂天年，何謂夭折 (2)
Happy longevity & unexpected death
o 天年 (natural span of life): 120 years
o 九折 (10% off): 108 years (茶壽)
o 八折 (20% off)：96 years (高夀)
o 七折 (30% off)：84 years
o 六折 (40% off)：73 years (虛歲)
o 夭折 (die before getting 60 years)：
o 人生七十三、八十四，閻王不叫自己去。
o 73歲後多有病痛纏身 (Getting illness from 73
years)。
我們可以無疾而終嗎？
Can we die without suffering?
(Downloaded from internet)
2
 2013年香港按十大死因劃分的登記死亡人數
10 top diseases of death in 2013
退而求其次
Compromising strategy
死 因 死亡人数 %

老
1. 惡性腫瘤 13 727

生 病
30.0
2. 肺炎
3. 心臟病
7 431
6 361
16.3
13.9
死
4. 腦血管病 3 328 7.3
Die without
5. 疾病和死亡的外因（意外） 1 513 3.3 無疾而終 suffering
6. 慢性下呼吸道疾病 1 740 3.8
7. 腎病 1 671 3.7 Die with
8. 痴呆 1 108 2.4 less illness
9. 敗血病 881 1.9 少疾而終 輕疾而終
10. 糖尿病 388 0.8
Die with
11. 所有其他原因 7 562 16.5
無痛而終 mild illness
12. 所有原因 45 710 100
Die without
Only <16.5% could die without suffering. pain

死亡品質指數
Quality of Death Index

⼀個衡量“好死不好死”的指標
An index of death with and without
suffering

3
The life expectancies of HK (1971-2015)
香港是全球最長壽之地
Hong Kong's women and men enjoy the
longest life expectancy in the world

p The life expectancies at birth for both sexes have steadily

increased during the past 45 years, from 67.8 years for
males and 75.3 years for females in 1971 to 81.2 years and
87.3 years respectively in 2015 (Source: Centre for Health
Protection, Department of Health, HKSAR)

Senile dementia in HK Classification of dementia

o Alzheimer's disease: 50%-70%
o Vascular dementia: 25%: stroke
o Lewy body dementia: 15%: visual
hallucinations and “parkinsonism".
o Frontotemporal dementia (FTD): 5%:
drastic personality changes and
From 86,000 in 2010 to 233,000 in 2036 language difficulties

Yu et al., 2010. WHO, 2012; Burns & Iliffe, 2009

4
 簡易智能測驗 The time course of cognitive
Mini-Mental State Examination (MMSE)
deterioration

o Mild cognitive impairment (MCI):

70% with MCI progress to dementia:
MMSE score 27-30 (normal).
o Early stage: MMSE score 20-25
o Middle stage: MMSE score 6-17
o Later stage: need 24-hour supervision

Comorbid symptoms of dementia Medications for dementia

o 乙醯膽鹼酯酶抑制劑 (Cholinesterase inhibitors):
o Balance problems
Locomotor
n 多奈呱齊 (donepezil)
o Tremor
symptoms o Speech and language difficulty n 利斯的明 (rivastigmine)
o Trouble eating or swallowing
n 加蘭他敏 (galantamine)
o Depression o NMDA拮抗劑: 美金剛 (memantine)
o Anxiety
o Anti-Aβ: aducanumab, crenezumab,
o Elated mood
o Agitation/irritability solanezumab
Psychiatric
symptoms o Apathy o β-secretase (BACE) 抑制劑: Lanabecestat,
o Impulsivity
Verubecestat
o Delusions and hallucinations
o sleep disorders
無效或療效極有限！

5
 高錕 (Charles K. Kao) (1933-2018) Management strategy for dementia
Nobel Prize in Physics in 2009
p Diagnosed Alzheimer’s p Preventive and
disease in 2003 when early intervention
he was 70 years old and p Mild cognitive
die in 2018 at 84 years
impairment (MCI)
of his age.
(輕度認知損傷)
p His wife Gwen said that
Charles would deliver If you forget taking keys
his speech in the Nobel when you leave from (Downloaded from internet)

Ceremony if the prize home twice per week, you

could be awarded him definitely have MCI
one year earlier.

中醫典籍有關癡呆症的記載 Chinese Herbal Medicine for MCI

Dementia recorded in TCM literatures
中藥治療輕度認知損傷
o 《靈樞 天年》：人生十歲，五臟始定，血氣已通，其氣在下
，故好走；二十歲，血氣始盛肌肉方長，故好趨；三十歲，
五臟大定，肌肉堅固，血脈盛滿，故好步；四十歲，五臟六
腑十二經脈，皆大盛以平定，腠理始疏，滎貨頹落，發頗斑
白，平盛不搖，故好坐；五十歲，肝氣始衰，肝葉始薄，膽
汁始減，目始不明；六十歲，心氣始衰，若憂悲，血氣懈惰
，故好臥；七十歲，脾氣虛，皮膚枯；八十歲，肺氣衰，魄
離，故言善誤；九十歲，腎氣焦，四髒經脈空虛；百歲，五
臟皆虛，神氣皆去，形骸獨居而終矣。
o 孫思邈《華佗神醫秘傳》：首次出現“癡呆”。

o 清 沈金鼇《雜病源流犀燭 中風源流》：“中風後善忘”。

6
Resveratrol (白藜蘆醇), a natural compound
derived from grape skins against dementia Ginseng against dementia

益智中藥方劑
百合水提取物改善更年期輕度認知損傷 Nootropic herbal formulae

p 補中益氣湯 p 六味地黃丸
p 益氣聰明湯 p 人參養榮湯
p 安神補心丸 p 黃連解毒湯
p 地黃飲子 p 小半夏湯
p 鉤藤散 p 小柴胡湯

Zhang et al, 2016

7
 益智中藥成分
Nootropic herbal compounds
Herbal Name Active Mechanisms of actions
compounds
千層塔 石杉堿甲 Inhibit AChE
Yokukansan Huperziaserrata (Huperzine A)
(抑肝散) 石蒜科植物 加蘭他敏 Inhibit AChE
(Amaryllidaceae) (Galanthamine)
for Dementia
銀杏葉 標準提取物 (EGb (1) Inhibit AChE, β-adrenergic
(Ginkgo) 761) receptors; (2) antagonize
GABAA receptors; (3) Neuro-
protection.
人參 人參皂甙 (1) Enhance ACh synthesis; (2)
(Ginseng) (Ginsenosides) inhibit β-amyloid; (3) neuro-
protection; (4) modulate ACh,
GABA, and HPA axis
Matsunaga et al., 2016

Nootropic herbal compounds (con’d) Nootropic herbal compounds (con’d)

Active
Herbal Name compounds Mechanisms of actions Herbal Name Active
compounds Mechanisms of actions
水提取物 Modulate ACh, 5-HT2, 5-HT1A (1) Improve hippocampal
Water extracts and GABAA receptors synaptophysin and synaptic
五味子酮 (1) Reduce APP+ cells；(2) 知母皂苷 plasticity；(2) enhance NA,
(schisandrone) reduce Tau levels；(3) (timosaponin) DA, 5-HT synthesis；(3)
antioxidant; (4) stabilize 知母 Common reduce the production of β-
五味子 intracellular calcium level. Anemarrhena AP.
Schisandra Rhizome (1) Modulate M1 and M2
五味子酚 (1) Antioxidant；(2) inhibit
知母皂苷元 receptors；(2) reduce β-AP-
(schisanhenol) AChE
(Sarsasapogenin) induced synaptic impairment;
五味子醇甲 (1) improve pathological antagonize cortical neuronal
(schisandrin) changes in brain tissues；(2) apoptosis.
increase synaptophysin
synthesis

8
 Nootropic herbal compounds (con’d)
Herbal Active
Nootropic herbal compounds (con’d)
Name compounds Mechanisms of actions
Herbal Name Active compounds Mechanisms of actions
(1) Increase hippocampal stem 天麻Gastrodia 天麻素(gastrodin) (1) antioxidants; (2) b-AP;
葛根 葛根素 cells and BDNF；(3) antagonize 天麻苷元(HBA) (3) Suppress GABA
Pueraria (puerarin) neurotoxic effects of free radicals transporters
and β-AP；(4) apoptosis.
吳茱萸 evodia 去氫吳茱萸堿 (1) 抑制AChE; (2) b-AP; (3)
rutaecarpa (dehydroevodiamine) apoptosis
靈芝 靈芝多糖 (1) Synaptophysin；(2) apoptosis；
Ganoderma (Polysaccharides) (3) neuroinflammation
鉤藤 Uncaria 鉤藤堿(rhynchophylline) M1, 5-HT2和NMDA
(1) Antioxidants and receptors
neuroprotection; (2) protect
枸杞 當歸Angelica 阿魏酸 (ferulic acid) Antioxidants
多糖 against brain ischemia-induced
Wolfberry
(polysaccharides) brain impairment; (3) apoptosis ; 益智仁 Water extracts (1) Antioxidants；(2)
(4) activate microglia to produce Alpiniae increase ChAT activity; (3)
immune factors. oxyphyllae inhibit AChE.

Non-pharmacological interventions for

Nootropic herbal compounds (con’d)
preventing from dementia
Herbal Active compounds Mechanisms of actions
Name p Yoga 瑜伽 (Danucalov et al., 2017)
側柏葉 紅松內酯 Antioxidants, neuroprotection
Platycladus (pinusolides) p Tai-chi 太極拳 (Lam et al., 2005)
遠志 提取物(BT-11) (1) AChE; (2) neuroprotection;
p Meditation 冥思 (Innes et al., 2018)
Polygala (3) Neurotropic factors p Acupuncture 針灸
黃芪 Water extracts (1) AChE; (2) antioxidants p Diet 食療
Astragalus p Chorus singing 合唱
續斷 Ethanol extracts Antioxidants, neuroprotection p Cross-word puzzles 文字遊戲
Dipsacus p Swimming 游泳
何首烏 Water extracts (1) Antioxidants；(2) 5-HT2A p Plaza Dancing 廣場舞？
Fallopia receptors；(3) MAO-B
multiflora Ashford et al., 2015; Zhou et al., 2015

9
 Our study: acupuncture
Acupuncture for Alzheimer’s disease improved vascular dementia

Plaza Dancing 廣場舞: 減緩癡呆發生？ 八段錦可以推遲癡呆嗎？身體力行

Photo downloaded from internet

10
 The prevalence and death of
The prevalence of stroke in HK (2012) stroke in China
p 215.6 per 100,000 each year.
p Over 8 million acute stroke
patients each year.
p > 1.5 million stroke-related
deaths every year.

p 絕大部份存活下來的中風病人成為不同程度的傷殘， Jia et al., 2010

而需他人照料。

中藥注射液治療急性腦梗塞 中藥用於中風後康復 Chinese herbal

Chinese herbal injections for treating acute medicines for post stroke recovery
cerebral infarction

p 丹紅滴注液 (Danhong)
p 舒血寧注射液 (Shuxuening)
p 銀杏達莫注射液 (Yinxingdamo)
p 疏血通注射液 (Shuxuetong)
p 紅花黃色素注射液 (HongHuaHuangSeSu)
p 燈盞細辛注射液 (DengZhanXiXin)
A, without acupuncture. B, combined with acupuncture
p 參芎葡萄糖注射液 (Shenxiong glucose)
Han et al. Medicine (2017) 96:49
Liu et al., 2018

11
Chinese medicine reduces poststroke
neurological symptoms

中藥降低中風
死亡率
Wu et al. 2007

Wu et al. 2007

Comprehensive Acupuncture
Acupuncture for stroke Therapy (CAT)
rehabilitation
p 肢體癱瘓 Limbic paralysis (Zhang et al., 2014)
p ⾔語障礙 Dysphasia/aphasia (Sun et al., 2012)
p 吞咽困難 Dysphagia (Xie et al., 2008)
p ⼆便失禁 Incontinence (Thomas et al., 2008)
p 精神症狀 Mental symptoms (Zhang et al., 2010)
p 呃逆 Hiccups (Yue et al., 2016)
p 疼痛 Pain (Mulla et al., 2015)

12

Diabetes
p Type II diabetes is currently
affecting around one in 10
people in HK or about 700,000
people.
Diabetes symptomatology
o Urinating often
o Feeling very thirsty
o Feeling very hungry, even though
you are eating
o Extreme fatigue
o Blurry vision
o Cuts/bruises that are slow to heal
o Weight loss—even though you are
eating more (type 1)
o Tingling, pain, or numbness in the
hands/feet (type 2)

Change in blood glucose level Diabetes: Herbal medicine

after ingestion
o increase the production of the body fluids
and relieve thirst (生津止渴): Tianhuafen (天
花粉), Zhi-mu (知母), ren-shen (人参), sheng-
di (生地), mai-dong (麦冬), niu-xi (牛膝), yu-
mi-xu (玉米须)。
o Expel heat and purge fire (清熱降火): huang-
qin (黄芩), da-huang (大黄), hou-po (厚朴),
huang-lian (黄连), Shigao (石膏)。
o Nourish the Kidney-yin (滋養腎陰): shan-zhu-
yu (山茱萸), shou-di (熟地), shan-yao (山药)﹐
Yizhiren (益智仁), Sang-piao-xiao (桑螵蛸).

13
 Diabetes
Dietary therapy: dietary porridges
o Spinach porridge(菠菜粥):Spinach 100-150g, non-
glutinous rice 50g.
o Celery porridge(芹菜粥)：fresh celery 60-100g, cut
it into pieces and cook into porridge with 50g of
non-glutinous rice. Diabetics with hypertension.
o Radish porridge (萝卜粥): Fresh radish, cook into
porridge with 50g of non-glutinous rice. Diabetics
with body overweight.
o Chinese wolfberry porridge(枸杞子粥): Chinese
wolfberry 15-20g, cook into porridge with 50g of
non-glutinous rice. Diabetics with lower weight and
low fever.
Diabetes
Dietary therapy: Medicated Diets
o Balsam pear (苦瓜): It is proven clinically that it can
reduce the blood glucose.
o Onion: light taste with neutral in nature, it reduce blood
glucose. Take the decoction made from 50-100g of onion.
o Huangqi (黃蓍), Chinese Yam (山藥),sea cucumbers (海参)
and trichosanthes root (瓜蒌根) can be a supplementary
treatment.
o Stewed Duck with Yu-Zhu (玉竹) and Sha-Shen (沙参):
Yu-Zhu 30-50 g, Sha-Shen 30g, one old duck, stew them
with scallion (大蔥) and ginger. It is suitable for diabetics
of middle-aged people.
o Steamed Chicken with Chinese wolfberry: Chinese
wolfberry 15g, one hen, cook with wine, ginger and salt
and then steam them.

Diabetes Diabetes
Dietary therapy: soups and drinks Acupuncture and exercise
o Soup of Sticky Rice and the Root Bark of White Mulberry
(桑树根皮): quick-fried sticky rice 30g, the root bark of
o Acupuncture:
white mulberry 30g, drink the decoction made from n diabetic neuropathic pain
them. for diabetics with extreme thirst.
o Soup of Spinach and Tremella (白木耳): fresh root of
n retina degeneration
spinach 150-200g, tremella 20g. for diabetics with n erectile dysfunction
constipation.
o Pigeon Soup of Chinese Yam (山药) and Yu-Zhu (玉竹) : n constipation
one pigeon, Chinese yam 30g, Yu-Zhu 20g: for diabetics o Exercise: control body weight and
of yin deficiency type.
mood, improve the quality of life:
o Green Tea with Chrysanthemum (菊花) and Sophora
Flower (槐花): chrysanthemum 3g, sophora flower 3g,
taichi, qi-gong.
green tea 3g. for diabetics with high blood pressure.

14

Asthma (哮喘)
o Prevalence in HK
n 9.4% in children
n 5.8% in elderly aged 70 years
o Clinical manifestations
n air hunger with heavy breathing
n open mouth and raised shoulders
n The feelings of chest tightness
Asthma: herbal medicine
o Wind-cold constraining lung (风寒束肺): Mahuang tang
(ephedra decoction, 麻黃湯) plus banxia (半夏) bile-
treated nanxing (膽南星) and baijiezi (白芥子).
o Phlegm-heat blocking lung (痰热壅肺): Ma Xing Shi Gang
Tang (Ephedra, Almond, gypsum, and Licorice Decoction,
麻杏石甘湯)。
o Deficiency of Lung-qi (肺氣虛): Bu Zhong Yi Qi Tang
(Middle-restoring and Qi-augmenting Decoction, 補中益氣
湯): bai-zhu (白朮), ren-shen (人參), dang gui (當歸), chai-
hu (柴胡), da-zao (大棗), chen-pi (陳皮), gan-cao (甘草),
sheng-ma (升麻) and sheng-jiang (生薑).
o Failure of Kidney to catch Qi (腎不納氣): Jin Gui Shen Qi
Wan (Kidney-Qi Pill, 金匱腎氣丸): Fu-Ling (茯苓), Fu-Zi (附
子), Gui-Zhi (桂枝), Mu-Dan-Pi (牡丹皮), Shan-Yao (山藥),
Shan-Zhu-Yu (山茱萸), Sheng-Di-Huang箊(生地黃), Ze-Xie
(澤瀉).
TCM classification of asthma
o Excessive type (實證)
n Wind-cold constraining lung (风寒束肺): cough,
asthma, chest tightness, clear thin sputum, chills,
fever without sweating.
n Phlegm-heat blocking lung (痰热壅肺): urgent
asthma, chest tightness, yellowish viscid (sticky)
sputum, flushed face, high fever, dry mouth.
o Deficiency-type (虛證)
n Deficiency of Lung-qi (肺氣虛): urgent asthma,
shortness of breath, tiredness, cough and thin
sputum, spontaneous sweating, wind-aversion.
n Failure of Kidney to catch Qi (腎不納氣): chronic
asthma, more exhalation than inhalation,
aggravated by even slight activity, shortness of
breath, much thin sputum, sweating, cold limbs,
aching waist, edema.
Asthma
Moxibustion in the hottest days (三伏灸)
o TCM says: Winter diseases should be
treated in the summer (冬病夏治). Asthma is
a commonly incurring disease in the winter.
o The hottest, most sultry days of summer,
most commonly experienced in the months
of July and August, e. g.,
n 1st 10 days: Jul 16-25, 2020
n 2nd 10 days: Jul 26-Aug 14, 2012
n 3rd 10 days: Aug 15-24, 2012
15
 Asthma
Asthma: topical application with
Acupoints for moxibustion in the hottest days
(三伏灸) herbs in the hottest days (三伏貼)

Strongly pungent herbs

o Feishu (BL13, 肺俞) o Bai-Jie-Zi (白芥子)
o Da-zhui (GV14, 大椎) o Xi-Xin (細辛)
o Geshu (BL17﹐膈俞) o Yan-Hu-Suo (延胡索)
o Dry Ginger (干薑)
o Pishu (BL20﹐脾俞)
o Ganshu (BL18﹐肝俞)

Asthma: acupuncture
o Wind-cold constraining lung (风寒束肺): unblock the lung and
Asthma: dietary therapies
dispel Cold (宣肺驅寒): Lieque (LU7, 列缺), Shanzhong (CV17, 膻
中), Feishu (BL13, 肺俞), Fengmen (BL12, 風門), Hegu (LI4, 合
谷).
o Neutral and warm food: lamb, beef, pork,
o Phlegm-heat blocking lung (痰热壅肺): dissipate phlegm and chicken; apple, grape, peach, leechee, date,
purge Heat (祛痰清熱): Chize (LU5, 尺澤), Zhongfu (LU1, 中府), carrot (紅蘿蔔), Chinese cabbage (大白菜). red
Fenglong (ST40, 豐隆), Dingchuan (EX-BA-1, 定喘: 0.5 cun bean (紅豆), radish (蘿蔔), Chinese yam (山
lateral to Dazhui DU14, 大椎: the depression below the spinous
process of the seventh cervical vertebra).
藥)… …
o Deficiency of Lung-qi (肺氣虛): Strengthen Lung-Qi (補益肺氣): o Dieting (忌口): avoid cold-cool food (寒涼之品):
Shanzhong (CV17, 膻中), Taiyuan (LU9, 太淵), Zhongfu (LU1, 中 duck, crab (螃蟹) and other cold-type seafood
府), Feishu (BL13, 肺俞), Zusanli (ST36, 足三里). that may cause asthma, chrysanthemum
o Failure of Kidney to catch Qi (腎不納氣): Strengthen Kidney-Qi flower tea (菊花茶), green tea, mint, balsam
to catch down Lung-Qi (補腎納氣): Feishu (BL13, 肺俞), Shenshu
(BL23, 腎俞), Qihai (CV6, 氣海), Guanyuan (CV4, 關元), Taixi pear (苦瓜).
(KI3, 太溪), Zusanli (ST36, 足三里).

16
Asthma: dietary therapies
o Neutral and warm food: lamb, beef, pork,
chicken; apple, grape, peach, leechee, date,
carrot (紅蘿蔔), Chinese cabbage (大白菜). red
bean (紅豆), radish (蘿蔔), Chinese yam (山
藥)… …
o Dieting (忌口): avoid cold-cool food (寒涼之品):
duck, crab (螃蟹) and other cold-type seafood
that may cause asthma, chrysanthemum
flower tea (菊花茶), green tea, mint, balsam
pear (苦瓜).
Etiology of constipation
o Lack dietary fibers in food (飲食中缺乏
纖維)
o Excessive intake of acrid, spicy and
rich food (辛辣食物)
o Insufficient physical movement (運動
不足)
o Excessive stress (生活壓力)
o Chronic illness (長期生病)
o Side effects of medication (藥物副作用)
Constipation (便秘)
o Chronic constipation is a common medical problem,
with a prevalence of 14% in HK population and 24%
in elderly.
o Definition:
n have a bowel movement fewer than three times
per week.
n Stools are usually hard, dry, small in size.
n difficult to eliminate.
n It may be painful to have a bowel movement.
n Often experience straining, bloating, and the
sensation of a full bowel.
Constipation – herbal medicine
o Heat-type: cool heat and moisten the intestines (清熱潤
腸): Maziren Wan (Cannabis Pill, 麻子仁丸): huomaren
(火麻仁), kuxingren (苦杏仁), baishaoyao (白芍藥), zhizi
(梔子), houpo (厚朴), dahuang (大黃), baimi (honey, 白蜜)。
o Qi stagnation: smooth Qi movement and remove
blockage (順氣化滯): Liu Mo Decoction (Six grounded
herbs Decoction, 六磨湯). Binlang (檳榔), wuyao (烏藥),
muxiang (木香), zhishi (枳實), chenxiang (沉香), dahuang
(大黃), yuliren (鬱李仁).
o Deficiency-type: Warm and moisten to ease defecation
(溫潤通便): Ji Chuan Jian (Liquid-increasing moistened
Decoction, 濟川煎): Niuxi (牛膝), danggui (當歸),
roucongrong (肉蓯蓉), zhiqiao (枳殼), rougui (肉桂), fuzi
(附子), gancao (甘草).
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Constipation – Acupuncture
o Common acupoints: dachangshu (BL25, 大肠
俞), Tianshu (ST25, 天枢), Zhigou (SJ6, 支沟).
o Cold type: moxibustion
o Heat type: Hegu (LI4, 合谷), Quchi (LI11, 曲池).
o Qi stagnation: Zhongwan (CV12, 中脘),
Xingjian (LR2, 行间).
o Qi and blood Deficiency: Pishu (BL20, 脾俞),
Weishu (BL21, 胃俞).
o Yang-qi deficiency: moxibustion on Shenque
(CV8, 神闕), Qihai (CV6, 气海).
Constipation
Other therapies
o Regularly do exercises: sit-up, hiking after
meals, jog, swimming, taichi, etc.
o Self-massage around on Shenque (CV8, 神
闕), Tianshu (ST25, 天枢), and Zhongwan
(CV12, 中脘) to improve bowel movement.
Constipation
Dietary therapy
o Fiber-rich food:
n vegetables: spinach, broccoli, bean sprouts,
cabbage, various beans, etc.
n Whole grains
n Fruits: peaches, pears, pineapple, banana
n Various beans
o Avoid spicy and acrid food
o For heat and excessive constipation, often drink
honey water; for elderly with cold and
deficiency constipation, have vegetable-made
soups and porridges.
Menstrual pain 痛經
(cramps, dysmenorrhea)
o Manifestation: lower abdominal pain and
distention preceding and during menstrual flow.
The degree of pain is variable. It may be colicky
and may extend to the lumbosacral area,
companied with nausea, vomiting, diarrhea,
dizziness, and weakness.
o Menstrual pain can be primary and secondary.
Primary menstrual pain is not associated with
any organic diseases. The secondary may be
caused by diseases associated with the pelvic
cavity.
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 Menstrual pain
TCM classification
o Deficiency type: This may come from
inadequate endowment, overindulgence
in sexual activity, multiple pregnancies
and childbirth, or chronic illness.
o Qi Stagnation and blood stasis. This may
come from chronic depression, rage,
invasion of Cold evil, and accumulation of
dampness-heat.
Menstrual pain
Acupuncture, moxibustion and self-massage
o Deficiency type: Mingmen (DU4, 命門), Shenshu
(BL23, 腎俞), Guanyuan (RN4, 關元), Zusanli (ST36,
足三里). Sanyinjiao (三陰交)
o Qi Stagnation and blood stasis. Zhongji (RN3, 中極),
Ciliao (BL32, 次髎), Diji (SP8, 地機).
o moxibustion and self-massage at Guanyuan (RN4, 關
元) and Qihai (RN6, 气海).
Menstrual pain
herbal medicine
o Dong Gui (當歸) is also known as the "female ginseng," it is
commonly used to regulate the menstrual cycle and relieve
menstrual cramps.
o Chuan Xiong (川芎) is a key medicinal herb for treating
menstrual pain by improving blood circulation and promoting
the flow of "qi" or vital energy.
o Bai Shao (炒白芍) can nourish the blood, improve circulation,
and alleviate tension and anxiousness. It is also used for a
wide variety of gynecological problems.
o Yi Mu Cao (Chinese Motherwort, 益母草) is widely used to treat
menstrual problems. It can improve blood circulation and clear
blood clots that occur in menstrual disorders and after
childbirth.
o Yan Hu Suo (Corydalis Rhizome, 延胡索) is a well-known herb
to strengthen blood circulation and to relieve pain.
Menstrual pain
dietary therapy
o Fishes rich in omega-3 fatty acids having an
anti-inflammatory effect can help with cramps
as well as bloating.
o whole grain, fresh fruit and vegetables that are
rich in calcium: milk, green leafy vegetables, etc.
o Deficiency of magnesium is a cause of menstrual
cramps. Magnesium-rich foods: bran (rice,
wheat, and oat), pumpkin, watermelon and
sesame seeds, almonds, cashews, soybeans.
o Foods to avoid: Caffeine and alcohol should be
completely avoided.
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 Migraine 偏頭痛
o Almost one in ten people suffer from
migraine headaches. Almost half of
them suffer a migraine attack one or
more times a month.
o Most migraine sufferers are women.
One in four women have migraine
headaches.
Migraine – herbal medicine
o Bupluerum (Chai Hu, 柴胡)
o Peony (Bai Shao, 白芍)
o Gouteng (鉤藤)
o Chuangxiong (川芎)
o Stiff silkworm (Jiangcan, 僵蠶)
o Dried earthworm (Dilong, 地龍)
o Gastroda and Uncaria Drink (Tian Ma Gou
Teng Yin, 天麻鉤藤飲): Calm the Liver and
subdue hyperactive Yang (平肝潛陽).
Migraine – symptomatology
o A typical migraine headache may include
all of the following symptoms:
n Moderate to severe pain usually on
one side of the head.
n Pain that worsens with activity
n Nausea with or without vomiting
n Sensitivity to light and/or sound
n Headache lasting from 4 to 72 hours
n Visual disturbances (auras)
Migraine – Acupuncture
o Acupuncture may be the first choice for migraine. The
efficacy of acupuncture in patients with migraine has
been well confirmed in many clinical trials, showing
significant decrease in the episode of headaches and
their duration after acupuncture treatment.
o Major local acupoints: o Major distance acupoints:
n Shuaigu (率穀) n Yanglingquan (陽陵泉)
n Fengchi (風池) n Hegu (合穀)
n Taiyang (太陽) n Taichong (太沖)
n Touwei (頭維) n Fenglong (豐隆)
n Qubing (曲鬢) n Houxi (後溪)
n Baihui (百會)
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 Migraine Children and adolescent
Nearsightedness (myopia)
Changing life style 儿童少年近视
o Avoid alcohol, caffeine, smoking and exposure to smoke.
o Avoid foods containing the amino acid tyramine (found o Nearly 40% primary school students
in red wine, smoked fish, chicken livers, and some
beans), chocolate, nuts, peanut butter, some fruits (like in HK have nearsightedness. As high
banana and citrus)
as 70% of high school students in
o Avoid foods with monosodium glutamate (MSG – an
additive in many foods), onions, meats containing the Mainland are nearsighted.
nitrates (bacon, cured meats).
o Avoid physical and emotional stress (the headache often o Nearsightedness can be classified
occurs a particularly stressful time). into pseudomyopia and true myopia.
o Avoid low blood sugar, e. g., missing meals.
o Avoid certain odors (such as perfume), allergic reactions,
bright lights and/or loud noises.
o Do not sleep too little or too much.

Acupoints for acupressure Step 1: Knead Zanzhu acupoint

and acupuncture (眼保健操) 第一节：按揉攒竹穴
o Yuyao (魚腰) o Taiyang (太陽)
o Zanzhu (攒竹) o Sizhukong (絲竹空)
o Sibai (四白)
o Jingming (睛明)
o Fengchi (風池)

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 Step 2: Press Jingming acupoint Step 3: Press Sibai acupoint
第二节：按压睛明穴 第三节：按揉四白穴

Step 4: Press Taiyang acupoint and rub the Step 5: Press Fengchi acupoint
upper eye socket 第四节：按揉太阳穴,刮上眼眶
第五节：按揉风池穴

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 Step 6: knead the ear lobes
第六节：揉捏耳垂
Eczema 濕疹
o Eczema is a chronic condition,
with the inflammation of the
upper layers of the skin.
o The prevalence is highly variable.
It is about 5% in HK, particularly
in children and humid seasons.
o Although corticosteroids, a class
of hormones, may be effective in
controlling or suppressing the
symptoms, they do not cure
eczema.

Eczema – symptomatology Eczema – TCM diagnosis

o It can affect any part of the skin, but
the most common is on the face, neck,
overlying surfaces, of joint and limbs,
and groin.
o Its major manifestations are
itching, rashes, dryness, flaking,
even blistering and bleeding.
o Dampness-heat is a major type:
flushing, swelling, intense itch,
with a burning sensation, thirsty,
restless, and yellow tongue coating.
o Wind-heat type: red skin with
papule, vesicle, crusts and scales,
itch.

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Eczema – herbal medicine
o Many clinical trials have confirmed the efficacy of
herbal medicine in the treatment of eczema. Herbal
medicine could be first choice for patients with
eczema either oral or external route or both.
n Dampness-heat is a major type: Cool heat,
eliminate dampness, dispel wind and stop itch
(清熱燥濕﹐祛風止癢): Liver-clearing Gentiana
Decoction, 龍膽瀉肝湯).
n Wind-heat type: Dispel wind, cool heat, and
eliminate dampness (祛風清熱燥濕): Wind-
extinguishing Powder, 消風散)
Eczema – commonly used
herbal medicine
o Flos lonicerae (Jinyinhua, 金銀花): clear
heat and eliminate dampness.
o Herba menthae (Bohe, 薄荷):
aromatically eliminate dampness
o Cortex moutan (Danpi, 丹皮): clear heat
o Rhizoma atractylodis (Cangzhu, 蒼術):
strongly eliminate dampness.
o Cortex phellodendri (Huangbai, 黃柏):
expel dampness-heat.

Eczema – dietary therapy

o Good for Eczema:
n Bitter gourd (苦瓜) n Portulaca oleracea
Thank you!
n Celery (芹菜) (马齿苋)
Tomato (番茄) n mung bean (绿豆)
n
n Chive (韭菜) n Seaweed (海带) Email: zhangzj@hku.hk
n wax gourd (冬瓜)
n Job's tear grains (薏米)
n cucumber (黄瓜)
n Red beans (红豆)

o Dieting (忌口):
n All spicy, roasted and fry foods
n Seafood and animal internal organs

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