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DRY EYE SYNDROME CM PATTERNS

Liver Yin Deficiency


Lung Yin Deficiency
Heart Yin Deficiency
Kidney Yin Deficiency
Lung Heat
Liver Fire
Wind Heat

LIVER YIN DEFICIENCY DRY EYE SYNDROME


Aetiology: Liver Qi stagnation generating Heat that consumes Liver Yin resulting in a
lack of nourishment of the eye by the Yin aspect of the Liver contributing to dry eye
syndrome. Can be coupled with deficient Heat that ascends the internal channel pathway
and consumes eye Yin. The pattern can also stem from KD Yin deficiency.
Pulse: Empty Tongue: Peeled or rootless coat
Treatment Principle: Nourish Liver Yin to promote eye tear portion production and
nourish the eyes.
Herbal Prescription: Qi Ju Di Huang Wan Nourishes Liver & Kidney Yin while
nourishing the eyes or Yi Guan Jian with Liver Qi stagnation + Mu Dan Pi & Zhi Mu if
there are empty Heat from Liver Yin Xu signs. + Gou Qi Zi & Ju Hau
Acupuncture Prescription:
LV8+ Nourishes Liver Yin & Liver Blood
BL18+ Nourishes Liver Yin
KD3+ Nourishes Kidney Yin to generate Liver Yin
KD6+ Nourishes Kidney Yin to generate Liver Yin & is Master of Yin Qiao Mai coupled
with LU7 will improve the ascent of fluids and influence the eye
BL1 Directs Qi and Yin to the eyes while increasing flow of Qi and Blood
Yuyao Increases Qi & Blood flow around eye and helps direct Yin to the eye
(Maciocia, 2004, p.896)

LUNG YIN DEFICIENCY DRY EYE SYNDROME


Aetiology: Lung Yin deficiency may result from Lung Qi deficiency with reduced fluid
metabolism, via prolonged Liver Fire that has insulted the Lungs or via Stomach Heat or
prolonged Yin deficiency. Because the Lungs have the spreading and dispersing of fluids
function a Yin deficiency here will reduce the nourishment to the head and eyes
Tongue: Dry with no coat or rootless coat Pulse: Empty
Treatment Principle: Nourish the Lung Yin to increase the nourishment of the eyes and treat
the underlying factors that have resulted in the Lung Yin deficiency
Herbal Prescription: Bai He Gu Jin Tang + Gou Qi Zi, Ju Hua, Sang Ye & Nu Zhen Zi
Nourishes Yin, moistens the Lungs & transforms Phlegm & nourishes the eyes
Acupuncture Prescription:
LU9+ Nourishes Lung Yin
BL13+ Nourishes Lung Yin
REN4+ Nourishes KD Yin to preserve and nourish Lung Yin
KD6+ Nourishes Kidney Yin & opens Yin Qiao Mai LU7
BL1 Directs Qi to the eyes, increases flow of Qi and Blood and will direct Yin to the eyes
Yuyao Increases Qi and Blood flow to the eye and directs Yin to the eye
(Maciocia, 2004, p.900)

HEART YIN DEFICIENCY DRY EYE SYNDROME


Aetiology: The Heart rules the Blood and a deficiency of the Yin aspect of which will result in
a decrease in the Blood supply to lacrimal glands via the vessels that nourish the eye and
contribute to a reduced secretion of tear portion from this gland. And if progressed can
developed into a deficiency heat that can consume Yin of the eyes via the two internal Heart
channel internal pathways that ascend upward to the eye.
Pulse: Floating or empty Tongue: Normal or peeled & possibly red tip if deficiency Heat is
present
Treatment Principle: Nourish Heart Yin to nourish the eyes & if deficient Heat is present
nourish Heart Yin to anchor Yang and clear deficiency Heat
Herbal Prescription: Tian Wang Bu Xin Dan + Gou Qi Zi, Ju Hua, & Sang Ye. Nourishes
Heart Yin & Blood, clears the deficiency Heat.
Acupuncture Prescription:
BL15+ Nourishes Heart Yin & Blood
HT7+ Nourishes Heart Yin
PC6- Clears Heat and opens the Yin linking vessel
HT9- Clears Heart Heat and Benefits the eyes
Taiyang- Clears Heat activates Qi & Blood
Yuyao Increases Qi and Blood flow to the eyes
BL1 Brings Qi to the eyes, increases flow of Qi and Blood and will direct Yin to the eyes.
(Maciocia, 2004, p.880)

KIDNEY YIN DEFICIENCY DRY EYE SYNDROME


Aetiology: A decline in Kidney Yin generate and false Heat generally/systemically with Heat
rising to consume fluids, and at the same time reduced Yin will result in decreased
nourishment of the eyes. Here Heat rises up to affect the head and Yin is inadequate to
nourish the Liver & Lung organs which are involved in eye tear production.
Pulse: Empty
Tongue: May be normal colour with peeled coat
Treatment principle: Nourish Kidney Yin, subdue Yang and nourish the eyes
Herbal Prescription: Da Bu Yin Wan + Guo Qi Zi, Ju Hua. Nourishes Kidney Yin while also
subduing Fire
Acupuncture Prescription:
REN4+ Nourishes KD Yin
KD3+ Nourishes Kidney Yin & clears deficiency Heat
KD2- Clears deficiency Heat
KD6+ Nourishes Kidney Yin, clears deficiency Heat & opens the Yin Qiao Mai
BL1 Directs Yin to the eyes and increases Qi and Blood flow to the eyes
Qiuhou Increases Qi and Blood flow around eye and will help direct Yin to the eye

LIVER FIRE DRY EYE SYMDROME


Aetiology: Factors that contribute to Liver Qi stagnation and also Liver Yin deficiency generate
Liver Fire that can ascend towards the eye via the Liver channel internal pathway and consume eye
Yin contributing to dry eye syndrome.
Pulse: Wiry & rapid Tongue: Red with red sides with dry yellow coat
Treatment Principle: Clear and subdue Liver Fire while nourishing Liver yin and nourishing the
eyes
Herbal prescription: Long Dan Xie Gan Tang + Gou Qi Zi, Ju Hua, Cu Chai Hu, Bai Shao,
Subdues rising Liver Fire to prevent eye dryness due to Fire.
Acupuncture Prescription:
LV3- Subdues Liver Yang and spreads Liver Qi while clearing the head and eyes
LV2- Clears Liver Fire and Heat and spreads Liver Qi
GB20- Clears the head & eyes
GB1- Clears Heat from the eyes
DU24- Clears the head and eyes
BL1- Clears Heat from the eyes
Taiyang- Clears Heat from eyes
(Maciocia, 2004, p.893)

LUNG HEAT DRY EYE SYNDROME


Aetiology: The Lung is the upper source of water & the Lung dominates the movement of
water. Either of exogenous or internally generated Lung Heat consumes Yin and impairs the
Lungs role of dispersing and diffusing fluids which fail to nourish the head and eyes. This
blocks and consumes fluids. Lung Heat can easily go deeper, transferring to the Heart, then
ascend along the two internal pathways of the Heart which enter the eye.
Pulse: Rapid Tongue: Red with yellow coat
Treatment Principle: Clear Lung and eye Heat to encourage fluid dispersal nourish the eyes
Herbal Prescription: Xie Bai San + Gui Qi Zi, Ju Hua. Clears Lung and eye Heat while
nourishing the eyes
LU5- Clears Lung Heat
LU10- Clears Lung Heat & descends rebellious Qi
LI11- Clears Lung Heat
LU1 Disseminates Lung Qi
BL13- Clears Lung Heat
BL1- Clears Heat from eyes
Taiyang- Clears Heat locally
(Flaws, 2007, p.500)

WIND HEAT DRY EYE SYNDROME

Aetiology: Heat consumes Yin and impairs the Lungs role of dispersing and diffusing
fluids which fail to nourish the head and eyes and throat.

Symptoms: Dry mouth & throat, red dry swollen eyes, swollen parotid glands, aversion to
wind & fever

Tongue: Red with thin yellow coat

Pulse: Floating & rapid

Treatment Principle: Dispel Wind and dissipate Heat, nourish Yin & fluids

Herbal Prescription: Sang Xing Tang + Guo Qi Zi, Ju Hua, Sang Ye & Nu Zhen Zi
Dispels Wind Heat, nourishes Yin & fluids

Acupuncture Prescription:

LI4- Releases the exterior Wind Heat, regulates defensive Qi & regulates/clears the eyes

LU5- Clears Lung Heat

KD6+ Nourishes Kidney Yin to generate Liver Yin & is Master of Yin Qiao Mai
coupled with LU7 will improve the ascent of fluids and influence the eye

BL1- Clears Heat from the eyes

(Flaws, 2007, p.500)

DRY EYE SYNDROME CM RESEARCH


In 2004 a double blinded control trial of Qi Ju Di Huang Wan was carried out using 80
participants suffering from DES that showed positive results. This was in spite of CM pattern
differentiation to determine the presence of Liver and Kidney Yin deficiency as a root cause not
being carried out. The severity of the participants DES was obtained at base line, both
objectively via Schirmers paper swab test and subjectively with a questionnaire determining
patient subjective discomfort level with their condition of DES symptoms. Both the control and
treatment group received the biomedical AT intervention with the treatment group receiving the
CM formula via a generic tablet and control a placebo tablet of same appearance. At end point
both groups showed reduction in eye dryness with the treatment group showing greater
reductions than control. (Chang, 2005, p.350)
in 2006 a controlled study was undertaken on 43 patients to determine the effectiveness of
electro acupuncture and standard acupuncture in DES treatment, again in conjunction with the
prevailing biomedical AT treatment. (Tseng, 2006, pp.198-199) This study showed positive
results in favour of acupuncture intervention when combined with AT treatment. In this study
there was no pattern differentiation carried out and again in spite of this fact there were positive
results obtained. This treatment had a focus on treating DES that would be due to a heat
condition where heat has consumed the Yin of the eyes. (Tseng, 2006, pp.198-199)