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Parkinson’s Disease is a neurodegenerative disease characterized by rigidity of movement and tremors. 50,000 cases are diagnosed in the US amongst the geriatric population. The Mayo Clinic website defines Parkinson’s Disease as “a progressive disorder of the nervous system that affects your movement. It develops gradually, sometimes starting with a barely noticeable tremor in just one hand. But while a tremor may be the most well-known sign of Parkinson's disease, the disorder also commonly causes stiffness or slowing of movement.”

According to the Parkinson’s Disease Foundation, Parkinson’s is diagnosed by an experienced practitioner, an intern, or an MD. These are the tests that are performed: Look for whether or not the face is animated, notice if there are tremors in the limbs even at rest, check for balance by standing behind patient and pulling them back off of their balance (does he or she regain balance quickly), examine their walk to see if they take short steps and if they are not swinging their arms ( as they would with a usual gate), see if there is stiffness in the neck or limbs, and watch the patient get up from sitting—if it is difficult this would be one of the positive signs. Other than the above implied symptoms, slurred or slow speech can occur with Parkinson’s. As the disease progresses to the late stage, the patient often sits immobile, walks taking small, shuffling steps, talks slowly with monotonous speech and a low voice, and writes in progressively smaller handwriting. According to Howard Shifke’s blog, Fighting Parkinson’s Drug Free, the test his neurologist did to diagnose the disease included having him lay down on a table, hold his right arm up while patting his left hand on his left thigh – shortly into the exercise, his right arm began shaking wildly, indicative of a positive diagnosis.

Dopamine is the neurotransmitter in depletion with PD. If a patient’s symptoms improve upon taking Levadopa (a drug that increases the dopamine levels in the brain), this can be a positive sign as well. Acetocholine increases which is what causes the tremors.

There are no standard diagnostic tests as of yet. The only thing that can be used to measure dopamine metabolism in the brain are a brain scanner, but this is pricey and needs to happen at an imaging center.

Drugs that improve symptoms are Levidopa + Carbidopa or Sinimatt. Patients with rigidity should use 4 – 8 gm per day to get some of dopamine to the brain. This combination of compounds block the enzyme Dopa de Carboxylase.which depletes dopamine. If Entacapase is added to these two compounds the enzyme that decreases norepinephrine is blocked. The combo of the three is called Stalevo. All three stimulate mobility. Bradykinin, a naturally occurring chemical in the body, reduces mobility.

Mild early Parkinson’s can be treated by Amantadine, Benztopine, or Biperden – Amantidine being the most common drug used. This increases dopamine production. Drugs to treat the tremors are Artane and Benadryl. Benztropin and Artane are anticholinergic so the block actions of acetocholine.

Unfortunately there are no cures for Parkinson’s disease at this time. The above mentioned drugs merely lessen the symptoms.

Interesting Tid Bit:

Howard Shifke (mentioned earlier) who recovered from Parkinson’s without drugs, explains from a TCM diagnosis that Parkinsons if from 3 main factors:

“1. Qi and Blood Deficiency, which is caused by emotional stress, anger, frustration, and resentment.

2. Phlegm-Fire Agitating Wind, which is caused by dietary considerations such as consumption of too much greasy, fried or sweet foods.

3. Kidney and Liver Wind Deficiency, which is caused by overwork and insufficient rest which unbalances the body’s natural rhythm.”

He points out that some other factors played a part in his having PD: “my Mother had Parkinson’s for 24 years before she died, I was exposed to numerous environmental factors as were most of us who grew up in the 1960’s and 1970’s, and I ate a tuna fish sandwich for lunch at school every day from grade 1 through 12 (mid-60’s-1979, so I would have to say I have ingested more mercury than most)…these are the things that made me more prone to the disease, but I feel it was the three above-listed factors that allowed the disease to grow inside me for a long time until it reared its ugly head in September of 2009.”

So the disease running in the family played a role as well as environmental factors, specifically eating tons of mercury.

TCM perspective of Parkinson’s Disease:

There is an underlying Decline of Kidney essence from age, overwork, too much sex, improper diet, and emotional stress. This in turn leads to Liver and Kidney deficiency.

Other key factors of Parkinson’s: Liver and Kidney disharmony and Liver wind. Deficient root and excessive manifestations – wind phlegm obstruct the channels leading to qi stagnation and blood stasis.

The disease goes from mild to severe. Qi and Blood deficiency at beginning. If untreated, progresses to Liver and Kidney deficiency. Then wind phlegm are prone to obstruct the channels. Finally, Yin and Yang become deficient.

Treatment principle: nourishing yin and extinguishing wind. Invigorating blood and transforming phlegm.

Point prescription should be prescribed in groups and alternated in consecutive sessions since it is a long period of disease and you want to avoid overusing points.

Acupuncture treatment of Parkinson’s disease

Body acupuncture Main Points:

Parkinson’s Disease

Main Points

nourish Kidney and Liver yin to treat the root

tonify the liver and support treating the root

Extinguish Liver Wind

4-Gates moves qi and blood

KID-3, BL-18, LIV-3, LIV-8

SP-6, REN-4

GB-20, GB-31

LI-4 + LIV-3

Modifications

pronounced liver and kidney deficiency

tonify deficient qi and blood

wind phlegm obstructing the channels

blood stasis and endogenous wind

for yin and yang insufficiency

severe tremors

constipation

relieve dry mouth and numb tongue

BL-23, KID-6, GB-34

REN-6, ST-36

SP-9, ST-40

BL-17, SP-10

KID-6, DU-4, REN-6, ST-36

DU-14, HE-3, SI-3

ST-25, REN-6

REN-23, REN-24

.

Bleeding Technique

Effective method for PD

P-3, BL-40, DU-14, Taigyang

Moxibustion

Especially for yang qi deficiency, rigidity of muscles and limbs

SP-15, LIV-14, REN-8, ST-36

Herbal medicine for Parkinson’s:

Gou Teng has been prescribed with success for “the shakes” (Parkinson’s Disease) for 2000 years according to New Scientist Health.

According to Yufang Xue’s article The Treatment of Parkinson’s Disease by Acupuncture and Herbal Medicine, Here are a combination of herbs that work to address the root and branches, tonify the Liver and Kidney BIG TIME and strengthen the Spleen, and treat patterns and complications:

Nourish Liver and Kidney

Sheng Di Huang, Shi Hu, Bai Shao, Rou Cong Rong, Niu Xi, Du Zhong, Bie Jia

Warm Yang to get Yin through Yang

Du Zhong, Rou Cong Rong

Subdue uprising of Liver Yang to subdue Wind

Niu Xi

Extinguish Liver Wind

Tian Ma, Gou Teng, Long Gu and Mu Li

Transform Phlegm, invigorate Blood, activate the channels, extinguish int. Wind

Fu Shen, Hai Zao, Jiang Can and Chuan Shan Jia

Calms the Heart Shen to help extinguish Wind and promote Spleen and Stomach to prevent cloying of other herbs, and soften the stone and shell herbs

Fu Shen

For Modifications:

Tonidy Deficient Qi and Blood

(+) Huang Jing, Dang Gui and Bai Zhu

Deficient Liver and Kidney Yin

(+) E Jiao, Gui Ban, Mai Men Dongm, Wu Wei Zi

Wind Phlegm obstructing the Channels

(+) Shui Zhi, Dang Gui, Ji Xue, Lu Lu Tong

Blood Stasis with Endogenous Wind

(+) Huang Qi, Hong Hua, Tao Ren

Yin/Yang Deficiency

Ba Ji Tian, Lu Jiao Jiao, Wu Wei Zi

Severe Tremors

(+) Zhen Zhu Mu, Bai Ji Li

Rigidity and Tightness of Muscles and Limbs

Mu Gua, Quan Xie

High Cholesterol or Obesity

(+) Dan Nan Xing, He Ye, Cang Zhu

Constipation

(+) Tao Ren, Huo Ma Ren

Numb Tongue and Slurred Speech

(+) He Shou Wu, Shi Chang Pu, Yauan Zhi

Resources: http://www.fightingparkinsonsdrugfree.com/about/

The Journal of Chinese Medicine, The Treatment of Parkinson’s Disease by Acupuncture and Herbs, by Yufang Xue

http://www.mayoclinic.org/diseases-conditions/parkinsons-disease/basics/definition/con-20028488

http://www.pdf.org/en/causes?gclid=CjkKEQjw5-OdBRDW3ceD9fL0r4QBEiQAW7htXdpT_x2b-ky6jZuRQJy63ZFDQmtPSA0jM8npEy8QtYrw_wcB

Notes from Pharmacology class extrapolated from Pharmacology Lippincott’s Review

#neurodegenerationunderaconfocalmicroscope

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