Hong Hai 黄海

The Renhai Clinic 仁海堂 (www.renhai.com.sg)

and

Nanyang Technological University 南洋理工大学

Brahm Centre Talk

11th July 2015

Managing Chronic Illnesses with TCM

TCM Fundamentals

Human body is healthy when:

1. Internally balanced and externally in harmony

with the environment

2. Flows are smooth in the body

Illness occurs when there are imbalances

and/or blocked flows

(Germs then take hold, cells malfunction)

Therapy by restoring balance and flow, drawing

on self healing capabilities with which the body is

endowed

Different Approaches to health and healing

Biomedicine TCM (Western medicine)

Cause of illness: etiology Environment Treatment Interventions Facilitation Evidence Clinical trials Case studies Ideology Reductionist Holistic, heuristic

“Diseases of civilization” (Stephen Ilardi, MD)

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1. Depression, atherosclerosis, asthma, diabetes and cancers are

results of modern lifestyles following the industrial revolution (“Radical

environmental mutation”)

2. Evolution Interrupted: Man changed from hunter-gatherers to

factory and desk jobs, for which he is not adapted. The brain’s “runaway

stress response” replaced by prolonged stress (months, years). Processed

foods, less exercise and social interaction worsens it (c.f. Blue Zones)

3. Proliferation of synthetic drugs that replace the body’s self-healing with

interventions. Clinical trial: Walking half an hour 3 times a week beats Zoloft.

4. Solution : Return to old lifestyles. TCM Yangsheng 养生 (Life

cultivation) goes in this direction: regularity in living habits, moderation in

diet, balance yin and yang, and seek tranquility of mind.

Cardiovascular diseases(CVDs) CVDs comprise coronary heart disease, hypertension and stroke and

account for 30% of all deaths

Plaque in arteries TCM Treatment of CVD

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Slow down plaque formation by reducing blood stasis and boosting “heart qi”

Stroke incidence can be reduced “wind”, “phlegm” and blood stasis

Western and TCM methods in CVDs

Stenting removes an arterial blockage. But the underlying reasons for

clogging -- diet, lifestyle may remain.

Preventing re-stenosis: TCM uses herbal combinations (e.g. huangqi,

renshen, gualou, chuan xiong, taoren, honghua) that improve qi and reduced

blood stasis

Inflammation -- most cardiologists recognize this as the possibly the

important factor for coronary heart disease

TCM attributes CVDs to blood stasis, weakness of qi and poor

circulation of qi in the body. (Conjectural): These in turn may well be

the basis for the inflammation

TCM management of Hypertension & Strokes

Causes

• Stress leads to the hyperactivity of liver yang 肝阳上亢, expressed as

hypertension. It is a cause of liver wind (肝风) which could lead to stroke

Treatment

• Mild cases treated with diet and lifestyle changes and medications like tianmagouteng

yin 天麻钩藤饮 to calm the liver

• Stroke patients in the recovery phase usually have qi deficiency, and poor blood flow.

Buyang huanwu tang 补阳还五汤 is used

• Acupuncture, qigong and taiji improve qi level and flow and motor skills; counselling

to cultivate positive emotions. (Common acupoints used: taichong 太冲，hegu 合谷，renzhong 人中，baihui 百会)

Herbs for blood circulation

Hongqumi 红曲米 (Red yeast rice)

Shanzha 山楂 (Hawthorn berry)

Hawthorn berries also have the action of dilating coronary arteries. German scientists have used extracts from hawthorn leaves and flowers for Crataegutt for a similar medicinal effect of reducing blood stasis.

Red yeast rice reduces cholesterol levels

Chuanxiong 川芎 , honghua 红花 (safflower)， taoren 桃仁 (peach kernel) and tianqi 田七 reduce blood stasis and are used extensively in TCM for treating coronary heart conditions.

Chuanxiong 川芎

Herbs for improving qi

Huangqi 黄芪 (Astragalus)

Xiyangshen 西洋参 (American Ginseng)

Zhigancao 炙甘草 (Liquorice)

Huaishan 山药 (Wild yam)

Renshen 人参 (Ginseng)

All these herbs have the action of restoring the body’s qi level. Most of these herbs are also good tonics for the spleen.

Adequate qi will promote a better blood flow and reduce blood stasis.

Herbs for lowering blood pressure

Tianma 天麻 Gouteng 钩藤

These are the two main herbs used in the prescription tianma gouteng yin 天麻钩藤饮for treating hypertension and managing the initial period after a stroke. Both herbs have the action of calming liver yang and expel liver wind. Hence, they are also often used to treat headaches and dizziness resulted from hyperactivity of liver yang.

Foods for cardiovascular health

• Food that may reduce blood stasis include black fungus, yellow

ginger, celery, walnuts, cereals with high fibre content (e.g. rye

bread, whole grain wheat).

• Oily fish (salmon, tuna) can increase good cholesterol (HDL) level

• Food which may help to control blood pressure within the healthy

range are beet juice, spinach, lettuce, cabbage, carrots, bananas,

raisins, potatoes, raisins and melons.

Cancers

Biomedical viewpoint TCM Viewpoint

Causes not fully understood by biomedical science, but some risk factors are known.

Prevention focuses on avoiding these risk factors

The biggest factor of all is ageing

Treatment: Destroy tumours

Underlying condition is the loss of balance

between yin and yang, deficiency and excess

syndromes.

Deficiency in “healthy qi” leads to accumulation

of toxins, phlegm and dampness conducive to

tumors

Emotions upset balance in organs, making them

them vulnerable to cancers

Prevention: yangsheng; balance

Treatment: Restore harmony and internal

balance in the body, and strengthen healthy qi

(zhengqi 正气); remove toxins

Tumours and Terrorists

Early tumours can be destroyed by surgery, radiation or chemotherapy. Anita Mui could have been saved with such treatment for early for cervical cancer.

Cancer cells are like “terrorists” : killing them provides transient relief; only eradicating the underlying social reasons yields lasting solution.

But no assurance tumours would not come back if the underlying causes remain

Case of farmer from Ikaria with terminal cancer who survived after returning to his homeland

TCM complementary cancer treatment involves restoring body balance and healthy flows of qi and blood to improve remission prospects

Depression 郁病

In Western medicine, depression refers to a condition in which a person

suffers from several (but not necessarily all) of the following symptoms:

Lack of motivation, no interest in enjoyment, loss of appetite and libido, restlessness, sadness,

poor memory, insomnia, early morning awakenings

TCM yubing 郁病 does not exactly correspond to Western medical use of the term depression, but has a great deal in common with it. “yu” 郁 means stagnation; yubing is an illness involving stagnation in qi flow brought about largely by emotional factors

Common syndromes (patterns) in yubing

1. Stagnation of liver qi 肝气郁结

Symptoms: moodiness, chest oppression, sighing, belching, loss

of appetite, irregular bowel movements (chaihushugan san 柴胡

疏肝散)

2. Confusion in the spirit 心神惑乱

Symptoms: absent-minded and confused, unstable moods,

paranoia, nervousness, hysteria, pale tongue (Decoction of

liquorice, wheat and dates 甘麦大枣汤)

3. Deficiency of heart and spleen 心脾两虚

Symptoms: excessive contemplation, paranoia, nervousness,

insomnia, amnesia, poor appetite, pale complexion, pale tongue

(Decoction for strengthening heart and spleen 归脾汤)

For further reference (Chapters 1, 2, 10 and 11 )

•Interprets TCM in modern scientific terms

•Bridges the gap between Western science and Chinese medical thinking

•Chapters on diagnosis, herbs, chronic illnesses, convergence between biomedicine and TCM