Tratamentos Para Doenças Neurodegenerativas

Treatment of Neurodegenerative Disorder

By Dr. John K. Chen and Dr. Hua Long Zhang

Alzheimer's, Stroke and Parkinson's Disease

"The silent epidemic" is regarded by many as the disease of the 90's. The silent epidemic is a term which refers to neurodegenerative disorders (such as Alzheimer's disease, sequelaes of stroke & Parkinson's disease) which plagues the majority of the geriatric population but is poorly recognized by the society due to their low public visibility and their social isolation. Though neurodegenerative disorders include a vast number of illnesses, this article will attempt to focus its discussion on Alzheimer's disease, stroke sequelaes, and Parkinson's disease. This article will approach these three illnesses from the viewpoints of both Western and Oriental medicine, and will further explore treatment options specifically with acupuncture and herbal therapies.

Neurodegenerative Disorders According to Western Medicine

The fundamental principle in Western medicine is that nerve cells cannot regenerate once they die. Alzheimer's disease, sequelaes of stroke, and Parkinson's disease each involves the death and atrophy of neurons (nerve cells) in the brain. Therefore, this is no cure for neurodegenerative disorder at the present time. All available treatment options focus on symptomatic treatment only.

Though the causes may differ, patients with neurodegenerative disorders are likely to show localized to generalized atrophy of brain cells leading to compromises in both mental and physical functions. Mentally, the patients will exhibit forgetfulness, poor memory, decrease in mental capacity, emotional disturbances, poor speech, etc. Physically, the patients will exhibit partial to complete incontinence, aspiration of food particles, tremor, poor balance, muscle rigidity, muscle paralysis, etc. These decreases in mental and physical functions dramatically reduce the quality of life for the patients and increase the burden of the family and care-takers.

Neurodegenerative Disorders According to Oriental Medicine

Neurodegenerative disorders are complex with an onset that is followed by progressive deterioration. Their clinical manifestations are determined by the location and the seriousness of neurodegenerative disorders. Its pathogenesis is a mixture of deficiency and excess conditions, represented by the deficiency of kidney essence or the blocking of the brain channel by blood stasis (an excess condition) - or both.

The cause of neurodegenerative disorders lies not so much in the brain (though it is the brain that shows the symptoms) as in the kidney, which according to the theories of Traditional Chinese Medicine controls the bone and generates the marrow. From the point of view of disease differentiation through viscera and their interrelations, the root of the disease is due to the deficiency of the kidney and the bone marrow. While the blood stasis and the phlegm accumulation are considered as the symptoms, not the cause. Therefore, the keys to treating neurodegenerative disorders are to tonify the kidney, eliminate the phlegm, remove blood stasis and induce resuscitation.

Treatment of Neurodegenerative Disorders with Acupuncture

According to the theories of Oriental Medicine, the spirit (shen) resides within the heart and the brain. The spirit is affected by the overall mental and physical health of a person. If the spirit is damaged, both the mental and the physical functions of a person would be greatly compromised. Deterioration in mental functions may result in delirium and dementia with the decline in physical functions resembling complications of stroke. Therefore, the treatment for neurodegenerative disorders should focus on awakening up the spirit (shen), opening up the sensory orifices and stimulating the brain. Dr. Zhang's treatment of neurodegenerative disorders and stroke involves awakening the spirit (shen), opening up sensory orifices and stimulating the brain. He focuses his treatment by selecting acupuncture points from the Yin channels. The selection of points are as follows:

1. Selection of Main Points: neiguan (P6), renzhong (Du 26) & sanyinjiao (Sp6).

Neiguan (P6) has the function to nourish the heart, calm the spirit, and promote smooth circulation of Qi and blood. Renzhong (Du 26) opens up sensory orifices, stimulates the brain and awakens the spirit. The combination of Neiguan (P6) and Renzhong (Du 26) has been found to increase the contractile strength of the heart and the cardiac output of blood circulation to the brain. Sanyinjiao (Sp 6) is the meeting point of the three yin channels of foot. Sanyinjiao (Sp 6) nourishes the kidney as well as tonifies the essence and the marrow to improve the function of the brain.

2. Selection of Local points:

Jiquan (H 1), chize (Lu 5), weizhong (UB 40), and hegu (LI 4) are local points which open up the channels and collaterals and improve the circulation of Qi and blood. Jiquan (H 1), chize (Lu 5), and hegu (LI 4) are used for paralysis and tremor of the arms and the hands; and weizhong (UB 40) is used for paralysis of the legs. Fengchi (GB 20), yifeng (SJ 17), wangu (GB 12) and tianzhu (UB 10) are four excellent points which help patients who may have speech impairment or frequent aspiration of food particles leading to respiratory infections.

Shanshangdien (upper thunder point) and xiashangdien (lower thunder point) are two extraordinary points which were discovered through clinical trial and experience. These two acupuncture points are very potent and should be reserved for those patients who have partial to complete paralysis. Shanshangdien (upper thunder point) is located on the lateral side of the neck, on the same level with Adam's apple, and between the sternal head and clavicular head of m. sternocleidomastoideus. Its is three cun posterior to the Adam's apple and one cun posterior-inferior. It is located slighted inferior to Neck-Futu (L.I.18). Its indications include frozen shoulder, shoulder pain, paralysis of the arm, stiff and rigid muscle of the arm, and tremor of the hand. Xiashangdien (lower thunder point) is located in the buttock region. Xiashangdien (lower thunder point) is the posterior tip of an equalateral triangle with greater trochanter and the iliac crest as the anterior two points. It is located slightly superior to Huantiao (G.B. 30). Its indications include pain in the lower back and hip region, muscular atrophy, sciatica, pain, weakness and muscular atrophy of the lower extremities, and hemiplegia.

3. Needling Technique: