periphial neurapathy

January 12, 2001

GB31, SP6, ST42, ST43, ST44, DU2

In a message dated 1/12/1 12:34:12 AM, capuaco writes:

< Can anyone tell me if AP can help periphial neuropathy. It takes the

> form of numbness in my feet. Its cause could be related to my

> thyroid or perhaps high sugar i am told.

>

> Any suggestions would be appreciated.

>

> Thanks

> Rob

> >>

January 12, 2001

I have a handbook acupuncture guide, and can't seem to find anything

relating to numbness in the feet, let alone " neuropathy " .

However, you say that it might have something to do with your thyroid, try

rubbing up and down the neck (from the collarbone to the bottom of the

jawline). Auriculotherapy (acupuncture of the ear) is also said to help

treat the whole body (grab your right earlobe with your right hand and reach

over your head grabbing the top of the right ear, then massage the ridges of

the ear and gently pull the ear away from the skull). Scalp massage, and

kidney energizing should help to.

> Can anyone tell me if AP can help periphial neuropathy. It takes the

> form of numbness in my feet. Its cause could be related to my

> thyroid or perhaps high sugar i am told.

>

> Any suggestions would be appreciated.

>

> Thanks

> Rob

>

January 14, 2001

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& Diabetic Peripheral Neuropathyby Bob Flaws, Dipl. Ac. & C.H.

Peripheral neuropathy (a.k.a. polyneuropathy & peripheral neuritis) is a disease that is usually secondary to collagen vascular diseases, such as systemic lupus erythmatosus (SLE), scleroderma, and rheumatoid arthritis (RA), to metabolic diseases such as diabetes, or to infectious agents such as Lyme disease. In diabetes, symptoms of neuropathy may precede other signs and symptoms of carbohydrate and vascular abnormalities. As many as 60-90% of patients with diabetes suffer from peripheral neuropathy. However, modern Western medicine does not have any truly effective treatments for this condition. One of the most common treatments of PN is the prescription of amitriptyline, frequently sold under the brand name Elavil. Amitriptyline is an antidepressant. Some of its side effects include skin rashes, headache, dizziness, weakness, hepatitis, agitation, nightmares, nausea, fluctuations in blood sugar levels, heart palpitations, and even peripheral neuritis.

Therefore, if there are any effective alternative treatments for diabetic PN, I believe many people, physicians and patients alike, would like to know about them. In addition, PN is also commonly encountered in AIDS, and recent research published in the Journal of the American Medical Association suggests that amitriptyline is definitely not effective for that type of peripheral neuropathy. However, the Chinese medical descriptions of the pathophysiology of diabetes and AIDS are essentially the same and especially the Chinese description of peripheral neuropathy in both of these diseases. This Chinese description also accounts for the PN associated with SLE and Lyme disease and often, though not always, also covers the PN associated with RA and scleroderma.

Below is a report on a recently published piece of Chinese medical research on the treatment of diabetic PN with Chinese medicinals. In composing his protocol, the author assumes that most patients with diabetic PN present the Chinese medical pattern of qi and yin vacuity with vacuity heat complicated by blood stasis in the network vessels. The title of the original Chinese article in English is "The Use of Yi Qi Zhu Yu Tong Mai Tang (Boost the Qi, Dispel Stasis & Free the Flow of the Vessels Decoction) in the Treatment of Diabetic Peripheral Neuropathy." It was authored by Xu Sheng-sheng and published in Jiang Su Zhong Yi (Jiangsu ), issue #3, 1999, on page 23.

Cohort description:

Altogether, there were 118 patients in this study, all of which met the WHO criteria for the diagnosis of diabetes mellitus. In addition, all displayed varying symptoms of diabetic peripheral neuropathy. These included lower extremity tingling and numbness, formication, vague pain, piercing pain, burning pain, and muscular loss of strength. In addition, patellar and achilles reflexes were either weakened or absent.

These 118 patients were divided into two groups which were statistically similar in terms of age, sex, and basic symptoms. These two groups were the treatment group and the comparison group. The treatment group consisted of 86 patients, 45 of whom were male and 41 of whom were female. These patients ranged in age from 31-76, with a median age of 50.6 years. Eighty-four of these 86 patients were diagnosed with non insulin-dependent diabetes mellitus (NIDDM) and two with insulin-dependent diabetes mellitus (IDDM). Of the 32 patients in the comparison group, 18 were male and 14 were female. These patients ranged in age from 29-74, with a median age of 52.8. Thirty-one of these patients had NIDDM, while one had IDDM.

Treatment method:

In addition to dietary restrictions and sugar-lowering medications (i.e., insulin), the patients in the treatment group were orally administered the following basic formula: uncooked Radix Astragali Membranacei (Huang Qi), 30g, Radix Dioscoreae Oppositae (Shan Yao), 10g, Radix Scrophuariae Ningpoensis (Xuan Shen), 10g, Rhizoma Atractylodis (Cang Zhu), 10g, Radix Angelicae Sinensis (Dang Gui), 12g, Radix Rubrus Paeoniae Lactiflorae (Chi Shao), 12g, Flos Carthami Tinctorii (Hong Hua), 12g, Cortex Radicis Moutan (Dan Pi), 12g, Semen Pruni Persicae (Tao Ren), 12g, Caulis Milletiae Seu Spatholobi (Ji Xue Teng), 8g, dry Lumbricus (Di Long), 5g, Lignum Sappan (Su Mu), 6g, Radix Achyranthis Bidentatae (Huai Niu Xi), 9g, Radix Dipsaci (Chuan Duan), 10g, Fructus Chaenomelis Lagenariae (Mu Gua), 10g, Radix Gentianae Macricphyllae (Qin Jiao), 10g, Radix Pseudoginseng (San Qi), 6g, Hirudo (Shui Zhi), 3g. All except this last ingredient were decocted in water once per day and administered orally. The Hirudo was powdered and taken orally in gelatin capsules. Twenty days of this regimen equaled one course of therapy.

Instead of the Chinese medicinals described above, the comparison group was administered 25mg of dipyridamole, 10mg of vitamin B1, and 20mg of vitamin B6 , all three times per day. Likewise, 20 days of this regime equaled one course of treatment.

Treatment outcomes:

Marked effect was defined as a marked improvement in or disappearance of self-conscious symptoms and either normal or markedly improved patellar and achilles reflexes. Some effect meant that there was some improvement in both self-conscious symptoms and patellar and achilles reflexes. No effect meant that there was no improvement in self-conscious symptoms and no improvement in patellar and achilles reflexes.

Based on these criteria, 41 patients or 47.7% of the patients in the treatment group were judged to have gotten a marked effect. Another 38 patients or 44.2% got some effect, and only seven patients or 8.1% failed to register any effect. Therefore, the total amelioration rate in the treatment group was 91.9%. In the comparison group, only two patients (6.3%) were judged to have experienced a marked effect. Nine patients (28.1%) got some effect, and 21 patients or 65.6% got no effect. Thus the total amelioration rate in the comparison group was only 34.4%. Hence there was a very marked difference in statistical outcomes between these two groups (Pá0.005).

Author’s discussion:

According to the author of the above study, diabetic peripheral neuropathy should be categorized as xue bi or blood impediment in Chinese medicine. While yin vacuity and dry heat are the basic disease mechanisms in diabetes, these do not just damage yin but also consume the qi. According to Chinese medical theory, if the qi becomes vacuous and weak, then there is no power to move the blood. Likewise, if there is yin vacuity, the movement of blood will also become difficult and choppy or astringent. In addition, because enduring diseases enter the network vessels (i.e., the smallest vessels in the body), this results in static blood in the network vessels. Because the movement and transportation of qi and blood is not smooth and easy, static blood obstructs and stagnates. Hence the muscles and flesh of the four limbs lose their nourishment. This results in the symptoms of numbness and insensitivity. If the stasis obstruction is marked, then lack of free flow leads to pain.

Based on the above ideas of Chinese pathophysiology, the author then goes on to say that the requisite treatment principles for remedying this situation are to boost the qi and nourish yin, dispel stasis and free the flow of the network vessels. Within self-composed Yi Qi Zhu Yu Tong Mai Tang, Astragalus, Dioscorea, Scrophularia, Atractylodis (a.k.a. Atractylis), and Dipsacus nourish yin and boost the qi, supplement and boost the spleen and kidneys. Chaenomeles and Gentiana soothe the sinews and free the flow of the network vessels. Achyranthes guides the other medicinals to move downward (to the lower half of the body). Dang Gui, Red Peony, Moutan, Persica, Carthamus, Pseudoginseng, Lumbricus, and Hirudo are all strongly blood-quickening, stasis-dispelling medicinals, while Lumbricus and Hirudo particularly transform stasis and free the flow of the network vessels.

Among these, Hirudo’s flavor is salty and its nature is cold. It enters the blood division and strongly dispels stasis. However, its nature is slow and relaxed (i.e., moderate), and thus it does not damage the righteous qi. It is used in this formula in order to eliminate deeply recalcitrant stasis accumulation. Another medicinal which the author singles out for special mention is Pseudoginseng (a.k.a. Notoginseng). According to the author, Pseudoginseng has the ability to supplement vacuity at the same time as it is able to quicken the blood and dispel stasis.

The author ends this article by saying that the patients in this study were treated with these medicinals for a long period of time and that no hemorrhagic symptoms or any other adverse side effects were seen during that period. Therefore, based on both this formula’s reported clinical efficacy and its freedom from side effects, I do think it is a good one to try for all PN patients whose Chinese medical pattern is (spleen) qi and (liver-kidney) yin vacuity complicated by blood stasis in the network vessels. However, if the patient’s pattern is not the one stated above, one should not attempt to use this formula as a generic treatment for PN. As I have stated in previous issues of The Townsend Letter, professional Chinese medicine bases its treatment on each patient’s personal pattern and not on their disease diagnosis.

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Lee Lieske [capuaco]Friday, January 12, 2001 6:20 AMacupuncture Subject: Re: acupuncture periphial neurapathyI have a handbook acupuncture guide, and can't seem to find anythingrelating to numbness in the feet, let alone "neuropathy".However, you say that it might have something to do with your thyroid, tryrubbing up and down the neck (from the collarbone to the bottom of thejawline). Auriculotherapy (acupuncture of the ear) is also said to helptreat the whole body (grab your right earlobe with your right hand and reachover your head grabbing the top of the right ear, then massage the ridges ofthe ear and gently pull the ear away from the skull). Scalp massage, andkidney energizing should help to.> Can anyone tell me if AP can help periphial neuropathy. It takes the> form of numbness in my feet. Its cause could be related to my> thyroid or perhaps high sugar i am told.>> Any suggestions would be appreciated.>> Thanks> Rob>>>>>