Parkinson’s Disease Treatment with Acupuncture and Herbs

• September 25th, 2009
• Posted in Acupuncture and Its Theories, Herbal Medicine, Longevity and Beautiful Aging

Parkinson’s Disease with Acupuncture and Chinese Herbs

 

Parkinson’s Disease Symptoms

The diagnosis of PD depends upon the presence of one or more of the four most common motor symptoms of the disease, which are: resting tremor, bradykinesia, rigidity and postural instability.

In addition, there are other secondary and nonmotor symptoms that affect many people and are increasingly recognized by doctors as important to treating Parkinson’s.

Each person with Parkinson’s will experience these symptoms differently. For example, many people experience tremor as their primary symptom, while others may not have tremors, but may have problems with balance. Also, for some people the disease progresses quickly, and in others it does not.

Primary Motor Symptoms

• Resting Tremor: About 70 percent of people with Parkinson’s experience a slight tremor in the early stage of the disease – either in the hand or foot on one side of the body, or less commonly in the jaw or face. The tremor appears as a “beating” or oscillating movement. Because the Parkinson’s tremor usually appears when a person’s muscles are relaxed, it is called “resting tremor.” This means that the affected body part trembles when it is not doing work, and it usually subsides when a person begins an action. The tremor often spreads to the other side of the body as the disease progresses, but remains most apparent on the original side of occurrence.
• Bradykinesia (Slow Movement): Bradykinesia is the phenomenon of a person experiencing slow movements. In addition to slow movements, a person with bradykinesia will probably also have incomplete movement, difficulty initiating movements and sudden stopping of ongoing movement. People who have bradykinesia may walk with short, shuffling steps (this is called festination). Bradykinesia and rigidity can occur in the facial muscles, reducing a person’s range of facial expressions and resulting in a “mask-like” appearance.
• Rigidity: Rigidity, also called increased muscle tone, means stiffness or inflexibility of the muscles. Muscles normally stretch when they move, and then relax when they are at rest. In rigidity, the muscle tone of an affected limb is always stiff and does not relax, sometimes resulting in a decreased range of motion. For example, a person who has rigidity may not be able to swing his or her arms when walking because the muscles are too tight. Rigidity can cause pain and cramping.
• Postural Instability (Impaired Balance and Coordination): People with Parkinson’s disease often experience instability when standing or impaired balance and coordination. These symptoms, combined with other symptoms such as bradykinesia, increase the chance of falling. People with balance problems may have difficulty making turns or abrupt movements. They may go through periods of “freezing,” which is when a person feels stuck to the ground and finds it difficult to start walking. The slowness and incompleteness of movement can also affect speaking and swallowing.

Secondary Motor Symptoms

The secondary motor symptoms include those below, but not all people with Parkinson’s will experience all of these.  

• Stooped posture, a tendency to lean forward
• Dystonia
• Fatigue
• Impaired fine motor dexterity and motor coordination
• Impaired gross motor coordination
• Poverty of movement (decreased arm swing)
• Akathisia
• Speech problems, such as softness of voice or slurred speech caused by lack of muscle control
• Loss of facial expression, or “masking”
• Micrographia (small, cramped handwriting)
• Difficulty swallowing
• Sexual dysfunction
• Drooling

Nonmotor Symptoms

• Pain
• Dementia or confusion
• Sleep disturbances 
• Constipation 
• Skin problems
• Depression
• Fear or anxiety
• Memory difficulties and slowed thinking
• Urinary problems
• Fatigue and aching
• Loss of energy
• Compulsive behavior
• Cramping

If you find out more and go to http://pdf.org/en/symptoms.

 

All the symptoms listed above are what the Parkinson’s disease patients may experience and literally affecting the whole body and mind as well. 

Today, We are not going to see what kinds of treatments are available in Western, Allopathic medicine but in East Asian medicine – Acupuncture, Herbal Medicine, Qigong, Acupressure etc. and how Acupuncturist treat the PD patients effectively and produce the positive results.

 Of course, any traditional Asian medicine book doesn’t have the diagnostic name such as Parkinson’s disease however, the different diagnostic names exists based on its own physiological and pathological theories.

 First of all, Acupuncturist will find out the right diagnosis through their unique differentiation from your symptoms, you may have all of the listed or a part of them and pulse, tongue and more lifestyle questionnaires.

 If you look at those symptoms and you will know most of the things happening on the movement involving the muscles and balance; tremor, rigidity, slow movement, impaired balance and coordination and dizziness, nausea and which all belong to the category of Liver, Spleen in the zang fu theory (Asian medicine physiology)

 Therefore our first goal is to treat the impaired organ or energy meridian and balance them. And now let’s pull the remains and place them to the corresponding organs.

Compulsive behavior, depression, fear or anxiety, memory difficulty or slowed thinking, sleep disorder, dementia or confusion will all go to the liver and kidney.

 The related organs

• Liver
• Spleen
• Kidney

 The possible combination of the diagnosis

• Liver wind phlegm
• Liver Spleen Disharmony
• Liver blood deficiency
• Liver Kidney Yin Deficiency
• Spleen qi deficiency

 The appropriate formulas:

• Ban xia bai zhu tian ma tang(ban xia, tian ma, bai zhu, ju hong, fu ling, gan cao, sheng jiang, da zao)
• Si wu tang(shu di huang, bai shao, dang gui, chuan xiong)
• Gui bi tang(ren shen, huang qi, bai zhu, fu ling, suan zao ren, long yan rou, mu xiang, zhi gan cao, dang gui, zhi yuan zhi)
• Tian ma gou deng yin(tian ma, gou teng, shi jue ming, zhi zi, huang qin, yi mu cao, chuan niu xi, du zhong, sang ji sheng, ye jiao teng, fu shen)
• cheng qi tang variation(da huang, mang xiao, zhi shi, hou po)
• Chong pae sa gan tang(Korean Sasang Medicine)(ge gen, huang qin, gao ben, lai fu zi, jie geng, sheng ma, bai zhi, da huang)

 

The appropriate acupuncture points:

 PC6,  SP4,  LV3,  LI11,  LI4,  DU20, Yin Dang, GB31, 34, GB20, UB10, L120

HT8, LV2, HT7, SP3, REN17, REN12

Master Tong’s: bloodletting on zheng hui and needles on shang san huang(tian huang, ming huang, qi huang), zhen jing, zhou shui, zhou ling.

 

The Western doctors are also interested in acupuncture and herbal medicine in treating Parkinson’s disease.

 Handbook of Parkinson’s Disease–forth edition edited by Rajesh Pahwa, Kelly E. Lyons also introduced Acupuncture and Herbal Medicine as some of the alternative treatments as below.

 Acupuncture

 Persons with PD receiving acupuncture report a reduction in pain and sometimes improved sleep and mood and increased energy. Reduction of pain has consistently been reported by persons receiving acupuncture for a variety of conditions. Stimulation of the nerve fibers with the acupuncture needle is thought to activate the nervous, lymphatic, and electromagnetic pathways and result in a release of hormones that reduce pain as well as stimulate the immune system and improve circulation. Treatments often last 40 to 90 min while laying on one’s back with needles in place and to be effective may need to be done o minimum of one to three times weekly for a series of 10 to 12 weeks and then continue on a maintenance program of one to two times monthly. There are a few limited studies suggesting potential benefit of acupuncture for PD. One study involved 53 patients, 29 who received acupuncture every other day for a total of three months and 24 who received no acupuncture and did not change their western medications for PD. A significant improvement in PD motor symptoms was reported in the patients receiving acupuncture as well as an ability to reduce their dopaminergic medications, whereas the control group reported an overall worsening of symptoms. In similar studies, persons with PD have reported no change in symptoms or have withdrawn from the study due to lack of perceived benefit; however, in some studies improvements in sleep, depression, and quality of life were observed.

 Chinese Herbs

A number of herbs based upon the Chinese concept of PD would likely be prescribed and be tailored for the specific symptoms of the individuals. Herbs that support liver and kidney function to replenish the deficient yin state thought to occur in PD are lyceum fruit and ho-shou-wu. Supplemental herbs that might be added to these to boost yin are rehmania, dioscorea, cornus, peony, tortoise shell, ligustrum, and achyranthes. Yang deficiency may also occur and would be treated with cistanche and cuscuta that would gently support yang while also benefiting yin. More advanced PD is thought to result from stagnation of the body fluids or phlegm obstruction of the channels(meridians and blood vessels) and  would benefit from the herbs acorus, arisaema, and pinellia. Herbs to support blood circulation include ginseng, hoelen, atactylodes, licorice, rehmannia, tagkuei, peony, and cnidium all found in the Bazhen Tang formula. Specific symptoms such as tremor might be treated with the addition of gastrodia, uncaria, oyster shell, mother of pearl, or scorpion, whereas chaenomeles, peony and magnolia bark would be prescribed to lessen rigidity.

 Though there are no controlled, double blind studies on herbal therapies for the treatment of PD, several open label studies have reported a reduction in the motor symptoms of PD. One study reported 40 persons with PD treated with a standard herbal prescription(20g of he-shou-wu, 12g of lyceum(gou qi zi), 12g of cistanche(rou cong rong), 15g of gastrodia(tian ma), 18g of uncaria(gou teng), 18g of cnidium(she chuang zi), 10g of acorus(shi chang pu)). The standard herbal remedy was then altered with the addition of specific herbs according to the particular symptoms of the individual patient( i.e., magnolia bark(hou po), peony(bai shao), and chaemomeles(mu gua) for rigidity). A tea with the herbs was made and ingested three times daily for three months and all prior western dopaminergic medications were discontinued during the study. Only five patients(8%) were reported to be markedly improved and 15(27%) reported some improvement in the motor symptoms of PD, whereas the remainder(65%)had little improvement, no improvement, or a worsening of PD symptoms. Guoshong reported 32 persons with PD randomly assigned to receive the herbal remedy, wengan zhichan jianonang at 2000mg three times daily or carbidopa/levodopa for up to 12 weeks. There were no differences in motor symptoms between the two groups suggesting that the herbal therapy was as effective as the most potent conventional PD medication.

 Specific herbs for some of the associated symptoms of PD include some of the following. Datura stramonium seeds provide anticholinergic effects and can reduce tremor and rigidity. Evening primrose oil(oenothera biennis) may lessen tremor by increasing bioavailability of levodopa. Ginger(zingiber officinalis) minimize nausea and vomiting which may occur as a side effect from dopaminergic medications. Banisterine and nicotiana tabacum both have monoamine oxidase inhibitor activity similar to that of selegiline and rasagiline, and thereby may enhance the activity by reducing the metabolism of naturally occurring endogenous dopamine as well as synthetic dopamine. Passion flower(passiflora incarnate) may lessen anxiety and insomnia as well as  enhance sexual libido. St. john’s wart(hypericum perforatum) has been studied and shown to reduce symptoms of mild depression. Memory may improve with use of ginko biloba and constipation can be treated with triphala.

 Conclusion:

 Since we do not know what causes Parkinson’s, there is no cure yet. Scientists suspect that for most people the cause is probably the combination of the genetics and environmental factors and still try to find the answers and cure.

 Therefore I believe the goal of treatment in PD is to slow the development and ease the symptoms and help the patients live more quality of life. And to get the most positive result, I recommend the combination of Western and Eastern treatment together.

 The formulas and herbs introduced here can’t be used without consulting your acupuncturist or herbalist, only the experienced acupuncturist can make the proper formulas together with acupuncture treatment.

 For more information Contact TAO OF MEDICINE, ACUPUNCTURE and WELLESS

The research article : Acupuncture Therapy for The Symptoms of Parkinson’s

The Michael J. Fox Foundation for Parkinson’s Research

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