TREATMENT

7.

    ;WorldJ.Acup-Mox.Vol10,No.1,March,2000.

    ;(;

    ;嬲馓;妇锻嗡

    ;TREATMENTOFTENCASESOFCHRONICFATIGUE

    ;SYNDROMEWITHCHINESEHERBS,ACUPUNCTURE,

    ;ANDDIETPRECAUTIONS

    ;C

    ;FredericC.W.Cheung,Dr.TCMJaneC.P.Cheung,B.Sc.,Dr.TCM ;InstituteofChineseMedicineandAcupuncture,Canada

    ;ABSTRACTTencasesofchronicfatiguesyndrome(CFS)weretreatedfor4weeksbyacupuncture,

    ;ChineseherbsanddietprecautionsDiagnosisofCFSwasdeterminedbyconventionalmedicinecriteria

    ;(CDCcriteriaforCFS),physicalexamination,androutinelaboratorytests.TCMdiagnosisofCFS

    ;reliedOilFourExaminationMethodsandEightPrincipalPatternsTheywerediagnosedaSGanyu

    ;Qizhi(1iverandqistagnation)andPixuQiruo(spleenandqideficiency).Thet

reatmentmethodis

    ;todispersetheliverandfacilitateqi,rehabilitatethespleenandstrengthenqi(ShuganLiqi,Jianpi

    ;Yiqi)TheresultofthetreatmentindicateelthatthetotaleffectiveratewaslO0%interms0ffatigue.

    ;difficultyconcentrating,headache,sorethroat,musclepain,jointaches,feverishness,rapidpulse,

    ;insomnia,depression,irregularmenses,abdominalcramps,andnightsweats.Thepercentagesofspe—

    ;cificsymptomsofCFSinthepatientswerecomparabletotheconventionalmedicalrecord(Table1).

    ;Table1.ApproximatePercentagesoftheSpecific

    ;S~ptomsofPatientswlththeChronicFatigue

    ;Syndror~intheConventionalMedicalRecord

    ;SymptorasPercentages

    ;Fatigue

    ;Difficultyconcentrating

    ;Headache

    ;Sorethroat

    ;Tendernessoflymphnodes

    ;Musclepain

    ;Jointaches

;Feverishness

    ;lrssomnla

    ;Psychiatricproblems

    ;Allergies

    ;Abdorninalcramps

    ;Weightl

    ;Rash

    ;Rapidpulse

    ;Weightgain

    ;Chestpain

    ;Nl口htsweats

    ;Chineseherbalprescription)?？蛐?ctu匿.

    ;INTRoDUCTIoN

    ;CFSiSawell—knowndiseaseItischarac—

    ;terisedbydebilitatingfatigueandavarietyofas—

    ;sociatedphysical,constitutional,andneuropsy—

    ;chologicalcomplaints(Tahie1)ll1. ;Themedical

    ;1iteratureofthepastthreecenturiesinformaus ;thatthisisnotaIlewtypeofsyndrome.The ;COnventionalmedicinefnCUseSonantivira1.the ;enhancementofimmunodefensivemechanism.

    ;andphysicalstrengthincombatingthissyn ;icineandAcupunc—

    ;ture,Canadafrom1996to1998.andthesyrup—

    ;tomsofthepatientsweredescribedinTable3. ;GENERALINF0RMAT10N

    ;Outoftencase8.ninearefernalesandoneis ;maleTwooasesarebetweentheages18and ;23;fouroasesarefromages31to41.Three ;cafesarebetweentheages48and54,andone ;caseisage65.Al1caseshaveahistoryoffatigue ;oraggravatedfatigueafteractivity.Thereisone ;cagewithseventeenyearsofhistory.fiveoases ;fromtwotofouryearsofhistory,threeoases ;fromfivetosixyearsofhistory,andonecase ;withsixmonthsofhistoryEightcasesexhibit ;low—gradefeverandrapidpulse.Thereareseven ;caseswithasorethroat.Eightcasesexperience ;paininmusclewhilefiveoasesexperiencepainin ;joint.Ninecaseshaveinsomnia.twooasessuffer ;fromnightsweats.Therearesixcaseswithab—

    ;dominalcramps.andfourcasesthatendureir. ;regularmenses.Sevencasessufferfromdepres—

    ;sion.Sevencaseshavedifficultyconcentrating. ;Thereareeightoasesthatexperienceheadaches. ;Table2?TheDiagnosticCriteriaforChronicFatl~me ;SyndromeFormulatedbytheU.S.C~ntreforDisease ;ControlmadPrevemlon

    ;Acaseofchronicfatiguesyndromeisdefinedby ;thepresenceof:

    ;1)Clinicallyevaluated.unexplained,persis—

    ;tentorrelapsingfatiguethatisnewofdef—

    ;initeonsettime;isnottheresultofongo—

    ;ingover—exertion;isnotalleviatedbyrest; ;andresuhsinsubstantialreductionofpre—

    ;viouslevelsofoccupational,educationa1. ;socia1.orpersonalactivities;

    ;2)Fourormoreofthefollowingsymptoms ;thatpersistorrecurduringsixormore

    ;consecutivemonthsandthatdonotPredate ;thefatigue;

    ;(1)Self—reportedimpairmentinshort—term

    ;memoryorconcentration;

    ;(2)Sorethmat;

    ;(3)Tendernessofcervicalorauxiliary

;nodes;

    ;(4)Musclepain;

    ;(5)Multi—jointpainwithoutrednessor

    ;swelling;

    ;(6)Headachesofanewpatternorseveri—

    ;ty;

    ;(7)Somnolence;

    ;(8)Post—exertionalmal~selastingtwenty ;fourhoursormore.

    ;TCMANDC0NVENT10NAL

    ;MEDICINEDIAGN0SIS

    ;Diagnosiscriteriaineonventiona1medicine ;isbasedoncDC(CenterforDiseaseControlin ;USA)criteriaforCFS(Tab1e2)【.Inaddi—

    ;tion,physicalexaminationandroutinelaboratory ;testshavetobeundergonetoexcludeotherail—

    ;ments.

    ;DiagnosticcriteriainTraditionalChinese ;Medicine(TCM)isbasedonFourProcedures ;(inspection,inquiry,olfactionandpulsepalpa- ;tion)andEightPrincipalPatterns(. ;Yang.Interior.Exterior,Cold.Hat.Deficien—

    ;cy.andExcess).Thedifferentialdiagnostic ;syndromeofTCMforthetencasesismainly ;GanyuQizhi(1iverandqistagnation)andPixu ;

    ;WorldJ.Acup-MoxVoL.10,NoI,March,20009 ;Qiruo(spleenandqideficiency)

    ;THERAPEUTICMETHoD

    ;Thetreatmentmethodistodispersethe1iv—

    ;erandfacilitateqi,rehabilitatethespleenand ;strengthenqi(ShnganLiqi,JianpiYiqi) ;GuipiTangismainlyappliedforCFS.It ;consistsofAstragalus(Huangqi)15g,Codonopsis ;Root(Dangshel1)15g,ChineseAngelicaRoot ;(Danggui)12g,Longan(Lon~anrou)12g, ;Big—HeadActractylodes(Baizhu)10g,Poria ;(Fuling)10g,SourJujubeSeed(Suartzaoren)10 ;g,Five—LeafAkebiaSeed(Muxiang)5g,Pre—

    ;paredLicoriceRoot(Zhegancao)5g,Polygala ;(Yuartzhi)3g.FreshGinger(Shengjiang)5 ;pieces.Jujube(Dazao)5fruitsF0rsorethroat, ;Seutellaria(Hoangqin)10gandPlatycodon ;(Jiegeng)10gareadded.PubescentAngelica

    ;Root(Duhuo)15gandLedebourielhRoot ;(Fangfeng)15gareaddedforjolntaches.For ;depression,Bupleurum(Chaihu)15gisadded. ;WhitePeonyRoot(Baishao)15gandBupleurum ;(Chaihu)15gareaddedforirregularmensesand ;abdominalcramps.Forheadsches,DahuficueA ;ngeliceRoot(Baizhi)15gisaddedForlow ;gradefever,rapidpulse,andnightsweats,Chi—

    ShdledTurtleShell(Biejia)15gand ;neSoft—

    ;LyciumBark(Digupi)5gareadded.Theherbal ;prescriptionwastakenthrcetimesperday.Sev—

    ;endaysconstituteonecours~.

    ;Acupointswerechosenasfollows:

    ;PrescriptionI:LeftNeiguan(PC6), ;Zhongwan(CV12),bilateralZusanli(ST36) ;PrescriptionII:Dazhui(GV14),Shenzhu ;(GV12),Zhiyang(GV9),Mingmen(GV14) ;PrescriptionIII:Feishu(BL13),Geshu ;(BL17).Ganshu(BL18),Pishu(BL20), ;Shenshu(BL23),Qihaishu(BL24).

    ;Treatmentwasadminsteredthreetimesper ;week.AcupointprescriptionsI—II1wereap—

;pliedahernately.

    ;ManipulationMethod

    ;Theevenmethodwasappliedtoleft

    ;Neiguan(PC6)ofPrescriptionI.Therestof ;theacupeintsweretonified.

    ;Thetonificationmethodwasappliedtoall ;theacupointsofPrescriptionII.

    ;eevenmethodwasappliedtoGans岛i

     ;(BL18)ofPrescriptionIII.Therestoftheacu—

    ;pointsweretonified.

    ;DIETPRBCAUTIONS

    ;Coffee,chocolate,alcohol,smoking,and ;hotspicyfoodswereprohibitedinthisstudy. ;RESULT

    ;Theabovetencasesweretreatedforfour ;weeksandwereanalysedintermsoftheirthera—

    ;peuticeffectiveness(Table3).

    ;FromTable3,wecanseethatthetotalef ;fectiverateofacupuncture,herbsanddietpre—

    ;cautionsappliedtotheteneasesofCFSinterms ;offatigue,difficultyconcentrating,headache, ;sorethroat,muscleaches,jointaches,feverish—

;nessandrapidpulse,insomnia,depression,ir—

    ;regularmens?,abdominalcramps,andnight

    ;sweatswas100%.

    ;

    ;10WorldJ.Acup-MoxVo/10,Noj.March.2000 ;Tible3.TheTherapeuticEffectivenessofTenCasesofCFS ;TreatedwithTCMandAcupunctureFoerWeeks ;DISCUSS10N

    ;Thetenco&esofCFSmanifestedmainlyby ;thesymptomsoffatigue,difficultyeoncentrat—

    ;ing,headache,80rethroat,muscleaches,joint ;ache~feverishnessandrapidpulse.insomnia, ;depression,irregularmenses.abdominal ;cramps,andnightsweatsinclinicTheTCM ;diagnosis(GanyuQizhi,PixuQiruo),liverand ;qistagnation.spleendeficiency,andqiweak—

    ;nesswasdeterminedafterthefourTCMexami—

    ;nationprocedures(inspection.inquiry.olfac. ;tion,andpulsepalpatation).Theetiopathology ;ofCFSwasduetolong—termdeficiencyand

    ;weaknessofthebodysystem.irregulareating ;anddrinkinghabit,emotionaldisturbarice,and