Acupuncture Continuing Education

Acupuncture for COVID-19 and Long COVID

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Wen Yi & Li Qi

In traditional Chinese medicine, COVID-19 is a wen yi (瘟疫) illness because it is an epidemic illness, one that is highly contagious and spreads quickly. Wen yi is often translated as pestilence, plague, or epidemic.

SARS-CoV-2 is the li qi (疠气), which is the specific pathogen that causes COVID-19. According to TCM principles, highly contagious wen yi requires treatment, isolation, and preventative measures to prevent spreading throughout the populace.

COVID-19 is transmissible by people with asymptomatic and symptomatic presentations. The incubation period ranges from 1–15 days, but is usually…

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Epidemic Damp-Toxin

Differential diagnostics vary among patients, populations, and throughout the duration of the disease. Overall, COVID-19 is categorized as an epidemic damp-toxin, with some translations using the term damp-toxin pestilence. Damp pathogens are yin pathogens characterized by insidious onset that lingers combined with…

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healthcmi loingcovidsc2

Long COVID

Since COVID-19 is a damp-toxin, which has the quality of lingering and resisting recuperation, long-term COVID (Long COVID) may persist. Many cases have been reported with long-term fatigue and loss of taste and olfactory function…

More in course materials including signs, symptoms, and acupuncture points with locations and functions for prevention, treatment of active cases, and long-term recuperation...

 

 

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Clear Toxin Treatment

Renowned Chinese medicine physician Prof. Shui Wae, L.Ac. used GV14 combined with GV13 and GV12 for the treatment and prevention of external pernicious influences, including bacterial infections, viral infections, and other exteriorly contracted illnesses. GV14, GV13, and GV12 combined with…

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Wuhan Leishenshan Hospital Research

Research supports acupuncture for the treatment of COVID-19. Wuhan Leishenshan Hospital researchers integrated acupuncture and Chinese herbal medicine for the treatment of severe COVID-19. A total of… (more in course materials…)

Zhichuan
Zhichuan is located on the medial aspect of the forearm on a line connecting PC3 (Quze) and PC7 (Daling). Zhichuan is located at the upper third of this line, between the wrist crease and the transverse cubital crease. Indications for use of Zhichuan are myocardial disease, rapid heart rate, chest tightness, shortness of breath, and congestive heart failure.

Zhichuan is an extra point located along the pericardium channel, thus its relevance to the heart and pericardium. Its use for COVID-19 patients is based on the stages of disease progression. Initially, external pathogenic diseases often affect the lungs and the taiyang channels. Eventually, diseases may progress to the jueyin level (liver, pericardium). Acupoint Zhichuan helps to prevent the progression of the illness to critical stages and to prevent the invasion of fire-poison…

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Loss Of Olfaction

healthcmi smell olfaction19

A controlled clinical trial published in the Journal of Otolaryngology – Head and Neck Surgery finds acupuncture effective for restoring olfaction in patients with dysosmia (sense of smell dysfunction) due to viral infections.  Notably, the patients that…

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Hearing Loss and Tinnitus

Hearing loss and tinnitus are adverse effects correlated with COVID-19 for both acute cases and Long COVID. Three principle acupoints used to alleviate hearing loss and tinnitus are TB21 (Ermen), SI19 (Tinggong), and…

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Long COVID Exhaustion & Fatigue

Two major factors in long-term COVID-19 related depleted energy levels are lingering pathogenic factors and qi & blood deficiency. Lingering pathogenic factors may be viewed biomedically as insufficient clearing of the virus or secondary infections. Lingering pathogenic factors may also be viewed in terms of the six evils (wind, cold, damp, heat, summer heat, dry) and other Chinese medicine diagnostics. The goal is to clear the lingering pathogenic factors (pernicious influences) to restore vitality. The clear toxin treatment...

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Acupuncture For Long COVID Research 

ling gu da bai tung points

Acupuncture is effective in alleviating symptoms of Long COVID. Chronic COVID-19 (Long COVID) involves diverse conditions caused by acute COVID-19 that begin weeks, months, or years after the acute phase.

Tung's Acupoints
Linggu (灵骨, Spirit Bone, 22.05) and Dabai (大白, Great White, 22.04) acupoints belong to Master Tung's Dao Ma technique of unique acupuncture points. Linggu acupoint is located on the …

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Brain Fog

Brain fog is a common persistent symptom after COVID-19. Researchers note that it is a syndrome characterized by...

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1–28 Governing Vessel Acupuncture

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Governing Vessel: Pathways

The governing vessel (du mai, GV) guides qi circulation from the lower to the higher: from GV1 to GV20. The qi then flows anteriorly to the conception vessel (ren mai). The governing vessel (GV) assists the conception vessel in moving the qi from...

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Sample from Course Materials on Meeting Points:

Meeting Points Section

CV24
(Chengjiang, Jade Fluid Receptacle, 承漿)

CV24 is in the depression in the center of the mentolabial groove.

202413 cv24

CV24 is a meeting point of the conception vessel with the governing vessel. In addition, CV24 is a meeting point of the large intestine and stomach channels with the conception vessel. CV24 is a Sun Si-miao ghost point.

The jade fluid is purified saliva as discussed in the description of CV23. The kidney water of the governing vessel goes up to the crown of the head and then descends to this point and contributes to the jing-essence of the jade fluid. This is the transfer of jing-substance from kidney water to the jade fluid as it embraces qi. Taoist textbooks note that the qi of the governing vessel descends to this acupoint, which is the transfer of... 

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Sample from Course Materials on Acupoints:

GV13 (Taodao, Kiln Path, 陶道)

240213 gv13taodao

Location
GV13 is on the midline of the back, below the spinous process of the 1st thoracic vertebra. Standard needling is oblique and upward insertion, approximately 0.5 to 1.0 cun. Caution: the spinal canal is approximately 1.25–1.75 cun deep to the skin surface.
 
Taodao (陶道)
Taodao (陶道) may be translated as pottery kiln path, the way of happiness, or the path of Tao. A kiln is fiery hot. This translation emphasizes treating deficiency or excess fire.
This point also supports healthy fire and therefore has anti-aging properties. This point is also translated as a happiness path, because GV13 nourishes kidney yang and calms the spirit. This acupoint is specifically indicated for the treatment of unhappiness.
 
Meeting Point
This point is the meeting point of the governing vessel with the bladder channel.
 
Primary Functions
GV13 regulates the governing vessel, clears heat, relieves exterior conditions, and calms the spirit. 
 
Indications
Indications include steaming bone syndrome, chills, fever, headaches, heaviness of the head, blurry vision, spasms or stiffness of the spine, anhidrosis (absence of sweating), unhappiness, disorientation, and malaria.
 
Deficiency Fire: Steaming Bone
Steaming bone syndrome is a deficiency fire condition. Patients often experience one or more of the following:
 
• sensation of heat in the bones but the skin is a normal temperature
• afternoon tidal fever
• chronic low-grade fever
• severe night sweats
• dark red cheeks
 
A common herbal formula used for the treatment of steaming bone deficiency fire is Qing Gu San (cool the bones pills). This herbal formula is contraindicated during pregnancy. Qing Gu San contains the following herbs:
 
• Yin Chai Hu
• Zhi Mu
• Hu Huang Lian
• Di Gu Pi
• Qing Hao
• Qin Jiao
• Bie Jia
• Gan Cao
 
Wellness Visits
This acupoint is effective for relieving exterior conditions and clearing heat. As a result, GV13 combines with GV14 and GV12 for the treatment and prevention of external pernicious influences, including bacterial infections, viral infections, and other exteriorly contracted illnesses. GV14, 13, and 12 are often combined with LI11 and ST36 for...
 
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Sample from Course Materials—Outline of Research Section:

Research Section

Governing Vessels Acupoints in Research
The following section reviews several pieces of research. Each study includes the use of governing vessel acupoints. The following is a list of articles covered in the research section:

  • MRIs Predict Acupuncture Migraine Treatment Success
  • Acupuncture Surpasses Drugs For Asthma
  • Acupuncture And Herbs Found Effective For Pneumonia Relief
  • Acupuncture Found Effective For Lumbar Disc Herniations

COVID-19
This is a special section on COVID-19 research. (For additional research, visit the HealthCMi newsroom at the website for more research publications.)

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Sample of Course Material from the Research Section:

MRIs Predict Acupuncture Migraine Treatment Success

20240213 mriscan

 

Acupuncture is effective for the treatment of migraines. Researchers from Harvard Medical School, Xidian University, and Capital Medical University find acupuncture effective for the reduction of migraine attacks. They discovered that a patient’s pre-treatment brain structure is predictive of the success rate achieved by acupuncture for the reduction or elimination of migraines. Using MRIs and machine learning, specific patterns in brain gray matter prior to treatment were correlated with improved response rates to treatment. The acupuncture points applied to all patients were the following:
 
• GV20 (Baihui)
• GV24 (Shenting)
• GB13 (Benshen)
• GB8 (Shuaigu)
• GB20 (Fengchi)
 
Patients received three acupuncture treatments per week for a total of four weeks. Each acupuncture treatment lasted for a total of thirty minutes.  Patients receiving acupuncture were…
 
References:
1. Yang, X.J., Liu, L., Xu, Z.L., Zhang, Y.J., Liu, D.P., Fishers, M., Zhang, L., Sun, J.B., Liu, P., Zeng, X. and Wang, L.P., 2020. Baseline Brain Gray Matter Volume as a Predictor of Acupuncture Outcome in Treating Migraine. Frontiers in Neurology, 11, p.111.
 
Author Affiliations:
Department of Neurology, Beth Israel Deaconess Medical Centre and Harvard Medical School (Boston, Massachusetts).
Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, Xidian University.
Beijing Hospital of Traditional Chinese Medicine, Capital Medical University.
China Academy of Chinese Medical Sciences. 
 
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CPR #4

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Sample #1

Sudden Cardiac Arrest

Like every muscle in your body, the heart muscle moves when stimulated by an electrical impulse. The heart, however, does not rely on your brain to send these impulses like all other muscles; it creates its own electrical current from nodes located inside the heart. The sinoatrial node, located in the upper right portion of the heart, is primarily responsible for creating this impulse that then travels through conduction pathways through the muscle in an organized manner. As this impulse travels it stimulates the different…

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Sample #2

CPR Compression Techniques

  • To perform compressions, position yourself at the patient’s side.
  • Place the heel of one hand on the sternum in the center of the chest between the nipple line.
  • Place your other hand on top of the other, interlocking your fingers.
  • Slightly pull your fingers back so that only the heel of your hand is on the patient’s chest.
  • Lean over the patient so that your shoulders are directly over your hands and lock your elbows.
  • Begin by pushing straight down onto the chest hard and fast. Press down approximately at least two inches (5 cm).
  • Lift up, bringing your weight completely off the chest but keeping the hands in place. Let the chest completely rise.
  • Continue to do this at a rate of 100 per minute.

 

CPR

 

It is important to ensure that your compressions are hard and fast. With each compression you are building pressure inside the chest to help push blood to vital organs. Compressions that are too shallow or too slow do not build the necessary pressure and will not improve the chance of survival. It is also important to release the pressure on the chest so that the heart can refill with blood before your next compression. In review:

  • The hard and fast compression move the chest downward approximately 2 inches to push blood to vital organs.
  • The release of pressure refills the heart with blood and is accomplished by letting the chest completely rise.

Some rescuers have been trained to provide ventilations to a patient after 30 compressions. If you have...

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Sample #3

Automated External Defibrillators

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What are They?
Automated External Defibrillators, or AED, is a device that determines if a patient in SCA needs an electrical shock and then delivers that shock. Recent research has shown that the use of an AED nearly doubles the chance of survival in SCA. They are safe and easy to use and should be used whenever possible during SCA.​

How to Use Them
Once you have determined in your assessment that a patient appears to be suffering from SCA (unconscious, unresponsive, and displays no signs of life), you should attempt to find an AED while calling for help. When returning to the patient, use the AED as soon as it is available. The first step in using an AED is to turn...

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Dietetics Soups

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Two Soups & Ingredients

We start our dietetics journey in Prof. Jeffrey Pang’s office, discussing the two soups to be reviewed. This section provides a guide to what you see in the video and helps to clarify topics covered in the preparation and cooking process.

Two soups are presented, Ba Wang Hua (霸王花) soup and Shan Yao soup. The Ba Wang Hua soup focuses on clearing heat & toxins, stopping coughing, and dissolving hot phlegm.

The Shan Yao (山藥) soup mildly tonifies the spleen and benefits digestion. Hei Mu Er (黑木耳, black fungus) can be added as one of the ingredients. Hei Mu Er adds a mild invigorate blood function. Notably, the Shan Yao soup is good for the treatment of...

 

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Sample of Video Materials

This continuing education course is a multimedia experience with two major components: a cooking video and written materials. Enjoy this tasty culinary adventure about healling soups and Chinese medicine dietetics!
 

  

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Ba Wang Hua (霸王花)

ba wang hua forsoup

This herb is soaked in water to rehydrate and soften, and later cooked. Ba Wang Hua is sweet and enters the lung and liver channels. Ba Wang Hua (also called Jian Hua, Ba Huang Hua, Hylocereus undatus, Flos Hylocerus flower) dissolves hot phlegm nodules under the skin, which makes it appropriate for the treatment of swollen glands, lymph, and tonsils. Ba Wang Hua clears heat and toxins and….

 

 

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Xi Yang Cai (西洋菜, watercress)

watercress forsoup

Xi Yang Cai is cold, nourishes the lungs, alleviates constipation, and is valued for its significant nutritional and medicinal benefits. Watercress contains PEITC-NAC (N-acetylcysteine conjugate of phenethyl isothiocyanate) that has been shown in the following research to inhibit the proliferation of...

 

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Asian Pear (Xue Li)

asianpearforso

Xue means snow and Li refers to pear. Sometimes Asian pears are referred to as apple pears. The skin can be green, yellow, or white. A good quality Asian pear is juicy and crisp. Asian pears are sweet, cooling, and enter the lung and stomach channels. Asian pears nourish yin to promote the production of jin-ye (bodily fluids) and clear heat. The Asian pear treats dry coughs and...

 

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Shan Yao Soup

shan yao tonify qi

As we noted before, the Shan Yao (山藥) soup tonifies the spleen and benefits digestion. Notably, the Shan Yao soup is good for the treatment of weakness and is used to strengthen the body. The soup is also a good choice for strengthening the constitution of children, recovering from a dry cough or chronic illness, and balancing the body.

The total cooking and preparation time is approximately 30 minutes. Fill a pot with water and bring to a boil. Take pork spare ribs and cut into cubes (about 6–8 cubes) with a clever. Spare ribs have a mild tonify property and therefore combines well with the functions of Shan Yao. The use of spare ribs is for flavor. A vegetarian alternative to pork is the use of dried shitake mushrooms...

 

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Ba Wang Hua Soup 

ba wang hua soup diet01

Ba Wang Hua soup focuses on clearing heat & toxins, stopping coughing, moistening the lungs, and dissolving hot phlegm. This is appropriate for coughing with sore throat or fever. Some nicknames and labels in markets say things like aloe flower, dried Da Wang flower, and similar packaging labels.
In a bowl, soak the Ba Wang Hua (霸王花) for one hour to soften the dried herb. Empty the water from the bowl fill it again with...

 

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Pu-erh Tea

pu erh tea dietsoup01

Pu-erh tea is made from a large leaf variety of Camellia sinensis, primarily grown in the mountains of Yunnan province. It is often pressed into bricks but is also available in loose-leaf form after completing a special process of pressing. The special preparations involved in Pu-erh production allow the tea to mature with age. Unlike other teas, the flavor of pu-erh improves with age.

Pu-erh, like many forms of tea, is known for its antioxidant properties. This is due in part to the presence of catechins and flavonoids in the tea. [1] Pu-erh has the special ability to raise the ‘good’ HDL cholesterol while lowering levels of the ‘bad’ LDL cholesterol...

Reference:
1. Pin-Der Duh, Gow-Chin Yen, Wen-Jye Yen, Bor-Sen Wang, and Lee-Wen Chang. Effects of Pu-erh Tea on Oxidative Damage and Nitric Oxide Scavenging. J. Agric. Food Chem., 2004, 52 (26), pp 8169–8176.

 

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Herbs: Purity & Potency

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Medicinal herbs travel from seed to the medical practitioner’s office. Here, we explore how purity, potency, and sustainability are impacted by this journey. From seed to bottle, we look at farming practices, extraction techniques, protection of endangered flora and fauna, quality certifications and testing, traceability, herbal medicine research, and methods for verifying the geo-authenticity of herbal medicines. Ultimately, this entire chain affects the ability of medicinal herbs to deliver positive patient outcomes.

This continuing education course is a multimedia experience with two major components. Written materials are one component, the other is a 1.5 hour video. The following are samples from course materials:

 

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China Pharmaceutical University

This history is important because Tianjiang created an educational consortium with China Pharmaceutical University’s Department of Genetics and Breeding, that specializes in Chinese medicinal herb cultivation. This resulted in the first publication of a work that identified the historically correct species of Chinese medicinal herbs, confirmed by various testing methods, including TLC (thin-layer chromatography). In this way, correct seed stocks are identified and maintained. That work is entitled TLC Atlas of Concentrated Granule Prescription. The following pictures are from a two volume set:

TCMatlas2volset

 

 

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Seeds

The TLC Atlas allows for determining exact botanical identity. Herb producers throughout China and the Chinese government have adopted the TLC Atlas as a definitive standard of Chinese herbal medicine identification. Using TLC and mass spectrometer multi-constituent testing, Tianjiang (in partnership with China Pharmaceutical University) has differentiated specific herb varieties with the greatest concentrations of therapeutic components.

Several decades ago, this level of determining herbal authenticity was unavailable. However, the nascent Chinese herbal medicine industry has grown significantly enough to document this important information.

Requirements for testing and maintenance of seeds is an active process, involving...

 

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Daodi

Daodi regions are the first choice for growing herbs, unless potency and purity are superior in other regions. The term daodi is similar to the French term terrior (environmental conditions, including soil and climate, for growing grapes).

Daodi has a broader scope in that the term also includes individual herb organoleptic qualities and clinical efficacy. Daodi refers to the traditional regions and...

 

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Dry Granulation & Optimal Parameters

Tianjiang uses a dry granulation technique, which is superior to wet spray. Dry granulation does not require an excipient and can be achieved at low temperatures, thereby preserving the active ingredients in many herbs.

Tianjiang sets optimal parameters based on variables such as temperature, pressure, length of time, and number of extractions. These parameters have been repeatedly tested in several ways. For example, HPLC (high-performance liquid chromatography) is used to measure the active ingredients in herbs before and after processing to ensure that the active ingredients are...

 

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A special 1.5 hour video has been developed for this course. Here is a preview of the video materials included in your online CEU course package:

 

 

 

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Ethics In Acupuncture #5

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Confucian Temple (Taichung, Taiwan)

 

 

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Sample #1

“I have just three things to teach: simplicity, patience, compassion. These three are your greatest treasures.” — Lao Tzu

Confucianism

Basic principles of medial ethics have their their roots in ancient traditional Chinese medicine. Daquing Zhang and Zhifan Cheng note in "Medicine Is a Humane Art: The Basic Principles of Professional Ethics in Chinese Medicine":

The value system of medical ethics in China has a long tradition that can be traced back to ancient times. Those values are reflected in the (Confucian) precept that "medicine is a humane art." That is, medicine is not only a means to save people's lives, but also a moral commitment to love people and free them from suffering through personal caring and medical… [1]

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1. Zhang, Daqing, and Zhifan Cheng. "Medicine is a humane art the basic principles of professional ethics in Chinese medicine." The Hastings Center Report 30, no. 4 (2000): S8-S12.


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Sample #2

Hippocratic Oath

Hippocrates (460–375 BCE) was an ancient Greek physician. Authorship of the Hippocratic Oath, an ancient ethical code, is attributed to Hippocrates. To this day, classical and contemporary versions of the Hippocratic Oath are included in some medical school graduation ceremonies. By today’s standards, there are several aspects of the Hippocratic Oath that are considered significantly controversial. The following is a translation of the Hippocratic Oath from the original Greek by Francis Adams in 1849:

I swear by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation—to reckon him who taught me…


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Sample #3

Taoism & Buddhism

taoist temple garden

Taoist Temple Garden at Weibao Mountain (Yunnan, China)

 

In addition to Confucianism, Chinese medicine ethics has its roots in both Taoist and Buddhist values:

Taoism and Buddhism also influenced the development of medical ethics in China, themselves vigorously promoting the practice of medicine as a means of doing good. Taoism favors life and resents death. It regards being alive as the happiest thing and pursues immortality. Taoists pursue long life in either of two ways: by taking special medicines made from plants, animals, or minerals and by doing good deeds that benefit others. Five commandments are at the heart of Taoist religious codes. A Taoist is forbidden to... [2]

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2. Zhang, Daqing, and Zhifan Cheng. "Medicine is a humane art the basic principles of professional ethics in Chinese medicine." The Hastings Center Report 30, no. 4 (2000): S8-S12.

 

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Sample #4

Chinese Medicine Physicians

A famous 7th century physician, Sun Simiao, wrote a treatise entitled “On the Absolute Sincerity of Great Physicians.” This was a section of the work entitled The Important Prescription Worth a Thousand Pieces of Gold. The treatise is sometimes referred to as the Chinese Hippocratic Oath, although there are significant differences between the Hippocratic Oath and the values documented by Sun Simiao. The treatise “requires the physician to develop first a sense of compassion and piety, and then to make a commitment to try to save every living creature, to treat every patient on equal grounds, and to…

 

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Sample #5

Fairness

It is maintained by many scholars of Chinese medicine that patients deserve fair and equitable access to healthcare and quality treatments. In this respect, patients must be treated with equal respect. The concept that patients deserve equal access to care has historical roots in Chinese medicine:

Chen Shih-kung (AD1605) also presented the similar idea of treating high or low, rich or poor equally. He particularly mentioned that prostitutes should be treated in the same way as daughters from a good family, which entails both equality and respect. Moreover: "Medicine should be given free to the poor. Extra financial help should be extended to the destitute patients; if possible..." [3]

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3. Tsai, D. F. "Ancient Chinese medical ethics and the four principles of biomedical ethics." Journal of medical ethics 25, no. 4 (1999): 315-321.

 

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Sample #6 

Medical Records

Acupuncturists are required by law to maintain medical records for several years in many states, provinces, and countries. Additional requirements for medical record retention may be made by malpractice insurance carriers. Health insurance companies may also require…

 

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“#1 – 20” True Meaning of Large Intestine Acupoints

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Sample from the Acupoint Section

LI2 (Erjian, Second Space) 二间


LI3 (Sanjian, Third Space) 三间

LI2 is on the radial side of the index finger, distal to the metacarpal-phalangeal joint, at the junction of the red and white skin. This point is located with the finger slightly flexed. LI3 is located when a loose fist is made, the point is on the radial side of the index finger, in the depression proximal to the head of the second metacarpal bone.

 

LI2 EjianLI3 Sanjian

LI2 is a ying-spring, water, and son point. Traditional indications include epistaxis, toothache, sore throat, and fever. LI3 is a shu-stream and wood point. Traditional indications include toothache, eye disorders, sore throat, and inflammation of the hand.

The flow of qi from LI2 to LI3 is similar to the flow of qi from in front of a small hill to behind the hill. At LI2, the qi is resting and getting ready to traverse the hill. At LI3, the qi is ready and is exposed, it will eventually grow in power to the valley of LI4 (Hegu). This is a reflection of the point’s anatomical location. The qi flows from the depression distal to the metacarpo-phalangeal joint (front of the hill) to the depression proximal to the joint (behind the hill). The qi is growing in power as it moves toward LI4. We say the qi is maturing from LI2 to LI3. We can also say it is developing, from a relatively undeveloped state to a more developed state. We say the qi is gathering strength from the underground spring (ying-spring point) to the stream (shu-stream point) above ground.

The energy behind the bone matures and blossoms at LI3 as it travels from LI2; therefore, LI3 is more for mature (developed) symptom presentations. LI2 is more for immature (undeveloped) symptoms because the qi has not yet grown. For example, a skin rash that is hiding under the skin is immature and therefore LI2 is appropriate. Once the rashes expresses, we say it has matured and therefore LI3 is a better choice.

Similar to the underground spring, unexpressed symptoms are more appropriately addressed with LI2. Similar to the above ground stream, expressed symptoms are more appropriately treated with LI3. Another example, asymptomatic common cold infections are immature and therefore LI2 is a good choice over LI3. However, once there are presentations of symptoms, the disease is maturing; therefore...

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Sample from the Acupoint Section

LI4 (Hegu, Gathering Valley) 合谷


LI4 is on the dorsum of the hand, between the first and second metacarpal bones, approximately at the midpoint of the second metacarpal bone on the radial side. When squeezing the thumb against the index finger, LI4 is at the highest point of the muscle bulge, approximately level with the end of the crease.

LI4 hegu samplehcmi

LI4 is a yuan-source point and an entry point. LI4 disperses the wind, release the exterior, eliminates pain, and clears the channels. Traditional indications include headaches, eye pain, epistaxis, toothaches, deafness, facial edema, facial paralysis, sore throat, trismus (locked jaw), fever, delayed labor, local pain, and general pain. Combined with KD7, this point is used for insufficient sweating. In addition, this point is often used with SP6 with electroacupuncture for the treatment of delayed labor.

LI4 is a Gao Wu command point for the treatment of face and mouth disorders. LI4 is a Ma Dan-yang heavenly star point, indicating that this point is an important and powerful point, especially for indications such as headaches, facial swelling, malaria, fever, chills, and toothaches. This acupuncture point is contraindicated during pregnancy, especially when there is qi and blood deficiency.

The lung and large intestine are paired organs in the Chinese medicine system. Both organs have the function of clearing and expelling stagnation. The lungs are capable of expelling stagnant foreign objects and phlegm and the large intestine are responsible for eliminating stagnated stool. This point powerfully eliminates stagnation and has the energy of both the lungs and large intestine.

 

Tiger Power
According to five element theory, the lungs are correlated with the white tiger. The tiger is strong and gets rid of anything he/she does not like. LI4 shares the lung channel power of the tiger and is used to eliminate excess and exterior conditions. This is, in part, due to the lung and large intestine being paired organs.

The lung channel “white tiger” and LI4 share the tiger’s power and name. One historical name for LI4 is tiger mouth. The reference to tiger mouth comes from ancient Chinese culture, especially from the martial arts. In the martial arts, applying pressure to this point creates powerful reactions and can subdue an opponent. This is one power of the tiger. In addition, the shape of LI4 is a reference to a tiger’s mouth. It is where the thumb and index finger open like a tiger’s mouth.

The large intestine has the power of moving stagnation and this power is expressed in this acupoint’s ability to eliminate things that are not healthy. With the power of the lung tiger and large intestine, LI4 powerfully...

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Sample from the Acupoint Section

LI10 (Shousanli, Arm Three Miles )
 手三里

LI10 is on the line joining LI5 and LI11, 2 cun distal to LI11.

LI10 Shousanli ArmThreeMiles

Although the character li (里) in the name of the point is translated as mile, it is technically shorter than a mile. Although there have been variations in this traditional measurement over time, 1 li is approximately 0.3 miles or 0.5 km.

Note: the literal translation of Shou (手) is hand, but this is also used to refer to the arm as in Shouwuli (LI13, Arm Five Miles). The character for hand is also cultural reference to the arm when used for the name of LI13.

LI10 is synchronized with ST36 (Zusanli, Leg Three Miles). The reference to the synchronization is within the names of the points: Arm Three Miles, Leg Three Miles. Anatomically, LI10 and ST36 are in similar locations distal to the elbow and knee respectively. As a result, they communicate with each other, which is reflected in the names. These are paired points that are used to tonify qi. LI10 clears the large intestine channel pathway and assists the strengthening function of ST36 to benefit the stomach and spleen.

ST36 zusanli legthreemiles

LI10 has a powerful function to reduce stagnation and is therefore effective for invigorating qi and blood circulation to the arm, elbow, rotator cuff, and scapula. For example, when a patient has frozen shoulder syndrome, this point can be needled while passive or active motion is exerted, which frees mobility in the arm and shoulder. For any shoulder or arm pain, this point provides a deep...

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Sample from the Safety & Ethics Section

Sun Simiao

A famous 7th century physician, Sun Simiao, wrote a treatise entitled On the Absolute Sincerity of Great Physicians. This was a section of the work entitled The Important Prescription Worth a Thousand Pieces of Gold. The treatise is sometimes referred to as the Chinese Hippocratic Oath. The treatise “requires the physician to develop first a sense of compassion and piety, and then to make a commitment to try to save every living creature, to treat every patient on equal grounds, and to avoid seeking wealth because of his expertise.” [1] Sun Simiao commented on relations with colleagues, “it is inappropriate to emphasize one’s reputation, to belittle the rest of the physicians and to praise only one’s own virtue.”
----
1. Veatch, Robert M. Cross-cultural perspectives in medical ethics. Jones & Bartlett Learning, p 320-321, 2000.

 

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Sample from the Research Section

Acupuncture Nerve Regeneration

Acupuncture repairs injured nerves. Findings published in Neural Regeneration Research demonstrate that acupuncture causes injured lower and upper limb motor nerves to repair. Electromyographic nerve conduction tests of acupuncture patients with nerve injuries document “an effective response” in 80% of patients participating in the study. Electromyography confirms that acupuncture significantly improves motor nerve conduction velocity and amplitude and also promotes functional nerve repair.

The researchers made an important discovery. A special set of acupuncture points resulted in good to excellent clinical responses at a very high rate. Using only local acupuncture points, patients had an effective rate of 38.5%. By adding acupuncture points to the…

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Allergic Rhinitis: Acupuncture Downregulates IgE

Ige acupuncture HealthCMi

Acupuncture alleviates nasal and eye itching, sneezing, and runny nose for patients with allergic rhinitis. Researchers confirm that acupuncture successfully downregulates IgE (immunoglobulin E), an antibody active in hypersensitivity reactions, while simultaneously reducing symptoms of allergic rhinitis. In a controlled investigation published in the Annals of Allergy, Asthma & Immunology, university researchers demonstrate that acupuncture downregulates allergen specific IgE for dust mites.

Researchers from Stanford University, RMIT University, Griffith University, and Western Sydney University conclude that acupuncture…

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Acupuncture For Carpal Tunnel Syndrome

carpaltunneltx healthcmi

Acupuncture relieves carpal tunnel syndrome pain and restores function. Two independent studies reveal the benefits of warm needle acupuncture for CTS (carpal tunnel syndrome). Participants in both studies experienced significant improvements in pain levels and wrist function following acupuncture treatment combined with…

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Acupuncture Modulates Brain Activity

MRI studies reveal the neurological mechanisms of acupuncture on human health. Research published in Autonomic Neuroscience demonstrates that stimulation of specific acupuncture points induces hemodynamic changes in specific brain networks. The researchers add that brain networks accessed by specific acupuncture points relate to specific medical disorders and suggest an “acupoint-brain-organ” pathway.

Functional magnetic resonance imaging (fMRI) studies reveal specific acupuncture point effects…

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Oncology

Acupuncture Course Samples

Prof. Jeffrey Pang, L.Ac.Ken Pang, L.Ac. and Prof. Jeffrey Pang, L.Ac.

 

 

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Sample from Biomedical section:

Forms of Cancer

There are in excess of 100 types of cancer. Many are named after the original area where the cancer formed or the type of cells involved. In this section we review common types of cancer.

Carcinoma
This is one of the most common forms of cancer, formed by epithelial cells, which are the cells that cover bodily surfaces including the skin, blood vessels, organs, and urinary tract. Different names are given to carcinomas based on the origin of what type of epithelial cell gave rise to the cancer. For example, 

"Adenocarcinoma is a cancer that forms in epithelial cells that produce fluids or mucus... Basal cell carcinoma is a cancer that begins in the lower or basal (base) layer of the epidermis, which is a person’s outer layer of skin…. Squamous cell carcinoma is a cancer that forms in squamous cells, which are epithelial cells that lie just beneath the outer surface of the skin. Squamous cells also line many other organs, including the stomach, intestines, lungs, bladder, and kidneys." [1]

1. cancer.gov/about-cancer/understanding/what-is-cancer. 4-15-2020. About Cancer.

adenocarcinoma20082321 

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Sarcoma
Cancers that form in soft tissue and bone are sarcomas. This includes lymph vessels, tendons, ligaments, fat, and blood vessels.

sarcoma oncology

 

Leukemia
Leukemia is cancer originating in the blood-forming tissue of bone marrow. This type of cancer does not form tumors. Leukemia is characterized by “large numbers of abnormal white blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow, crowding out normal blood cells.” This creates issues with the proliferation of normal blood cells and impairs oxygen distribution and fighting infections.

Lymphoblastic leukemia is when the bone marrow produces too many lymphocytes (a white blood cell type). Myeloid leukemia is when the bone marrow produces excess white blood cells and myeloblasts (immature white blood cells) buildup in the bone marrow and blood. This “impairs development of other blood cells, leading to a shortage of red blood cells (anemia) and platelets.”

 

Melanoma
Melanoma is cancer that forms in pigmented tissues, primarily in the skin. However, any pigmented tissue may be involved, including tissue in the eye. Melanoma originates in cells that become melanocytes, which are responsible for creating melanin (pigment).

The following illustration depicts melanoma that enters the bloodstream and lymphatic tract:

melanoma oncology

Lymphoma
Lymphoma is a type of cancer originating from T cells or B cells (lymphocytes). These are white blood cells that are abnormal and build-up in lymph nodes and vessels and other areas of the body. Hodgkin lymphoma is the term….

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Sample from Chinese Medicine introduction section...

Chinese Medicine

The treatment of cancer patients is covered in the course material and is based on Pang family treatment strategies and the years of experience in treating cancer patients by Ken Pang, L.Ac. and Prof. Jeffrey Pang, L.Ac. It is our belief that combining Chinese medicine with western medicine is the best choice for patients and increases the ability of the immune system to fight cancer.

Disclaimer: Nothing in this course is intended to indicate that acupuncture or herbal medicine treats or cures cancer. The course materials present TCM and its perspective on supporting cancer patients.


TCM Etiology Of Tumors

  • Qi Stagnation
  • Blood Stasis
  • Dampness
  • Heat and Toxins
  • Phlegm Stagnation
  • Zheng Qi Xu (Good/Upright Qi Deficiency)
    
In this course, we use the term zheng qi. It is translated as good qi or upright qi, and refers to qi that protects the body and maintains health.

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General Acupuncture Points

Cancer patients suffer from emotional trauma after being diagnosed with cancer. As a result, the following points apply for all cancer patients:

  • DU20 (GV20), Yin Tang, PC6, HT7, LV3, LV14, LI4
  • Ear Points: Shenmen and points for the Zang-Fu organs related to the specific cancer diagnosis (e.g., Heart, Liver, Kidney, etc.)

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Sample from cancer pain treatment section:

Acupuncture For Cancer Pain

The following are points that assist in pain relief for specific types of cancer:

  • Lung Cancer: LU6, LU10, KD3, PC6, SP4
  • Liver Cancer: GB34, LV6
  • Stomach Cancer: CV12, ST36
  • Breast cancer: CV17, LV14, GB21, SI11

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Sample from treatment principles section:

TCM General Cancer Principles

The following are general treatment principles for supporting patients with cancer.


A. The Relationship of Tonifying Zheng Qi and Expelling Evil

1. Early stage: focus on expelling the evil and slightly tonifying the zheng qi.
2. Middle stage: equally tonify the zheng qi and expel the evil.
3. Late stage: focus on tonifying the zheng qi and slightly expelling the evil.

The aforementioned three principles are general guidelines; however, adjustments are made for specific diagnostic considerations. For example, a patient may be in the stage 1 “early stage” but may require stage 2 “middle stage” treatment strategies.

The term evil refers to unhealthy influences and processes that cause illness. This includes the six evils, which are also called the six pernicious influences: wind, cold, damp, heat, summer heat, dryness. Evil also refers other influences, including bloods stasis and heat toxins.

 

B. Bian Zheng vs. Bian Bing

Two important ways of looking at disease must be considered: bian zheng (pattern differentiation) and bian bing (disease differentiation). Bian zheng is the classic TCM (traditional Chinese medicine) differentiation of illness into syndrome patterns. This is based on principles including zang-fu syndromes (internal organ syndromes), eight principles/parameters, six stages, four levels, channel diagnostics, san jiao disorders, and qi, blood, and fluid disorders.

Bian bing refers to naming a specific disease based on location or other etiology by disease differentiation (e.g., lung cancer, liver cancer, breast cancer, prostate cancer).


Lung Cancer Clinical Example

Let’s take a look at a real world example from the Pang family clinic. A patient presented with the bian bing diagnosis of lung cancer; however, the bian zheng diagnosis was determined to be spleen qi deficiency with liver fire uprising.

  • Bian bing: lung cancer
  • Bian zheng: spleen qi deficiency with liver fire uprising

According to TCM principles of pattern differentiation…

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Sample from channel guiding herb section:

Channel Guiding Herbs

The following is a list of channel guiding herbs that help herbal formulas reach specific locations:

1. Liver channel: Chai Hu 柴胡, Qing Pi 靑皮, Chuan Xiong 川芎, Wu Zhu Yu 吳茱萸
2. Gallbladder channel: Chai Hu 柴胡, Qing Pi 靑皮
3. Heart channel: Huang Lian 黃連, Xi Xin 細辛
4. Small intestine channel: Huang Bai 黄柏, Gao Ben 藁本
5. Spleen channel: Sheng Ma 升麻, Cang Zhu 蒼朮
6. Stomach channel: Shi Gao 石膏, Bai Zhi 白芷, Ge Gen 葛根, Sheng Ma 升麻
7. Lung channel: Jie Geng, Sheng Ma 升麻, Cong Bai

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Sample from oncology principles section: 

TCM Oncology Principles

The following are six specific treatment principles for the treatment of patients with cancer within the Chinese medicine system:

1. Clear Heat and Toxins
2. Invigorate Blood and Dissolve Blood Stasis
3. Support Zheng Qi and Tonify the Root
4. Soften the Firmness and Spread Out Nodules
5. Yi Du Gong Du: “Toxic to Toxic”
6. Permeate the Dampness and Dispel Toxicity

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Sample from herbs section:

Bian Bing Herbal Medicine Choices

The following are herbs used when considering bian bing (disease differentiation). Herbs listed as “comprehensive” are considered generally helpful for cancer patients. On the other hand, herbs listed citing specific conditions are considered helpful for supporting patients with that particular condition.

Disclaimer: Please note that many areas legally forbid listing any traditional medicine as beneficial for the treatment of cancer and this listing only indicates that the herbs support the patient that has cancer and does not specifically treat cancer. Check for local and national laws on the use of specific herbs as these regulation fluctuate.

1. Qing Dai 青黛 1 qian, three times per day: chronic leukemia
2. Zhi Zi 山梔子 acute leukemia with excess heat
3. Qian Cao 茜草 digestive system cancers
4. Qi Ye Yi Zhi Hua 七葉一枝花,蚤休,重樓 comprehensive
5. Bai Hua She She Cao 白花蛇舌草 comprehensive

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Sample from herbal formula section:

General Immunity Support

This following formula is for general immunity support for patients with tumors but is not listed for treating and removing tumors. Patients with tumors require referral to an appropriate medical professional for consultation and treatment of tumors.

Pang family traditional support formula:

Treatment Principle: Support the upright qi, expel evil qi

  • Ban Zhi Lian 半枝莲 30g
  • Bai Hua She She Cao 白花蛇舌草 30g
  • Kui Shu Zi 葵树子 15g
  • Yi Yi Ren 薏苡仁 30g
  • Zhu Ling 猪苓 30g
  • Fu Ling 茯苓 15g
  • Ling Zhi 灵芝 30g
  • Dang Shen 党参 15g
  • Xi Yang Shen 西洋参 15g
  • Bai Zhu 白术 15g
  • Huang Qi 黄芪 15g
  • Nu Zhen Zi 女贞子 9g
  • Chai Hu 柴胡 9g
  • Yu Jin 郁金 9g
  • Ji Nei Jin 鸡内金 6g
  • Zhi Gan Cao 炙甘草 9g

Preparation:
Cover the herbs in water and decoct. Because this is a large amount of herbs…

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Sample from dietetics section:

TCM Dietetics Treatments for Reducing Toxicity from Chemo & Radiation Therapy

Patients undergoing chemotherapy and radiation therapy require support. The depleting nature of chemotherapy indicates that tonifying qi and blood becomes an important principle in supporting these patients. The fire and toxins from radiation therapy indicates that clearing the fire toxins is an important principle. The following are helpful dietetics suggests for inclusion into the dietary regimen of patients.

1. Green tea with Jiao Gu Lan tea 
(Jiao Gu Lan Cha)  绞股蓝茶療法
Jiao Gu Lan 绞股蓝 is slightly bitter, cold, and enters the lung and heart channels. It tonifies qi, moistens the lungs, and dispels phlegm. Jiao Gu Lan also clears heat, eliminates toxins, and reduces inflammation. Green tea (Lu Cha, Cha Ye) clears heat, dispels dampness, and eliminates toxins. Together, these two herbs support patients with gentle detoxification. This is a simple dietary addition that helps support the patient.


2. Hai Dai Lu Dou Sheng Gan Cao Tang
海帶綠豆生甘草湯
This is a simple three herb formula of Hai Dai, Lu Dou 綠豆, and Sheng Gan Cao 甘草. The mung bean (Lu Dou) and raw licorice (Sheng Gan Cao) combination is taken as a hot tea or soup. It clears heat and relieves fire toxicity. Together, these herbs…

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Sample from Fa Foods section:

Improper Diet Triggers: Fa Foods & Rich Tonics

Eating Fa foods too early or resumption of strong tonifying foods too early may cause difficulty in wound healing, especially after surgery when organs need to heal. The general principle is to maintain a balanced diet, eat things that are easy to digest, and no heavy tonifying foods. Fa foods are those that cause the growth of pathogens.

Fa foods are contraindicated if skin problems are present, after an injury or surgery, or if there is an infection. The same is true for patients with cancer or having recently recovered from cancer. The Fa foods may lead to unwanted growth. The one Fa food exception is mushrooms because, in many cases, this food may be beneficial.

Fa Foods

  • Shellfish, including shrimp and crab: these foods are particularly contraindicated for psoriasis, eczema, and patients with infections. Shellfish tend to turn red when cooked and the concept is that the red from the cooking equates into increased redness and inflammation for these patients. Science confirms that there are several forms of reactions to shellfish including the release of histamines from mast cells.
  • Alcohol
  • Green onions and chives may present problems due to their warming nature.
  • Roasted or barbecued foods: top contraindications are attributed to domestically raised roasted duck, goose, and Peking duck.
  • Chicken, especially rooster, is contraindicated because it tonifies yang.
  • Goat meat

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Sample from research section...

Sloan-Kettering Cancer Center Research & Lymphoedema

Memorial Sloan-Kettering Cancer Center research demonstrates that acupuncture significantly reduces lymphedema related arm swelling in women after breast cancer surgery. Lymphoedema is a when there is fluid retention and tissue swelling in the body due to disorders of the lymphatic system. The lymphatic system controls the return of interstitial fluid to the bloodstream. After breast cancer surgery, the lymphatic system can be damaged by lymph node surgery or radiation therapy. Symptoms may appear quickly or take several months or years to become apparent. Swelling of the arms and sides of the body is most common after lymphatic system damage due to breast cancer procedures.

The researchers at Sloan-Kettering (New York) note that existing conventional treatments for lymphoedema are only “marginally beneficial, rarely reducing arm swelling in any meaningful way.” The new study concludes that acupuncture...

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Reference: Acupunct Med. doi:10.1136/aim.2011.004069. A safety and efficacy pilot study of acupuncture for the treatment of chronic lymphedema. Barrie R Cassileth, Kimberly J Van Zee, Yi Chan, Marci I Coleton, Clifford A Hudis, Sara Cohen, James Lozada, Andrew J Vickers.

 

 

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Sample from research section...

Acupuncture Pancreatic Cancer Pain Research

Researchers conducted a randomized, placebo controlled study to investigate whether or not acupuncture reduces pain associated with pancreatic cancer. This type of cancer is often accompanied by severe abdominal or back pain. The researchers concluded that, “Electroacupuncture was an effective treatment for relieving pancreatic cancer pain.”

A total of 60 pancreatic cancer patients with severe pain were randomly divided into two groups. Group 1 was the placebo control group and group 2 received verum acupuncture. The acupuncture points used in the study were the…

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Heart Disease

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Congestive Heart Failure (CHF)

Biomedicine
This section focuses on the treatment of chronic CHF. According to the National Heart, Lung, and Blood Institute of the U.S. National Institutes of Health, heart failure (also termed congestive heart failure):

... is a condition in which the heart can't pump enough blood to meet the body's needs. In some cases, the heart can't fill with enough blood. In other cases, the heart can't pump blood to the rest of the body with enough...

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The NIH (National Institutes of Health) notes in the U.S. National Library of Medicine website:

The weakening of the heart's pumping ability causes:

  • Blood and fluid to back up into the lungs
  • The buildup of fluid in the feet, ankles and legs [edema]
  • Tiredness and shortness of breath

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Diagnostics include listening to heart sounds, lungs sounds indicating fluid buildup, and swelling of the legs, ankles, feet, abdomen, and veins of the neck. Tests include EKG (electrocardiogram), chest X-ray, a BNP hormone (B-type natriuretic peptide) blood test, echocardiography, ultrasound measurements of lung and heart blood flow, Holter monitor of the heart’s electrical activity over a 24–48 hour period, stress tests, nuclear heart scans, cardiac...

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CHF Diagnosis

  • Heart yin and yang deficiency
  • Spleen qi deficiency

Chronic CHF encompasses a complex of diagnostic considerations and there are variations in differential diagnostics per each individual case. Primary diagnostic considerations are heart yin and yang deficiency and spleen qi deficiency. Additional considerations include:

  • Water obstruction due to kidney yang deficiency affecting the heart
  • Blood stasis due to qi deficiency
  • Phlegm dampness obstructing the lungs

Patients often present with shortness of breath (especially upon exertion), fatigue, cyanosis of the lips or nail beds, palpitations…

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Acupuncture

Pang Family Acupuncture Point Prescription

  • PC6, HT7, ST36, SP9, SP6, BL15. Needle BL15 using warm needle moxa technique.
  • Auricular points: Shenmen, heart, kidney, spleen. For auricular points, selection of ear tacks for longer-term retention of needles is appropriate.

Acupoints
pc5pc6hd01

Neiguan, PC6 (Inner Pass)
This point is 2 cun above the transverse wrist crease, on the line connecting PC3 and PC7, between the tendons of the palmaris longus and flexor carpi radialis.

PC6 is the luo (connecting) point of the pericardium channel. It is the confluent point of the Yinwei vessel (Yin Linking Vessel). PC6 regulates the heart, calms the spirit, regulates qi, suppresses pain...

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Alternate Point Selections

Dirty Water Affecting The Heart Due To Kidney Yang Deficiency
When there is water affecting the heart due to kidney yang deficiency as a predominant presentation, the acupuncture formula may be modified. The principle is to warm the kidney yang and remove the dirty water.

Acupuncture Points:

  • HT7 (Shenmen)
  • PC6 (Neiguan)
  • BL15 (Xinshu)
  • SP9 (Shuifen)
  • ST36 (Zusanli)
  • BL23 (Shenshu)
  • GV4 (Mingmen)

This selection includes the addition of BL23 and GV4 to the Pang family point prescription…

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PC5 – PC6 Research

University of California School of Medicine researchers demonstrate that electroacupuncture applied to PC5–PC6 produces “point-specific effects on cardiovascular reflex responses.” [i] The researchers add that sympathetic cardiovascular rostral ventral lateral medulla neurons that respond to both visceral (reflex) and electroacupuncture nerve stimulation “manifest graded responses during stimulation of specific acupoints.” [ii]

The researchers conclude that electroacupuncture "demonstrates a range of cardiovascular responses" and the levels of "visceral reflex pressor responses are influenced by the anatomic location of somatic nerves beneath the acupoints." [iii] They identified specific responses; "deep nerves exerting strong influence and superficial cutaneous nerves demonstrating little or no attenuation of cardiovascular reflex responses." [iv] The results were published in the American Journal of Physiology – Regulatory, Integrative and Comparative Physiology.

The researchers note after testing multiple acupoints, including PC5 and PC6...


References from this section:
i. Tjen-A-Looi SC, Li P, Longhurst JC (2004) Medullary substrate and differential cardiovascular responses during stimulation of specific acupoints. Am J Physiol Regul Integr Comp Physiol ii87: R852-R862.
ii. Ibid.
iii. Ibid.
iv. Ibid.

 

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Sample of Research Materials On Coronary Heart Disease

Single Photon Emission Computed Tomography

An acupuncture study from the Department of Nuclear Medicine at Peking University Shenzhen Hospital successfully measured improvements in blood flow to the heart for patients with coronary heart disease (CHD).

Using single photon emission computed tomography (SPECT), researchers discovered that needling two specific acupuncture points caused significant improvements in patients with CHD. Acupuncture successfully increased “blood perfusion of ischemic myocardium.”

Coronary heart disease is...

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Arrhythmias and Pulses

According to Chinese medicine principles, it is usually easier to correct issues of the pulse when the heart beat is irregularly irregular. An irregularly irregular pulse involves irregular beats but they do not have a specific pattern. Generally, a regularly irregular pulse is considered a more intractable disorder. A regularly irregular pulse has a set pattern of irregularity. The following is a list of some of the types of irregular pulses that are commonly seen in a Chinese medicine clinic:

Hesitant-Choppy
In Chinese medicine literature, this pulse is described as a sick silkworm eating a mulberry leaf or a knife scraping bamboo. It is considered the opposite sensation of feeling a slippery pulse. It is uneven, rough, and sometimes irregular in strength and fullness. This may be caused by qi and blood stagnation. If this pulse is thin, it may be caused by jing, blood, or yin deficiency.

Abrupt-Hurried
This pulse is fast and irregularly skips...

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Hyperactive Heart Yang Tachycardia

A common presentation of tachycardia is due to hyperactivity of heart yang. Common presentations of heart yang pathologically floating upwards include tachycardia, palpitations, insomnia, and mental restlessness. Yin fails to nourish the heart due to yin and blood deficiency. Yin deficiency heat disturbs the chest and often results in mental restlessness. This presentation often results from excess stimulation and output from the sympathetic nervous system (SNS).

Diagnosis
Heart yang floating upwards

Treatment
Anchor the yang, Tonify qi

Pang family herbal formula
This herbal formula tonifies qi and anchors the floating yang. The herbs Ku Shen and Bai Zi Ren have a special function to slow the heart rate.

Dang Shen          (Radix Codonopsitis Pilosulae, 党参)      12 grams
Gan Jiang          (Dried Rhizoma Zingiberis, 干姜)           2 g
Mai Men Dong       (Ophiopogon Root Tuber, 麦门冬)           12 g
Rou Gui Fen        (Cortex Cinnamomi Cassiae powder, 肉桂)    1 g
                    put the cinnamon powder in the tea cup with cover
Sheng Di Huang     (Rehmannia Root, 地黄)                    12 g
Ku Shen            (Radix Sophorae Flavescentis, 苦参)       12 g
Huo Ma Ren         (Semen Cannabis Sativae, 火麻仁)          15 g
Huang Lian         (Rhizoma Coptidis, 黄连)                   4 g
Fu Ling            (Sclerotum Poriae Cocos, 茯苓)            30 g
Bai Zi Ren         (Semen Platycladi, 柏子仁)                12 g
Long Gu            (Os Draconis, 龙骨)                       30 g
Zhi Gan Cao        (Radix Glycyrrhizae, 炙甘草)               10g

 

Decoction Instructions
Cover the herbs with water plus 2–3 inches of additional water above the herb line in the pot. This is a large amount of herbs, so this formula can be boiled up to three times per bag. Each dose can be decocted and consumed separately. Alternatively, boil each bag three times and then mix the decocted herb tea from all three boilings. This creates a more even dosage. Then, separate the mixture into three doses. Drink one cup per day during periods of relative remission. During more serious states of the disease, drink one cup in the morning and one cup at night.

 

Individual Herbs Within The Formula

Dang Shen
Dang Shen is sweet, neutral, and enters the lung and spleen channels. This herb tonifies the middle jiao (burner) and tonifies lung and spleen qi. Dang Shen nourishes blood and promotes the generation of bodily fluids.

Gan Jiang
Gan Jiang is spicy, hot, and enters the heart, lung, spleen, and stomach channels. Gan Jiang warms the middle jiao, expels cold, dispels wind-dampness affecting the lower jiao (burner)...

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Master Tung #1

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Sample from course materials:

This course focuses on two acupuncture point selections used for the treatment of gynecological disorders. The first point (11.06 Return to the Nest) is a single acupuncture point used by Master Tung and his family. The second (11.24 Gynecological Points) is a two-point combination also developed and used by Master Tung within his family tradition. Together, they are a powerful combination for the treatment of gynecological disorders. Supplementary points (including 11.17 Wood Anger) are also reviewed.

Used primarily for women, 11.06 Return to the Nest and 11.24 Gynecological Points are acupuncture points combined to treat all gynecological diseases, such as premenstrual syndrome, menopausal hot flashes and night sweats, infertility, ovarian disease, cyclic migraines, PCOS, and endometriosis. Both point selections are presented in detail, starting with 11.06 Return to the Nest.

 

11.06 Return to the Nest (Huan Chao)

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master tung rtn3

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Location
11.06 Return to the Nest is located on the ulnar side of the middle phalange of the ring finger, centered between the second and third finger creases, just palmar to the intersection of...

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Kidney Stones, Enuresis, and Kidney Disease

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Sample 1

Biomedicine
Kidney stones are hard pieces of material formed in the kidneys due to high levels of minerals in the urine that are not properly excreted. “Kidney stones are caused by high levels of calcium, oxalate, and phosphorus in the urine. These minerals are normally found in urine and do not cause problems at low levels.” [1]

Usual care terms for kidney and urinary tract stones are often the following: nephrolithiasis, urolithiasis, urinary stones. The following is from the Hackensack University Medical Center:

  • Urolithiasis (urinary tract calculi or stones) and nephrolithiasis (kidney calculi or stones) are well-documented common occurrences in the general population of the United States. The etiology of this disorder is multifactorial and is strongly related to dietary lifestyle habits or...

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1. niddk.nih.gov/health-information/urologic-diseases/kidney-stones/symptoms-causes

 


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Sample 2

Chinese Medicine
Lin syndromes generally present with urgent, frequent, difficult, or painful urination. Kidney and urinary tract stones are termed stone lin (shi lin).

Symptoms

  •  low back pain that may radiate to the abdomen or groin
  •  painful or scanty urination
  •  pain of the lower abdomen and groin region
  •  hematuria (blood in the urine)
  •  passage of stones through the urine


Diagnostic Patterns

  • lower jiao (burner) damp heat
  • qi and blood stagnation turns into stone
  • deficiency of spleen and kidney qi

Damp heat kidney and urinary tract stones may be caused by excessive intake of hot and spicy foods, greasy and fried foods, and excessive alcohol intake. In some cases, heart fire transmits to the small intestine. The damp heat may lead to hematuria. For this presentation, the tongue is red and the coating is greasy and yellow. The pulse is slippery and rapid.

Qi and blood stagnation kidney and urinary tract stones may be caused by emotional factors including anger and irritability causing liver qi stagnation leading to fire. The fire in the lower burner and through the liver channel disturbs the kidneys and bladder. The tongue is purple and the pulse is wiry and rapid.

Spleen and kidney qi deficiency kidney and urinary tract stones may be caused by overexertion, long-term fatigue, ...

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Sample 3

Acupuncture

  • Needle ashi points on the lower abdomen and back
  • SP6 (Sanyinjiao)

Use strong stimulation techniques on the acupoints. Often, the pain resolves within a few minutes.

  1. SP6 (Sanyinjiao)
    SP6 is 3 cun directly above the tip of the medial malleolus, on the posterior border of the medial aspect of the tibia. Sanyinjiao is translated as 3 yin junction; this point is the meeting of the 3 lower yin meridians. SP6 strengthens the spleen, transforms dampness, spreads liver qi, and benefits the kidneys. SP6 is an important acupuncture point in obstetrics and...

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Sample 4

Herbal Formula
The following herbal formula is effective for expelling urinary tract stones and kidney stones, especially when due to lower jiao damp heat and qi and blood stagnation:

  • Jin Qian Cao 30g
  • Bai Shao 30g
  • Ji Nei Jin 20g
  • Bai Mao Gen 12g
  • Nui Xi 15g
  • Hou Po 12g
  • Zhi Shi 12g
  • Yan Hu Suo 15g
  • Yu Jin 15g
  • Qing Pi 3g
  • Mu Xiang 6g (add last five minutes)
  • Gan Cao 6g

Herbal Formula Chief Herbs
Jin Qian Cao, Bai Shao, and Ji Nei Jin are all used with heavy dosages and they are the main herbs used to expel the stones. The remaining herbs regulate qi and blood and also relax the smooth muscles of the urinary tract.

Directions
Cover the herbs with water and leave approximately...

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Sample 5

Nocturnal Enuresis
Nocturnal enuresis is the involuntary discharge of urine at night. It is intermittent urinary incontinence or bedwetting during sleep. The discussion below covers the topic of adult and adolescent bedwetting. Acupuncture and herbal medicine are often effective for resolving this condition, thereby avoiding the need for aggressive medical interventions and associated iatrogenic risks. For a usual care perspective, Cornell University researchers (Department of Urology, Weil Medical College) state the following:

  • Adult onset nocturnal enuresis with absent daytime incontinence is a serious symptom that usually heralds significant urethral obstruction, and a high incidence of...

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Sample 6

Chronic Kidney Disease
Chronic kidney disease (CKD) is when damaged kidneys are not able to filter blood properly. Typically, the kidney damage happens gradually over an extended period of time and wastes build-up in the body, which may lead to secondary illnesses.

The kidneys filter excess water and waste from the blood and create urine. They are responsible for balancing minerals and salts (e.g., calcium, phosphorus, sodium, potassium) that circulate in the bloodstream. Other important functions include producing hormones responsible for regulating blood pressure and producing red blood cells. In addition, the kidneys play a crucial role in...

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Sample 7

Kidney Dietary Recommendations
Reduce consumption of proteins with saturated fats. Reduce sodium and sugar consumption. Increase the amount of carp fish in the diet and drink Chi Xiao Dou soup.

Li Yu Chi Xiao Dou Tang
Li Yu Chi Xiao Dou Tang is a soup that promotes urination and treats dirty water stagnation. Indications include edema, chronic nephritis, leg qi disorder, obesity, water retention due to PMS and liver cirrhosis with ascites. Two important ingredients are carp and adzuki beans, the full recipe is covered:

  • Carp (Li Yu)
    Carp enters the lung and kidney channels and promotes urination. According to Chinese medicine theory, carp is a strong variety of fresh water fish much like shark is considered a strong saltwater fish. Carp appear to have a mustache, have golden-shiny scales, survive outside of water longer than many fish, jump high above the water at high speeds, and can grow to approximately 140 lbs. and 56 inches in length. Carp are representative of the dragon. Bighead carp has a stronger medicinal function than other varieties; however, silver carp is often more widely available while continuing to provide similar medicinal benefits.
  • Adzuki Beans (Chi Xiao Dou)
    Adzuki beans are sweet, sour, neutral and enter the heart and small intestine channels. Chi Xiao Dou promotes...

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Ethics in Acupuncture #4

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Sample # 1

Rights, Privacy, Dignity
Respect the rights, privacy and dignity of my patients and maintain confidentiality and professional boundaries at all times.

Misconduct
This NCCAOM ethical item touches upon both legal and ethics concerns. For example, sexual contact with a patient is legal misconduct. This also violates this ethical code regarding professional boundaries. The NCCAOM notes that this is grounds for professional discipline. The NCCAOM Certification Handbook notes that professional discipline is appropriate unless six months has elapsed:

  • Engaging in sexual contact with a former patient unless a period of six (6) months has elapsed since the date that the professional relationship ended…

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Sample # 2

Sign-In Sheets
At the healthcare office, sign-in sheets are visible to the public if left on the desk at the reception area. This is permissible by HIPAA; however, only the person’s name can be required. It is illegal to have “major complaint” or “purpose of visit” on the form. A sign-in sheet is…

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Sample # 3

Confidentiality
The NCCAOM code of ethics respects the rights, privacy, and dignity of the patient. What about speaking to our patients in the reception area or in a semi-private clinical setting? From an ethical point of view, there is wisdom and compassion in not revealing medical information in public that a patient may find undignified, intrusive, or embarrassing. The legal perspective is somewhat flexible in this regard. The HHS (U.S. Department of Health & Human Services ) writes the following:

  • Can health care providers engage in confidential conversations with other providers or with patients, even if there is a possibility that they could be overheard?
    Answer: Yes. The HIPAA Privacy Rule is not intended to prohibit providers from talking to each other and to their patients. Provisions of this Rule requiring covered entities to implement reasonable safeguards that…

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Sample # 4

Fairness
Accept and treat those seeking my services in a fair and nondiscriminatory manner. Sun Szu-miao wrote about nondiscrimination:

If someone seeks help because of illness or on the ground of another difficulty, a great physician should not pay attention to status, wealth or age, neither should he question whether…

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Influenza, Asthma, Bronchitis

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Samples from influenza biomedicine section

People with influenza are most contagious in the first three to four days after their illness begins….
Adults may be able to infect others beginning one day before symptoms develop and up to 5–7 days after becoming sick…
The time from when a person is exposed and infected with flu to when symptoms begin is about 2 days, but can range from approximately one to… 

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Sample from the influenza 4 Levels section

In our discussion, influenza is a warm disease special category of the 4 Levels called Spring Warm. Spring Warm begins like the wei or qi level. In cases of Spring Warm, the disease quickly declines to a more serious condition. Usually, the presentation of the wei or qi levels lasts for up to approximately 1–2 days, followed by a rapid decline…

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Sample from the influenza herbal formula section

sanyahusampleSan Ya Hu

This herbal formula uses San Ya Hu (San Cha Hu Gen ) for high fever. San Ya Hu is bitter, cold, and clears heat and toxins. This herb treats lung heat coughing and swelling and pain of the throat. It is indicated for use for patients with fever, lung abscess, meningitis, encephalitis, and influenza. San Ya Hu clears wind dampness and is indicated for the treatment of dampness with itching (including topical applications), rheumatoid arthritis, sciatica, and low back pain (cooling, clear heat and toxins, wind damp bi pain). In a comparison of herbs, San Ya Hua is especially useful for clearing high fever temperatures whereas Gui Yu Jian is especially useful for clearing the influenza virus from the system.

Gui Yu Jian is used for its antiviral actions. Gui Yu Jian, also known as Cruciate Blueheart, is bitter and cold. It clears heat and toxins, cools the blood, and is used for the treatment of skin eruptions (e.g., measles) and other wind-toxin rashes….

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Sample from the influenza acupuncture section

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Neiting, ST44 (Inner Courtyard)

ST44 is 0.5 cun proximal to the margin of the web between the second and third toes.

ST44 is a ying-spring, water, and Ma Da-yang heavenly star point. ST44 clears heat and calms the spirit. ST44 is especially useful for clearing and draining stomach heat or intestinal damp-heat. ST44 regulates qi and suppresses pain. This point is special for heat in the upper jiao (burner), including yangming fevers. This point has a strong cooling effect and is especially effective for yangming channel forehead headaches...

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Sample from the asthma Chinese medicine section

Asthma is characterized by paroxysmal dyspnea (difficult or labored breathing) and wheezing. Excess conditions leading to asthma include wind-cold and hot-phlegm. Deficiency causes of asthma include lung and kidney deficiency; the kidney qi must be strong enough to grasp the lung qi.

Allergic asthma is seasonal or living in specific areas stimulates an allergy to something specific. Allergies are mostly related to wind evil (suddenly happens and disappears). All cases of asthma have general underlying lung and kidney deficiency. For allergic asthma, any of the six evils (exogenous pernicious influences) may stimulate an attack. Long term, by benefiting the kidney qi, the root of the disorder is addressed and may ultimately…

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Sample from the asthma acupuncture section

Dingchuan, M-BW-1 (Calm Dyspnea, Stop Wheezing)

This acupoint is located 0.5–1 cun lateral to the depression below the spinous process of the 7th cervical vertebra, level with GV14. A perpendicular-oblique insertion towards the spine to a depth of 0.5–1 cun is recommended by many texts.

 A cutaneous branch of the dorsal ramus of the 7th cervical nerve is located at Dingchuan. Deeply, this point is innervated by the medial branch of the dorsal ramus of the 8th cervical nerve.

This extra point is used for calming dyspnea and stopping both coughing and wheezing. Indications include asthma, coughing, bronchitis, stiff neck…

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Sample from the research section

influenzaresection01aInfluenza Virus Image

Acupuncture is effective for the treatment of influenza. Two independent investigations confirm acupuncture’s efficacy for fighting influenza. One laboratory investigation tested acupuncture as a monotherapy and determined that acupuncture lowers mortality rates, increases serum interferon levels, and improves the phagocytosis of viruses. Another investigation finds acupuncture effective for enhancing the clinical efficaciousness of anti-viral drugs. Let’s start with the integrative investigation and we’ll look at the acupuncture monotherapy next.

Researchers from the Taizhou Municipal Hospital combined acupuncture with standard drug therapy. Patients receiving both oseltamivir and acupuncture in a combined treatment protocol had superior patient outcomes compared with patients receiving only oseltamivir. [1] In an independent laboratory experiment, the researchers proved that acupuncture exerts an antiviral effect by increasing the serum level of interferon (IFN) and improves phagocyte function in rats with influenza virus infections... [2]

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References:
[1] Lang BX, Jin LQ, Liu SN, Liu XR. Clinical observation on the effect of acupuncture combined with conventional therapy on influenza H1N1 [J]. Chinese Archives of Traditional Chinese Medicine, 2011, 29(2):411-412.
[2] Chou YF, Cao YM, Wang JL, Yang ZM, Qiu ML. Protective effect of acupuncture on mice infected with influenza virus [J]. China Journal of Traditional Chinese Medicine and Pharmacy, 1990(2):16-18.


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CPR #2

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Sample #1

Case 1
You are working in a warehouse when you hear cries for help in the next room. Since you know First Aid and CPR, you walk into the room to see if you can help. You find several co-workers standing near your friend, an electrician, lying on the floor. You notice a pair of wire cutters lying near your friend's hand and several arching wires near his head. He does not respond to you calling his name. How would you respond?

The answer is in the CPR Case Studies Answers section of this course.


Case 2
You are at a local swimming pool when lifeguards pull an unconscious middle-aged male from the water. You inform the lifeguards that you know CPR and can help. They begin the steps of CPR and direct you to call 911 and get the AED. After calling 911, you return with the AED. The lifeguards ask you to apply the AED, but you notice the patient is still wet from the pool. Another bystander yells out that you can't use an AED on a wet victim. What should you do?

The answer is in the CPR Case Studies Answers section of this course.


Case 3
You are enjoying dinner with your family at a local restaurant when the woman next to you abruptly ….

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Sample #2

Compressions
Once you have identified that an adult is in SCA and requires CPR (and the emergency response system has been activated), the next step is chest compressions. In review, identification of SCA involved two major steps:

  • 1. Check for Responsiveness

    Attempt to wake the patient: Shake or tap the patient and shout, “Are you ok?”


  • 2. Check for Signs of Life

    Look for chest rise (indicating breathing), listen for grunting, groaning, or sounds of heavy breathing, or place your hand on the patient’s chest to feel for rise and fall.
    Advanced provider: check for pulse, airway, and breathing issues.

Chest compressions squeeze the heart, building up pressure within the heart’s chambers to begin pumping blood. Good compressions circulate oxygenated blood throughout the body, slowing the damage to the heart and other organs caused when these organs have stopped receiving blood from the heart. It is important to provide good, quality chest compressions during CPR to maximize blood flow and increase the chances of survival. Let’s look how to perform chest compressions...

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Sample #3

Allergic Reactions
An allergic reaction is the body's response to an allergen and is usually not an emergency. Minor reactions consist of red, itchy skin often at the site of the allergen such as a bee sting. Other common, non-life-threatening responses include hives and minor swelling. In these cases, no emergency care is needed. If the cause of the reaction is an insect bite or sting, remove the stinger by scrapping a credit card or other small, hard object across the skin, and apply a cool wet compress to reduce discomfort. DO NOT use tweezers when removing a stinger as it will cause more toxin to be injected into the skin potentially …

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Sample #4

Seizures
A seizure is caused by abnormal activity in brain cells. This can cause a victim to suddenly begin experiencing severe muscle convulsions in an area of the body or even the entire body. In many cases the victim loses consciousness during the convulsions which can often continue for several minutes after the convulsions have stopped. Seizures can be caused by conditions such as epilepsy, a dramatic drop in blood sugar, and even simply due to a high fever especially in children under five.
When assisting a victim experiencing a seizure, if he or she is not already lying on the floor, assist them to the floor and call 911. Clear the area around the victim so that the convulsions don't cause further injury. Do not attempt to stop the convulsions…

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Safety in Herb-Drug Combinations #4

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Chuang Xiong sample

 

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Sample 1

Review of Pharmacological Actions

Drug interactions are both pharmacodynamic and pharmacokinetic. Pharmacodynamics concern the actions of two or more drugs and pharmacokinetics concern the absorption, distribution, metabolism, and/or excretion of one or more drugs affecting another. Interactions can be additive, synergistic, and antagonistic. Additive interactions…

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Sample 2

Anti-estrogenic drugs & breast cancer

Herbs that strengthen Qi, Blood, Jing and Kidney Yang should be used with caution because they may stimulate estrogen production. Careful diagnosis of the Yin and Yang balance and the Heart and Kidney communication is essential to treating patients who are taking anti-estrogenic drugs. It is recommended that these patients have their estrogen levels checked often.

Many tonic herbs have properties that reduce inflammatory responses, benefit the immune system, and encourage the production of red and white blood cells. These responses may be helpful for patients undergoing chemotherapy and radiation treatments.

 

Breast tissue is stimulated by estrogen
Breast cancer cells need estrogen to grow

 

Drugs
Tamoxifen and aromatase inhibitors (Arimidex, Aromasin, Femara) are used to prevent recurrence of estrogen receptor-positive breast cancer in post-menopausal women.

Tamoxifen (Nolvadex, Istubal, Valodex) is an antagonist of estrogen receptors in breast tissue and is an agonist in the endometrium. It is used as a form of anti-estrogen therapy for breast cancer because some forms of breast cancer cells require estrogen to grow. Tamoxifen is an estrogen receptor agonist in bone and therefore inhibits osteoclasts. As a result, tamoxifen prevents osteoporosis.

One of the most serious side effects of tamoxifen use is uterine cancer due to its estrogen receptor agonist actions in the uterus. Tamoxifen may also cause cataracts.

 

Tamoxifen is estrogenic in the uterus
Raloxifene is anti-estrogenic in the uterus

 

Raloxifene (Evista) is often used in the treatment of breast cancer instead of tamoxifen because…

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Sample 3

Beta-blockers, sedative/hypnotics, antidepressants, and insomnia

Use caution when combining beta blockers with calm spirit herbs due to potential slowing of the heart beat.

Calm spirit herbs combined with heat clearing and phlegm dissolving herbs may significantly improve the condition of patients suffering from mental disorders even though they are already taking medications. The additive and synergistic effects of the calm spirit herbs combined with improvements…

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Sample 4

Case I

A 80 year old male patient is taking a long-acting beta-blocker, metoprolol (Lopressor, Toprol XL), for his irregular heart beat. He is suffering from insomnia, constipation, and his tongue has a red tip and a dry coating. The pulse is small, slow and irregular.

Diagnosis:  Heart Yin deficiency with deficiency heat

The patient was given Bai Zi Ren (Semen Biotae Orientalis). His constipation resolved and his sleep improved significantly but his pulse slowed. Lowering the dosage of Bai Zi Ren (Semen Biotae Orientalis) returned the pulse to normal.

Bai Zi Ren (Semen Biotae Orientalis) lubricated his Large Intestine Yin, nourished the Heart Yin and calmed the mind while the lower dosage prevented the slowing of the heart beat.

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Upcoming Live Acupuncture Webinars

CEU and NCCAOM PDA Acupuncturist License Credit

 

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Live Webinars  >

 

Upcoming live webinars feature microscopy of acupuncture needles and the latest in acupuncture and herbal medicine research. Breaking acupuncture news and research is covered as the main body of work covered in the acupuncture webinars. As an added feature, microscopic close-ups of acupuncture needles show what types of acupuncture needles are made of the finest quality, have excellent tips that are intact, and more.

 

Live Acupuncture CEU and PDA Credit
All live webinars at HealthCMi are valid for live CEU credit.

 

Research and Chinese Medicine
The acupuncture webinars feature ancient acupuncture point prescriptions that have been tested by scientific research. This includes the treatment of musculoskeletal pain and internal medicine.

 

Webinar Topics
Acupuncturists often inquire as to why we do not advertise all of the topics to be covered in the webinars. This is because the news and research department at HealthCMi is consistently translating and presenting breaking news and research. As a result, many topics to be covered in the live webinars are so new that they have never been translated into English before and they are so current that we cannot include this information until just before the event. If you would like to inquire about specific topics, please click on the support page link and contact us. We will be happy to give you an update on the latest topics to be covered.

 

Access
Join us for our upcoming events online. To learn more about our webinars and view samples of events, click the following link to gain access:

 

 

Live Webinars  >

 

 

 

Acupuncture For Knee Pain

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Sample #1

Bursa

The knee has several bursae (fluid-filled sacs or cavities, especially ones countering friction at a joint)...

bursae knee

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Sample #2

ACL

Anterior cruciate ligament or ACL (an intracapsular ligament)—The ACL prevents the knee from hyperextending and the tibia from sliding anteriorly. ACL injuries often occur during non-contact sporting activities involving rotation of the knee (some experts believe internal rotation may create greater risk). However, injuries can occur from any activity that stretches the ligament beyond its normal capacity, particularly while the leg is in a valgus position (internally rotated tibia). The trauma can result in...

knee anatomy 1a

torn acl 1a

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Sample #3

Steroid Injections

Dr. Kirstie Saltsman, Ph.D. published findings on the National Institute of Arthritis and Musculoskeletal and Skin Diseases website:

  • Among people with osteoarthritic knees, repeated steroid injections over two years brought no long-term improvement in reducing pain, according to a study funded in part by the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Rather than showing any benefit, the results revealed that the injections sped the loss of the cartilage that cushions the knee joint. The study appeared in the Journal of the American Medical Association (JAMA).
  • “Use of corticosteroid injections to treat knee OA is based on the medicine’s capacity to reduce inflammation, but corticosteroids have also been reported to have destructive effects on cartilage,” said Dr. McAlindon. “We now know that these injections bring no long-term benefit, and may, in fact, do more harm than good by accelerating damage to the cartilage.” [1]

The aforementioned study referenced by Dr. Saltsman that cautions against the long-term use of corticosteroid injections concludes the following:

  • Among patients with symptomatic knee osteoarthritis, 2 years of intra-articular triamcinolone [intermediate-acting synthetic glucocorticoid], compared with intra-articular saline, resulted in significantly greater cartilage volume loss and no significant difference in knee pain. These findings do not support this treatment for patients with symptomatic knee osteoarthritis. [2]

 

NIH and Acupuncture

A division of the National Institutes of Health, the National Center for Complementary and Integrative Health, notes the following:

  • A landmark study has shown that acupuncture provides pain relief and improves function for people with osteoarthritis of the knee and serves as an effective complement to standard care. The study, the largest Phase III clinical trial of acupuncture for knee osteoarthritis, was…

 

References:
1. niams.nih.gov/newsroom/spotlight-on-research/long-term-benefit-steroid-injections-knee-osteoarthritis-challenged
2. McAlindon, Timothy E., Michael P. LaValley, William F. Harvey, Lori Lyn Price, Jeffrey B. Driban, Ming Zhang, and Robert J. Ward. "Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: a randomized clinical trial." Jama 317, no. 19 (2017): 1967-1975.

 

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Sample #4

Chinese Medicine

Knee pain may be due to excess or deficient etiologies. Rheumatoid arthritis, osteoarthritis, and trauma are common causes. Invasion of external pathogenic factors is a risk factor for knee pain.


Cold and Damp
Environmental risks include dampness and cold. Patients exposed to these conditions may experience wind, cold, and damp attacking the joints, especially when the wei qi (defensive qi) is deficient. Cold and damp exogenous pernicious influences lead to qi and blood stasis, thereby causing knee inflammation and pain. For cold and dampness, patients present with knee pain, coldness of the limbs, and the pain is alleviate by warmth. The pulse is deep, tight, or slow. The tongue is pale or purple.


Qi and Blood Deficiency
Qi and blood deficiency may result in knee pain.Patients often present with bilateral knee pain that worsens throughout the day, weakness of the knees, pallor, dizziness, and palpitations. Risk factors include aging and chronic illness. Deficiency precipitates invasion of external pernicious influences (including wind, cold, and dampness) and subsequent…

 

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Sample #5

Acupuncture Points

The following are common acupuncture points used for the treatment of knee disorders.


Xixia (M-LE-15, Below Knee, Hsi Hsia)
This point is at the patellar ligament at the lower border of the patella. The point is below the center of the inferior margin of the patella. Needle insertion is approximately 1–1.5 cun, perpendicularly. Pressing on the point prior to needling often helps to prevent patient discomfort.

This acupoint is very effective for the treatment of many knees disorders, including disorders of the soft tissues of the knee region.

  • Xixia is indicated for the treatment of knee arthralgia (joint pain), patellar ligament strains, and arthritis.
  • This acupoint pairs with medial and lateral Xiyan (MN-LE-16) for the treatment of knee pain, arthritis, ACL and meniscus injuries, and many soft tissue injuries.
  • For arthritis of the knee, Xixia may be combined with Xiyan (MN-LE-16), Heding (M-LE-27), ST36 (Zusanli), GB34 (Yanglingquan), and SP9 (Yinlingquan).

Classic Three Point Combination
The three point combination of medial and lateral Xiyan with Xixia is a powerful and effective treatment for knee disorders. Xiyan is also commonly used with Heding….

knee 1knpa2

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Sample #6

Osteoarthritis and Cartilage Repair Research

Acupuncture stimulates cartilage repair for patients with knee osteoarthritis. [1] Using MRIs, researchers have quantified the therapeutic effects of acupuncture. Within four weeks, acupuncture successfully improves the condition of cartilage in the anterior medial and lateral tibial regions of the knee. In addition, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores document that acupuncture reduces pain and stiffness levels while simultaneously improving physical function.

In a controlled trial (Zhang et al.), acupuncture was compared with the therapeutic benefits of physical therapy. The MRIs demonstrate that acupuncture improves cartilage in the knee region. Physical therapy did not stimulate cartilage repair. Pain, stiffness, and physical functioning improved with both therapies. However, acupuncture significantly outperformed physical therapy across all three WOMAC indices (pain, stiffness, and physical functioning).

 

MRI Results and Acupuncture Points
The researchers used T2 MRIs (magnetic resonance imaging) to measure changes in knee cartilage integrity…

Reference:
1. Zhang, Yan, Fei Bao, Yan Wang, and Zhihong Wu. "Influence of acupuncture in treatment of knee osteoarthritis and cartilage repairing." American journal of translational research 8, no. 9 (2016): 3995.

 

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California Board of Registered Nursing

Continuing Education Provider

Provider Number: CEP15110

 

CEP15110 CA

 

 

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The Healthcare Medicine Institute (HealthCMi) is an official provider of continuing education courses for all nurses in California. All courses at HealthCMi are valid for California nursing continuing education credits. Nursing CNE/CEU credits are available in 24/7 distance learning course and live webinar formats. Distance learning courses are provided in eBook (PDF), audio, and video formats to meet the needs of nurses.

Many acupuncturists are both nurses and acupuncturists. The acupuncture continuing education courses at HealthCMi serve a dual purpose because they are valid for continuing education credit for renewal of both acupuncture licenses and nursing licenses. This is an important and convenient way to fulfill license renewal requirements with quality educational material.

Enjoy our acupuncture continuing education courses while simultaneously fulfilling your nursing continuing education requirements. In addition, HealthCMi courses fulfill NCCAOM PDA requirements and many other state, national, and international requirements.

 

 

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Acupuncture for Hypertension and Arrhythmias

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Overview
Hypertension (high blood pressure) poses an enormous public health risk worldwide. Hypertension dramatically increases the risk of stroke, heart attack, and heart failure. Additionally, it is second only to diabetes as an antecedent to end stage renal disease. In the year 2000, over 26% of the adult population had hypertension, enumerating approximately 972 million people globally, and those numbers are expected to rise. In 2010 in the United States alone, over 1 million people died from cardiovascular, lung, and blood diseases, accounting for 41% of all deaths. Among these, the leading cause of death is heart disease and cerebrovascular disease (including stroke) ranks fourth. In the United States, the estimated cost of treating these illnesses in 2009 accounted for $424 billion, or 23% of costs associated with illness and...

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Chinese Medicine
The focus of this course is to present research supporting the use of specific points. First, we’ll start with a brief overview of Chinese medicine diagnostic theory and commonly used acupoints. Next, we’ll present the research. Excesses of food, alcohol, and stress precipitate hypertension. Causes of hypertension may due to excess, deficiency, or a combination of both. Hypertension often arises from one or more of the following patterns:

  • Excess phlegm and dampness
  • Kidney and liver yin deficiency with liver yang uprising
  • Liver Fire
  • Ascendant liver yang excess causes internal wind
  • Blood stasis due to qi deficiency
  • Yin and yang deficiency

One common condition is when kidney yin fails to moisten and soften the liver. In this scenario, kidney yin deficiency leads to liver yang uprising. In a vicious cycle, the ascendant liver yang further depletes kidney yin. If this condition is not addressed, excess liver yang may lead to liver fire or internal wind, which places the patient at a high risk for a stroke. The following indications and diagnoses may point to hypertension:

  • Excess phlegm and dampness is characterized by chest congestion, dizziness, palpitations, nausea, vomiting, and heaviness or numbness of the limbs. The tongue has a thick, greasy coating and the pulse is slippery.
  • Deficiency of yin with hyperactivity of liver yang is characterized by dizziness, vertigo, restlessness, insomnia, dream disturbed sleep, blurry vision, tinnitus, chest irritability, or numbness of the limbs. The pulse is deficient, wiry, floating, or rapid. The tongue is red.
  • Liver fire blazing upwards is…

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Research Acupoints
This course focuses on scientific research confirming the efficacy of acupuncture points. Research indicates that several acupoints are effective for the treatment of hypertension. We will take a closer look at the following acupuncture points in research articles reviewed following this section:

From hypertension research article #1:
Electroacupuncture from PC5 (Jianshi) to PC6 (Neiguan)
Electroacupuncture from ST36 (Zusanli) to ST37 (Shangjuxu)

From hypertension research article #2:
LV3 (Taichong), LI4 (Hegu), SP10 (Xuehai)

 

Common Acupoints For Hypertension
The following is a brief overview of acupuncture points commonly used in Chinese Medicine for the treatment of hypertension:

GB20 (Fengchi)
This acupuncture point is in the depression between the upper portion of the sternocleidomastoideus and the trapezius, level with GV16, below the occiput. It is midway between GV16 and GB12. Care must be used when needling this acupoint, do not puncture the medulla oblongata. GB20 is the meeting point of the gallbladder and sanjiao (triple burner) channels with the yang motility and yang linking vessels. GB20 disperses wind, benefits hearing and vision, and clears wind-heat. GB20 is given its name Fengchi, meaning wind pool. GB20 treats both internal and external wind. GB20 is effective for the treatment of many disorders and is especially useful for the treatment of hypertension, headaches, dizziness, eye disorders, vertigo, tinnitus, insomnia, febrile diseases, seizures, sinusitis, rhinorrhea, and neck pain.

LI11 (Quchi)
When the elbow is flexed, this point is in the depression at the lateral end of the transverse cubital crease, midway between LU5 and the lateral epicondyle of the humerus. LI11 is a He Sea, earth, mother, Ma Dan-yang heavenly star, and Sun Si-Miao Ghost Point. LI11 regulates the blood, drains dampness, cools heat in the blood, clears exterior heat, and eliminates wind. LI11 is indicated for...

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Point Combinations and Variations
Let’s look at ways to combine the aforementioned acupuncture points based on differential diagnostics and indications. If patients present with liver yang uprising due to deficiency of heart, liver, and kidney yin, the following acupoints may be applied:

  • LV3 (Taichong)
  • GB20 (Fengchi)
  • HT7 (Shenmen)
  • KD3 (Taixi)
  • GV20 (Baihui)

This combination nourishes yin, calms the liver, settles the yang, and eliminates wind. The points are often used when there is pronounced hyperactivity of liver yang characterized by headaches, dizziness, irritability, restlessness, tinnitus, insomnia, blurry vision, a flushed red face, and a wiry pulse. Add the following acupoints for specific presentations:

  • If there is phlegm, add ST40 (Fenglong).
  • If there is tinnitus, add SI19 (Tinggong).
  • To focus on nourishing kidney and liver yin, add BL18 (Ganshu), BL23 (Shenshu)…

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Research #1

University of California School of Medicine researchers have proven that acupuncture lowers blood pressure in subjects with hypertension. The depth and breadth of the research extends across multiple university controlled studies. The investigations also reveal how acupuncture works; the biological mechanisms stimulated by acupuncture are no longer a mystery. 

The University of California School of Medicine, Irvine, researchers determined several key items. Acupuncture produces long-lasting lowering of blood pressure in subjects with hypertension. Acupuncture regulates sympathetic nervous system responses resulting in lower blood pressure in cardiovascular related centers of the brain and “specific neurotransmitter systems.” In addition, their cross-over double blinded research identifies specific acupuncture points and procedures that are especially effective for lowering blood pressure.

The researchers note that electroacupuncture is effective “at two sets of standardized acupoints known to provide input to brain stem regions that regulate sympathetic outflow lowers blood pressure….”  They highlight three key points. First, electroacupuncture that is administered once per week in 30 minute acupuncture sessions over a period of 8 weeks is effective for lowering blood pressure…

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Research #2

high blood pressure acupoint

Researchers conclude that acupuncture reduces hypertension and prevents brain damage due to chronic high blood pressure. A controlled laboratory investigation finds acupuncture effective for the regulation of blood pressure while simultaneously preventing excessive cell death in the brain. In a quantification of acupuncture’s effective mechanisms, researchers identified important biological responses elicited by acupuncture responsible for producing therapeutic benefits.

The research team of Lu et al. identified biochemical responses elicited by the application of three acupuncture techniques. Reinforcing twirling, reducing twirling, and needle retention techniques resulted in reduced blood pressure and downregulation of cell death in the brain when compared with a control group. All three manual acupuncture techniques prevented “target organ damage by increasing the Bcl-2/Bax ratio and inhibiting apoptosis of hippocampal neurons…

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Cardiac Arrhythmia Acupuncture

  • HT7 (Shenmen), HT5 (Tongli)
  • PC6 (Neiguan), PC7 (Daling)
  • GV20 (Baihui)

This acupoint combination nourishes the heart and shen (spirit). This is a great treatment for insomnia, palpitations, or heart arrhythmias (including atrial fibrillation). This acupoint prescription is beneficial to patients wherein qi and blood deficiency creates insufficient nourishment to the heart. It is also beneficial to patients wherein sudden fright causes these indications.

Indications

  • palpitations
  • insomnia
  • arrhythmias
  • dizziness
  • diminished vision
  • dyspnea
  • poor memory
  • pale complexion
  • excess worrying or anxiety
  • fatigue
  • weak pulse

The following research confirms the efficacy of employing HT7 (Shenmen) and PC6 (Neiguan) for the treatment of cardiac arrhythmias, as mentioned above. Note the addition of either CV17 (Danzhong) or BL15 (Xinshu)…

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Research #1
University of Minnesota (Minneapolis) researchers find acupuncture effective for the treatment of cardiac arrhythmias. In a meta-analysis of eight independent investigations, acupuncture had an 87% – 100% success rate for converting patients to a “normal sinus rhythm after acupuncture.” Based on the findings, the University of Minnesota researchers recommend additional studies, including those with long-term follow-up examinations, to confirm…

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Research #2

Acupuncture regulates heart beats and improves patient outcomes for patients taking drugs. Researchers from the Tianjing University of Chinese Medicine tested the efficacy of combining acupuncture with drug therapy. The addition of the Traditional Chinese Medicine (TCM) therapies increased positive patient outcomes by 28% for patients with tachycardia, arrhythmias, and palpitations…

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Coronary Heart Disease Risk
Researchers conclude that acupuncture reduces the risk of coronary heart disease in patients diagnosed with fibromyalgia. A massive sample size of over 158,420 patients with fibromyalgia were included in the study. A total of 81,843 patients received acupuncture treatments and 76,582 patients never received acupuncture. A total of 12,522 patients developed coronary heart disease during the follow-up period. Only 4,389 patients receiving acupuncture developed coronary heart disease but 8,133 patients that did not receive acupuncture developed coronary heart disease. The researchers conclude that acupuncture “significantly decreased the risk of CHD [coronary heart disease] in patients with fibromyalgia with or without comorbidities.”
The researchers note that acupuncture decreased the risk of coronary heart disease equally for…

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Low Back Pain

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This course focuses on acupuncture treatments for musculoskeletal related lower back pain. This course primarily limits its scope to lower back pain and sciatica due to invasion of external cold and dampness, kidney qi deficiency, qi and blood stasis, and biomechanical causes including sprains and contusions. 

 

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Sciatica

13022313lbpa23.jpgSciatic Nerve

 

The Mayo Clinic website defines sciatica as the following [1]:

  • Sciatica refers to pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. Typically, sciatica affects only one side of your body.
  • Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.

Koes et al. note that lumbosacral radicular syndrome, nerve root pain, and nerve root entrapment are often used synonymously with the word sciatica. [2] True sciatica involves radiating symptoms specific to the course of the sciatic nerve. Lumbar radiculopathy may involve radiating pain, numbness, loss of reflexes, and weakness that does not follow the course of the sciatic nerve but instead follows...

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1. mayoclinic.org/diseases-conditions/sciatica/basics/definition/con-20026478. 8-16-2016.
2. Koes BW, Van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. British Medical Journal. 2007 Jun 23;7607:1313.

 


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Piriformis Syndrome

According to the National Institute of Neurological Disorders and Stroke (a division of the National Institutes of Health):

  • Piriformis syndrome is a rare neuromuscular disorder that occurs when the piriformis muscle compresses or irritates the sciatic nerve-the largest nerve in the body. The piriformis muscle is a narrow muscle located in the buttocks. Compression of the sciatic nerve causes pain-frequently described as tingling or numbness-in the buttocks and along the nerve, often down to the leg. The pain may worsen as a result of sitting for a long period of time, climbing stairs, walking, or running.

 

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Cold-Dampness

Exposure to a cold or damp environment contributes to low back pain. Care must be taken to avoid unwanted exposure including extended periods in the rain, swimming in cold water, or exposure to wind after sweating. The cold contracts and the dampness heavily obstructs thereby leading to channel blockage and consequent pain. Inactivity and excess lying down exacerbates the condition.

Cold-dampness blocking qi and blood circulation causes lower back pain, tingling, or numbness that may radiate to the buttocks, lower limbs, groin, or lower abdomen. Indications include a heavy sensation, stiffness, range on motion impingement, and a cold sensation on the lower back.

The Du (Governing Vessel), Bladder Foot-Taiyang, or Gallbladder Foot-Shaoyang channels are affected. Dampness tends to linger and therefore the pain may become chronic. Pain is exacerbated by cold and damp exposure, which increases qi and blood stasis, and is relieved by warmth. Light exercise or walking may help to warm and dispel dampness thereby relieving pain. Unilateral dull aching and weakness of the lower back and legs indicates excess cold and dampness whereas a bilateral presentation of symptoms may indicate kidney qi deficiency.

Tongue: pale with a greasy, white coating
Pulse: thin, wiry, slow, deep, or moderate

Treatment Principle
Dispel cold and dampness, warm the channels, invigorate qi and blood

Acupuncture Points
Moxibustion as a standalone therapy or attached to the needles is appropriate to dispel cold and dampness.

  • BL23 (Shenshu) — Kidney back shu point
  • BL25 (Dachangshu) — Large intestine back shu point
  • BL26 (Guanyuanshu) — Gate of origin back shu point
This point is located 1.5 cun lateral to the lower border of the spinous process of the 5th lumbar vertebrae. A great local point for lower back pain, electroacupuncture is often run across the back from one BL26 acupoint to the other for the treatment of disc disorders and other spinal conditions resulting in nerve impingement or inflammation. This point is especially useful given the commonality of L5/S1 disc protrusions.
  • BL40 (Weizhong) — Command point of the back
  • BL60 (Kunlun)
This is a jing-river, fire, and Ma Dan-yang Heavenly Start point acupoint indicated for the treatment of lower back pain, headaches, stiff neck, ankle and heel pain, and difficulty with labor and delivery.
  • GV3 (Yaoguanshu) — This point is translated as the lumbar yang gate. Its location on the midline at the depression below the spinous process of the 4th lumbar vertebrae makes it a useful point for the treatment of lower back pain.
  • M-BW-24 (Yaoyan)
Translated as lumbar eyes, this acupuncture point is...

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07031317lbp7443.jpgBladder channel acupoints of the lower back

 

 

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Yaotongxue

Acute lower back pain is a common condition that may be treated by a variety of approaches with acupuncture. A time honored favorite is the use of Yaotongxue, translated as lumbar pain point. Alternately, this point is referred to as Yaotongdian, translated as lumbar pain spot. Numerically, N-UE-19a is assigned to the Yaotongxue point between the second and third metacarpal bones and N-UE-19c is assigned to the Yaotongxue point between the fourth and fifth metacarpal bones.

 

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There is an additional Yaotong (lower back pain) point, N-UE-19b. It may be used to treat lower back pain and pain resulting from injury to the chest or extremities. It is located between the third and fourth metacarpal bones. The Yaotongxue points between the second and third and the fourth and fifth metacarpal bones are more common in clinical practice. Here, the focus is on the use of points (N-UE-19a, N-UE-19c) as a paired set.


Location
Yaotongxue (N-UE-19a, N-UE-19c) is a paired set points located on the dorsum of the hand. Both points are midway between the transverse crease of the wrist and the metacarpophalangeal joint. One point is located between the second and third metacarpal bones and may be referred to as Yaotong #1. The other is located between the fourth and fifth metacarpal bones and may be referred to as Yaotong #3. Yaotongxue points are in the depressions distal to the base of the metacarpals.


Indications
Yaotongxue points are indicated for the treatment of acute lumbar sprain. Yaotong #1 is indicated for pain due to injury to the head, lower back, and extremities. Yaotong #3 is indicated for pain due to injury to the lower back and extremities.


Clinical Notes
Needling Yaotongxue invigorates the qi and blood in the lumbar region. Needling may be applied perpendicularly or obliquely (45º) towards the direction of the wrist. Oblique insertion is the preferred method. Depth of insertion is 0.5” – 1.5”.

17042014998rtp.jpgRound Tip Probe

 

Perhaps one of the best ways to determine whether or not Yaotongxue will benefit the patient is through palpation using a stainless steel ball-shaped tip probe. Press the round head of the probe into the Yaotongxue points on both hands with moderate, steady pressure. If probing one of the points evokes an unusually painful response, it is active and may yield the best results. If no point evokes a sensitive response, needling Yaotongxue may or may not achieve clinical results. Yaotongxue is often applied with the patient in the seated position. The seated position is the preferred position because patients are often asked...

 

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BL53

Baohuang (BL53) is translated as bladder’s vitals. This point is 3 cun lateral to the midline (GV channel) and is level with the 2nd sacral foramen (palpate to find the 2nd sacral foramen). An alternate method to locate this acupoint is to firmly press on the lateral edge of the buttocks and locate the point halfway between the midline and the lateral edge of the buttocks (level with the 2nd sacral foramen). This acupoint benefits urinary system, the lumbar region, and is effective for the treatment of lower back pain, sciatica, and associated radiculopathies.

17110209ssf554443.jpg

 

Triple Acupuncture
Triple acupuncture is often applied to BL53, Yaoyan, or GB30 to enhance manual acupuncture effectiveness. The first needle is inserted to a moderate depth at the acupoint location. The second and third needle are inserted approximately 1 cun laterally and medially to the acupoint and angled slightly toward the acupoint. The second and third needle are inserted more deeply than the first needle, which was applied directly to the acupoint site. The moderate depth at the acupoint provides peaceful stimulation and the greater depth at the medial and lateral areas provides a stronger, supportive stimulation.

 

Crossing Midline Electroacupuncture
For patients with lumbar disc protrusions causing radiculopathy (distally radiating pain, weakness, numbness), electroacupuncture may be applied through the disc region to the area of perceived pain or numbness. For example, if a disc protrusion at L5/S1 causes radiating pain to the right buttocks region, apply one electroacupuncture alligator clip to the left BL25 acupoint and another to the right BL53, GB30, or Yaoyan acupoint. If the radiculopathy radiates even further (e.g., to the right side legs or feet), one may choose to connect electroacupuncture between the left BL25 acupoint and the right sided BL60 (Kunlun) or KD3 (Taixi) acupoint.

Most research suggests that electroacupuncture intensity levels may be set to patient tolerance levels. As for specific frequency settings, research conclusions vary. The research section towards the latter part of this course lists specific settings for specific acupuncture point prescriptions. A review published in Anesthesiology - The Journal of the American Society of Anesthesiologists concludes that electro-acupuncture is more effective at the 2 – 10 Hz setting than the 100 Hz setting for the relief of inflammation and neuropathic pain. The investigators note that electro-acupuncture “blocks pain by activating a variety of bioactive chemicals through peripheral, spinal, and supraspinal mechanisms.” [1] Caution: crossing the midline is not appropriate in areas near the heart. This example covers the lower back region only.

In this example, BL25 was selected because it is level with the lower border of the spinous process of the 4th lumbar vertebra. The disc protrusion is located on the next level down, at the L5 level. As a result, the current from the electroacupuncture passes from the L4 region through the L5 disc region and then to the distal acupoint in the buttocks or leg where the radicular pain or numbness resides. The following illustration shows how the current passes through the disc region:

 

17073017elsf45.jpgExample of L5/S1 region receiving electroacupuncture stimulation

 

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1. Zhang, Ruixin, Ph.D.; Lixing Lao, Ph.D.; Ke Ren, Ph.D.; and Brian M. Berman, MD. "Mechanisms of Acupuncture–Electroacupuncture on Persistent Pain." Anesthesiology 120, no. 2 (2014): 482-503.

 

 

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Research #1

Qi-guiding acupuncture relieves disc herniation pain and a special intensive silver acupuncture needle protocol relieves chronic lower back myofascial pain.

Researchers find acupuncture effective for the treatment of lower back pain disorders. In a protocolized study from the Shanghai Jiaotong University Sixth People’s Hospital, researchers determined that a special type of manual acupuncture therapy, known as qi-guiding acupuncture, produces significant positive patient outcomes for lumbar intervertebral disc herniation patients. In related research from Xinping Hospital of Traditional Chinese Medicine, investigators find acupuncture combined with moxibustion effective for the alleviation of lower back pain due to lumbodorsal myofascial pain syndrome. A special application of silver acupuncture needles produced superior patient outcomes. Let’s start with a look at the Shanghai Jiaotang University research and then we’ll see how the silver needle protocol boosts treatment efficacy for the treatment of lower back pain.

Acupuncture is effective for the treatment of lumbar intervertebral disc herniations. Wu et al. (Shanghai Jiaotong University Sixth People’s Hospital) investigated the treatment results of qi-guiding acupuncture with meridian differentiated acupoint selections and determined that it produces significant positive treatment outcomes for lumbar intervertebral disc herniation patients. Wu et al. also find electroacupuncture with meridian differentiated acupoint selections effective; however, qi-guiding acupuncture had a slightly higher rate of producing positive patient outcomes. Qi-guiding acupuncture had an 87.5% total treatment effective rate and electroacupuncture achieved an 86.6% total treatment effective rate. Qi-guiding acupuncture also had better outcomes for increases in nerve conduction velocity. The results are definitive given the large sample size of 549 patients with lumbar disc herniations evaluated in this study.

Lumbar disc herniation patients experience lower back pain and radiculopathy (radiating pain and numbness) as a result of anulus fibrosis damage, IVF encroachment, and other issues associated with disc damage (Hu et al.). Acupuncture, as one of the most common non-surgical treatment methods for lumbar disc herniation, has a high treatment effective rate and no significant adverse effects (Cheng).

Qi-guiding acupuncture was first documented in ancient literature, including The Systematic Classic of Acupuncture & Moxibustion by Huang-fu Mi. In qi-guiding acupuncture, needle entry and removal is controlled and slow. To direct qi upward, the acupuncture needle is oriented upward; similarly, to direct qi downward, the needle is pointed downward. Subsequently, the needle is frequently rotated, lifted, and thrust to regulate the flow of qi in the body. Additional manipulation techniques may be intermittently applied. In modern use, qi-guiding acupuncture repairs ultramicroscopic structures of damaged nerve roots and accelerates other aspects of nerve repair, thereby increasing nerve conduction.

In this study, lumbar disc herniation patients receiving qi-guiding acupuncture achieved an 87.5% total treatment effective rate. Patients receiving electroacupuncture achieved an 86.6% total treatment effective rate. Both qi-guiding acupuncture and electroacupuncture significantly increased nerve conduction velocity. Qi-guiding acupuncture had a slightly greater improvement in common peroneal nerve conduction velocity and superficial fibular nerve conduction velocity. Common peroneal nerve conduction velocity increased from 38.26 (± 12.8) to 44.75 (± 5.24) after the application of qi-guiding acupuncture, and increased from 39.11 (± 3.64) to 39.86 (± 10.95) after electroacupuncture. Superficial fibular nerve conduction velocity increased from 41.63 (± 4.37) to 42.55 (± 6.43) after the application of qi-guiding acupuncture, and increased from 40.71 (± 9.56) to 40.43 (± 4.01) after electroacupuncture.

A total of 549 patients with lumbar disc herniations were treated and evaluated in this study. These patients were diagnosed with lumbar disc herniations between December 2012 and March 2014. They were randomly divided into a treatment group and a control group, with 280 patients in the treatment group and 269 patients in the control group. The treatment group underwent qi-guiding acupuncture therapy, while the control group received electroacupuncture. Acupoint selection for both groups was based on meridian differentiation. Identical acupoints were selected for both patient groups.

For Taiyang meridian lumbago and leg pain (scelalgia):

  • Shenshu (BL23)
  • Dachangshu (BL25)
  • Zhibian (BL54)
  • Huantiao (GB30)
  • Juliao (GB29)
  • Yinmen (BL37)
  • Weizhong (BL40)
  • Chengshan (BL57)
  • Kunlun (BL60)

For Yangming meridian lumbago and leg pain:

  • Shenshu (BL23)
  • Dachangshu (BL25)
  • Qichong (ST30)
  • Biguan (ST31)
  • Futu (ST32)
  • Tiaokou (ST38)
  • Zusanli (ST36)

For Shaoyang meridian lumbago and leg pain…

 

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