Pediatric Hyperactivity And Attention Deficit Syndromes 2010

Acupuncture and Chinese Medicine: an Integrated Perspective

PK Melethil, L. Ac. , Dipl. Oriental Medicine Traditional Chinese Medicine Physician

Melethil Acupuncture Services, LLC Wilsonville, OR 97070

Pediatric Hyperactivity & Attention Deficit Syndromes

COMMUNITY HEALTH PROGRAMS, Wilsonville

Winter 2010

OVERVIEW

• Traditional Chinese Medicine- an overview, focusing on child development

• Pediatric Hyperactivity & Attention Deficit Syndromes(i.e., AD-HD): a developmental condition affecting children

• Chinese medicine therapeutics for Pediatric Hyperactivity & Attention Deficit Syndromes

Melethil Acupuncture & Chinese Medicine AD-HD Syndromes (2010)

Anthropological Record Archaeological evidence: 10,000+ years.

Ma Wang Dui site: 2,000+ years

– clinical tools, philosophical and qigong manuscripts.

Written Texts: 2,000-3,000 years old.

– Herbal Medicine, Acupuncture, Body work

Medicine guided by empiricism Daosim, Confucianism, Buddhism Multiple overlapping and co-existing models

Shared knowledge with Yoga, Ayurveda (India) Greek Influences

Conversations between Huang Di and Chih-Po


Background • Harmony and Balance

• Movement of Qi and Blood

12 Primary Meridians- 6 on each side (symmetry) 8 Secondary (Extraordinary) Meridians

• Acupuncture Points (400-500 x 2) Jing-Luo Network of points

analogy: a river and its tributaries, a net

Variable size, shifting locations Ah-shi points

• Mechanism of Action- Contemporary Ideas • Conductivity gradients (Prognos)

Electrochemical gradients • Optical/Thermal gradients • Acoustics- variations in visco-elastic properties of tissues


What is Qi? • 5 functions of Qi

Source of all movement

Protects the body

Source of harmonious transformations

Ensures stability and governs retention

Warms the body

• 5 types of Qi Organ qi

Organs are functional systems, not anatomical structures

Meridian qi

Nutritive qi

Protective qi

Ancestral qi


TCM Models of Pathology- “Disharmony” Models of Pathology

Cold Induced Illnesses Progresses from External (Yang) to Internal (Yin) channels- 6 Levels

Zang-Fu Theory

Based on Organ Disorders (Meridians)

Warm-Febrile Diseases Progresses from Outer to Inner layers Models: Triple Burner, 4 Levels

Causative factors

External /Environmental Pathogenic Influences Damp, Cold, Heat/Fire, Wind, Dryness, Summer heat

Internal Pathogenic Influences

Emotions (Stagnation) Phlegm << Body Fluids + “Heat” Deficiency Patterns


ACUTE

CHRONIC

Diagnostics & Therapeutics • Diagnostics

Interview

Palpation

Tongue

Pulse

vein along outer edge of index finger (< 3 y.o.)

• Therapeutics Acupuncture

TuiNa (Medical Massage)

Internal Medicine Diet/Nutrition, Herbs, Minerals, Animal products

Qigong, Tai Ji Quan, meditation (Exercises)


Ma Wang Dui- Ancients Qi Gong


Pain • Stagnation/Anisotropy

Qi, Blood

• Types of pain (paresthesias)

Sharp, piercing

Dull, throbbing

(Heaviness)

(Numbness)


Advantages of Acupuncture

Simple, Gentle Painless (200-300 mm,

single-use needles) Safe, Minimal side effects Reduced use of narcotics &

other medications Effective, Economical


Modern Applications of Acupuncture Anesthesia for Breast Reconstruction Surgery, OHSU

Photo provided by Roger Lore, DAOM


Chinese/Asian Medicine: 2000+ years of realizations about health

Shen (Heaven)

Qi (Human)

Jing

(Earth) taiji

wuji

Heart

Spleen

Lung

Kidney

Liver

Macrocosm Microcosm Melethil Acupuncture & Chinese Medicine AD-HD Syndromes (2010)

Pre Heaven

Post Heaven

congenital

in utero

growth-development

ex utero

TCM Toolkit • Acupuncture v. effective for cerebral palsy

• TuiNa digestive disorders

• Internal Medicine dominant strategy

Over 1000 herbs in TCM pharmacopoeia; formulas are well-tested, hundreds to thousands of years old

Current herbal products manufactured under cGMP guidelines

• Qigong (exercise)


Development: a TCM perspective

• meridians are incompletely developed

• organs (Zang-Fu) are not fully formed

• Qi is weak, susceptible to external pathogenic influences – e.g., cold, heat, dryness

• diseases generally due to deficiency – transforms rapidly, but resolves quickly also

• AVOID exposure to cold, improper diet

• tian kui “dew of heaven” cycles: females-7 years, males- 8 years


Development: a TCM perspective (contd.)

• Excess of yang , relative deficiency of yin (viz. fast metabolism) – Manifest as Taiyin “Great Yin” disorders, predominant in childhood

respiratory (Lu), digestive-assimilative (Sp) systems

• Congenital disorders , slow development (Jing <Earth> essence)

bones, organs, brain

Factors of relevance to AD-HD • maternal health (diet, environment) Pre-Heaven (in utero)

• childs’ diet, psych-soc environment Post-Heaven (ex utero)


Treatment: a TCM perspective

Therapeutic focus

• Augment Qi – strengthen digestive, assimilative functions

– Tonify Sp, Lu

– Increase Exercise, Activity (as appropriate)

• Nourish Yin – Internal medicine

• Diet, Nutrition

• Herbs


Further Readings • The Web That Has No Weaver, Ted Kaptchuk

• Medicine in China, Paul Unschuld

• Acupuncture: A Comprehensive Text, John O’Connor, Dan Bensky

• The Practice of Chinese Medicine, Giovanni Maciocia

• The Psyche in Chinese Medicine, Giovanni Maciocia

• CDC (ADHD, LD) http://www.cdc.gov/ncbddd/ADHD/ http://www.cdc.gov/nchs/data/series/sr_10/Sr10_237.pdf

National Center for Health Statistics

CDC-National Health Interview Survey


http://www.cdc.gov/ncbddd/ADHD/

http://www.cdc.gov/nchs/data/series/sr_10/Sr10_237.pdf

Documents

Pediatric Hyperactivity And Attention Deficit Syndromes 2010