From the Book Concepts of Integrative Medicine by Dr Jason Mallia PhD
Integrative Medicine is also referred to in the practice of Traditional Chinese medicine (TCM) and Modern Western Medicine. Combining both disciplines in theory and in practice can be very difficult however very achievable in an integrative approach to health. The main challenge however today is the language barrier as much of the TCM knowledge and philosophy is not easily translated into usable western medical practice.
There is not yet enough research to support some forms of TCM for western medicine understanding to advocate its use in conjunction with Western Medicine practice however it is well regarded in Complementary medicine circles as a great adjunct to other modalities. These include Naturopathic, Osteopathic and chiropractic medicine.
With these challenges TCM still has found its way into the mainstream with many medical doctors recommending its use. In Australia TCM practitioners are government accredited practitioners and is covered by health insurance. Several Integrative Medicine wards have emerged in Australia including use of Acupuncture and other complementary medicines as part of an integrated approach to healthcare. In the coming years a hospital first of its kind will be opening in Sydney Australia which has the objective of providing Eastern and Western Medicine treatment and research.
Mainstream research into TCM has mainly been in the area of pain using Acupuncture, and many studies support its use in various pain conditions. This is not to say that Acupuncture works only in this area. TCM can help in a wide variety of conditions and thousands of years of use support its efficacy. The approach however of TCM practitioners differs greatly from that of Western Medicine.
For example a patient may present with clinical depression diagnosed by Western Medical practitioner. TCM theory is based on the ancient study of the meridian system and the interconnections to the organs and tissues, diagnosis of the patient is obtained by understanding the patient’s clinical pattern from their physical signs and symptoms. These include the Pulse, Tongue, hot and cold principles, smell and other. An understanding of a patient’s pattern of illness is then built based on these findings
A TCM practitioner may refer to the Western Diagnosis of Clinical Depression as a pattern of Liver qi Stagnation with wood affecting earth, Or liver qi stagnation with heat .The approach on the other hand by Western medical is to focus on the symptoms and the biochemical imbalance that constitute the prescription of neurotransmitter balancing drugs or psychiatry referral.
In TCM an individual is assessed and once the pattern identified it is treated using a variety of therapies including Acupuncture, cupping and Moxibustion on various points to treat the pattern imbalance. In the Case of Liver qi stagnation Liv 3 is a common point used for the condition which helps patients with depression.
As recent Study at the University of Technology Sydney(Dr Kirk Wilson Etal Acupuncture in the treatment of Depression) looked at an integrative treatment of Clinical Depression using SSRI medications and Acupuncture
Patients were treated over an 8 week period and given 12 treatments of acupuncture alongside their prescribed SSRI medication. After the treatment 89.66% of the subjects reported significant improvements to symptoms compared the group who received no acupuncture and SSRI medication alone
In conclusion patients with Diagnosed Clinical depression exhibiting Liver qi stagnation as their TCM pattern diagnosis, Acupuncture is shown to be an effective adjunct therapy which may reduce dependency on SSRI Medication.
Integration of TCM into a workable care plan for patients does have its challenges however very beneficial to the patient when done effectively
Integrative TCM and Western Medicine Case Studies
36 Year old female
Presenting Signs and Symptoms
Neck and Shoulder Pain and Headache, Frontal Sinus headache and sub occipital pain, with anxiety and depression, mild chronic lower back pain, low energy
Blood Type
A
Medications
Ventolin and Lexapro SSRI (long term use has tried coming off drug with no success) using a lot of pain medication (NSAIDS)
Western Diagnosis
Depression, Anxiety, OCD, Asthma
Naturopathic Diagnosis
Subluxation of C1 vertebra on right, pelvic rotation anterior on the right, Leg length discrepancy on right leg, Muscle hyper tonicity in Trapezius, levator scapulae and upper cervical muscle groups. Liver and general toxicity due to poor diet, stress, medication, dehydration, Gut dysbiosis related to poor diet and medications, Stress and tension related to life stresses
Lifestyle/Diet
Red meat, little water, Tomatoes, and foods not suitable for blood type
TCM Differential Diagnosis
- Tongue Pale
- Coat Sticky coating
- Pulse Soggy
- Liver yang rising heat rising
- Liver chi stagnation
- Chronic kidney chi deficiency
- Spleen qi deficiency
Acupuncture treatment Plan
- Move liver qi, tonify kidney spleen
- Ashi Points/ Gb20 ashi gb21 bitong
- Liv 3 Ki3 Sp 6 bladder 20 bladder 23, PC 5
Physical Therapies
- Myofascial soft Tissue manipulation in upper neck, traps and entire spine
- Re-Alignment of twisted pelvic and subluxation using the Dorn Method
- Acupuncture was given on local pain points and according to pattern diagnosis.
Western/ Naturopathic treatment
- Patient instructed to reduce NSAIDS and replace with
- Natural Anti-inflammatory (Metagenics inflavanoid) take up to 8 daily to manage pain and minimize liver stress
- Drugs to be continued as prescribed
Diet
Blood Type A diet given , drink more fruit and vegetables and drink less coffee and more water
Western Herbal Medicine given to support eliminatory organs and support stress containing
- St Marys Thistle 80
- Rhodiola, 60
- Yellow dock 30
- Oats 30
- 200ml
- 7.5 ml BID
Supplements
- Metagenics CalmX (containing high dose magnesium and Ph regulating nutrients. 2 scoop BID
- Homeopathic Gel for pain applied topically
Results
- After the first treatment detoxification tiredness followed however pain had been reduced and less Pain Medication was required over subsequent visits.
- Subsequent visits showed gradual improvement in Pain from a 9/10 to a 0/10 un medicated with NSAIDS.
- Patients symptoms well managed while on treatment of natural medication and SSRI medication, however suggested working with her Doctor to slowly reduce Antidepressants while we are supporting her Emotional Symptoms
- Up until this point effective and quick results where achieved with and integrated approach
Glen 68 Yr Old Female
Presenting Signs and Symptoms
Heavy smoker, SOB, Recently admitted to hospital for 02 therapy due to low blood oxygen, Dry cough, Cant sleep on sides due to pain, Cellulites, Legs on fire, Fatigue, Cramps, Joint stiffness
Blood type
O negative
Western Medical Diagnosis
- Emphysema, treatment Oxygen therapy
- Medications nil
Supplements
Magnesium Vit D
Western Naturopathic Diagnosis
- ES Teck Scan
- Respiratory acidosis, metabolic acidosis, hypoventilation, Hypoxemia
- Food intolerances, Hypertension, Liver inflammation, inflammatory bladder, decreased kidney function, increased PTH, Low 02 and ATP brain head area, arterial acidosis, electrolyte imbalances, Mis-alignment of L3 L4 L5 vertebra
Live Blood Analysis
- Symplasts (high levels)
- Microcytosis (severe)
- Anocytosis (severe)
- Atypical Lymphocytes (high)
TCM Diagnosis
- Tongue cracked lung area sides red
- Coat absent
- Pulse weak
- Acupuncture treatment Plan
- Lung yin deficiency
- qi stagnation
- points lung7, kid 6, liv 3, bl 15 23
- Weekly treatments using the above model
Western Naturopathic Treatment
- Target Ph and peripheral system and tissues
- Oxygenate the blood
- Decrease inflammation
- Vasodilatation, increase energy to cells and improve fatigue
- Replenish electrolytes and detoxify acids and toxins
- Support kidney function and elimination
- Increase 02 to head and improve mood, treat cough
- Dorn Method Re-Alignment of Lumbar vertebras contributing to peripheral pain
- 4 weekly Follow up
Herbal Medicines
- Adhotoda 200
- Coleus forsikoli 100
- Liquorice root 100
- Panax gensing 100
- 500ml
- 7.5ml BID
Supplements
- CalmX 2 teaspoons BID (magnesium powder with Ph regulating minerals)
- Cell Food 15 drops UID (02 drops)
- Renoxl 1 BID (kidney tonic)
- Hemagenics 1 (iron supplement)
- D3
- Tyrosine
- Infavanoid (antiinflammatory herbs)
- Metabolic Kit (tissue cleansing homeopathic)
Integrative Follow up 4 weeks later
After 4 weeks, Pain had markedly reduced from her joints, Patient was able to walk With less SOB, Patient has been advised to stop smoking and hypnosis was recommended.