Treating Pediatric Bedwetting or Nocturnal Enuresis with Acupuncture

Bedwetting, or Nocturnal Enuresis is involuntary urination while asleep after the age at which bladder control usually occurs. Nocturnal enuresis is considered primary (PNE) when a child has not yet had a prolonged period of being dry. Secondary nocturnal enuresis (SNE) is when a child or adult begins wetting again after having stayed dry.

Bedwetting is often genetic and often runs in families.

The acupuncture treatment is targeted to improve the communication between the nervous system and the bladder muscles, and reduce the mistaken signals between them. Acupuncture is relatively effective in treating this condition. Besides treating the underlying cause of this disorder, acupuncture can also reduce the nervousness and emotional stress brought upon the patients by this disorder.   There are studies that support that, “Acupuncture can influence spinal micturition centers and parasympathetic innervation to the urinary tract and is known to modulate brain function via the descending serotonergic system.”

According to TCM, the pathology of bedwetting is always characterized by deficiency pattern of the Lungs, Spleen or Kidneys:

• Lungs governs Qi in general, also provide Qi to the bladder to control urine.
• Spleen Qi raises Qi in general, and a sinking spleen Qi may be unable to control urine, which leaks out.
• The kidneys form urine and the bladder stores and excretes urine. If the kidneys are deficient they are unable to support the function of the bladder in regulating urinary output. In addition, the kidneys in TCM cheks the two lower orifices. 

General acupuncture points:

• Ren 3 (Zhong Ji) 
• Ren 4 (Guanyuan)
• SP 6 (San Yin Jiao)
• LIV 8 (Qu Quan)
• EX-UE-17 (Ye niao dian): It locates on the palmar surface of little finger, in the middle of the transverse crease of the distal interphalangeal joint. Before sleeping, the infant can make themselves acupresure with their nail without hurting the skin.

Indirect moxibustion with a cigar-mugwort

It is applied moxa from left to right as well: From BL20 Pishu (left) to BL20 Pishu (right), follow BL23 Shenshu (right), and then, BL23 Shenshu (left)..., for 10-15 minutes.

Kidney deficiency:

• BL23 (Shenshu)
• BL25 (Da chang shu)
• BL28 (Pang guang shu)
• KID3 (Taixi)
• KID1 (Yong Quan)
• REN 6 (Qihai)

Spleen and Lung deficiency:

• Ren 3 (Zhong Ji)
• SP 6 (San Yin Jiao)
• LIV 8 (Qu Quan)
• EX-UE-17 (Ye niao dian)
• LIV11 (Yinlian)
• LIV3 (Taichong)
• H7 (Shenmen)  
• SP9 (Yin Ling Quan)
• LIV1 (Dadun)
• BL13 (Feishu)
• BL20 (Pishu) 

Efficacy of acupuncture as a treatment for bedwetting

• Prospective randomized trial using laser acupuncture versus desmopressin in the treatment of nocturnal enuresis did not find significant difference between the 2 groups indicating acupuncture can be a valid alternative.
• A Cochrane review by Glazener et al found that acupuncture seems to offer some benefits over sham acupuncture and a combination of drug therapies. A systematic review by Bower et al also found tentative evidence for therapeutic benefits. Both reviews suggest further research be conducted with larger scale trials and greater methodologic quality.

   

  
  

Treatment Cough with Pediatric Chinese Massage

Cough is the most common symptom in respiratory system of pediatrics. It is a protective reflection an through which, the foreign substance and secretion in respiratory tract are drained away.

Etiopathology of cought according to TCM

Infant is immature, due to insecurity of defensive function, infant tends to catch exterior pathogens and the lung fails to purify and ventilate. Where is the adverserse rising of Lung Qi, there is cough. Moreover, infantile spleen and stomach are tender. If raw and cold milk or food impairs them, the spleen fails to transport, and phlegm-turbidity is engendered interior, which is deposited in the lung. Then the lung fails to purify and ventilate, inducing cough. In addition, infantile innate endowment is insufficient and lung and Spleen Qi are deficient, so infantile cough ususally has syndrome of Lung impairment or Lung and Spleen Qi deficiency. Though causes of infantile cough are diverse, the only single mechanism is the function of lung is affected.

Treatment according to syndrome differentiation with massage

 
Pattern of Wind-cold: This cough is characterized by frequent cough, terribly itching throat, thin and whitish phlegm, a stuffy nose, nasal discharge, aversion to cold, no sweat, fever, headache, thin and white fur. 

Arc-pushing bagua point, clearing liver meridian point and lung meridiant point, and pushing four transverse crease point.


Arc-pushing bagua point

 

Pattern of Wind-Heat: this cough is characterized by cough, sticky and yellow phlem, sore throat, thirsty, turbid nasal discharge, fever, headache, aversion to wind, slightly sweating, thin and yellowish fur.

Treatment: Arc-pushing bagua point, clearing liver meridian point and lung meridiant point,and stomach meridian point, and pushing six fu point

 

Pattern of Phlem-dampness: It is characterized by recurrent cough with deep and harsh wound, cough induced by phlegm and relieve by spitting the phlegm, cough aggravated in the morning and after eating, no appetite, lassitude, occasional loose stool, greasy and whithish fur.

Treatment: Clearing manipulation lung meridian point, pushing spleen meridian pointo to and fro, arc-pushing bagua point.

Pushing spleen meridian pointo to and fro

Pattern of Yin deficiency: This cough is characterized by dry and brief cough, sticky and whitish phlegm in small amounts, dry mouth and throat, feverish sensation in palms and soles, night sweat, red tongue and scarce fur.

Treatment: Clearing manipulation on lung meridian point for longer duration, pushing spleen meridian point to and for, kneading erma point.

Pattern of Lung deficiency: This cough is characterized by cough lack of strength, watery and whitish phlegm, pale complexion, short breath, reluctant to speak, easy to sweat even by a slight movement, no appetite, loose stool, pale tongue.

Treatment: Kneading erma, pushing spleen meridian point to and fro.

 Pediatric Chinese Massage is normally used in kids from 0-3 years old

Treating menopausal symptoms with acupuncture and TCM

Menopause literally means the "end of monthly cycles"  However, in common parlance, the word "menopause" usually refers not to one day, but to the whole of the menopause transition years. This span of time is also commonly called the change of life, the change, or the climacteric and more recently is known as "perimenopause", (literally meaning "around menopause").

During menopause, a woman's ovaries stop making eggs and they produce less estrogen and progesterone. These changes cause symptoms which can to vary from woman to women.

Menopause is complete when you have not had a period for 1 year. This is called postmenopause.  Postmenopausal women can no longer get pregnant.

Common symptoms of menopause include:

• Menstrual periods that occur less often and eventually stop
• Heart pounding or racing
• Hot flashes, usually worst during the first 1 - 2 years
• Night sweats
• Skin flushing
• Sleeping problems (insomnia)

Other symptoms of menopause may include: 

• Decreased interest in sex, possibly decreased response to sexual stimulation
• Forgetfulness (in some women)
• Headaches
• Mood swings including irritability, depression, and anxiety
• Urine leakage
• Vaginal dryness and painful sexual intercourse
• Vaginal infections
• Joint aches and pains
• Irregular heartbeat (palpitations)

Traditional Chinese Medicine does not recognize menopause as one particular syndrome. Instead, it aims to treat the specific symptoms that are unique to each individual using a variety of techniques such as acupuncture, Chinese herbs, bodywork, lifestyle/dietary recommendations and energetic exercises to restore imbalances found in the body.

Acupuncture and TCM treatment 

Yin deficiency: Menstruation is very irregular (scanty in amount or ceased completely), heat and irritable sensation in the chest, palms and soles, hot flashes, night sweats, vaginal dryness, insomnia, profuse dreams, chest tightness, recurrent headaches or migraines, skin itching, dry eyes, dry mouth, skin dryness, hair loss, hypoesthesia or cramps in the limbs, altered mood, irritability, easy anger, fear and anxiety, dizziness, decrease of the memory, yellow colored urination, dry stools, the tongue is red and covered with a light coating (or without coating) and the pulse is weak or fine and rapid.

•  Treatment principle: Nourish Kidney Yin.

•  Acupuncture: Qihai (Ren 6) - Shenshu (Bl 23) - Guanyuan (Ren 4) - Taixi (Kid 3) - Sanyinjiao (Sp 6).
• Herbal prescripcion:  Zuo Gui Yin (for Yin deficiency of Kidney) ; Qi Ju Di Huang (Liver and Kidney deficiency plus Liver Yang Rising) - Tian Wang Bu Xin Dan (for Heart and Kidney deficiency). 

Yang deficiency: Heavy menstrual bleeding, metrorrhagia or complete ceasing of menstruation, lack of sex drive (lack of libido), despondency, cold limbs, cold appearance, inability to get warm, moderate headache (it might increase by the fatigue), the face is dark and glossy,  tendency to overweight, loose stools, profuse clear urine, polyuria, urinary incontinence, spontaneous sweating, lassitude, soreness and weakness of the lower back and knees, edema of the face and limbs. The tongue is pale with white coat and the pulse is slow, deep and weak.

• Treatment principle: Warm the Kidney Yang, strengthen the spleen Qi and nourish the blood. 

• Acupuncture: Mingmen (Du 4) - Shenshu (Bl 23) - Qihai (Ren 6) - Guanyuan (Ren 4) - Taixi (Kid 3) - Fuliu (Kid 7) - Zusanli (St 36) - Sanyinjiao (Sp 6) - Pishu (Bl 20).
• Moxibustion:  Mingmen (Du 4) - Shenshu (Bl 23) - Qihai (Ren 6) - Guanyuan (Ren 4)
• Herbal perscripcion: You Gui Wan + Li Zhong Wang

Lifestyle and Dietary Instructions

• Menopause patients are encouraged to follow a diet with a high content of raw foods, fruits and vegetables to stabilize blood sugar.
•  They should avoid the foods that may promote hot flashes or changes mood, such as: red meats, alcohol, sugar, spicy foods, and caffeine. 
• In addition, smoking or exposure to second-hand smoke should be avoided as they may dry up yin and body fluid. 
• The practise of Qi gong or Yoga can help in order to avoid the ansiety and emotional tension. 

It is really very important to practise some exercise in order to promote the free flow of the Qi by the body.

Tuberculosis (TB) in acupuncture

 

Pulmonary Tuberculosis -  MTB, or TB (short for tubercle bacillus) is caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. It's a very powerful infection that might to spread from the lungs to other parts of the body through the blood or lymph system.

The primary stage of TB usually doesn't cause symptoms. When symptoms of pulmonary TB occur, they may include:

• Cough (usually cough up mucus)
• Coughing up blood
• Excessive sweating, especially at night
• Fatigue
• Fever
• Unintentional weight loss

Other symptoms that may occur with this disease:

• Breathing difficulty
• Chest pain
• Wheezing

According to Traditional Chinese Medicine,  this infectious disease is a deficiency pattern of various different kinds:

Lung Yin deficiency

Treatment principle: Nourish Lung Yin, remove bacteria, relieve cough.

Acupuncture –  Hand taiyin, foot yangming, foot shaoyin,*LU9 (yuan), *KI3, LU1 and BL13, BL43, ST36 and SP6 (tonify mother)

Yin deficiency – KI 6 

Fire – KI 2, LR 2 (ying-spring) 

Yin and Qi deficiency – BL 20, 21, Ren 6 

Yin and Yang deficiency – Moxa Ren 4 

cough Phlegm – LU 5 

cough blood – LU 6 (xi-cleft), BL 17 (blood influential)

tidal fever – LU 5, 10 (purge Fire)  

night sweat – HT 6, KI 7  

Lung Yin deficiency Fire 
  
Lung Jing Luo are damaged, cough blood more, more dryness and heat symptoms, tidal fever, afternoon malar flush, Tongue without coating, red geographic.

Acupuncture LU 9 (yuan), LU 1 & BL 13 (mu/shu), KI 3 (Yin), LU 10 (deficiency Heat), LU 6 (xi-cleft, bleeding), HT 6 (night sweats)

Lung Qi and Yin deficiency 

Treatment principle: Strengthen Spleen and Lung

Acupuncture – hand and foot taiyin, moxa, LU 9, BL 13, 43 (Qi), SP 6, ST 36, Ren 17 (regulate Lung Qi)  

poor appetite – BL 20, 21  

Yin and Yang deficiency

Clinical manifestations: Blood-flecked sputum, coldness, diarrhea, night sweating.

Tongue pale and geographic - Rapid pulse and empty

Treatment principle: nourish Yin and Yang. 
 
Acupuncture – hand taiyin, foot shaoyin and yangming, Moxa, LU 9 (yuan), BL 13, 43, 23, Ren 4, KI 3,ST 36, Ren 17

Alternative treatment methods

• Ear acupuncture: LU, SP KI, endocrine, Shenmen, with electro or points injection.
• Acupuncture injection: TB points 3.5 cun bilateral to Du 14, and LU 1, BL 13.  Inject B1 and/or antibiotics