Transcript asthma and allergies in tcm

Integrating Natural Medicine
into
Asthma and Allergy Management
Beth Kohn-Converse L.Ac.
M.T.O.M, Dipl.Ac., Dipl.CH.
Henry Ford Center for Integrative
Medicine
40000 W 8 Mile Rd
Northville,MI 48167
248-380-6201 [email protected]
Complementary, Alternative, Integrative:
Complementary Medicine: Systems used as an adjunct
to allopathic medicine
Alternative Medicine: Systems of care used in place of
allopathic medical care
Integrative Medicine
Blending “conventional” care using allopathic care (Western
Medicine) and “alternative” methods (ie: eastern medicine,
etc). Or blending many modalities of care.
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
What is Wholistic/Holistic Care?
 Treating
the whole person: mind, body and
spirit together
 Undertanding that we need to address all
aspects of a person in treating illness
This creates an overall better quality of life!
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
EFFECTS OF STRESS ON THE BODY:
Pain (Headaches, back, neck, etc)
Insomnia
More frequent asthma issues
Digestive Problems
Emotional issues: Depression, Anxiety
Hypertension
Changes in reproductive health
Depresses immune system (herpes)
Weight Gain
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Managing Asthma and Allergies
with natural therapies
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
TRADITIONAL CHINESE MEDICINE
BIOFEEDBACK
CHIROPRACTIC CARE
HOMEOPATHY
NUTRITION THERAPY
SUPPLEMENT THERAPY
EXERCISE/BREATHING THERAPIES
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
What is Traditional Chinese
Medicine?
Acupuncture Therapy
Chinese Herbal
Medicines
Tai Chi and Qi Gong
Massage and
Bodywork
Dietary and Lifestyle
Modifications
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
THE EVOLUTION OF TRADITIONAL
CHINESE MEDICINE
Acupuncture and Chinese Herbal Medicine- >5000 year
history
 NIH Acupuncture Consensus Conference:
 postoperative pain & chemotherapy nausea and
vomiting
 postoperative dental pain
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TCM benefits are documented in peer-review western
medical literature
 NIH sponsored trials: IBS, osteoarthritis, cardiovascular
disease, endometriosis, cancer, and many others
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Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
How Popular Is Acupuncture?
 An
Estimated 8.2 million U.S. adults have
used acupuncture
 Used by every class of population and from a
multitude of cultures
About.com: Holistic Healing (2008). What is Acupuncture?, About, Inc. A part of
The New York Times Company
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
ENERGY BASED THEORY OF
ACUPUNCTURE
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Body’s vital life force: Energy/ “Qi”
Energy travels along pathways: meridians: anatomical
location of acupuncture points
Energetic and substance imbalance creates symptoms
Acupuncture point stimulation along meridians
balances energetics, herbal therapies: substance
Balancing energy helps enhance body’s ability to help
in its own recovery/healing
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
ROOT AND BRANCH THEORY OF
TREATMENT
Root- identify/understand what caused the
symptom
 Branch – the symptom itself
 Treatment handles resolution of symptom and
helps to balance root causes
(energetic/substance)
 Goal is to rebalance substance and energetics of
the whole body
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Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
CONCEPTS OF YIN AND YANG
 Complimentary
opposites/balance in nature
and in body
 Yin: Relates to moistening, cooling,
nourishing substances in body: blood,
mucous, synovial fluids
 Yang: Relates to functions, and warming and
moving properties (body temperature,
peristalsis, digestion)
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
HOW DOES ACUPUNCTURE
WORK?
A. Increased circulation of blood
systemically
 B. Neurotransmitter release
(endorphins and enkephalins)
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This creates the “Acupuncture analgesic”
response and “relaxation response”
 Energetically: body “qi” movement/flow is
restored= balanced body (better health)
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Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Diagnosis in TCM
 Practitioner
does detailed intake
 Pulse and tongue evaluations are done to
determine TCM diagnosis
 Acupuncture treatment and herbal therapies
are then recommended
 Dietary/lifestyle adjustments may also be
recommended
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
ASTHMA AND ALLERGIES IN
TCM
Patterns of asthma relate to Kidney, Lung and
Spleen meridian energy deficiencies
 These lead to difficulties with inhalation, exhalation
and phlegm
 Allergies relate to deficient Qi/energy, thus
creating vulnerability to environmental factors
(pollen, dust, etc)
 The relaxation response and immune support
benefits from acupuncture also aide in successful
treatment
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Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
CUPPING THERAPY
 Cupping
therapy is an adjunct modality used
in TCM
 Originally used to help reduce phlegm in the
lungs related to colds/asthma
 Also can be used as a myofascial release
technique
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
LOOKING AT THE TONGUE
 SIZE
AND SHAPE
 COLOR OF TONGUE BODY
 COATING
 TOPOGRAPHY
ALL GIVE INFORMATION ABOUT THE
HEALTH OF THE ORGAN SYSTEMSCONSIDER MEDS,
TREATMENTS,SCRAPING TONGUE
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Migraine & Digestive Disorder Patient
Pre Tx
3 mo
Post Tx
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Emotions and Energetics
 Use
acupuncture therapy to help balance
energetics to affect emotions
 Each meridian system relates to specific
emotions
 Acupuncture is a simple therapy which yields
powerful results
 Effective for helping with depression and
anxiety
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Meridians and Emotions
 Liver
Meridian – Anger/Frustration
 Heart Meridian – Joy/sadness, Anxiety
 Spleen Meridian – Worry, Obsessive
thoughts
 Lung Meridian – Grief
 Kidney Meridian – Fear
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Chinese Herbal Therapies
 Can
be used safely in conjunction with
prescription medications
 Are often a good option for people who are
unable to tolerate meds
 Help to harmonize and balance the system
to prevent allergic reactions and asthma
attacks
 Typically combinations of herbs, not single
herb therapy
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Considerations for Herbal Therapy
 Patient’s
current medications
 Understanding of health history including
information about type of cancer
ie: estrogen receptive cancers, use of
estrogenic like herbals
 Consider patient’s compliance- best
preparation
 Consider upcoming procedures (surgeries)
Comparing Meds to Herbs
Both work based on their biochemical properties
 Natural doesn’t always mean safe for everyone
 Important to monitor patient’s progress if using
them long term and with other medications
 Important to use therapeutic dose with herbs
and NOT take extra
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Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
BIOFEEDBACK
 “A learned method to monitor and gain control over
autonomic reflex-regulated body functions using data
obtained from a monitoring apparatus”
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“In one study, biofeedback appeared to lessen
bronchoconstriction by inducing relaxation of the facial
muscles, …..associated with a decrease in air flow
resistance as evidenced by an increase in Peak
Expiratory Flow Rate (PEFR) in both asthmatic and
healthy children” *
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Types of Biofeedback
There are many types-these have been
associated with successful results in
treating asthma
 RSA-BF- Respiratory Sinus Arrhythmia
 EMG-BF – Neck/TrapeziusElectromyographic Biofeedback and
Incentive Spirometry Biofeedback *
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
RESPIRATORY SINUS
ARRHYTHMIA
 Monitoring
patterns of heart rate variation
related to the respiratory cycle. Electrodes
translate heart rate into auditory and visual
form. Patients learn to control heart ratethus improving asthmatic symptoms *
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Neck/Trapezius Electromyographic and
Incentive Spirometry
 Patients
learn abdominal breathing to help
relax thoracic muscles assisted by EMG-BF
training of the scalene and trapezius
muscles. Incentive spirometer training of
thoracic muscles during slow, even
breathing. *
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Other Types of Biofeedback
 Electromyogram: Uses electrodes to
measure muscle tension and can promote
relaxation in tense muscles
 Temperature
biofeedback: Monitors skin
temperature and patients learn to redirect blood
flow to other muscles and organs
 Galvanic
skin response: Measures electrical
conductance in skin related to emotional arousal
and sweat gland activity *
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
CHIROPRACTIC CARE
 Uses
spinal manipulation to restore normal
function to the spine and nervous system
 Chiropractic theory suggests that spinal
misalignments cause many health
problems because vertebrae pinch
important nerves and restrict their
effectiveness
 This could effect the vasoconstriction
patterns related to the lungs
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
HOMEOPATHY
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Roots of Homeopathy

Samuel Hahnemann, MD. was the foundercalled the “Father of Experimental
Pharmacology”.
 Discovered the concept of the Law of Cureknown as “Similia Similibus Curentur” or “Like
Cures Like”.
 This means that a remedy that produces
symptoms in a healthy person will cure the same
symptoms in a person who is diseased. **
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Primary & Secondary Actions of
a Remedy
 The
primary action results from the first
encounter between the external agent and
the vital force
 The second action is the result of the vital
force’s reaction to the symptoms of that
primary encounter.
 Led to understanding the curative powers
of poisonous substances.**
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Treating Allergies with
Homeopathy
 The
focus isn’t on using the opposite
approach (ie: allergies are related to
histamine so take an ANTI-histamine)
 Focus is use of remedies that create
similar symptoms: (ie: Allium cepa: red
onion) to produce the same symptoms that
would be related to common
cold/allergies.**
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
NUTRITION THERAPIES
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Diet therapies or nutritional advice is most common “alternative”
therapy
Thought to be mediated through both IgE (conventional) and IgG
(alternative)
Epidemiologic data demonstrates association between dietary
deficiencies (Omega 3, vitamin C, magnesium, selenium, Vitamin E)
and asthma
Populations with higher intake of polyunsaturated fatty acids (omega 6
fatty acids) have a higher prevalence of asthma, eczema and allergic
rhinitis
Thought that eliminating certain “allergenic” type foods and decreasing
exposure to things such as dairy products (believed to associated with
increased mucus production) will help with chronic asthma symptoms
and their severity. ***
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Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Studies say:
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Few studies to support dietary claims-mixed results
One positive long term study of vegan diet (Lindahl
1985)
1 year prospective study, 25 subjects
Diet excluded meat, fish, eggs, dairy, coffee, tea,
chocolate, sugar and salt
Decreased cost and use of medications
92% improvement in biochemical and clinical markers ***
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Elimination Diet
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Elimination diet- pick a food that the patient
appears to be sensitive to, such as nuts or eggs,
and then eliminate it from the diet for 2 weeks
 At the end of the 2 weeks, gently reintroduce the
food into the diet
 If there is significant change, such as bloating or
headaches, the patient may indeed be sensitive
to that particular food ***
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
More Nutrition Information
 Eliminate
allergens (dairy, preservatives
(MSG), sulfites, additives
 Increase fresh fruits and vegetables
 Increase fish in the diet (to increase
omega 3 fatty acids)
 Use healthier oils (ie: olive) ***
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Allergy Testing/Food Sensitivity
Testing
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Classic back scratch test: Can identify allergens,
not always accurate
 Food sensitivity testing: “Measures body’s
cellular response to various foods, additives,
colorings and chemicals. The individual’s cellular
reactivity after exposure of the blood to the
various test agents, versus the person’s own
baseline control, tells the healthcare provider
which substances may be causing a sensitivityrelated response in the body.”
****
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
SUPPLEMENT THERAPY
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Strong epidemiologic evidence demonstrates association between
poor dietary intake and asthma
Omega 3 fatty acids
Anti-oxidants and cofactors (Vitamin A, C,E, Zinc, selenium and
copper)
Vitamins and Minerals (Magnesium, B6 and B12)
Specific supplementation of nutrients has yielded mixed results at best
Nonetheless, very common integrative medicine strategy ***
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Exercise and Breathing
Techniques
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Numerous studies have shown improvement in
asthma is patients who exercise regularly
 Yoga: Helps to decrease medication use and
lowers anxiety (Vedanthan 1996).
 Reduces airway hyper responsiveness and
improved some aspects of quality of life
(Menocha 2002)
 Qi gong- deep diaphragmatic breathing in TCM
can help to relax musculature-creating more
systemic relaxation ***
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Center for Integrative Medicine, Novi
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
Center for Integrative Medicine
40000 W 8 Mile, Novi
Services Offered:
Acupuncture and Oriental Medicine
Chiropractic Care
Massage
St John Neuromuscular Therapy
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH
References
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*The Role of Biofeedback in Asthma, Georges Ramalanjaona, MD., DSc,
MBA, FACEP Alternative Medicine Alert, July 2003
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** Dr. Luc. Com website
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***Integrative Medicine: Management of Asthma lecture, Andrew Heyman,
MD, MHSA. Adjunct Assistant Professor, Department of Family Medicine,
University of Michigan
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****ALCAT Worldwide Testing brochure-Cell Science Systems, 852 South
Military Trail, Deerfield Beach, FL 33442 (Fell P. Brostoff, J, et.cal (1988),
ALCAT, “A New Test for Food Induced Problems in Medicine?”. Presented
at the Annual Meeting of the American Academy of Otolaryngic Allergy on
Oct 1, 1988.
Created by B.Kohn-Converse,
L.Ac., M.T.O.M.Dipl.Ac.,Dipl.CH