Treatment of Neurodegenerative Disorder

Alzheimer's, Stroke and Parkinson's Disease

"The silent epidemic" is regarded by many as the disease of the 90's. The silent epidemic is a term which refers to neurodegenerative disorders (such as Alzheimer's disease, sequelaes of stroke & Parkinson's disease) which plagues the majority of the geriatric population but is poorly recognized by the society due to their low public visibility and their social isolation. Though neurodegenerative disorders include a vast number of illnesses, this article will attempt to focus its discussion on Alzheimer's disease, stroke sequelaes, and Parkinson's disease. This article will approach these three illnesses from the viewpoints of both Western and Oriental medicine, and will further explore treatment options specifically with acupuncture and herbal therapies.

Neurodegenerative Disorders According to Western Medicine

The fundamental principle in Western medicine is that nerve cells cannot regenerate once they die. Alzheimer's disease, sequelaes of stroke, and Parkinson's disease each involves the death and atrophy of neurons (nerve cells) in the brain. Therefore, this is no cure for neurodegenerative disorder at the present time. All available treatment options focus on symptomatic treatment only.

Though the causes may differ, patients with neurodegenerative disorders are likely to show localized to generalized atrophy of brain cells leading to compromises in both mental and physical functions. Mentally, the patients will exhibit forgetfulness, poor memory, decrease in mental capacity, emotional disturbances, poor speech, etc. Physically, the patients will exhibit partial to complete incontinence, aspiration of food particles, tremor, poor balance, muscle rigidity, muscle paralysis, etc. These decreases in mental and physical functions dramatically reduce the quality of life for the patients and increase the burden of the family and care-takers.

Neurodegenerative Disorders According to Oriental Medicine

Neurodegenerative disorders are complex with an onset that is followed by progressive deterioration. Their clinical manifestations are determined by the location and the seriousness of neurodegenerative disorders. Its pathogenesis is a mixture of deficiency and excess conditions, represented by the deficiency of kidney essence or the blocking of the brain channel by blood stasis (an excess condition) - or both.

The cause of neurodegenerative disorders lies not so much in the brain (though it is the brain that shows the symptoms) as in the kidney, which according to the theories of Traditional Chinese Medicine controls the bone and generates the marrow. From the point of view of disease differentiation through viscera and their interrelations, the root of the disease is due to the deficiency of the kidney and the bone marrow. While the blood stasis and the phlegm accumulation are considered as the symptoms, not the cause. Therefore, the keys to treating neurodegenerative disorders are to tonify the kidney, eliminate the phlegm, remove blood stasis and induce resuscitation.

Treatment of Neurodegenerative Disorders with Acupuncture

According to the theories of Oriental Medicine, the spirit (shen) resides within the heart and the brain. The spirit is affected by the overall mental and physical health of a person. If the spirit is damaged, both the mental and the physical functions of a person would be greatly compromised. Deterioration in mental functions may result in delirium and dementia with the decline in physical functions resembling complications of stroke. Therefore, the treatment for neurodegenerative disorders should focus on awakening up the spirit (shen), opening up the sensory orifices and stimulating the brain. Dr. Zhang's treatment of neurodegenerative disorders and stroke involves awakening the spirit (shen), opening up sensory orifices and stimulating the brain. He focuses his treatment by selecting acupuncture points from the Yin channels. The selection of points are as follows:

1. Selection of Main Points: neiguan (P6), renzhong (Du 26) & sanyinjiao (Sp6).

   Neiguan (P6) has the function to nourish the heart, calm the spirit, and promote smooth circulation of Qi and blood. Renzhong (Du 26) opens up sensory orifices, stimulates the brain and awakens the spirit. The combination of Neiguan (P6) and Renzhong (Du 26) has been found to increase the contractile strength of the heart and the cardiac output of blood circulation to the brain. Sanyinjiao (Sp 6) is the meeting point of the three yin channels of foot. Sanyinjiao (Sp 6) nourishes the kidney as well as tonifies the essence and the marrow to improve the function of the brain.

2. Selection of Local points:

   Jiquan (H 1), chize (Lu 5), weizhong (UB 40), and hegu (LI 4) are local points which open up the channels and collaterals and improve the circulation of Qi and blood. Jiquan (H 1), chize (Lu 5), and hegu (LI 4) are used for paralysis and tremor of the arms and the hands; and weizhong (UB 40) is used for paralysis of the legs. Fengchi (GB 20), yifeng (SJ 17), wangu (GB 12) and tianzhu (UB 10) are four excellent points which help patients who may have speech impairment or frequent aspiration of food particles leading to respiratory infections.

   Shanshangdien (upper thunder point) and xiashangdien (lower thunder point) are two extraordinary points which were discovered through clinical trial and experience. These two acupuncture points are very potent and should be reserved for those patients who have partial to complete paralysis. Shanshangdien (upper thunder point) is located on the lateral side of the neck, on the same level with Adam's apple, and between the sternal head and clavicular head of m. sternocleidomastoideus. Its is three cun posterior to the Adam's apple and one cun posterior-inferior. It is located slighted inferior to Neck-Futu (L.I.18). Its indications include frozen shoulder, shoulder pain, paralysis of the arm, stiff and rigid muscle of the arm, and tremor of the hand. Xiashangdien (lower thunder point) is located in the buttock region. Xiashangdien (lower thunder point) is the posterior tip of an equalateral triangle with greater trochanter and the iliac crest as the anterior two points. It is located slightly superior to Huantiao (G.B. 30). Its indications include pain in the lower back and hip region, muscular atrophy, sciatica, pain, weakness and muscular atrophy of the lower extremities, and hemiplegia.

3. Needling Technique: Dr. Zhang has proposed that stroke is an excess condition and sedation is warranted. This is because stroke is characterized by the spirit trapped inside with the head with the complete or partial closure of the sensory orifices. Therefore, the overall treatment focus should be to open up the sensory orifices, release the spirit, and awaken the brain.

   To achieve the maximum benefit from acupuncture, Dr. Zhang recommends slightly different location for some of the acupuncture points and their corresponding needling techniques. Both neiguan (P6) should be needled first. Insert the needle 1 to 1.5 cun, then stimulate the point for at least one minute by slightly turning the needle and moving it up and down. The healthy side should be tonified while the diseased side should be sedated. Next, needle renzhong (Du 26). Aim slightly upwards toward the top of head and stimulate strongly until the patient shows tears in his or her eyes. Stimulation should be done with quick rapid movements, a motion similar to a woodpecker drilling on trees. The third point is sangyinjiao (Sp 6). The point of insertion for sangyinjiao (Sp 6) should be moved 0.5 cun toward the dorsal side of the body (or towards kidney channel) for greater stimulation. Tonify sangyinjiao (Sp 6) by moving the needle up and down until the patient shows a "jerking motion" of the lower leg three times.

   Jiquan (H1) should be needled with the patient raising his or her arm upward in the air. The point of insertion is moved 0.5 cun toward the fingers and away from the body. Jiquan H1 should be sedated by moving the needle up and down until the patient shows "jerking motion" of the arm three times. Weizhong (UB 40) may be needled with the patient lying on the back or on the stomach. Point of insertion should be moved 0.5 cun higher toward the buttocks along the UB channel. The needle should be inserted for 1 to 1.5 cun, and the point should be sedated until the leg shows "jerking motion" three times. Hegu (LI 4) should be needled obliquely with the tip of the needle pointing toward sangjian (LI 3). This point should be sedated until the index finger jerks three times. Shanshangdien (upper thunder point) should be needled perpendicularly 1 cun deep, and stimulated until there is an "electric sensation" that runs through the entire length of the arm. The needle is then withdrawn at that time. Shanshangdien (upper thunder point) should never be needled downward toward the lung as it may puncture the lung and cause pneumothorax. Lastly, xiashangdien (lower thunder point) should be needled perpendicularly 1.5-3.0 cun deep, and stimulated until there is an "electric sensation" that runs through the entire length of the leg. The needle is then withdrawn at that time.

Treatment of Neurodegenerative Disorders with Herbs

Dr. Zhang believes the continual use of herbs is the key to recovery for patients with neurodegenerative disorders. Through many years of experience, he has used herbs to successfully treat patients with a decrease in mental and physical functions with such symptoms as poor memory, forgetfulness, slow and delayed responses, tremor, muscular rigidity, poor balance, difficulty walking, slurred speech, tongue stiffness, involuntary salivation, frequent urination and constipation.

The herbal formula of choice is Neuro Plus (Nao Wei Kang Wan), formulated by Dr. H. Zhang after 40 years of clinical experience treating geriatric patients. It functions to tonify the kidney and its essence, regulate Qi and blood circulation, remove blood stagnation and open up the sensory orifices. Clinical applications of Neuro Plus (Nao Wei Kang Wan) include patients with different types of neurodegenerative disorders who exhibit a decrease in both mental and physical functions. In China, many patients who were previously diagnosed with dementia, Alzheimer's, stroke, or Parkinson's have benefited from taking Neuro Plus (Nao Wei Kang Wan) if they exhibited the symptoms and signs listed above.

The recommended dosage is 6 grams per day, or 4 capsules three times daily. The patients will generally begin to show improvements after two to four weeks of therapy. However, for acute type of neurodegenerative disorders such as stroke, the patient should take the herbs continuously for one month prior to making a clinical evaluation. And for chronic types of neurodegenerative disorders such as Alzheimer disease, the patient should take the herbs continuously for three months prior to making a clinical evaluation.

Neuro Plus (Nao Wei Kang Wan) is a patented herbal formula in Tianjing, China and is currently distributed by Evergreen in the United States. The list of ingredients is as follows: morinda (ba ji tian), eucommia (du zhong), lycium fruit (gou qi zi), polygonum (he shou wu), alpinia fruit (yi zhi ren), cuscuta (tu si zi), cornus (shan zhu yu), cordyceps (dong chong xia cao), Ginseng (ren shen), dioscorea (shan yao), astragalus (huang qi), american ginseng (xi yang shen), white atractylodes (ba zhu), poria (fu ling), pseudoginseng (san qi), crataegus (shan zha), leech (shui zhi), salvia root (dan shen), carthamus (hong hua), anteater scales (chuan shan jia), gastrodia (tian ma), tokoro (bei xie), fresh rehmannia (sheng di huang), scolopendra (wu gong), polygala (yuan zhi), acorus (shi chang pu), angelica (bai zhi), testudinis (gui ban) and cornus cervi fragments (lu jiao shuag).

Lifestyle Instructions

1. Instruct the patient to decrease the amount of food ingested at any meal (i.e., stop eating when approximately 80% fullness is achieved). They should lose weight if obese.
2. Cholesterol level should be reduced (utilize vegetable oil instead of animal oil for cooking)
3. They should eat more "white meat" and less "red meat."
4. They should consume adequate amounts of vegetables for vitamin A, B1, B2, C & E.
5. Fried, smoked or barbecued foods should be avoided.
6. They should take frequent small meals instead of 1 or 2 large meals.
7. They should stop smoking tobacco and avoid drinking hard liquor.
8. They should avoid food containing heavy metals, i.e. aluminum.
9. They should exercise daily and maintain a positive, hopeful outlook toward the future.

Case Studies

Case Study #1:
J.D. is an 83 year-old female who had a stroke 2 years ago. On the first visit, the patient shuffled into the clinic, sat down, and promptly fell asleep. She was unresponsive to questions. Clinical observation showed an extremely deficient and deep pulse. The tongue was pink and slightly dusky with greasy yellow-green tongue coat which was much thicker on her left side.

J.D. started taking Neuro Plus (Nao Wei Kang Wan) daily (4 capsules three times daily) and received acupuncture treatment twice weekly. The points used were P-6, SP 6, SP 9, LI 4 & LIV 3. The patient showed marked improvement. She can lift her feet, smile, and respond somewhat and stayed awake throughout the entire treatment. The patient improved rapidly at two treatments per week. Her progress slowed when she had to reduce the treatment to once per week due to financial reasons. However, she continues to improve. Her tongue coat became granular and brownish, changing over the course of treatment to a slightly-thick, more-even white, or slightly yellow coat.

After 4 months of treatments she is able to converse more normally. Her friends are happy because she can now talk with them on the phone. Treatment continues....

Case Study #2:
Kong Xiang Lin is 64 year-old retired male. The date of his first visit was on January 29, 1995. Clinical manifestations include the following signs and symptoms: poor attention span, hand tremor, stiff tongue and inability to hold a rice bowl or chop sticks, poor balance and he requires help when walking. He also has partial urinary and fecal incontinence with frequent urination. A CT scan taken on December 22, 1995 confirmed cerebral atrophy. The patient's condition dramatically improved after taking Neuro Plus (Nao Wei Kang Wan) for only 5 days. On the sixth day, the patient's hand tremors stopped. He was much more energetic. His frequency of urination decreased, and did not require assistance walking. He commented that Neuro Plus (Nao Wei Kang Wan) was like a "magic bullet" - and he said it without stuttering.

About the Authors

Dr. Hua Long Zhang is a licensed acupuncturist in Tianjing, China, where he has over 40 years of clinical experience in acupuncture and herbs. Dr. Zhang has specialized in treating geriatric illness for the past 10 years. A third-generation practitioner, he is a graduate of Tianjing University of Oriental Medicine and currently serves as the Director of Bai Lou Hospital in Tianjing, China.

John K. Chen, Ph.D., Pharm.D., OMD, L.Ac. is a recognized authority on western pharmacology and Chinese herbal medicine. He graduated from the University of Southern California (USC) School of Pharmacy and South Baylo University of Oriental Medicine. He also received extensive postgraduate training in China specializing in herbology and internal medicine.

Dr. Chen currently teaches herbal medicine at USC, Chinese herbology at South Baylo University, and western pharmacology at Yo San University and Emperor's College. He is the Chair of the Herbal Medicine Committee for the American Association of Oriental Medicine (AAOM) and an herbal consultant for the California Association of Acupuncture and Oriental Medicine (CAAOM).

Dr. John Chen is the president and founder of Evergreen Herbs.

Evergreen Herbs & Medical Supplies
17431 E Gale Ave.
City of Industry, CA 91748
Tel: 626-810-5530 Fax: 626-810-5534
Website: www.evherb.com Email: sales@evherb.com

© 1997 Written by Dr. John K. Chen and Dr. Hua Long Zhang. All rights reserved.