TCM Flashcards by Claire Jamieson

evidence based medicine has 3 parts

patient presentation
clinical experience
research evidence (NOT AS MUCH)

first 2 are more important

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PICO

population/patient (age, gender, inclusion criteria)

intervention (points needled, depth, duration, # of visits)

comparison (inert/ no needles, active/sham, active?/ streitberger)

outcome

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forms of accupuncture

manual accupuncutre

electro accupuncutre

laser acupuncture

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modify points in TCM?

Modification of points during a treatment cycle is
recommended in TCM

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sham vs streitberger acupuncture

Sham acupuncture (ACTIVE)
Non-point needling

Streitberger controls
(ACTIVE?)
Designed to mimic needle insertion without penetrating the
skin

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study design concerns

Individualized diagnoses
Multiple acupuncture point protocols
Frequency concerns
Access to treatment site
Number of acupuncturists
Training of acupuncturists
Control groups

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STRICTA - Standards for Reporting Interventions in Controlled Trials of Acupuncture

6 compoennets

accupuncture rational ( include style of acu. i..e TCM, Japanese..)
detail of needling
treatment reginmen
other components of tx
practitioner background
control or comparator interventions

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TCM diagnoses

Single organ vs multiple organ pathologies

Emotional vs Mental vs Physical etiologies

Chronic vs acute

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acc as adjunct therapy for lung cancer

immunomodulation: Significant increase in IL-2, T cells (CD3+ and CD4+), and NK cells

Alleviates therapy-induced bone marrow suppression

Decreases nausea and vomiting

Can improve Karnofsky performance status (KPS), immediate
tumor response, QoL, and pain control

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acupuncture and lung cancer

improve HRQol (health related quality of life) and sleep

decreased hot flush score

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accuncutpure research via

STRICTA

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EBM in TCM relies on

EBM in TCM/acupuncture relies more on patient
presentation and clinical experience than research
evidence

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layers from inner to outer of functional defence system

muscle
wei qi
skin

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Chinese herbs used in order of most yang to most yin

Flowers
Leaves, peels, and bark
Stems and vines
Roots
Shells and minerals
Animal-based

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natures and flavours of Chinese herbs

Spicy
Sour
Bitter
Sweet
Salty
Bland

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4 components of formula composition for Chinese herbs

chief or principal or monarch
deputy or minister
assistant or adjuvant
envoy or cunductant or guiding

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role of chief or principal or monarch in Chinese herb formula

The herb with the greatest power
The herb which treats the primary disorder
Usually the herb in the greatest amount

role of deputy or minister in Chinese herb formula

Aids the chief in treating the primary disorder
Treats secondary disorders or co-primaries

role of assistant or adjuvant in Chinese herb formula

Benefits the chief or deputy (Helpful assistant)
Moderates the toxicity of the chief or deputy (Corrective
assistant)
Antagonist effect of the chief (Opposing assistant)

role of envoy or cunductant or guiding in Chinese herb formula

Harmonizes all of the ingredients
Focuses the actions on a certain area or channel

methods or action for Chinese herbs

Diaphoresis
* Releases exterior

Emesis
* Removes phlegm, stagnation of food or toxins

Draining downward/purging
* Removes stagnancy, phlegm, water, blood, parasites, heat and/or cold

Mediation/Harmonizing
* Tries to eliminate pathogens and tonify upright Qi

Warming
* Warms the middle, rescues Yang, and dispels cold

Clearing heat/Cooling
* Clears heat from all levels, organs, and clears empty heat

Reducing/Elimination
* Reduces blood stagnation, food stagnation, phlegm, parasites

Tonification
* Qi, and blood, yang, nourishes yin, nourishes blood, and
moistens dryness

combining effects with Chinese herbs

Single effect
Mutual Accentuation
Mutual Enhancement
Mutual Counteraction
Mutual Suppression
Mutual Antagonism
Mutual Incompatibility

forms of Chinese herbs

Decoction

Granules

Powder (raw herbs ground into a power)

Tablets (granules compressed into a tablet)

Pills (water, paste, concentrated)

Medicinal wines

Extracts
* Liquid
* Semi-solid/dry
* Soft
* Medicated ointment
* Adhesive plaster

Syrups

Dan: Mixed with minerals to aid absorption

Lozenges

Injections

best form of herbal tx in TCM

decoctions

pros of decoctions

Allows the herbs to work Takes long to prepare synergistically before consumption Herbs are boiled based on their relative strengths and hardness, as well as their toxicity Liquids are clear of grit Strong taste/smell is good in TCM * will activate organ systems Modification can be done daily

cons of decoctions

long to prepare odor taste/smell costly cant be sure of quality of herbs

pros of grnanules

cheaper easy to use; no boiling premade fromula strong taste and smell is good in TCM to activate organ systems modifiable with minimal expense

cons of granules

cant change herbs daily single herb formulas remove synergistic aspect bad taste and smell powder doest dissolve fully/gritty may cost more than raw herbs

tablets

conveneient inecpsenisve hard to find

patent pills

low dosage since over the counter longer to see changes that decoctions good for acute conditions since cheap some sugar coated which is bad based on historical formulas contaminant and heavy metals

choose a patent formula

based on primary dx limited to certain organs or body areas cant be modified low cost = low efficacy

release the exterior: wind cold (2) release the exterior: wind (1) release the exterior: wind heat (3)

wind cold 1. ma huang tang 2. gui zhi tang wind 1. chuan xiang cha tiao san wind heat 1. sang ju yin 2. yin qiao san 3. gan mão ling jie du wan

- Ma Huang Tang (ephedra decoction) for which pathogen? action? indication? contraindication?

wind cold o A= Action  Release the exterior and promote sweating  Move lung qi  Stop wheezing and dyspnea o I= indication  Wind cold invasion o CI= contraindication  Discontinue once sweating occurs  Exterior deficiency  Wind heat invasion  Bleeding disorders  Postpartum  Caution in hypertension

- Gui Zhi Tang (cinnamon twig decoction) for which pathogen? action? indication? contraindication?

wind cold o A= Action  Releases pathogens from muscle layer  Regulates ying and wei qi o I= indication  Wind cold (deficient type) aka exteriror deficiency of wind cold  Yin and wei qi disharmony  Deficiency of the middle burner with cold o CI= contraindication  Wind cold invasion (excess type)  Excess internal heat  Alchol consumption; leads to nausea, vomit, bloating

- Chuan Xiong Cha Tiao San (ligusticum powder to be taken in green tea) for which pathogen? action? indication? contraindication?

wind o A= Action  Clears exterior wind to relieve pain o I= indication  External wind cuasing headaches o CI= contraindication  Headaches from liver yang rising, qi def, blood def, or liver and kidney def.

- Sang ju yin (morus and chrysanthemum decoction) for which pathogen? action? indication? contraindication?

wind heat o A= Action  Promotes sweating to release the exterior  Clears wind heat  Moves lung qi to stop coughing o I= indication  Wind heat invasion  Cough from wind heat o CI= contraindication  Cough from wind cold

- Yin qiao san (honeysuckle and forsythia powder) for which pathogen? action? indication? contraindication?

wind heat o A= Action  Releases the exterior  Clears wind heat  Clears heat toxins o I= indication  Wind heat invasion with heat toxin  Sore throat, boils, sores o CI= contraindication  Wind cold invasion  Damp heat (ineffective for the condition)

- Gan Mao Ling Jie Du Wan (common cold effective remedy) for which pathogen? action? indication? contraindication?

wind heat o A= Action  Clears wind heat  Release the exterior  Clears heat toxins o I= indication  Wind heat invasion with heat toxin (sore throat, boils, sores)  Similar to yin qiao san but most effective at the onset of sx  Can treat all external patterns since 74% of the herbs are antiviral o CI= contraindication  Severe chills -

which herb for common cold

- Gan Mao Ling Jie Du Wan (common cold effective remedy)

which 2 herbs for wind heat invasion with heat toxin i.e. sore throat, boils, sores

2. yin qiao san 3. gan mão ling jie du wan

which herb for when wind is causing headaches

- Chuan Xiong Cha Tiao San