Herbal USA

Peripheral neuropathy, a.k.a. polyneuritis, is a syndrome composed of sensory, motor, and vasomotor symptoms which may occur singly or in combination caused by simultaneous disease of a number of different nerves. This condition is usually secondary to collagen vascular conditions, such as polyarteritis nodosa, SLE, scleroderma, and RA, metabolic diseases, such as diabetes mellitus and hypothyroidism, infectious agents, such as Lyme disease and HIV, or poisoning by such things as heavy metals, carbon monoxide, many solvents, and various drugs. The symptoms of this syndrome include bilateral numbness and insensitivity tingling, burning pain, muscle weakness, and atrophy. Pain is frequently worse at night and may be aggravated by touch and temperature changes.

Because peripheral neuropathy is a symptom complex rather than a disease in its own right, the Western medical diagnosis and treatment of Peripheral neuropathy primarily revolve around that of the primary disease. However, electromyography and nerve conduction velocity tests may be used to help confirm neuropathy. Treatment of the underlying systemic disorder may halt the progression of this condition and even improve symptoms, but recovery tends to be slow at best. Various experimental drug therapies, such as the antidepressant amytriptilline (Elavil), have shown mixed results in clinical trials.

CHINESE DISEASE CATEGORIZATION: Peripheral neuropathy is categorized as wei zheng, wilting condition, in Chinese medicine. Numbness and tingling are referred to as ma mu, tingling and woodenness. Insensitivity is bu ren, no feeling. Since Peripheral neuropathy associated with systemic disease tends to affect the lower extremities first, this condition may also be referred to as xia zhi ma mu, lower extremity numbness and tingling, or xia zhi teng tong, lower extremity aching and pain.

DISEASE CAUSES: The six environmental excesses, the seven affects, unregulated eating and drinking, taxation fatigue, enduring disease, aging, poisoning, and iatrogenesis

DISEASE MECHANISMS: The disease mechanisms of Peripheral neuropathy are nothing other than the disease mechanisms of wilting, pain, and numbness and tingling. Any evil qi, whether externally invading or internally engendered may lodge in the channels and network vessels, thus obstructing the flow of qi and blood. On the one hand, lack of free flow may cause pain. On the other hand, malnourishment may result in insensitivity and wilting. Lack of nourishment may also be due to A) anything which damages the spleen, the latter heaven root of qi and blood engenderment and transformation, B) enduring evil heat damaging and consuming blood and fluids, C) over or erroneous use of windy, dispersing medicines and recreational drugs, and D) the debility and decline of aging.

Treatment based on pattern discrimination:

Damp Heat Invasion & Excessiveness Pattern

Lung-Stomach Fluid Damage Pattern

Spleen-Stomach Vacuity Weakness Pattern

Liver-Kidney Insufficiency Pattern

Spleen-Kidney Insufficiency With Cold Dampness Pouring Down Pattern

Remarks

1.  Because Peripheral neuropathy is usually seen in enduring, chronic diseases, there will be liver depression qi stagnation even though none of the above patterns mention it. One can also count on fatigue due to spleen vacuity. Further, as the majority of the above formulas imply, there will also be concomitant blood stasis. Qi and yin vacuity with damp heat and qi and blood stasis and stagnation is a commonly seen combination of patterns in patients with Peripheral neuropathy due to diabetes, SLE, RA, and AIDS. If yin vacuity reaches yang, there may also be concomitant yang vacuity.

2.  If blood stasis has entered the network vessels, worm and insect ingredients should be used, such as Di Long (Pheretima), Jiang Can (Bombyx Batryticatus), Quan Xie (Scorpio), Wu Gong (Scolopendra), Shui Zhi (Hirudo), and Tu Bie Chong (Eupolyphaga/Steleophaga). Most of these medicinals also track down and extinguish wind, thus relieving tingling and itching.

3.  When needling either the Ba Feng (M-LE-8) or Ba Xie (M-UE-22) points, it is necessary to needle deeply into theinterosseous spaces, taking care not to needle into the periostreum on either side. By deep needling, we mean at least 1-1.5 cun. In order to do this, one should spread the ringers or toes apart manually while inserting and guiding the needle to its right depth and position.

4. The majority of published research from China on Peripheral neuropathy is on the oral administration of Chinese medicinals, not acupuncture. Since Peripheral neuropathy tends to be a root vacuity (commonly qi and yin vacuity) with a branch repletion (blood stasis and/or damp heat impediment), acupuncture alone is not generally considered the standard of care for this condition. Nevertheless, it may be an effective adjunctive therapy.

5.  In order to treat blood stasis and damp heat impediment locally more effectively, it is possible to use Chinese medicinal hot foot soaks. One such formula consists of: XiXian Cao (Herba Siegesbeckiae), 100g, Ji Xue Teng (Csailis Spatholobi), Ren Dong Teng (Caulis Lonicerae), and Ai Ye (Folium Artemisiae Argyii), 60g each, Wu Jia Pi (Cortex Acanthopanacis) and Tou Gu Cao (Herba Impatientis), 30g each, and Hong Hua (Flos Carthami), Ku Shen (Radix Sophorae Flavescentis) and Mo Yao (Myrrha), 20g each. These medicinals are boiled twice—the first time in seven times more water than the medicinals for 1.5 hours, the second time in five times as much water for one hour. The resulting two batches of medicinal liquid are combined. This should result in aproximately one liter of medicinal liquid. Bottle and reserve for use. Each time, use 30ml of this liquid in three liters of hot water (40-50° C), soaking both feet for 30 minutes each time, four times per day if possible.

6.  Restless leg syndrome, which is also seen in diabetics and hypertensives, is treated according to basically the same pattern discrimination as above with an emphasis on qi and yin vacuity, dampness or damp heat, wind, and blood stasis.

This entry was posted on Tuesday, May 31st, 2011 at 11:08 am and is filed under Herbal Therapy. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.