Chinese Differential Diagnosis
The organ patterns primarily disturbed in hepatitis C virus (HCV) are the liver organ patterns and the spleen organ patterns. These organ patterns affect a person's digestion and energy. According to Chinese traditional medicine, acute viral hepatitis is generally associated with excess damp heat or damp cold conditions.
While in a few cases a person infected with HCV may have or notice acute symptoms, it is rare. Therefore, the TCM stages at which one is diagnosed with hepatitis C are often the chronic stages of qi stagnation, and the qi and yin deficiency stages. Advanced chronic disease includes a development of the patterns of xue (blood) stagnation and deficiency.
All HCV is associated with the li qi (pestilence/epidemic factor) toxic heat:
Toxic Heat
Symptoms: Itching, sensations of heat, agitation
Tongue: Red spots and body
Pulse: Rapid
In addition, there are 10 syndromes specifically associated with viral hepatitis.
The following excess syndromes are associated generally with acute hepatitis and increased liver enzymes. However, these may persist in chronic hepatitis (along with additional syndromes that develop as liver disease progresses).
1. Liver /Gallbladder Damp-Heat
- bright yellow face/eyes
- fever
- costal pain
- jaundice
- nausea
- pulse: wiry
- tongue: red, with yellow greasy fur
2. Spleen Damp-Heat
- bright yellow face
- abdominal pain
- nausea
- jaundice
- fever
- decreased appetite
- pulse: slippery
- tongue: red, with yellow greasy fur
3. Spleen Damp-Cold
- sallow yellow face
- abdominal pain
- nausea
- feels cold/often has fever
- decreased appetite
- pulse: slippery
- tongue: pale, with greasy white fur
The following excess syndrome is generally associated with chronic hepatitis.
4. Qi Stagnation
- fatigue
- costal pain
- fullness in abdomen
- nausea
- flatulence/bloating
- often increased liver enzymes
- swollen liver and spleen
- pulse: wiry
- tongue: purplish or normal, with thin white coat
The following deficiency syndromes are associated generally with chronic hepatitis:
5. Spleen Qi Deficiency
- fatigue
- abdominal tenderness
- nausea/queasiness
- lack of appetite
- muscle weakness
- loose stools
- pulse: deficient
- tongue: pale, swollen with toothmarks
6. Liver Yin Deficiency
- dryness of eyes, nails, throat and mouth
- fatigue
- blurry vision
- dizziness
- muscle spasms
- reddish cheeks and eyes
- numb limbs
- quick temper
- pulse: thin, deficient, wiry, rapid
7. Qi Deficiency (General)
- fatigue
- bleeding (such as purpura)
- leg edema
- ascites
- pulse: deficient
- tongue: pale, swollen
8. Yin Deficiency (General)
- fatigue
- reddish cheeks
- night sweats
- afternoon fevers or hot flashes
- restlessness
- waking up during night
- pulse: thin, deficient, rapid
The following deficiency syndrome is often associated with cirrhosis.
9. Xue (Blood) Deficiency
- pale and lusterless face
- general dryness
- enzymes often normalize
- shrunken liver
- pulse: deficient and thready/hollow if loss of blood
- tongue: pale
The following excess syndrome is often associated with liver cancer (and is in addition to deficiency syndromes).
10. Xue (Blood) Stagnation
- sharp, stabbing costal pain
- abdomen hurts with movement
- pulse: choppy or wiry (with pain)
- tongue: purple or purple sides
Treatment with Acupuncture, Moxibustion and Massage
General Chronic Hepatitis Treatment
For Specific Chinese Patterns:
Moxibustion
Moxibustion may be used in HCV to stimulate specific acupuncture points. This warms the channels and expels cold and dampness; creates a smooth flow of qi and xue; strengthens yang qi; prevents disease; and maintains health.
For hundreds of years, moxibustion has been partnered with acupuncture. According to the Chinese text, Introduction to Medicine, "When a disease fails to respond to medication and acupuncture, moxibustion is suggested."
For chronic hepatitis, whenever there are increased AST and ALT levels, you may use the following points:
Additional points for various conditions include:
Acupressure/Massage
I instruct the client to perform self-acupressure at the following points:
Abdominal massage is helpful to harmonize the large and small intestine, liver, spleen, stomach and gallbladder. To increase the massage's effectiveness, warm the abdomen first with a hot pack or ginger compress. You may also massage using warming oil infused with cinnamon essential oil.
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
| Digital Exclusive
One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
| Digital Exclusive