Editor's Note: This study was completed by a group at the teaching clinic at Farmingdale State College, run by the New York College of Traditional Chinese Medicine (NYCTCM). A complete list of authors and their biographies are listed at the end of this article. In this continuation, you will learn about the acupuncture points selected for the study subject's treatment, and get the results of the case study.
Acupuncture Point Selection
The selection of the acupuncture points used were based on the principles of:
The points used and selected were modified slightly during each successive treatment based on JA's constitution at the time of the follow up consultations. The point formulas chosen were alternated back and front treatments every treatment, and occasionally, if there was time, both treatment formulas were performed.
Doctor's Orders (Recommendations)
The patient was recommended to not drink any wine due to it causing the eczema to worsen (according to TCM, wine is warming in nature, worsening her blood heat), and to incorporate Napa Cabbage, and Mung Bean, both cooling foods, into her daily diet.
Needling Technique
All points were needled using even method. Bleeding was done with a diabetic lancet on areas where the rashes were most present.
Treatment Schedule
The treatment schedule was twice a week indefinitely for the patient's symptoms to be managed. Each treatment session lasted 25 minutes, with 15-20 minutes for initial consultation, and another ten minutes for aftercare recommendations.
JA's Outcome
JA reported that her eczema has drastically reduced after each treatment, in all areas of the rashes — face, hands and lower legs (the eczema on her face has reduced to about 10 percent, and is now only around the creases of her mouth). However, due to the patient's own admittance that she eats foods and drinks beverages that cause flare ups, her eczema symptoms are not as well managed as they could be.
JA also reported that she enjoys gardening, despite the fact that touching the soil and plant material causes the eczema to worsen on her hands. Although it was recommended she reduce her time in the garden, she has not been able to follow that suggestion. JA is satisfied with the acupuncture treatments in reducing the itching and rashes when there are flare ups, and said she will continue to get treatments at the clinic as long as time permits.
Key Findings
JA's reduction of symptoms after each treatment supports the theory that her root cause is due to blood heat, the itch resulting from wind. Sima, consisting of the three points master, 88.17, 88.18, and 88.19, located using GB31 (Fengshi) as a reference point, is has the clinical indication for skin conditions, due to the fact that it is used for issues with the Lung.
The lung, in "Nei Jing" theory, is related to the skin. LU3 is used due to the clinical indication of reducing itches of all kinds. Sima is also located between the stomach channel and the GB channel. Therefore, it borrows properties from both channels. Due to its proximity to the GB channel, it can help in cases of wind, and due to its proximity to the stomach channel, issues pertaining to stomach heat can be resolved.
Bloodletting
Bleeding is the other major method of reducing the symptoms of itching and redness in our patient. Traditionally, Eastern and Western philosophies have long used bleeding as a means of reducing symptoms of heat.
Fever and skin itching are due to the nature of heat, and therefore the release of it should theoretically reduce those symptoms.7 However, with the advent of modern medicine, it fell out of favor as an archaic, unhygenic, and ineffective form of treatment.
Renewed interest in bloodletting has brought about scrutiny in its effects for issues such as hypertension, diabetes, and cholesterol. Indeed, statistical significance was found in the reduction of all three levels following blood donation.8 Interestingly, bloodletting in the modern medical world is only specific for a few types of medical issues, including Polycythemia and Porphyria cutanea tarda, both which manifest with painful and itching/blistering skin, and for which bloodletting is a valid and reasonable mode of treatment in reducing those symptoms.9
Asthma & Eczema
A reduction in using her inhaler as well as the type of inhaler has also seen a reduction in the rashes and itching on her legs. In the fall of 2015, the patient had what was a supposed severe eczema flare up on her legs (purple and shiny in quality), which were poorly controlled by acupuncture and only saw minor relief.
Finally, upon questioning her medical history again, the patient reported she had changed her inhaler from Proventil to Proair for financial reasons. Further study into the side effects of Proair showed a warning for itchy dark rashes is considered an allergic reaction that warranted a change in inhaler.
At that time it was recommended she change her inhaler back to Proventil, which she did, and the following acupuncture treatments helped resolve the remaining rash.
A comorbidity of asthma and eczema is often seen, and children who have severe eczema are likely to develop asthma 70 percent of the time.10 Some research suggests that it could be due to a side effect of the steroid inhaler medications and therefore this is a possible area of further study.11
New studies in the efficacy of TCM in treating eczema have gained the attention of the Western medical field. Some studies have shown a decrease in both area of the the symptomatic rashes and the itch brought on by the disorder.12
References
7. Székely M, Szelényi Z. "Contributions to thermal physiology: Satellite symposium of the 28th International Congress of Physiological Sciences, Pécs, Hungary." Oxford, England ; Elmsford, N.Y.: Pergamon Press, 1981.
8. Khosrow SH, Rainer Lüdtke, Gustav JD, et al. "Effects of phlebotomy-induced reduction of body iron stores on metabolic syndrome: Results from a randomized clinical trial." BMC Medicine, 2012; 10:54.
9. Assi TB, Baz E. "Current applications of therapeutic phlebotomy." Blood Transfusion, 2014; 12(Suppl 1), s75–s83.
10. Spergel JM, Paller AS. "Atopic dermatitis and the atopic march." J Allergy Clin Immunol, 2003; 112 (6 Suppl): S118–127.
11. Isaksson M. "Skin Reactions to inhaled corticosteroids: Incidence, Avoidance and Management." Drug Safety, 2001; (24)5: 369-373.
12. Salameh F, Perla D, Solomon M, et al. "The effectiveness of combined Chinese herbal medicine and acupuncture in the treatment of atopic dermatitis." The Journal of Alternative and Complementary Medicine, 2008; 14(8): 1043-1048.
Joseph G. Montalto earned his bachelor's degree in biology from Molloy College and his master's degree in physical therapy from Touro College. He owns a physical therapy practice in N.Y. and is board certified in orthopedics.
Dr. Bin Xu received his bachelor's and master's in medicine from the Harbin Medical University, his diploma of acupuncture and TCM from the University of Heilongjiang, and his PhD in medical science from Kanazawa Medical University in Japan. He worked as a physician in China from 1990 to 1993, and since 1993 has been employed as a research scientist in N.Y.
Dr. Yemeng Chen graduated from Shanghai University of Traditional Chinese Medicine in 1985. After that, he worked as an instructor in Shanghai Medical University and practiced as a physician in the affiliated Huashan Hospital, becoming the director of the acupuncture department in 1989. Dr. Chen has more than 30 research papers published in various medical journals in different countries and has also published 10 acupuncture books, including two large-scale reference works. He is currently president of New York College of Traditional Chinese Medicine.
Audrey Krapf is the director at the Health and Wellness Center at Farmingdale State College in N.Y. She is recipient of the NYSCHA Susan Shearer Award for leadership, commitment and enthusiasm in college health.
Kevin Murphy is the director of the Health and Wellness Center at Farmingdale State College. Prior to this appointment, Kevin served as assistant director of the Health and Wellness Center. Mr. Murphy worked as a Level 1 trauma nurse prior to his career in college health. Kevin received an AAS in nursing from Suffolk Community College, A BSN in Nursing from Western Governors University, and a MSN in Nursing Management and Leadership from Western Governors University. Kevin is a lifelong resident of Long Island, and currently lives in West Islip along with his wife and two children. Kevin is focused on providing cost effective, evidence based care to the students of Farmingdale State College in order to allow them to peruse their educational endeavors.
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