7월 06, 2010

Preventive Medicine For Modern Times

written by: Seonghee Joo, Seonghwan Cho, Jongwoo Kim, Nayeon Ha, YeoEun Park
edited by: YeoEun Park

Modern times breed modern diseases. While unprecedented growth of civilization set most of human race free from plague and famine, new health problems are coming into spotlight. More nutrition and less exercise led to deterioration of health, which can be loosely bound in a category of diseases called 'adult diseases.' Adult diseases, also called lifestyle diseases, include variety of diseases such as obesity, diabetes, arthritis, and cancer. As many of adult diseases are caused by one's diet, stress factor and overall lifestyle, every day prevention is necessary. In this article we will discuss how Traditional Korean medicine can help prevent adult diseases such as obesity, hypertesion, diabetes, and stroke.

1. Obesity

A person with obesity is generally overweight, but a person who has lots of muscles instead of fats can also be overweight, so we define 'obesity' as a condition of an accumulated excess body fat. Body Mass Index, a measurement which compares weight and height, defines people being overweight when BMI is over thirty for western people, and over twenty-five for Asians.
Obesity is known as a direct cause for adult diseases like diabetes, stroke, hyperlipidemia, high blood pressure, heart disease and is also related to arthritis, gout, infertility and menstrual irregularity. It may even trigger more serious diseases such as colorectal cancer, prostate cancer, gallbladder cancer and breast cancer, and is one of the greatest risk factors to health that shortens our life span and lowers our life quality.

(1) Dietary treatment for Obesity

Adult diseases are not individual disease to each other. Rather they are closely connected that they cause and aggravate other adult diseases. Therefore dietary treatments for them have a lot in common. Basically we need to cut back a high-salt and a high-fat diet which is wrong diet of modern people. Also roasted and fried food which is rich in carbohydrate, three-white food (white rice, white wheat, white salt), and drinking alcohol should be moderated. Instead we should plan the Mediterranean diet, which mainly consists of fruits, fishes, and vegetables. Additionally intake of potassium is recommended that it boost discharge of sodium to bring down blood pressure.
Low calorie diet containing adequate amount of essential nutrient is recommended. Fruits and vegetables, for instance beans, adlay, tomatoes, cucumber, low-fat fish, buckwheat, weed, onion, carrot and cabbage are good for obesity cure.

(2) Exercise cure for obesity

Highly intensive aerobic exercise is effective for obesity but it should not be continued after the body feels fatigue. Though exercise that lasts less than an hour has appetite-suppressing effect, exercise more than an hour reversely boost appetite, so 40 minutes-exercise for 4 times a week is recommended.
One of the traditional exercise treatments is Qigong exercise, which is descended from ancient China exercise school(養生長壽術 十勢功法道家 華山派). It is called 龍遊功(Yongyoogong, which is also called 三環功-Samhwangong, as it puts hands together and turn around three times), because its movement is quite similar to dragon’s waving. It is effective for losing unwanted weight and keeping good body shapes. Other exercises such as 按腹行法(Walking while massaging stomach), 正坐深呼吸法(Sitting up straight and deeply breathing), 香陵六合氣功(hyangnengyukkigong) are becoming accepted as being helpful on treating obesity.

(3) Medicinal Treatment for Obesity

① Bangpungtongseongsan(防風通聖散)
- Cnidium officinale 4.0, Saposhnikovia divaricata 4.0, Angelica gigas 4.0, Paeonia lactiflora 4.0, Mentha piperascens (Malinv.) Holmes 4.0, Forsythia viridissima 4.0, Ephedra sinica 4.0, Erigeron canadensis 4.0, Rheum palmatum 4.0 gypsum 4.0, Platycodon grandiflorum A. De Candolle 4.0, Scutellaria baicalensis 4.0, Artractylodes japonica 3.0, Schizonepeta tenuifolia var. japonica 3.0, Zingiber officinale 3.0, talcum10.0, Gardenia jasminoides 3.0, Glycyrrhiza uralensis 2.0
- Used when colonic motility is too excessive, as this hyperactivity tends to cause constipation.
- Used when patients have lots of fat cells, suffer from obesity and hyperlipidemia which causes skin allergies, mucous allergies, skin diseases, hypertension, mental disorders, etc :
* Reduce the viscosity of blood
* Anti-inflammatory and anti-allergic action
* Proliferate the blood circulation
* Controls autonomic nervous system
* Treats inflammation of the urinary system

- Mentha piperascens Holmes, Platycodon grandiflorum A. De Candolle, Scutellaria baicalensis have anti-inflammatory effects.
- Forsythia viridissima, Scutellaria baicalensis, Artractylodes japonica have anti-allergic effects.
- Forsythia viridissima, Saposhnikovia divaricata, Rheum palmatum, Schizonepeta tenuifolia var. japonica, talcum have antibacterial activities as to treat the inflammation of urinary system and skin.
- Rheum palmatum, Scutellaria baicalensis, Schizonepeta tenuifolia var. japonica, Gardenia jasminoides reduces the viscosity of blood as to relieve inflammatory diseases and hypertension.
- Cnidium officinale, Gardenia jasminoides tranquilize the nerves.
- Cnidium officinale, Angelica gigas, Paeonia lactiflora proliferate the blood circulation by improving the vasomotion ability
- Erigeron canadensis, Rheum palmatum cause quick discharge of the intestinal contents as to treat the viscosity of blood caused by intestinal stagnation of the contents.
- Ephedra sinica, Paeonia lactiflora, Zingiber officinale excrete impurities in interstitial cells by letting the patient sweat.
- This herbal medicine often used for person who has excessive subcutaneous fat around the belly button. It is effective for obese patients with constipation and hypertension as it eliminates unnecessary wastes through the secretion of sweat, urine and feces.

② Chegameuiin-tang(體減薏苡仁湯)
- Coix lacryma-jobi 8g, Rehmannia glutinosa 7g, Sinomenium acutum 4g, Glycyrrhiza uralensis ․ Astragalus membranaceus ․ Dioscorea batatas ․ Akebia quinata ․ Alisma canaliculatum ․ Magnolia obovata ․ Polyporus umbellatus ․ Juncus effusus ․ Raphanus sativus ․ Angelica gigas ․ Epimedium koreanum ․ Lycium chinense Miller ․ Cornus officinalis 2.5g each, Cnidium officinale ․ Carthamus tinctorius ․ Caesalpina sappan 1.5g each.
- This herbal medicine is effective for generally healthy, yet obese patients who have great appetite, sleep much and hate moving their body.
- It treats these patients by improving blood circulation, reducing the appetite, improving endurance, promoting fat decomposition and smooth discharge of urine and feces.

(4) Acupuncture and Moxibustion for Obesity
Meridians are pathway for qi and blood, the principle constituents of human activity. They are affiliated with organ in internal part of body, and distributed all over the external part. Traditional Korean medicine defines heath as the state in which qi, blood, and body fluids are appropriately circulating. Acupuncture and moxibustion can stimulate certain points on meridians, thus controlling overall energy and metabolism system, and cure diseases. Historical books on medicine show that 'life-nurturing moxibustion'(養生灸), by applying moxa on certain areas during healthy state, can prevent illness and invigorate human body.
It has been studied that stimulation by acupuncture or chuna may promote metabolism and regulate endocrine system. These functions lead to effects similar to lipolysis and thus help reduce body fat. Chuna or massage basically stimulate the body in the same way as acupuncture, and also has weight reducing effect. Traditionally used body area for weight reduction is the back. Stimulation of he back induce fat reducing effect on the whole body. The back is seen as the area where body's Yang qi is concentrated, and governor vessel, which is the meridian that controls the overall yang meridians, passes through the back. Modern studies show that brown fat cells are amassed on the back. Massage on the back stimulated heat production of the brown fat cells, and lets the excess energy to be consumed.

2. Diabetes

Diabetes is called ‘wasting-thirst’(So-gal) in Korean medicine. It is true that diabetes is often caused by stress, lack of exercise, high-calories, fats and proteins diet. Diabetes, however, can also be occurred by specific gene deficiency and also by pancreas operation, infection and medicine. People who have diabetes can easily have obesity, high blood pressure, and hyperlipidemia, and in treatment doctors must take those other factors into consideration.
When diabetes is not severe, there are no special symptoms, but usually when blood glucose is high, patients feel thirsty, drink lots of water, eat lots of meals but lose weight and feel lethargy, and urinate more.

(1) Dietary treatment for Diabetes

Being overweight easily leads to wasting-thirst, therefore fatty food, roasted or fried food, high-carbohydrate food which causes obesity should be avoided. Additionally, drinking alcohol and eating sweet fruits should also be kept off. Instead low-salt diet is strongly recommended. In this way, diabetes can be prevented without any medication treatments.

(2) Exercise & Mental cure for diabetes

“Treatise on the Pathogenesis and Manifestations of All Diseases”(諸病源候論), Korean medicine classic emphasized importance of proper exercise, and says that we should walk 125~1000 steps before taking a meal. Another classic “Medical Secrets of an Official”(外臺秘要) suggests to concrete example of abstentious life style; exercises should not be too intensive, take a walk to digest after having a meal, prohibits late-night meal, and having small amount of meal at once but for several times.
Mental stress like anger, agony and depression forms heat inside the body that induces wasting-thirst. Accordingly, at the early period, wasting-thirst can be treated if one suppresses greed and worry. However, once this moderation is neglected, even the best medication and doctor can’t treat wasting-thirst.

(3) Medicinal Treatment for Diabetes

① Yukmiziwhangwhan-gagambang(六味地黃丸加減方)
- 生地黃(Rehmanniae Radix), 山藥(Dioscoreae Rhizoma), 石膏(Gypsum Fibrosum) 10g each, 牧丹皮(Moutan Cortex), 瓜蔞根(Trichosanthis Radix), 麥門冬(Liriopes Radix), 山茱萸(Corni Fructus) 6g each.
- Boil down the above herbs as a pack after meals, two times a day.
- Rehmannia Radix reduces the blood sugar to low level, nourishes the blood and strengthens the heart.
- Gypsum Fibrosum, Liriopes Radix relieves thirst, and treats eating disorder and bulimia.
- Moutan Cortex and Trichosanthis Radix soothes the skin inflammation caused by diabetes, reduces fever, and relieves thirst.
- Corni Fructus reduces polyuria, and Dioscoreae Rhizoma relieves thirst along with Gypsum Fibrosum, Liriopes Radix, and Trichosanthis Radix.

② Gami-Jeonssibaekchulsan(加味錢氏白朮散)
- 葛根(Puerariae Radix) 2don, 人蔘(Ginseng Radix), 白朮(Atractylodis Macrocephalae Rhizoma), 白茯苓(Poria), 藿香(Agastachis Herba), 甘草(Glycyrrhizae Radix) 1don each, 木香(Aucklandiae Radix), 柴胡(Bupleuri Radix), 枳殼(Aurantii Fructus Pericarpium), 五味子(Schizandrae Fructus) 5poon each.
- It treats decreased appetite from wasting-thirst and the frequent feeling of starvation from wasting-middle(消中).

(4) Acupuncture and Moxibustion for Diabetes

The foremost cause of diabetes might be spleen, but the root of the matter lies in kidney. Spleen can only function properly when it is heated from the yang qi of the kidney. Also it is important for the lung to be lubricated by the yin fluid of kidney to smoothly function. This is why in treatment of diabetes, traditional korean medicine first applies acupuncture on the BL23(腎兪穴) of the back and waist area. Because kidney malfunction is often caused by liver disorders, BL18(肝兪穴), where qi of the liver assembles, is also used for acupuncture and moxibustion. Then BL13(肺兪穴) BL20(脾兪穴) is treated to cure the liver and spleen. Finally acupuncture and moxibustion is applied to CV12(巨闕穴), where qi of the heart accumulates on the upper abdomen, and all five viscera is treated. This not only cures diabetes but also prevents the disease itself or further complications.
An important characteristic of oriental medicine is that it emphasizes to tonify and strengthen the body before directly treating the pathogen. Thus treatment of diabetes includes acupuncture points that boost the healthy qi of the body. LR14(期門穴) regulates spleen. The spleen is considered as a digestive organ, and it is said to provide other visceral organs with the qi through digestion. ST36(足三里) on both legs, LI11(曲池) on both arms, and CV21(中脘穴) of the stomach are treated to control the balance of qi and blood. Also the source qi is strengthened through treatment of CV6(氣海穴), which is located below the navel and is called 'sea of qi', and CV4(關元穴), where the origin qi is gathered.

3. Hypertension

Hypertension, or high blood pressure, is the state when a person's systolic blood pressure is over 140 mmHgm, or diastolic blood pressure is over 90 mmHg for adults over eighteen. Systolic blood pressure is the pressure on blood vessels when the heart contracts and pushes blood out. Diastolic blood pressure is the pressure on blood vessles when the heart expands and takes blood in.
Hypertension can be divided into two types. One is secondary hypertension, which is hypertension when a direct causative disorder is known, and the other is essential hypertension whose cause is not found. Ninety-five percent of all high blood pressure patients are suffering from essential hypertension. The fundamental cause of essential hypertension is not specific, but it seems to be caused by increase of cardiac output, a amount of blood pushed by heart during one minute or an increase of tip vessel resistance. Dangerous factors related to high blood pressure include family history, drinking, smoking, aging, lack of exercise, obesity, salty diet, and stress.

(1) Dietary treatment for Hypertension

Hypertension and arteriosclerosis are often due to lack of blood circulation, which is caused by excessive intake of salt and fat. Hence, diet has to be focused on promoting blood circulation and reducing intake of salt. Lowering blood pressure treatment is probably ineffective unless diet is improved. Consequently, planning proper diet is the very start of all cures.

(2) Exercise cure for hypertension

Qigong exercise like tai chi chuan is highly recommended. It moves body slowly , and doesn’t put stress on joint but strengthen cardiovascular system. Besides its effect of enhancing muscles, relaxing joints and making blood circulation smoothly, it is said to let the practicer absorb energy from Nature, remove pathogen and strengthen danjeon. Also tai chi chuan reconciles body and qi, it improves arteries and capillaries at the same time.

(3) Medicinal Treatment for Hypertension

① Samhwangsasim-tang(三黃瀉心湯)
- Rheum palmatum(大黃) 7.5g, Scutellaria baicalensis(黃芩) 3.75g, Coptis chinensis(黃連) 7.5g
- Slice the medicine to make 1 dose and soak it in 1 cup of boiling water. Wring it after a long while, discard the solids, and then drink warm over 2 sessions.
- Rheum palmatum(大黃) reduces the viscosity of blood by purgative action(瀉下作用).
- Scutellaria baicalensis(黃芩) is effective for the treatment of hyperlipidemia.
- Coptis chinensis(黃連), Scutellaria baicalensis(黃芩) relieve the hyperemia of blood vessels.
- Coptis chinensis(黃連), Scutellaria baicalensis(黃芩) have central nervous system depressant effect.

② Hwangryunhaedok-tang(黃蓮解毒湯)
- Coptis chinensis(黃連) 1.5g, Phellodendron amurense(黃柏) 1.5g, Scutellaria baicalensis(黃芩) 3g, Gardenia jasminoides(梔子) 2g
- Coptis chinensis(黃連), Scutellaria baicalensis(黃芩), Gardenia jasminoides(梔子) have a sedation effect.
- Coptis chinensis(黃連), Phellodendron amurense(黃柏), Scutellaria baicalensis(黃芩) relieve the congestion of blood, reduce the viscosity of blood and have antibacterial activities.
- As Hwangryunhaedok-tang(黃蓮解毒湯) can treat the hyperemia and inflammation of blood vessels and tranquilize the nerves, it can be used for the symptoms like the hyperemia, anxiety neurosis or inflammatory diseases.

(4) Acupuncture and Moxibustion for Hypertension

Acupuncture and moxibustion depend on natural healing power of human body to improve functions of circulation system, and can thus prevent hypertension.
Treatment principles on hypertenstion is to 'pacify the liver to subdue Yang' (平肝鎭陽), and usually add or omit allopathic treatment according to symptoms. Some studies show that acupuncture is effective on patients with essential hypertension. WFAS(World Federation of Acupuncture-Moxibustion Society) has issued experimental date that shows by applying ear acupuncture, participants' blood pressure can drop by minimum of 10mmHG to maximum 20 to 30mmHG.
Common use acupuncture points on hypertensions are: GB20(風池), LI11(曲池), ST36(足三里), LR3(太衝)

4. Stroke

Stroke, or cerebrovascular accident, is a long lasting disorder which is caused by partial or overall injury of the brain. In Oriental Medicine, it is called 'wind stroke' or simply 'wind', but 'wind' contains diseases not classified as stroke in Western medicine. Therefore it is better to distinguish stroke and wind stroke.
Ischemic stroke occurs when a brain blood vessel is blocked or when a brain blood vessel is torn and the blood permeates through brain tissues. Because the brain is an essential organ that controls all human behavior, various symptoms happen depending on which part of brain is damaged. The most common symptoms are paralysed arm and leg on one side of the body, sensory disorder, not specific pronunciation, feeling dizziness and other discomforts.

(1) Dietary treatment for stroke

As all other adult diseases, stroke prevention also requires large amount of potassium-rich food based on a low-salt and a low-fat diet so that blood can flow smoothly. To reduce calories, meal portion should be cut down to 80% of before. Dietary fibers and water intake must be increased but high-cholesterol foods like mushrooms, seaweeds and beans must be avoided.

(2) Medicinal Treatment for Stroke

① Ohyaksungisan(烏藥順氣散)
- 麻黃(Ephedrae Herba)·陳皮(Citri Pericarpium)·烏藥(Linderae Radix) 6g each, 川芎(Chidii Rhizoma)·白芷(Angelicae Dahuricae Radix)·白殭蠶(Bombycis Corpus cum Batryticatus)·枳殼(Aurantii Fructus Pericarpium)·桔梗(Platycodi Radix) 4g each, 乾薑(Zingiberis Rhizoma Siccus) 2g, 甘草(Glycyrrhizae Radix) 1.2g, 生薑(Zingiberis Rhizoma Recens) 3, 大棗(Zizyphi Fructus) 2
- Boil down the above herbs as a pack three times a day, 1 hour after meals.
- It controls qi to prevent and treat stroke. Also, it is good for people who are worried about having stroke due to physical disharmony and mental tension, since stroke seizures are prevented when qi communicates smoothly. For stroke and all of the signs of the disease, these herbs should be taken to communicate qi in advance, along with the following prescribed herbs. It is good to take this medicine when there is pain, a sense of illness somewhere in the body, or impediment in speech.

- 羌活(Notopterygii Rhizoma)·防風(Saposhnikovia Radix)·當歸(Angelicae Gigantis Radix)·川芎(Cnidii Rhizoma)·赤茯苓(Poria)·陳皮(Citri Pericarpium)·半夏(Pinelliae Rhizoma)·烏藥(Linderae Radix)· 柏脂(Thujae Resina), 香附子(Cyperi Rhizoma) 3.2g each, 桂枝(Cinnamomi Ramulus)·細辛(Asari Herba Cum Radix)·甘草(Glycyrrhizae Radix) 1.2g each, 生薑(Zingiberis Rhizoma Recens) 3 pieces.
- Boil down the above herbs as a pack three times a day, 1 hour after meals.
- It is prescribed when there are symptoms of a light stroke disease including the numbness at the end of four limbs.
- The name Sopung implies that the medicine dispels the wind from the body.

(3) Acupuncture and Moxibustion for Stroke

Cerebrovascular disorders, commonly called stroke, are often caused by hypertension. Traditional Korean medicine has long shown strongness on chronic stroke, half-body paralysis, dementia, and inappetance. It is also particularly effective for aftereffect of stroke. Traditional Korean medicine doctors diagnose 'phlegm-dampness' or 'phlegm-heat' as some of the pathogens of stroke. In those two cases, it is more important to unblock the meridian rather than using restorative herbal medicine. This is where acupuncture and moxibustion can step in as appropriate preventive treatment for stroke. Acupuncture and moxibustion have no side effects when used together with Western medicine treatment or herbal medicine. Also because acupuncture-moxibustion regulates autonomic nerve, it alleviates general symptoms and induce functional recovery. Thus acupuncture and moxibustion treatment are effectively used for prevention against stroke by regulating blood pressure or preventing relapse.

댓글 1개:

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