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Posts Tagged ‘Chinese Medicine’

This morning, a lady reported her pregnancy test strong positive–got pregnant. This is no.65 patient got pregnant, since 2007, by our acupuncture treatments.

She is 33 years old, married for 6 years, and tried seriously to get conceive for over one years. According to her, her husband is healthy and the sperm test was good. She also has a lot acne, so she hope we could adjust her hormones for both acne and fertility.

When she first saw me, she was in day 14 of her period cycle (she had  28-days-cycles before). I gave her acupuncture according to our protocol, and herb pills. after 8 sessions acupuncture, she felt her cervical mucus is slippery and very stretchable, better than before. after another two weeks, her period didn’t come. Then her pregnancy test became positive.

 

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J Sex Med. 2010 Feb;7(2 Pt 2):981-95. Epub 2009 Nov 12.

The ACTIV study: acupuncture treatment in provoked vestibulodynia.

Source

Elements of Health Centre, Victoria, Canada.

Abstract

INTRODUCTION:

Provoked vestibulodynia (PVD) is a distressing genital pain condition affecting 12% of women. Treatment modalities vary and although vestibulectomy has the highest efficacy rates, it is usually not a first-line option. Acupuncture has a long history in the traditional Chinese medicine (TCM) system and operates on the premise that pain results from the blockage or imbalance of important channels. The main principle of treatment is to move Qi and blood to cease genital pain.

AIM:

To explore effect sizes and feasibility in a pilot study of acupuncture for women with PVD.

METHODS:

Eight women with PVD (mean age 30 years) underwent 10 1-hour acupuncture sessions. Specific placement of the needles depended on the woman’s individual TCM diagnosis. TCM practitioners made qualitative notes on participants’ feedback after each session. Main Outcome Measures. Self-reported pain (investigator-developed), pain-associated cognitions (Pain Catastrophizing Scale [PCS], Pain Vigilance and Awareness Questionnaire), and sexual response (Female Sexual Function Index) were measured before and after treatment sessions 5 and 10. Qualitative analyses of TCM practitioner notes were performed along with one in-depth case report on the experience of a participant.

RESULTS:

A repeated measures analysis of variance revealed significant decreases in pain with manual genital stimulation and helplessness on the PCS. An examination of effect sizes also revealed strong (though nonsignificant) effects for improved ability to have intercourse and sexual desire. Qualitative analyses were overall more positive and revealed an improvement in perceived sexual health, reduced pain, and improved mental well-being in the majority of participants.

CONCLUSIONS:

Effect sizes and qualitative analyses of practitioner-initiated interviews showed overall positive effects of acupuncture, but there were statistically significant improvements only in pain with manual genital stimulation and helplessness. These findings require replication in a larger, controlled trial before any definitive conclusions on the efficacy of acupuncture for PVD can be made.

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中药,“病”了?

摘编自《新民周刊》第45期 作者 张襦心)

 

2006年,记者采访原国家药品监督管理局市场司司长骆诗文,他曾预言:“我们执行错误的‘中药现代化’路线与国际接轨三四年,已经使得中药加速走向衰败。如果这种情况再让它继续5年,中药就无法挽救了。”

2011年,记者拜访骆老,再度提及此事,他直言:“医药不分家。现在传统中药已经不复存在,医也完了!”
“前些日子得了结肠炎,一直拉肚子,最严重的时候一天十几次。”骆老解释说。

这位学徒出身、从事中药工作53年的退休老人,有点头疼脑热从来都是自己开方、抓药。结肠炎病程缓慢,反复发作,缠绵难愈。为了根治,骆老从医书找到一方。该方需要的药材,有一味颇为独特:伏龙肝。

伏龙肝就是灶心土,可治腹痛泄泻、便血。骆老托了朋友,终于在湖南农村寻找到了传统的老灶台。他特意交代:“要挖取灶底中心烧得最红的那一块,有多少要多少。”——这东西如今太金贵了,骆老保存了整整一大包,以备后用。为了保证这服药的品质,骆老亲自按古法炮制。果然几剂而愈。

很多人都以为“中医是慢郎中”,有时候连骆老的女儿都不例外。一次孩子发烧,咳得很厉害,工作繁忙的她为了快速治愈,也是直接送医院挂水去了,没想到连着一星期都没见好。而北京中医院一位医生,是名老中医的孙子,仅用了5味药,3服下去,小朋友就活蹦乱跳了。

这位医生姓周,夫人也是名门之后,是京城名医施今墨的第三代。周医生用药有何高明?骆老说,重点是他每一味药都经过自己精心炮制。而现在的医院大多不炮制、或者乱炮制。

一位老医生则对记者说:“不能怨老百姓骂中医。现在中药不灵了。价格涨得那么厉害,

假冒伪劣又空前严重,老百姓怎么能不骂?从来没有见过中药材质量像今天这么差,过去三五服中药下去疗效就出来了,现在十服八服也没见疗效。”

最可悲的事情莫过于,连治病救人的药都“病”了。骆老说:“我搞了50多年中药,现在的中药连我自己都不敢吃。不是危言耸听,很可能吃出问题。我吃中药,都得自己跑到药材市场亲手选药材,自己炮制。”

南京中医药大学周仲瑛教授断言:“中医将亡于药!”作为华夏5000年文化结晶的传统中药,到底怎么了?

“一袋袋包装扎实的枇杷叶码得像小山一样,一辆12吨的载重货车整装待发……”这是一名记者在全国最大的枇杷叶收购大户,福建仙游县书峰乡林文喜的收购站,看到的“壮观场面”。自2005年起,林文喜就以每吨700元至1000元的价格,向山民收购枇杷叶。并相继敲开了广州医药公司、山东制药厂、同仁堂的大门。

原来落到地上随其腐烂的枇杷叶,随便捡来就能换钱,瞬间激发了村民们的积极性,连残疾人都加入了捡叶大军。一位年逾古稀的老大爷,一年仅靠卖枇杷叶,就能收入4000元左右。枇杷叶应该如何采集、炮制?骆诗文为记者详细地讲解:“今年用的枇杷叶必须是去年从树上摘下来的老叶,树龄至少三五年。用鬃刷把枇杷叶背面的毛刷得干干净净,放在竹垫上晾到八九成干,以一公斤为单位,一叶一叶码好用绳子扎起来,再立起让它彻底干燥。做药的时候,拿出来,用药刀切成0.5厘米厚的丝,锅里加炼熟的蜂蜜和适量开水,放入枇杷丝拌匀,用文火炒到枇杷丝既能很均匀地沾上蜜,又不黏手,取出放凉即可。”

但现在农民们一般都是怎么采集落叶?“我亲眼看到,都是直接用一根金属的或者竹制的长签扎地上的落叶,管它老叶、新叶。很多叶子在泥里已经腐烂 ,再一下雨,浸泡过后还有什么用?采回来洗都不洗,毛也不去,晒干一扎。炮制的时候,甚至连绳子都不解,蜜炙就更不用提了,直接往提取罐里倒。”

中药材历来讲究原产地,是为“道地”。骆老解释说:“这是五千年来通过实践摸索出的规

律。大量验证表明,一旦改变了环境,药效往往就不行了。”
据骆老所言,“文革之前,中药如果需要异地种植,必须经过三代,考察是不是有疗效。用第一代的种子种第二代,第二代的种子再种第三代,直到三代药材的疗效和原产地药材一致,才允许移植。现在则随心所欲了,想去哪里种就去哪里种。

“前一段时间检查出鱼腥草有问题。什么问题?从原料上就不对。过去鱼腥草主要生长在深山的水沟溪泉两边,没有污染,煮了以后给小孩退烧很快就能见效。现在云南、贵州、四川,把鱼腥草洒在大地里,像种蔬菜一样。本身那个地是农田,已经施过很多年的化肥农药。长出来后用耙一耙,装在竹筐浸到水塘里,把泥洗掉就挑到集市上去当蔬菜卖了。当天卖不完怕烂掉才拿回去晒干,卖出去做药。肺炎发烧,以小孩居多。小孩病情变化很快,以往一服药就能扳过来,延误了就可能致命。你说拿这样没什么疗效的鱼腥草做药,吃了能不死人吗?”

不道地的药材一轰而上大量供应,优质的原产地药材则遭到人们竭泽而渔式的掠抢。如今浙江各中药房,已经难以看到原汁原味的“浙八味”了。云南白药最重要的原材料野生重楼,又名七叶一枝花,已经濒临灭绝。道地药材大多产于老少边穷地区,无论用什么手段,如果能使产量倍增,对当地都是有吸引力的。麦冬使用壮根灵后,单产可以从300公斤增加到1000多公斤。党参使用激素农药后,单产量也可增加一倍。但药效可想而知。

“就像我们吃黄瓜,头尾两端味道不一样,当归各个部位的药效不同。当归头止血,当归身补血,当归尾破血(催血),不能乱用。以前用当归,都要分清部位,一钱一钱算得很仔细。现在去配药,药房的人跟我说,当归都长得很大,给你一整根,都啃光也不会出事情,当然,也没什么疗效,跟吃萝卜差不多。”一名老医生告诉记者。

药材中农药残留超标的真相更令人震惊,这也是我国中药材出口最大的拦路虎 。从检测统计可以看出,我国中药材中农药残留污染具有普遍性,几乎在所有的样品中都有检出。二三十年前,为了消灭长白山上的松毛虫,政府曾组织飞机在林区大规模洒下666等剧毒农药,

至今该成分仍不时在长白山区的人参中被检出。

岷县当归又称“岷归”,为药材界公认的“道地药材”。前段时间岷县“毒当归”闹得沸沸扬扬。由于黄芪、当归、党参等药材常发麻口病,束手无策的农民最后只能用各类高毒高残农药一起“招呼”。吓得不少想买当归的朋友,不惜从香港绕道订购。

就在人们为转基因食品是否安全纠结不已时,转基因中药也已来到了我们身边。早在1999年,成都就利用转基因技术提高枸杞等药材的抗病虫害能力和药材产量。

“现在国家投资了好几个亿,在黄河以南的某省份搞黄芪转基因研究。黄河以北的黄芪疗效才好,到黄河以南有什么用?”骆老透露,“中药作为一个复杂的化合物集合体,转基因之后是不是会影响它的性味归经,这事没有人管,科研经费才是大家更重视的。”

目前列为转基因研究项目中药包括:金银花、忍冬藤、连翘、板蓝根、鱼腥草、人参、太子参、大枣、枸杞、核桃仁、丹参、绿豆、黄芪、百合、青蒿、何首乌、龙眼肉、杜仲、甘草、半夏、桔梗、银杏、麻黄、防风、芦根、地骨皮、竹叶、菊花、广藿香、巴戟天、枳壳、夏枯草等。

“抢青”之祸

内行人都知道这句谚语:“三月茵陈四月蒿,五月砍来当柴烧。”药王孙思邈更在一千多年前直接指出,不按时节采摘的中药材,有名无实,跟烂木头没有什么两样。

骆诗文说,中药市场放开以后,药材变成了“农副产品”,没多少人再指导农民种药了。现在种药主要靠价格调节,哪个上涨种哪个,哪种方法长得最大最快就用哪种。为了尽早上市,药农采收的天麻里面都是瘪的。桔梗生长两三年才能达标,现在人工种植一年就可以了。

杜仲等皮类药材,过去选择的标准是皮必须有0.3厘米厚,树龄一般10-15年,折断后杜仲丝拉都拉不动,那才有效。现在不管年限,也不管加工、研炒了,当年种的都拿来用,都是薄皮和枝皮的,也根本没有丝,疗效相差极大。黄芩五寸长才能用,现在才长到一寸长就被挖出来了。甘草、大黄三年以上的才能达标,可农民一旦遇到价好的年份,就会提前采收。

还有药用价值极高的辽五味子,本应到10月才能采收,已经提前3个月遭受了抢青之祸,采回来的青果还要喷上药水焐红,而真正自然成熟的五味子则无处寻觅。

中药也有“三聚氰胺”

药材采集之后,最基本的工作是除去泥沙和混杂物。然而目前市场上的药材,茵陈、蒲公英、菟丝子等所含泥沙重量几乎占20%以上。丹皮不刮皮抽心,白芍不去老根,板蓝根不去根头部,桃仁、杏仁不去皮,酸枣仁大量含壳,麦冬、莲子不去心……

饮片切法不同,药效也不同。板蓝根薄片的浸出物还原糖含量明显高于斜片、厚片。但现在药工怕切到手,随意把药片薄片改厚片,厚片改块状。片薄如飞的天麻,只能停留在老药工的记忆中了。

既然在加工修治上竭尽全力偷工减料,功夫都花到哪里去了?——“面子工程”,俗称“打磺”。既为了饮片色泽好看,延长保质期,又能让霉变药材焕然一新。

打磺本来是传统的熏制方法,目前的问题是反复打磺,造成硫超标。更有甚者是直接将硫黄粉洒在药材上面,注重养生的老百姓叫苦不迭,从我国进口药材的韩国商家也是颇为头痛。为了获得二氧化硫不超标的白芷,他们只能每年从中国直接进口新鲜白芷自己加工。

当今中国,已经被戏称为“化学大国”,中药商在这方面的“追求”更是孜孜不倦。近年来为了让药材更好看,除了打磺,还增加了用双氧水浸泡天麻漂白,用氧化铁水洗丹参染色,拿洗衣粉搓掉霉斑……

一言难尽话炮制

很多人都听说过何首乌能治少白头,但为此闹肚子的也比比皆是。

原来生首乌中含有一种蒽醌衍生物,能滑肠致泻。必须经过炮制,让蒽醌衍生物水解成无泻下作用,降低毒性,才可以正常行使乌须黑发的功效。

红顶商人胡雪岩开设的胡庆余堂,收藏着一套国家一级文物——金铲银锅。紫雪散祖传

最后一道工序,就是放入白银钵内,用黄金铲搅拌煎熬。

很多人以为这不过是药店的噱头,后来经过化验证实,白银含有硝酸银、弱蛋白银,对人体黏膜有抗菌消炎作用:金箔则具有镇惊、安神功效。

“中药加工炮制,一是减毒性,二是增加疗效,三是改变归经。”骆诗文告诉记者:“半夏有毒,临床大都经炮制后使用,分为法半夏、姜半夏、童子尿半夏。用盐卤、生石灰炮制的法半夏,用于健胃。童子尿半夏,主治跌打损伤、胃里咳血。姜半夏则是治疗妇女妊娠反应。而生半夏则是催吐的。”

但据骆诗文观察,现在的药厂和医院,虽然有炮制标准,但都锁在柜子里,好多都是不炮制,或者炮制不到家。即使某些著名的大药店也存在此类现象。“炮制首乌传统用黑豆煮,药材商代以锅底灰,甚至用墨汁染色。白术就是往锅里一倒,根本不翻炒,上面是白的,中间是黄的,下面的则是焦黑的。”

炮制不得法,轻则减效,重则害命。一名具有40年临床经验的中药师发现,炮制用醋如果用工业醋酸或食用醋酸配制的食醋,都有一定的毒性,能引起30%左右的小鼠死亡,而使用发酵米醋则无此不良反应。马兜铃则闹出过肾病风波,一时老鼠过街人人喊打。主要原因就是国外为了减肥,把马兜铃直接当茶饮,而不知道我们药典规定马兜铃要用蜂蜜炮炙解毒。

一位医生告诉记者,他们已经收治过多位因服用了炮制不到家的中药材,而导致中毒的病人。

更令人担忧的是,虽然炮制技术乃是中药的核心,但是后继无人,很多饮片厂甚至雇佣了对中药炮制一知半解的初中生、高中生来作业。

“现在善鉴别精炮制的中药专家,全国只剩下两位‘高徒’:83岁高龄的王孝涛和 85岁高龄的金世元,所有中药炮制方面的专家加在一起,总共40多位。说句难听的话,死一位少一位。”骆诗文说。

而一家驰名全国的老字号 ,由于老药工总坚持老规矩,新领导不乐意了,退休时一个都

没留。有些人就这样流失到深圳的外商合资药店当技术指导,我国炮制技术面临泄密之虞。

“王孝涛现在老得连门都出不去了,曾经想穷极毕生所学,为国家留下一本关于炮制方法的书,出版社问他要 20万元,他向有关部门申请经费支持,没想到一分钱都没批,王老一怒之下罢笔不写了。”

高价买“药渣”

“我买西洋参的时候特别烦,有时候一泡就没有味道了。”有位医生气愤地告诉记者,这类西洋参早已被萃取过有效成分。

骆诗文说,很多冬虫夏草也已被提炼,药材商将“药渣”用啤酒浸泡,误导消费者以为是真货。没有经过萃取的虫草外观饱满、色黄而亮,现在市场上至少70%的冬虫夏草 ,都被提取了有效成分,干巴巴的,虫体较硬,也没有香菇一样的香气。

即使正规药材市场,都充斥着以“药渣”冒充的正品,这让制药厂也很头疼。不买就得停产,买了药品质量肯定有问题。权衡再三,最终还是经济利益占了上风。

以下这些药材都发现过“被萃取”现象:人参、西洋参、党参、冬虫夏草、黄连、黄柏、牡丹皮、首乌藤、金银花、连翘、八角茴香、山茱萸、连翘、桔梗、淫羊藿、川贝、五味子、益母草、泽泻、白术、鸡血藤,柴胡、穿山甲、紫河车等。

如果说从前的中药造假,还只是在等级上以次充好,如今则是花样百出了。

骆诗文曾跑遍了全国17个中药材市场,总结出来常见的造假手法有山肉萸掺进葡萄皮,黄芩中掺桑寄生,用塑料做穿山甲甲片, 把树枝包上毛皮包切成片冒充鹿茸,在海马肚子里灌玻璃胶,往虫草上粘铅粉……中成药造假则更有隐蔽性。比如衡量萸肉的质量标准是熊果酸的含量,一些药厂就往里掺山楂,结果一样达标,疗效只有天知道了。

救救中药,救救中医

求医问药的人们经常感叹,找到合格的好中药难,找到一位好中医,就更难了。医之用

药如用兵,须有良医辨证施治、对症下药、才能精确打击。

但中国还有多少中医专家呢?

“过去能被国家外派给其他国家领导人治疗疾病的‘名师’已基本上没有了,只有高徒这一称谓,其中中医有145人,计划让他们再带上一批具有一定中医水平的中年中医,总数达到500人。”骆诗文谈道。

按照《执业医师法》规定,必须有4年以上医学院校的学历者,方能参加资格考试。 凡是师傅带徒弟的,基本上是学徒出身,没有这种学历,一律不能考执业医师,也就无法行医。仅有一条狭窄之门,允许七八十岁的带五六十岁的,五六十岁的带四五十岁的。如此以来,只有提高,没有继承。

“我在中医药局好几年,问老中医:‘你带了几个徒弟?’他说上面给安排的,又不是我自己带徒弟。如果是我自己带徒弟,肯定会像亲生儿子一样教他。现在我都七八十岁了,徒弟五六十岁,他都形成自己观点了,能跟我学什么?什么也学不了!’中医这不是等死吗?前年我写了调查文章,有领导批示我反映的问题很好,要允许中医带徒弟,可惜下到执行层面就不了了之。”

吕柄奎被誉为中医泰斗,他的儿子吕嘉戈告诉记者:“从中医人数上的变化,就能说明问题。西医人数,从1950年到2004年,增长了70多倍,达157万人。而中医从1950年的27万-30万人,达到2004年的27万人,实现了零增长!况且这27万人和55年前的那27万人,医疗水平无法相比。”

自从清末太医院被废止,中医药就开始走上了不被重视之路,经过“现代化”的洗礼,如今更是日渐风雨飘摇。

“中药现代化没错,只是我们的路走错了!”著名专家张吉林认为:“中药要走自己的现代化之路,而不是全盘西药化。”

一位药工批评说:“现在该研究的不研究。比如传统硫黄熏蒸加工方式有不足的一面,但

农民收的鲜药不处理无法卖出,怎么解决?没有人管。”

欧盟药典委员会草药专家组组长格哈德·弗兰兹,数年来研究中草药。今年7月,在世界中联中药分析专业委员会第二届学术年会上,他表示“西方的植物药偏重于对已知化学成分的研究;而中草药则是基于对‘阴阳’理论的研究。中药是在长期的临床实践中过来的,西药则是纯粹的化合物。因此,我们在尝试让中药和西药达到统一,结合两者的长处做一些整合工作。”

一位评论者提供了另一个思考角度:“目前西医、中医,西药、中药,谁更科学,以我们目前人类的认知能力,无法做出判断。所以最关键的不是谁先压倒谁,而是先保护,不要让两大体系中的一个先行消亡。”

“洋中药”启示录

中医药在全世界愈来愈受到重视,但是这一切,都与中国无关。我国的贡献,仅在于为日韩等国的汉方药提供原材料。

1949年,大局已定,苏共代表米高扬来到西柏坡。滹沱河畔,没有什么山珍海味,品尝着汾酒和红烧鱼,堪称美食家的米高扬赞不绝口。

毛泽东笑道:“我相信,一个中药,一个中国菜,这将是中国对世界的两大贡献。”

这番评价,他在1953年杭州刘庄宾馆小憩时,又再次重提。

他不会想到,作为中草药的发源地,今天中国大陆拿到的份额,只是世界草药销量的2%,日本则以90%的市场份额牢牢占据第一把交椅。韩国和中国台湾地区则占5%-7%。

曾获得日本医师会授予“最高功勋奖”的日本医学权威大冢敬节,1980年去世前,曾叮嘱弟子:“现在我们向中国学习中医,10年后让中国向我们学习。”不幸言中。

在日本,超市药店中卖得最火的,莫过于汉方药,甚至中国游客来此都会大买特买,带回去分赠亲友。

“我有一天夜里突发胆囊炎,想起抽屉里还有一包汉方大柴胡汤,赶紧冲了一杯喝下去,

不一会儿就舒服多了。现在已经好几年过去,没有再复发过。”一位在日本常年出差的中国工程师告诉记者。

汉方药是在公元513年经朝鲜引入日本的,受宠1000多年。明治维新之后,汉方医学遭到抛弃,又在几年前再度重兴。“中医学概论”2006年成为日本医生临床考试内容之—,2008年又被纳入日本医生资格考试。

生产汉方药的龙头企业集中在津村等少数企业手里,他们特意在深圳开办一家涉足中药饮片的药业公司,高薪聘请从中国药企退休的老药工担当技术指导,涉及人参、桂皮、柴胡等500余种中药材原料、中药饮片。

日本汉方药界,对饮片炮制技术的热情不止于此。

据炮制泰斗王孝涛回忆,只要他被请去日本讲学,对方总是不忘询问饮片炮制的关键环节。但王老提出想去参观一下他们的炮制技术,却被断然拒绝。

美国方面也不乏“卧底”。一位药界人士告诉记者,几年前美国人曾以旅行团的方式到山西运城来治疗结核病,当地有一位老中医有独门绝技。他曾公开打擂台:“你们哪家医院说治不好,最后发了病危通知的,都可以送到我这里。我保证一个月好转,三个月出院。”而美国病人来此,正是为了拿到他那张治疗结核病的方子。2008年,美国有关部门又拨款500万元给北京协和医院,委托该院帮其了解我国中药材资源和开发利用情况。著名中医学家邓铁涛老先生,则收了一位美国徒弟。

如今中国六七十岁的老中医,到美国去就有可能享受“敞开绿卡”的特殊优待。

一位中医学教授,在国内开不了药店,更开不起医院——他是老师 ,没有办法考执业医师,没有处方权。开医院则必须有100平方米的地方,配上检验员、药师,以及5名以上的医生。63岁那年,他远赴重洋。在美国,直接住在儿子家里坐诊。

为了给其他医生也留点饭吃,他的规矩是一天只看30个病人。为了避免低劣药材之祸,特意从香港进口药材。一个月收入9万多美元,交完税还有6万多。在美国,10万美元就可

以买一栋房了。“在美国开诊所什么都不要,但是就一条,每隔一天卫生部门会来检查处方,他们想学东西。”

湖南中医学院一位副教授陈勇,将自己在美国的考察,写成了《美国市场中草药的热销,对我国的中草药研究的反思与建议》一文,这篇从大洋彼岸寄来的文章,正放在记者案头。他在文中谈道:“1994年美国已经通过一条法规,中草药这样的补充品,不经FDA批准,就可以直接进入美国市场,在有机食品专卖店销售。看见美国有机食品专门店的货架上摆满了各种中草药制剂,真是既高兴,又惭愧,高兴的是中草药制剂在美国这么受欢迎,中医药发展有望。惭愧的是在琳琅满目的中草药制剂中,没有一种是中国制造的产品。”

今年4月份,陈勇的小外甥女被诊断为鼻内有炎症,西药用抗生素。他女儿拒绝了,去有机食品专卖店买了一支德国生产的纯中药喷剂,一喷见效,清鼻涕立刻不流了。婴儿使用尿不湿有一个副作用,就是很容易患尿布炎。将美国加州宝宝公司生产的一种纯中药软膏抹上去,10分钟内红色炎症就会消失。

我国古方“六神丸”,日本拿去改造后,开发出“救心丹”,曾一度风靡全球,被誉为“救命神药”,年销售额1亿多美元。日本老牌的汉方药“正露丸”,也已经返销中国。在向中国申请中药专利的国家里,以日本、韩国、美国、德国最热衷。2006年底,葡萄牙国立波尔图大学正式开设中医专业,并招收了首批27名学生。来中国研读自然科学的外国留学生中,学习中医药的人数位居第一。

中医药在全世界愈来愈受到重视,但是这一切,都与中国无关。我国的贡献,仅在于为日韩等国的汉方药提供原材料。

一位老中医则告诫说:“我们的中医药界要自尊自爱,不能始终靠‘外力’来带动。国外重视了一下,就急急忙忙去研究。国外没什么动静了,立刻视老祖宗留下来的宝藏为敝屣。”

 

(摘编自《新民周刊》第45期 作者 张襦心)

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My patients and many others sometime want to know what is the difference between IVF and acupuncture in infertility treatments.

Actually, the difference is significant.

1. IVF, using artificial procedure to help the infertility couple to get baby(s). It is a procedure with the external help(doctors) and get “pregnancy”, like a game.  And, sometime, using donor’s egg or sperm. The result could know in one month. If you see the patient has bleeding after some days post the procedure(embryo transferring), the IVF is failed.

2. Acupuncture, adjusts the hormones and improving the function, which makes patient become a normal people. And then she could get pregnancy in any cycle.

Yesterday, one patient told me she got pregnancy after our acupuncture treatments.

 

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Dear colleagues & Friends,

A Spring seminar will be hold by Virginia Institute of Traditional Chinese Medicine (VITCM) on April 1, 2012, Sunday. Hope everyone will arrange time to attend, and share your knowledge and experience.

Topics: The Western Diagnosis, TCM Treatments and Research Updates of Common Skin Diseases; Yellow Emperor’s Classics of Internal Medicine.

Location:Potomac Community Center, 11315 Falls Road,Potomac, Maryland 20854;Tel: 240-777-6960.

Skin problems, which affect more than 10 million Americans, can be one of the most frustrating and stubborn group of symptoms to successfully treat. Many pharmaceutical solutions offer quick relief but do not provide a lasting solution, and come with risks such as toxic build-up in the body and weakening of other organ systems. Therefore, more and more people are choosing alternative solutions such as Chinese Medicine, which can be safer and which intends to address the root cause of the symptom instead of covering it up each time it appears. In fact, dermatology is a recognized specialty in traditional Chinese Medicine. Treatments for skin disorders have been described as early as 1100-221 BC in China.  Acupuncture and Chinese herbs offer a natural solution to improving skin conditions with its sophisticated system, both external and internal administration. There are hundreds of herbal formulas available for skin disorders such as herpes, eczema, and psoriasis.

Fee: $208. (Mail check before March 15, 2012, discount rate at $188).

Contact Person: Dr. Arthur Fan,Tel:(703)499-4428, e-mail: ChineseMedicineInstitute@gmail.com. Address: VITCM,8214 Old Courthouse Rd,Vienna, VA 22182.

Lecture Details (included in lecture and discussion):

8:00AM-9:30AM: Tai Chi and Medical Applications. By Drs. Eugene Zhang, Arthur Fan (Outside, in Parking lot; if rain or snow, cancel). 

9:30AM-1:30PM: Western Diagnosis & TCM Management for Common Skin Diseases. By Dr. Yongming Li (this special lecture outline is available in the Blog part)

1:30 PM- 3:00PM:  TCM and Skin Disorder: An Update on Clinical Research. By Dr. Lixing Lao.

3:00PM-5:30PM: Yellow Emperor’s Classics of Internal Medicine: Four Seasons, Five Organs, Yin Yang and Related Experiments. By Dr. Quansheng Lu

Instructors

Dr.Lixing Lao,  CMD, PhD, LAc, Professor of Family Medicine, Director of Traditional Chinese Medicine Research, Center for Integrative Medicine,University of Maryland School of Medicine, Baltimore,MD.

Dr. Lao graduated from Shanghai University of TCM (MD in Chinese medicine) and completed his PhD in physiology at the University of Maryland at Baltimore. He has practiced acupuncture and Chinese medicine for more than 20 years, and has been awarded numerous grants from the NIH and the U.S. Department of Defense to conduct research on acupuncture and alternative medicine. He presents frequently at national and international conferences, including the seminal 1997 NIH Consensus Development Conference on Acupuncture and the White House Commission on Complementary and Alternative Medicine Policy. He was board cochair of the Society for Acupuncture Research, chief editor of American Acupuncturist, the official journal of American Association of Acupuncture and Oriental Medicine.

Dr.Lao was one of funders and professor of former Maryland Institute of Traditional Chinese Medicine (MITCM), which was a well-known school in TCM education during 1990s to 2000s. Currently, he is the honor president and main lecturer of VITCM.

Dr. Eugene Zhang, CMD, PhD, LAc. has been practicing acupuncture for over 15 years, and is a graduate of famous oriental medical school in the world: the Beijing University of TCM.

In China, Eugene Zhang was a Medical Doctor (MD in Chinese Medicine); here in  US he is one of the top Licensed Acupuncturists inVirginia,Maryland and Washington DC. area. He was a well-respected professor and Clinical Supervisor for the prestigious Maryland Institute of Traditional Chinese Medicine (MITCM). Because of his years of experience, he serves as a consultant for the council of Colleges of Acupuncture and Oriental Medicine (CCAOM).

Dr. Zhang is also a senior Taiji (Tai Chi) and Qigong Instructor, both in the United Statesand in China. He has written a detailed book, “The Ultimate Exercise for Mind and Body” that explains the benefits of Qigong and shows pictorially the different body postures.

Dr. Yongming Li, MD, PhD, LAc (in New York and New Jersey). Our guest speaker.

Dr.Li is a leading doctor in both Chinese medicine and Western medicine. He graduated from Liao-ning college of TCM in 1983, and got PhD, MD in USA.

He is a well-known doctor in dermatology, doctor and scholar in the field of acupuncture and Oriental medicine with more 20 years’ clinical experience. Currently, he also serves as a NIH grant reviewer. He was the president of American Traditional Chinese Medicine Society, which has more than 700 members in New York area.

He has published many academic papers and books,included in “Acupuncture Journey to America”, a new published book in acupuncture history.

Dr. Quansheng Lu, CMD, PhD, L. Ac. Dr.Lu is a licensed acupuncturist in Maryland. He graduated from Henan University of TCM in China and subsequently worked as a resident and attending physician of TCM at a general hospital in China for 8 years. During this period, thousands of patients recovered under his treatment.  Given his outstanding contribution in TCM, Dr. Lu was awarded the Outstanding Doctor Award from the Local government. Dr. Lu pursued his master degree in TCM at Beijing University of TCM.

He continued to expand his education and later received a  PhD in cardiology in Chinese and western integrated medicine  at the China Academy of Chinese medical science. He focused on exploring hypertension molecular mechanisms and looked for new anti-hypertensive natural herbs. His supervisor is Professor Keji Chen; president of The Chinese Association of Integrated Medicine, and academician of the Chinese Academy of Sciences. Dr. Lu was a postdoctoral fellow at Georgetown University Medical Center and Children’s National Medical Center.

Dr. Arthur Yin Fan (Fan Ying),PhD, CMD, LAc, a leading specialist in Acupuncture and Chinese herbology, has more than two decades of clinical experience in both Traditional Chinese Medicine (TCM) and Western medicine. In China, he was awarded an M.D. degree in TCM and a Ph.D. in Chinese internal medicine from famous Nanjing University of TCM. He completed additional one year’s training in the Western medicine diagnosis and treatment of neurological disorders as well as a six-year medical residency combining TCM and Western internal medicine. He was a medical doctor in both TCM and coventional medicine when he worked in a University hospital in China. He was the funder of  Nanjing Stroke Center which is now a China national key center in Stroke rescuing and rehabilitation.

An evaluator of medical science research grant applications for many countries, Dr. Fan is currently a consultant for the Complementary and Alternative Medicine program at the University of Maryland medical school. He has also conducted CAM research for the Georgetown University medical school’s programs in nutrition and herbology.

Dr. Fan holds the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) certificate in Oriental Medicine, which comprises Acupuncture, Chinese Herbology and Asian Bodywork. Dr.Fan was awarded the third place prize in Taiji-quan (Tai Chi) in China first national health-sport congress (1985,Shenyang,China). Dr.Fan is the funder of VITCM.

Ron Elkayam, MSTCM, graduated from the Academy of Chinese Culture and Health Sciences in Oakland,California in 2004 where he studied acupuncture and Chinese medicine. While still in school studying Chinese Medicine,  Ron studied with Robert Levine, L.Ac., in Berkeley, where he furthered his understanding of acupuncture, herbal formulas, diagnosis, and pulse taking. Inspired to take his learning to a new level, he moved to Taiwan in 2005 to learn Mandarin as a way of deepening his studies in Chinese medicine.Over the course of almost five years, Ron studied Mandarin in universities in Taipei, Shanghai, and Beijing, received advanced Mandarin language certification, and worked in hospitals (Guanganmen,Tonren hospitals) as interns, where he was able to communicate with doctors and patients in their native language and gain useful clinical experience.

Ron has a background in mind-body disciplines and has a 2nd kyu (brown belt) in aikido. He has also studied qigong (Wild Goose style), taiji (Wu and Chen styles), and Kripalu yoga. He also believes in the importance of diet and exercise in helping patients reach optimum health and happiness.

In late 2010, Ron finally returned to theU.S.to bring his clinical experience to American patients.  He has NCCAOM certification in acupuncture and herbal medicine, in addition to being licensed inVirginia,California, and Rhode Island. Ron is originally from Baltimore,MD.At present time, he works part-time to assist VITCM’s daily work.

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“Incredible, my daughter could sleep well and did not have hives again after first-time drinking of the herbal tea you prescribed. Just very slight in the second and the third day’s night. In one word, she has significant improvement, and will get cured.” the patient’s mom said in an e-mail to Dr.Arthur Fan.

This kid has hives several months, esp. during the night- time. Patient had a lot of hives all over the body, affecting her sleeping. Every interesting, the hives disappeared in morning automatically. During the day-time, patient had hives very occasionally.

 “难以置信,您开的药吃的第一夜我女儿就安睡,没有起荨麻疹。第二天下午有一些,但白天好办,玩儿一会儿引开注意力就没事了。第二夜有一点儿。第三夜好好的,一夜无话。总之明显好转,痊愈在即。

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Acupuncture and Chinese herbal medicine is very effective in Guillain-Barre Syndrome’s recovery in some cases.

Here we have a case record in video, I hope patients with Guillain-Barre Syndrome don’t get frustrated, use acupuncture or/and Chinese herbal medicine as early as possible, in most of cases, very good.http://www.youtube.com/watch?v=6Ngu5WrPDcE&feature=youtu.be

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“Opening Through” the menstruation Tong Jing 通经

from http://chinesemedicinetopics.wordpress.com/2010/05/11/%E2%80%9Copening-through%E2%80%9D-the-menstruation-tong-jing-%E9%80%9A%E7%BB%8F/

May 11, 2010 by sharon weizenbaum

I’ve been away in Taiwan for the last month and have unfortunately neglected this blog while I was away!  I hope I didn’t lose your attention!  If you are interested in our travels in Taiwan you can click here for the little blog of our trip.   Well I’m back and have some interesting material to post that I hope you’ll enjoy!  I am going to do a series now, relying heavily on the work of Dr. Xia Guisheng.  I’ll start here with a brief introduction to Dr. Xia and and follow this with a discussion of learning some of the subtleties in treatment and the term that I am translating as “opening through”.  I’ll follow this with some entries that include the writings of Dr. Xia together with some of my own clinical experience utilizing his insights.

Dr. Xia is the director of the Gynecology Department at the Affiliated Hospital in Nanjing and professor of Gynecology at the Nanjing University of Tradition Chinese Medicine.  Bringing  over 50 years of experience and insight to his writings, he is not only a highly effective practitioner, he is also a clear teacher/writer.  His material is written in a way that guides the student/practitioner through the necessary steps to gain understanding.

 

He has pioneered the articulation of the theories that direct us to work with the ebb and flow or Yin and Yang in relation to the menstrual cycle.  He applies this understanding to all areas of gynecology in great detail.  It is no surprise, after reading his books, to discover that he has become know as a manifestation of Guan Yin, the Chinese goddess who come to the aide of women and children.  Though he is perhaps best known in the West for his work with modifying formulas according the the timing of the menstrual cycle, Dr. Xia pays such close attention to the details of patho-physiology in combination with the function of formulas and the individual herbs within them that his books are really a treasure trove of useful gems.  In this particular series, I will be paying attention to his work with blood stasis and the idea of “opening through” in relation to women’s physiology, patho-physiology and menstruation.  These ideas have many implications in the treatment of women including but going beyond the treatment of dysmenorrhea and infertility.

Most entry level Chinese herbalists have a very limited idea of gynecological blood stasis, it’s diagnosis and treatment.  This becomes very apparent as the practitioner works with women in the clinic and finds that so much of what was learned in school simply doesn’t work or works in a way that is far from ideal.  Poor clinical results can be frustrating but they can also push us to learn more and can help our diagnosis and treatments become more nuanced. For me, less than excellent results have pushed me to research many topics, including the topic of “opening through” in relation to gynecology.  This topic also brings up the concept of a more nuanced use of individual herbs.  In relation to blood stasis – many of my own students don’t come in with much more of an understanding of blood stasis herbs other than that they all move the blood and that they should therefore not be used when there is heavy bleeding or during pregnancy.  And yet, through experience we learn that sometimes we must strongly move the blood in order to stop heavy bleeding and that sometimes moving the blood can help prevent a miscarriage.  We also learn that all blood vitalizing herbs are not equal to each other nor the same as each other.  They range from strong to weak and from cold to hot.  Some are especially good at stopping pain, others are especially good improving the quality of the blood itself.  Here is a bit of a preliminary list just some of the various functions of some individual blood vitalizing herbs:

Stopping pain

Softening hardness

Cracking stasis

Warming the blood

Regulating the Qi within the blood

Stopping bleeding

Harmonizing the blood

Nourishing the blood

Supplement the Kidneys

Descend the Heart blood to the uterus

Cool the blood

Relieve constipation

Open up the chest and breast area

And finally blood vitalizing herbs that function to “open through” the menstruation…..

I first noticed that there was something going on with this idea of “opening through” when I was working beside my teacher Dr. Sheng Yufeng, in Hang Zhou, PRC.  I was constantly trying to figure out why she would use particular herbs in particular situations.  I noticed that there were times she would give a formula for blood stasis and include herbs like Huai Niu Xi or Chuan Niu Xi along with herbs such as Su Mu, Chong Wei Zi and Shan Zha.  I wanted to know when and why she used these herbs.  It was not until I found the writings of Dr. Xia Guicheng that these ideas were fulling articulated for me.  Since studying these writings, the diagnosis and appropriate treatment methods for of some patients in my clinic has become clearer and the treatment results improved.

So, what is this “opening through”?  I am translating the character 通, tong1. as “opening through”.  The Eastland Press glossary translates this as “unblocks, promotes, pervades”.  Wiseman and Ye’s Practical Dictionary of Chinese Medicine, Second Edition translates this term variously as “free, open, restore flow, unstop and connecting.  Thinking of this as “opening through” just what gets opened through?  This term is used when the Luo vessels, the channels, the Qi, the lactation, the bowels, the nasal passages, the blood vessels, the urination, the Ren vessel and finally, the menstruation are blocked. What I want to point out in relation to all of these functions is that what is being “freed” or “opened” or “connected” all relates to structures in the body that are tubular.  This is why the idea of “opening through” is useful.  It gives us the image, not only of blockage, but of a tube that is blocked up and needs to be opened.  Though the term “unblocking” may suffice, it does not convey the image of a tube that should be open end to end the way that “opening through” does.  I have to admit “opening through” is a rather bulky term though, but at least for now, I’d like to use it to effectively illustrate the physiology, patho-physiology, treatment principles and function of herbs.

A bit more about the character tong1 通. It is made up of two parts. The first is this: 甬 yong3 which carries the meaning of path or corridor.  The second is 辶 chou4, which carries the meaning of walking or going.  So altogether we have the meaning of movement through a corridor or path.   When we take the 甬 yong3 corridor or path part of the character and combine it with the disease radical getting 痛 tong4, meaning pain.  In other words, when the corridor is pathologically effected, there is pain.  The characters 通 and 痛 are the one’s that are in the famous saying 通则不痛,不通则痛,  or when there is opening through there is no pain and when there is no opening through there is pain.

So what is this tube that is related to “opening through” the menstruation?  This tube is related both to the Ren Vessel and to the Bao Tai, which connects the upper body, especially the Heart and chest, to the uterus.  This tube can get blocked up and when it does, it needs to get opened through from end to end.  Various symptoms can arise when this tube gets blocked up including amenorrhea, scanty menstruation, lack of free flow of menstruation, painful menstruation, heavy menstruation and infertility.  Upper Jiao symptoms can involve the breasts, the head, the emotions or even cause bleeding in the upper warmer as the menstrual blood fails to descend.  The blockage can effect the middle Jiao as well.  Recently I successfully treated a woman with Achalasia, which involved difficulty swallowing and esophageal spasming that was worse premenstrually, integrating the method of opening through the menstruation.  In general, when the menstruation is not open through, a failure of the downward movement of the Qi mechanism can lead to a whole variety of upward rebelling symptomatology in addition to the lower warmer issues.

Before moving on to the entries that include the Dr. Xia’s writings on this topic, I want to include a bit about how he organizes his discussions in his book, Gynecology Formluas and Herbs from Clinical Experience and Study in Fifteen Chapters. In this text, Dr. Xia has a whole chapter devoted to the idea of “opening through”.  He divides this chapter into 8 parts, each part being represented by one of his “opening through” experiential formulas.  He begins with a basic formula Jia Yu Tong Yu Jian (modified Opening Through Stasis decoction) which is based on Zhang Jingyue’s formula Tong Yu Jian (Opening Through Stasis decoction). He uses this formula as a jumping off place for the deeper, more detailed discussion of the topic.  The formulas that follow morph off of the original idea in the variety of ways that Dr. Xia sees most often in his clinical work.  By carefully going through each chapter, the practitioner learns, not only about these particular formulas but so much more.  We learn how to modify a formula to suit a variety of clinical realities but more importantly, we learn about women’s physiology and patho-physiology in great depth.  Finally, we learn about the individual herbs and their nuanced and careful use.  It is like looking at an issue through a variety of lenses until we feel we have quite a complete understanding.  I’ve not previously seen texts organized in this manner and have found it to be an excellent way to transmit his valuable information.

So, stay tuned!  Dr. Xia’s writings will soon be posted here!

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针灸在美国

From: http://www.wfas.org.cn/en/show.asp?liststate=0&action=&men=3&Position=&id=1616&pageshow=1#

World Federation of Acupuncture-Moxibustion Societies.

(Author: Liu Jin;   source:information center, Published in 2009)


一、 历史的回顾

    据文献载中医药、针灸早在17世纪便由中国传入欧洲,再由欧洲传入美国。最早在美国出版英文版本针灸专书的是一位名叫F.Bache 的美国医师翻译由S.Morant所著的法文针灸 书,该书于1825年在费城出版( S. Morant: Memair on Acupuncturation)。次年即 1826年 F.Bache。进一步又在北美内科与外科杂志发表 他本人用针灸所治疗的病例报告(F.Bache: North American Medical and Surgical jourrnal l:311-321,1826)。此后便陆续有一些有关针 灸论文在美国发表。经过一百余年后,1942年 E.A.Brav与H.Sigmond曾在美国军医杂志上 报告针灸的疗效,特别强调针刺止痛的疗效 (E.A.Brav:Military Surgeon,9):545-549, 1942),可见在当时已将针灸疗法逐渐介绍到军医中采用。

    华人先侨随着美国自1848年开始的淘金热、铁路热及采矿热之后而大量涌入美国。不久之后,在旧金山及纽约等地随着华埠的出现便开始有一些老中医及针灸医师悬壶济世治病救人,真正的中医药/针灸医术亦随之在美国出现。但在美国掀起“中医针灸热”的要归功于著名报人赖斯顿(James Reston)。赖氏曾任纽约时报副总编,著作颇丰,蜚声国际。1971年赖氏随尼克松总统访问北京后(Arthur Fan Notes: it is before President Nixon’s visit),因患急性阑尾炎而入住协和医院进行手术。手术时及手术后曾用 针麻止痛,疗效甚佳。他于7月康复出院后详细着文介绍了亲身经用针刺止痛的经历及中国中医药的发展和中西医结合的情况,加上电视的播放,霎时间中国针灸针麻的奇迹便展现于美国的千家万户,针灸诊所的患者络绎不绝,对中医针灸医师之需要亦随之大增,不久针灸学校应运而生,歧黄医术随之渐盛于美国。

    由于受到美国“中医针灸热”的影响,美国国立卫生研究院(NIH)于1972年7月成立了“针刺疗法特别委员会”,由麻醉学者、神经病学 者及生理学者等人组成。其主要任务是:复习中国有关文献;组织调查研究有关针灸情况以 及举行针灸学术研讨会等。该委员会于1973 年3月在马里兰州比塞大召开了第一次学术会 议。会上有40余项有关针灸方面的初步研究 成果进行了交流。该会主席J.Bonica教授(华盛顿大学医学院麻醉科主任)在总结发言中指出:“现有资料证明针刺疗法是有效的,这对医 学是重要的。针刺作为某些外科手术中的一种 麻醉方法和一些急性和慢性疼痛的治疗手段是 有希望的。但要在美国广泛开展临床针刺治疗 之前,必须进行妥善精密的设计和严加管理的 科学研究(Proceeding NIH Acupuncture Res each Conference,VI,1973)。

      同一时期美国出版了两份国际有名的中医 针灸杂志。一为美洲中国医学杂志(The Americanl ournal of Chinese Medicine ),于 1973年1月出版,为季刊。另一为美国针灸杂 志(Americann Journal of Acupuncture), 于1973 年3月发行,办为季刊。

    这一时期有些学者还 相继在美国各地成立了有关中医针灸的学术性团体,如美国中国医学会、美国全国针灸研究学会等,都对推动中医药/针灸事业在美国的发展 起了积极的推动作用。

                                    二、美国中医药/针灸的现状

2.1中医药/ 针灸人员的情况

    目前全美国已有34(Arthur Fan notes: currently 44 States,pus DC)个州有针灸立法,颁发针灸执照,全美已有约一万(Arthur Fan notes:At least 3o,000) 名执照针灸医师。 其中约40%分布在加州,约10%分布在纽约州,其余分布在其它各州。另外,约有5000名西医师和3000名脊椎正骨师持有针灸执照,因而可以兼做针灸治疗工作。执照针灸医师由于所在各州立法的不同,职称和行医范围差异很大。例如,在新墨西哥州,州立法规定:凡取得该州针灸执照者,便可 称之为 Doctor of Oriental Medicine(DOM),并 有权写一般西医范围之内的化验单、X线检查 单等等,并可独立诊断疾病,进行医疗鉴定、穴 位注射、激光穴位治疗、指压推拿、开写中药处 方、美国草药、顺势疗法(homeopathic)、物理治 疗,以及给病人开维生素、矿物质、各种脢、氨基 酸等。加州则较特殊,中医与针灸合为一体,两种业务可以兼做。即凡取得针灸执照者,可同 时开写中药处方或给病人中药。对取得针灸执照并有相当医学背景者(即医学学历较高)可称为 Chinese Medicine Doctor(C. M.D)或 Oriental Medicine Doctor(O.M.D.)。佛罗里达州对有针灸执照者,可称为针灸医师(Acupuncture Physician),并允许针灸医师做穴位注射。纽约州针灸立法则规定,除非在中国已获得中医博士学位,广告上不得称自己为Doctor,若有足够的医学背景者亦只能写明: Physician in China, but not in N. Y. S。

    各州之所以有如此大的差异,除了各州情 况有所不同外,主要在于当权者对中医针灸的 理解程度和各州中医针灸工作者的力量,尤其是团结的力量情况而定。也有些州至今针灸执 照是附属于西医委员会之下颁发,如密执安州、 密苏里州及肯萨斯州等。 与针灸日益发展的同时,中医药界的队伍 也在日益壮大。中医诊所和中药店也如雨后春 笋般不断增加,其中不乏有国手及高明的中医 界老前辈。现在中医师及中药店不仅集中在华埠,而且已经不断的逐步深入到主流社会活动与居住地区并受到更多人士的欢迎。现在像在旧金山、洛杉矶、纽约、费城、波士顿、西雅图、亚特兰大等城市的中医诊所和中药店均已达上百家或数百家之多。但是,除加州等少数州中医师已取得合法地位之外,其它各州中医至今尚未立法。中医药到底要不要立法?以及如何立 法?看来需要全美国的中医师首先团结内部达成共识,再进行争取才会有力量。

 2.2中医药/针灸的教育与考试

    目前全美国已有约70所中医针灸学校,其中已被审批合格者有32(不止, 樊蓥注)所,其余正在申请审批中。大部分学校是培养针灸医师的,其学制一般为3年。也有一部份学校是培养针灸与中医师的,其学制多为4年。入学资格一般要求需具有2年大学(College)学历。在校内修完一定学分后可参加全美(N.C.C.A.O.M.)针灸或中医师(或两者全考)资格考试。毕业后也可参加加州针灸(中医)师执照考试,获得执照者可在加州独立开业行医。

    近年有部分中医针灸学校开设针灸或中医学硕士学位课程,也有的正在筹划开设博士(Ph D.)课程。 美国N.C.C.A.O.M.自1985年开始举行美国联邦针灸医师资格考试。每年4月在加州举行,10月在纽约州举行,到目前为止已有6000(现在过万,樊蓥注) 多位针灸医师通过考试。

参加考试的资格限于:

(1)美国国内经3年制或以上针灸(或中医)学历并完成一定学分者;

(2)在美国国外,如中国大陆5年制或以上中医学院毕业各科及格者;

(3)西学中学历要求在5年以上者(中、西医务科相加);

(4)跟师带徒式学习者,老师资格及学习内容需要公证。

    考试分3天进行(现在可以在各地网上考试,樊蓥注),1天为中医针灸理论 与临床知识笔试。限5个小时内答完200个选 择题;1天为点穴考试;1天为C.N.T.(洁针技 术)考试,包括笔试和操作。考试可用英、中、 日、韩文。自1995年开始N.C.C.A.又增加了中药考试,因此N.C.C.A.亦随之改名为N.C.C.A.O.M。中药考试为1天,在5个小时内要 求用笔答完200个有关中药和方剂的选择题, 其中包括中医基础理论。中药考试条件大体和针灸要求相似。到目前为止大约已有800多位中药师通过考试。 考试通过者由N.C.C.A.O.M.发给合格 证书及考试分数通知。持此合格证书者,说明 具有该科之资格,因此亦可称为资格证书。有 的州对有此证书者即颁发针灸执照证明,有的州对用中、日、韩文考试者,另外要求要有英语托福500分以上的成绩(或在大学修完3个学分的英文课)、毕业证明与所学各科成绩单及绿卡等。

 2.3中医药/针灸学术地位改变情况

    中医药/针灸在美国的学术地位是逐步改变和提高的。每提高一步,便说明国家主流社 会的认可程度亦提高一步。美国国立卫生研究院(NIH)对中医药/针灸一直抱着审慎的客观态度,即对中医药/针灸通过不断的考察研究,不断的提高认识水平。

    NIH于1992年起成立了另类医学办公室(O.A.M.),对包括中医药/针灸在内的所谓另类医学,每年拨款一千万美 元(逐年增加)进行研究。因而像哈佛、耶鲁、斯 坦福及霍普金斯等着名大学均承担了研究任务。通过多年的研究NIH终于在1997年11 月初召开了关于针灸的听证会。

其四点结论是:

Ⅰ针灸在美国已广泛应用并有应用价值;

Ⅱ 需探索更多的适应症;

Ⅲ原理研究已明确了能 释放神经及对内分泌的影响等;

Ⅳ尚需进一步解决的问题有:针灸医师的培训、颁发针灸执 照的标准及医疗保险费的支付等。

    美国国家药品和食品管理总局(FDA)在经过多年肯定针灸疗效的基础上,已于1994年正式通过针灸用针由第三类(实验性)医疗用品器械晋升为第二类(医疗用)器械类并宣布其安 全性。1996年9月第四届世界针灸大会在纽约召开,与会者为来自46个国家和地区的专家学 者,1200余人聚首一堂进行学术交流。克林顿总统曾发来专函向大会祝贺,这是美国中医药/ 计灸史上的一件空前大事。

 2.4 中医药/针灸业界的经济地位

    一个行业在一个国家的社会政治地位是由 经济地位决定的。中医药/针灸事业如要纳入美国主流社会的关键,除了其疗效及科学性被 主流社会认可之外,主要是保险业是否支付中 医药/针灸的医疗费用。直至1995年为止美国医学会负责主编的 通用医疗程序编码》(CPT code)一直拒绝将 针灸列入其中。其所持理由是:针灸在美国还 处于试验阶段。正是这种立场严重阻碍了中医药/针灸纳入美国主流社会的历史进程,使美国 保险业系统一直拒付针灸医师的医疗服务支付。

现在代表美国广大西医利益的美国医学会 终于承认针灸是一种正式的有效的医疗程序。 自1998年 1月起全美国中医/针灸医师终于可 以使用该程序,向保险公司申请医疗服务。 自1998年1月起牛津保险公司开始承认 并受理中医/针灸保险之后,同年6月蓝十字蓝盾公司也正式宣布接受针灸保险。现在中医药/ 针灸界的最大愿望是,争取国会在本世纪最后 l-2年之内通过中医药/针灸立法,从而促使 医疗补助(Medicaid)和医疗照顾(Medicare)两项全美国最重要的保险项目,开始对中医药/针灸医疗的全部支付。只有这样才能使更多的美 国民众接受中医/针灸医师的医疗服务,而中医 针灸医师社会地位亦会真正的纳入主流社会。

 三、中医药/针灸在美国的今后 展望

                                                                                                                                                          3.1时代的召唤,历史的使命     

    美国是一个年轻的多民族多文化融合的国家,它欢迎一切对其国家和人民有利的事物。 近20多年来中医药/针灸等所谓的另类疗法,得到越来越多的美国人的欢迎,并且正在发展 成为一个富有生命力的确有其存在和发展价值 的医学学科。 当今由于化学疗法对人体的各种副作用和 后遗症的不利影响越来越明显,加上环境污染 导致人类面临严重的生存危机。有证据显示人类由于这些公害的结果,现在生殖能力每况愈下。

    在此人类历史的大潮流之下,有越来越多 的人要求回归大自然。特别是要求回归自然疗法的呼声已经响起。因此,中医药渐灸推拿按摩以及医疗气功等自然疗法正好符合时代的召唤、肩负这一历史的使命。有人经过统计发现, 现在每3个美国人中,就有一个曾经求助过另类疗法。从医治感冒到绝症求医,各种各样的 病人都有。

    另有一项调查显示,有超过半数的 西医医生在使用其专业医疗方法之后没有疗效 时,曾暗示病人可以尝试另类疗法。一些素有 盛名的医科大学,也已经开设了针灸或中西医 结合的诊室、诊所或研究构等。总之,中医药 /针灸现在美国正是发展的大好良机。

3.2提高素质,加强组织建设

    当前中医药/针灸医师队伍的素质显然已经不断得到提高。但是从1996年纽约州中医药界所出现的那一场严峻的六月风暴来看,由 于个别的人违法乱纪(向病人卖假药等),几乎使得整个中医药界蒙受不白之冤。如果当时没 有纽约州针灸委员会出面调停和各方善心人士 的共同支持,尤其纽约中医药学会及各针灸学 会等的努力,后果不堪设想。可见中医药/针灸 业界人士的素质是极端重要的,为此应当首先 加强一的组织建设。 当前中医药/针灸界的学会性组织仍停留 在有如雨后春笋般的状态。这些组织都分别起 过巨大的有益的推动和团结提高的作用,它是 特定历史条件下所必然的产物。

    历史在前进, 时代在变化,现在应该将这些组织联合起来,再 统一组织全国性的中医药/针灸学术组织。西医师之所以力量强大,这与他们具有统一的全 国性或全州(市)性组织有很大关系。只有统一 的组织或组织健全之后,才能及时发现并纠正害群之马一类的事件,也才能更好的提高中医药/针灸业界人士的素质,并使之达到时代所要 求的医术和医德水平,更好地为广大民众服务。

 

3.3 争取与美国传统医学(西医)并驾齐驱

    在美国的主流社会中所认为的传统医学是 西医,他们认为只有西医才是正规的医疗体系。 中医药/针灸、推拿、按摩等只是另类疗法。这是 由于国情和历史条件所造成的。但是,事物总是遵照事实、真理和科学的规律在起变化和发展。相信只要中医药/针灸业同道们的业务水 平进一步提高,医疗水平和医疗效果进一步被 主流社会所认同,在科研、教学、医疗等方面均 能向科学化、客观化、标准化、规范化不断迈进, 医德和个人素质被广大患者所称颂和欢迎,最后必能与美国传统医学各科并驾齐驱。

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Someone wrote an article online, mentioned the first state had acupuncture legislation was California, actually this is a wrong information. The first state should be Nevada.  Maryland and Oregon were in the same year (1973) immediate after Nevada. Washington DC was in 1989. Virginia in 1993.

网上有人写文章,谈到美国第一个州通过针灸立法的是加利福尼亚,实际上有误。第一个通过针灸立法的应该是内华达,而马里兰和俄勒冈是同一年(1973年)通过立法的。华盛顿DC 是1989年,维吉尼亚则是1993年。

Below is a list from American Association of Acupuncture and Oriental medicine(AAAOM).

State Legislative Initiatives: The first practice act legislation was enacted in 1973 in Nevada Maryland and Oregon. Today, 44 States (PDF), plus the District of Columbia have enacted practice acts.

1973-Maryland, Nevada & Oregon
1974-Hawaii, Montana, South Carolina
1975-Louisiana, New York(I think), and California
1978-Rhode Island
1981-Florida & New Mexico
1983-New Jersey & Utah
1985-Vermont, Washington
1986-Massachusetts, Pennsylvania
1987-Maine
1989-Colorado, District of Columbia, Wisconsin
1990-Alaska
1991-New York(I think this should be the year for re-publishing the sate law)
1993-Iowa, North Carolina, Texas, Virginia
1995-Connecticut, Minnesota
1996-West Virginia
1997-Arkansas, Illinois, New Hampshire
1998-Arizona, Missouri
1999-Idaho, Indiana
2000-Georgia, Ohio, Tennessee
2001-Nebraska
2005-South Carolina
2006-Kentucky, Michigan

2009 -Alabama

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[Dr.Fan notes]: I graduated from Nanjing University of Chinese Medicine in 1986. During my study in that period (1981 to 1986), Dr.Xia Guicheng was my teacher in the class of Chinese Gynecology (Gynecology in Traditional Chinese Medicine), I also had internship under another TCM gynecologist Dr.Sun Ningquan.
Some colleagues asked my if I have Dr.Xia’s book or article, actually, there are several books written by him or his students, available at http://www.amazon.com:
1. Xia Guicheng Practical Chinese Gynecology (Paperback) by 2009 Chinese Medicine Press; 1 edition (October 1 (Paperback – Oct 1, 2009);
Dr.Xia Guicheng also published many academic papers, in Chinese language, some of them already available in English. Here are his papers online.
homepage.mac.com/sweiz/files/article/67-30.pdf
File Format: PDF/Adobe Acrobat – Quick View
by X Guicheng
Xia Guicheng is one the most eminent gynaecology specialists in China today. In my own practice, I find that adapting the treatment principle to the menstrual 
books.google.com/books?isbn=0936185481Bob Flaws – 1993 – Health & Fitness – 267 pages
Xia Guicheng gives the following account of such correlation in the Shanghai Journal of TCM, October 1992. 10 Xia identifies six types or categories of BBT 

Xia GuiCheng (1932 -) is a professor of gynaecology at Nanjing TCM College, and has been involved in teaching, research and clinical treatment for over 30 

Xia Guicheng « Topics in Chinese Medicine

chinesemedicinetopics.wordpress.com/category/famous…/xiaguiche

May 11, 2010 – Posted in Famous Doctors, Xia Guicheng on May 11, 2010 | Leave a Comment ». Dr. Xia is the director of the Gynecology Department at the 

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Last year, I tried to call and e-mail my former patients, who had treatments in our office  due to various infertility conditions, to see exact how many cases of pregnant (and rate) after our treatments of acupuncture, or/and Chinese herbology. I wanted to do a statistical work and give our patients a real data.  However, I found this task seems very difficult -I got frustrated, because some people don’t like to  discuss their personal stuff over the phone or in e-mail.

This week, a patient saw me for her low back pain. She told me she saw me because she feels comfortable with me and my acupuncture. She said she got a pair of twin boys after my one acupuncture treatment 5 years ago–this is really a good news, but I spend 5 years to get it!

There have been over 55 pregnancy success cases after our treatments since January, 2007.  Actually, there may be some more didn’t report to me. I hope I could get the news in time.

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Vulvodynia And Acupuncture

France Guevin, BS, Marc Steben, MD, Yves Lepage, PhD, Bernard Lambert, MD

Original article from http://www.medicalacupuncture.org/aama_marf/journal/vol17_1/article3.html

ABSTRACT
Background
 Vulvodynia, characterized by burning sensation, pain, and pruritus, is often treated with antidepressants. Recent studies indicate that acupuncture may be an effective modality.
Objective To evaluate the short-term effect of acupuncture on vulvodynia.
Design, Setting, and Patients A convenience sample of 13 patients in a private clinic setting.
Intervention Acupuncture at 3 main points for all patients: BL 22, SP 6, and LV 5, alternatively on the left and right meridians, in 4 weekly
treatments.
Main Outcome Measure Pain measured on a 10-point visual analog scale (VAS) before and at the end of treatment, and 3 months later (at 4 months).
Results Significant differences (at P<.001) were observed between pretreatment, and 1 and 4 months later, from a VAS mean of 8.69 to 4.38 and 2.31, respectively.
Conclusions Acupuncture appears to be a possible alternative to antidepressant treatment for vulvodynia. A longer surveillance period is
needed to verify our results.
KEY WORDS
Vulvodynia, Acupuncture, Vulvar Dysesthesia, Vulvar Pain, Visual Analog Scale (VAS)

INTRODUCTION
The prevalence of vulvodynia, or generalized vulvar dysesthesia, is largely unknown in the general population.1 It was described by Tovell and Young in 19782 as an undetermined disorder in 26 patients (2.6%) in a series of 877 consecutive cases. The diagnosis was founded on an eliminatory basis for skin lesions. Patients were distressed by a burning sensation, pain, and pruritus, and the term “pudendagra” was used. The concept of vulvodynia or chronic vulvar discomfort was accepted in 1984.McKay4 differentiated pruritic symptoms, as associated with skin changes, thus confirming vulvodynia as an exclusion syndrome associated to a disorder of unmyelinated C fibers. Tricyclic antidepressants amitriptyline and desipramine are typically first-line therapies5 but recently, new avenues have been evoked in 2 pilot studies on acupuncture for the simplicity of use and rapid clinical response.6,7

Danielsson et al,6 using a visual analog scale (VAS), noted significant changes (P=.01) for negative quality of life at 3 months following treatment: from a score of 7.2 to 3.2 in a series of 14 women. Pain at coitus was included in the sample of vulvar vestibulitis. Powell and Wojnarowska7 reported in 1999 a clinical response in 12 patients: 2 of the cases were stratified as cured, 3 cases with partial improvement, and 4 slightly improved.

In order to verify the possible action of acupuncture on vulvodynia, we reviewed 13 cases of generalized vulvar dysesthesia, without any coital pain or sexual interference.

METHODS
Thirteen patients with general vulvar dysesthesia filled out the Stanford pain visual questionnaire (VAS, 1-10) in an office setting with us.8 Verbal consent was obtained from all patients. No double-blind intervention or controls were used; this pilot study was strictly an evaluation of acupuncture effectiveness on vulvodynia patients. Patients were seen by their physician before and after acupuncture; they were informed about the technique and mechanisms on all spheres of their body, nervous system, Qi/xue, body, and mind. Our inquiry included patient age, duration of disease, and pain score before acupuncture, at 1 month, at the end of 4 weekly treatments, and at 4 months, or 3 months after the end of the treatment. All patients were screened by us and screening included a negative Q-Tip test, wet smears, vaginal cultures, and a negative clinical vulvar examination. An acupuncturist performed all the treatments. Dermatological lesions such as eczema, psoriasis, lichen simplex sclerosis and atrophicus, and planus were excluded. Cyclic yeast vaginitis, human papillomavirus, vulvar intraepithelial neoplasia, and localized dysesthesia (vestibulodynia) were also excluded. Patients did not receive antidepressive or antiepileptic medication at the acupuncture treatment or for 4 months thereafter.

Acupuncture is defined as an insertion of a needle on precise points of the body.9 The rationale is based on Traditional Chinese Medicine (TCM), covering Yin-Yang, Five Elements, Baguang, Meridians theories, and reflexology. According to the age of the patient and the duration of the problem, we referred to Liver (Shu Jueyin) and Bladder (Shu Taiyang) meridians (young persons, few months to a year of discomfort). Also, the Chong and Tae Mo (Curious Meridians) were considered. If symptoms were present for longer than a year, the diagnosis of Liver and Kidney Yin deficiency was considered, with apparent Fire or false Fire. In reference to the nervous system, neuralgia appeared stronger at the T2-T5 levels and lighter on L1-L5, including sacral holes painful pressure points. Literature sources are the confluence of French, Chinese, and American studies.9
Stainless steel needles from 2-6 cm and 0.25 mm diameter (#32), and 6 cm and 0.25 mm diameter (#32) were used (Suzhou Shenlong Medical Apparatus Co Ltd, China). They were individually packed in an aluminum and plastic plate of thin needles, then sterilized and discarded after a single use.

Needles were placed according to the chosen locations and the person’s size, at a depth of 2-10 mm, perpendicularly or longitudinally, with different angles. Needles remained in place for 20-30 minutes in a comfortable position. We use needles without any manual or electric stimulation. Treatment was repeated weekly for 4 sessions. (Patients may indicate a pinch when skin is pierced. A feeling of numbness may be experienced near the site of puncture but it disappears with the removal of the needle, with some variations to the patient’s pain threshold.) Three main points were used for all patients: BL 22, SP 6, and LV 5, alternatively on the left and right meridians (Figure 1). No Qi response or T-witch response was used . Other interventions were: moxibustion below the navel segment level, according to the season, age, and general condition of the patient, and recommendation to avoid cold at all levels of food, clothing, and space. This study was undertaken in a private clinic setting.

A single-factor analysis of variance with repeated measures followed by a contrast analysis using paired t test with Bonferroni correction was used to study the pain level before the treatment, after 1 month, and after 4 months. The association between the ages of the patients, the duration of pain, and the pain level was studied with Pearson correlation.

RESULTS
Patients’ mean (SD) age was 47.5 (15.3) years (range, 23-70 years) (Table 1). Mean symptom duration was 38.2 (18.6) months in 10 completed questionnaires. Mean pain score levels varied from 8.69 (1.75) in the pretreatment period to 4.38 (2.93) at 1 month to 2.31(2.66) at 4 months. These mean levels were significantly different (F=37.49, P<.001). Significant mean differences were observed between pretreatment and at 1 month (P<.001), and pretreatment and the end of the survey at 4 months (P<.001), and at 1 and 4 months (P=.02). One patient did not achieve any improvement, and another had a partial response (pain score reduced from 9 to 5). There were no treatment complications.

 

Table 1. Patient Information and Pain Outcomes

Pain on Visual Analog Scale (1-10)

Patient
No.

Age,
y

Duration,
mo

Before
Treatment

At
1 mo

At
4 mo

1

36

60

10

7

1

2

25

36

8

2

2

3

61

48

10

3

1

4

50

24

7

3

1

5

62

20

10

10

10

6

67

41

4

2

3

7

23

9

9

9

3

8

39

9

7

5

9

43

72

10

5

1

10

58

10

1

1

11

45

36

10

3

1

12

70

8

2

1

13

39

36

8

3

0

Mean

47.5

38.2

8.69

4.38

2.31

(SD)

(15.3)

(18.62)

(2.93)

(1.75)

(2.66)

Median
(range)

45
(23-70)

36
(9-72)

9

3

1

 

There wasn’t any significant linear relationship observed between age and duration (r=0.108, P=.77), age and pain levels at pretreatment (r=–0.230, P=.45), age and pain levels at 1 month (r=–0.327, P=.28) age and pain levels at 4 months (r=0.147, P=.63), duration and pain levels at pretreatment (r=0.195, P=.59), duration and pain levels at 1 month (r=–0.301, P=.40), and duration and pain levels at 4 months (r=-0.450, P=.19). The difference between the pain levels at 4 months and pretreatment was also not linearly related to age (r=0.259, P=.39) and duration (r=–0.502, P=.14).

Figure 1. BL 22 is located in the lumbar region and SP 6 and LV are on the antero-internal and mid-lower side of the leg

DISCUSSION
We are unaware of any controlled trials of acupuncture treatment for vulvodynia.10 A controlled trial comparing acupuncture with amitriptyline would be challenging, especially with medium and long-term follow-up. Neuropathic pain mechanisms in vulvodynia remain unclear.11Recently, quantitative sensory testing showed increased vulvar pain presence and peripheral body regions12 with the evocation of a possible central control mechanism. Reed et al13emphasized minimal differences between general vulvar dysesthesia and vestibulodynia, with no significant differences between both groups. They could be the variant of the same pathophysiological mechanism.

Sexual activities appeared similar between vulvodynic patients and controls,14 although frequency of intercourse or orgasm was less frequent in the affected group. Our study could be extended to vestibulodynia without the aid of physiotherapy or sexual therapy. A longer period of evaluation of up to 12 months is deemed optimal with inclusion of amitriptyline as control. However, our study raises hopes in the short-term management of a challenging and often undetected syndrome.

CONCLUSIONS
Acupuncture may be a possible alternative to antidepressant treatment for vulvodynia. A longer surveillance period is needed to verify our results.

ACKNOWLEDGEMENT
Many thanks to Bruno St-Pierre for Figure 1.

REFERENCES

  1. Harlow BL, Wisc LA, Stewart EG. Prevalence and predictors of chronic lower genital tract discomfort. Am J Obstet Gynecol. 2001;185:545-550.
  2. Tovell HMM, Young AW. Classification of vulvar diseases. Clin Obstet Gynecol. 1978;21:955-961
  3. Burning vulva syndrome: report of the ISSVD Task Force. J Reprod Med. 1984;29:457.
  4. McKay M. Vulvodynia versus pruritus vulvae. Clin Obstet Gynecol. 1985; 28:123-133.
  5. McKay M. Dysesthetic (“Essential”) vulvodynia treatment with amitriptyline. J Reprod Med. 1993;38:9-13.
  6. Danielsson I, Sjöberg I, Östman C. Acupuncture for the treatment of vulvar vestibulitis: a pilot study. Acta Obstet Gynecol Scand. 2001;80:437-441.
  7. Powell J, Wojnarowska F. Acupuncture for vulvodynia. J R Soc Med. 1999; 92:579-581.
  8. Stanford Patient Education Research Center Web site. URL: http://patienteducation.stanford.edu/research/painseverity.html. Accessibility verified June 25, 2005.
  9. Guevin F, Bossy J, Yasui H. Nosologie traditionnelle chinoise et acupuncture. Paris, France: Masson; 1990.
  10. White AR. A review of controlled trials of acupuncture for women’s reproductive health care. J Fam Plann Reprod Health Care. 2003;29(4):233-236.
  11. Wesselmann U, Brunett AL, Heinberg LJ. The urogenital and rectal pain syndromes. Pain. 1997;73(3):269-294.
  12. Gisecke J, Reed BD, Haefner HK, Giesecke T, Clauw, DJ, Gracely RH. Quantitative sensory testing in vulvodynia patients and increased peripheral pressure pain sensitivity. Obstet Gynecol. 2004;104(1):126-133.
  13. Reed B, Gorenflo DW, Haefner HK. Generalized vulvar dysesthesia vs. vestibulodynia: are they distinct diagnoses? J Reprod Med. 2003;48(11):858-864.
  14. Reed B, Advincula AP, Fonde KR, Gorenflo DW, Haefner HK. Sexual activities and attitudes of women with vulvar dysesthesia. J Obstet Gynecol. 2003;102(2):325-331.

AUTHORS’ INFORMATION
Ms France Guevin is an Acupuncturist in Montreal.
France Guevin, BS, d’Ac, MOAQ
415 Blvd Saint-Joseph East
Montreal QC H2J 1J6
Canada
E-mail: f.guevin@bellnet.ca

Dr Marc Steben is a Physician at the Vulvar Diseases Clinic at the Notre Dame Hospital Chum Montreal.
Marc Steben, MD
Vulvar diseases clinic, Hôspital Notre-Dame CHUM Montreal
1560 Sherbrooke E.
Montreal QC H2L 4M1
Canada
Fax: 514-528-2452 • E-mail: marc.steben@sympatico.ca

Yves Lepage, PhD, is a Professor of Mathematics at the University of Montreal.
Yves Lepage, PhD
Department of Mathematics and Statistics
C.P. 6128, Succursale Centreville University of Montreal
Montreal QC H3C 3J7
Canada
Fax: 514-343-5700 • E-mail: yves.lepage@umontreal.ca

Dr Bernard Lambert is an Obstetrician-Gynecologist, and Associate Professor of Obstetrics and Gynecology at the University of Montreal.
Bernard Lambert, MD, FRCSC, FACOG*
Dept of Gynecology, Hôtel-Dieu CHUM, University of Montreal
3840 St-Urbain
Montreal QC H2W 1T8
Canada
Phone: 514-890-8000, #12685 • Fax: 514-412-7213
E-mail: bernardlambert@vif.com

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Recently, I treated the third patient with Vulvodynia with acupuncture. The result is very encouraging.

Ms. D.  a middle age Caucasus woman came to see me because she has been frustrated with various treatments for her IC (Interstitial cystitis), she heard I had treated a IC patient very successfully with acupuncture. She had urinary tract bacteria infection, which was recovered after the extensive antibiotic treatments, however, after that, she still has urinary frequency and strong burning pain when urination. She has been diagnosed as Interstitial cystitis, and then secondary developed Vulvodynia and pelvic bottom dysfunction.

When Ms.D. started to see me, she told me her physical therapist had treated her for several months. She had many trigger points and knots around the tail bone, anus and both sides of vulva(esp. right), both  inner sides of thighs.

After six sessions’ acupuncture, included in local A’shi / trigger point treatments and adjusting liver, spleen, kidney meridians, patient’s pain has been improved 60%, most of trigger points and knots at both thigh and around tail bone disappeared. The urinary frequency still there, but the burning pain decreased. Patient is very happy and still under our treatment, twice a week.

Notes on 08/20/2012: patient’s overall health condition has been improved, the thighs’ pain no longer exist. The pain around tail-bone, anus, and vaginal only 5-10% left. Most of days seem no a lot of pain. The uncomfortable in bladder area, and urine urgency better, but there has not been improved much. This means: her IC issue didn’t get big improvement, but the vulvodynia and leg pain, pain around anus close to clinically cured.

Here is another article from online, for your information.

Vulvodynia and Acupuncture Treatments

By Maryann Child, Acupuncture Physician
www.coralspringsacupuncture.com 

http://www.vulvodyniasupport.com/acupuncture.html

Vulvodynia is a condition, which few in the medical profession have yet to resolve or even understand. Little research exists and little is known about its origins or how best to treat it. What does seem apparent is that for those women who do have it, it is a constant daily dis-ease. Characteristics of Vulvodynia may vary from woman to the next, what is very certain is that there is usually pain and possible burning of the vulva. The level of pain can change from mild to severe. The etiology behind the condition may vary from one woman to the next, so differential diagnosis is essential for individual patient care. This differential diagnosis is what sets Chinese Medicine aside from Western Medical approach. Two women with the same diagnosis may have completely different disharmonies, so treatment is very unique to the patient’s personal body care.

Acupuncture may be a treatment option for Vulvodynia and Vestibulitis. In the proceedings workshop sponsored by the US Dept of Health in collaboration with the National Institutes of Health, National Institute of Child Health and Human Development, Office of Research on Women’s Health, and the National Office of Rare Diseases on April 14-15, 2003, discussion on the lack of understanding and research on the subject of vulvodynia was addressed. Dr. Elizabeth Stewart, of Harvard University had stated that physical therapy might alleviate the vulvar pain that was referred from the ligaments and joints in the spine and pelvis. One study did confirm that patients that used acupuncture to alleviate the pain showed improvement, and over all quality of life. She also did state that surgery for Vestibulitis was highly controversial because of the lack of clear pathophysiology for vulvar pain. There was great concern over cosmetic results. The overall consensus is that there is a relationship to the pudendal nerve being pinched. In Europe and in pain centers in the US, decompression of the nerve is attempted. Acupuncture is a great alternative to relieve compression of this nerve, and to strengthen overall system health.

Acupuncture is part of an ancient system of healing which incorporates all aspects of the physical and non-physical bodies. It is part of a larger doctrine called Oriental Medicine or Traditional Chinese Medicine. The belief is there is a vital energy that surrounds all living things. We call this “qi” or “prana”. It seems that just about every ancient culture has a name for it. We all recognize it as being real and existing. Even allopathic, western medicine has a name for it “vitality”. It is within this energy that the practitioner works his or her art. Constantly changing and creating harmony where there is disharmony, tonifiying what has been depleted and rectifying what has been in exuberance. The I ching states that all things are constantly changing and that nothing stays the same. This is the beauty of life. Every practitioner counts on this change to occur. After every treatment one anticipates the positive change in the body, hoping to rectify its disharmony. Acupuncture points are small areas of energy that spiral round, each with a different action and indication. These small energy spirals travel a pathway, which for the most part connect to an internal body organ. However there are other pathways that do not connect to any organ, these are referred to as extra ordinary pathways. Then lastly there are smaller pathways that diverge from the larger ones and cross the body. These smaller pathways allow for even the smallest communication between energy and body. The insertion of a needle into an acupuncture point creates communication between the function of the point and the body’s energetics. The formulation of points creates a reaction in the body. The body accepts the information and begins a cycle of change. Cycles of change can vary from one body to the next. Gradual improvement of symptoms is what is expected.

In Traditional Chinese Medicine the body is viewed as having patterns of harmony and disharmony. A practitioner pays very careful attention to what the condition of the body is. One examines closely what the blood is doing, what the “qi” is doing, and what it is not. The practitioner further seeks to determine where the patterns of disharmony exist. Differential diagnosis is attained and treatment to restore the body is begins. Women’s bodies are so diverse, that there are no two bodies alike. With treating Vulvodynia, I have noticed that even though there may be some similarities between patient’s symptoms, their etiologies or rather the root cause of the disorder is very different.

I first became aware of this disharmony about five years ago around the year 2000. I began treating a young patient who complained of sheer fire burning of her external genitalia. I remember feeling a bit puzzled because I had not heard of such a condition, so naturally I began to do some research. Very few of my colleagues had even heard of it. No one in my area had ever treated it. With this I began her treatment protocol.

The response that I have seen from my patients, lead me to believe that VV is completely treatable and I will explain why. I will cite two examples of patients that were treated with Acupuncture. What follows are two brief patient cases that were treated with Acupuncture. I’d like to mention that both patient’s are still receiving treatment, and are still obtaining very favorable results.

Mrs. P is a 35-year-old non-smoking married woman who was recently given a name to her burning and stinging of the vulva. For the past two years she has been treated for urinary tract infections. She has a history of low back pain and migraines. Although her migraines were a big concern for treatment, even more so was the constant irritation of the vulva. Mrs. P had a total of four treatments over the course of one month before significant results were obtained. Currently Mrs. P still comes in for treatment one time a month occasionally twice a month. Mrs. P is still undergoing treatment and is about 60 to 70 percent improved. There are many days where she is free from burning and stinging. She can remain free of discomfort for many weeks at a time.

Miss. M is a 49 year old, non-smoking non-married woman who was diagnosed
with Vulvodynia over the summer of 2004. The pain started in 2003, but was recently given a diagnosis. Her major complaint is pain of the vulva. The pain is drawing in nature. The pain is worse while sitting and better lying down. Mrs. was initially treated with Chinese herbal formulas that were modified specifically for her disharmony. Three weeks into treatment she began to feel improvement of her symptoms. Initially her improvement was minimal, then gradually began to feel better. Currently Mrs. M is treated every 4 to 6 weeks.

I wish to express my very concern for the lack of study on VV and treatment. Many women that I have seen have informed me of different experimental procedures that their Dermatologist, Gynecologist and Neurologists have mentioned. I say experimental because there is no significant data to show proof of success. I have even heard of a new use for botox. Injecting botox was the latest that I have heard this week. This is a desperate attempt in the medical world. Although there is no concrete evidence of a cure, in any medical model, all physicians would like to see a resolution of Vulvodynia. I hope if nothing else to bridge the gap between a woman and her options for treatment.

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