Pediatric Hyperactivity And Attention Deficit Syndromes 2010

Acupuncture and Chinese Medicine: an Integrated Perspective

Pediatric Hyperactivity & Attention Deficit Syndromes

PK Melethil, L. Ac. , Dipl. Oriental Medicine
Traditional Chinese Medicine Physician
Melethil Acupuncture Services, LLC
Wilsonville, OR 97070

COMMUNITY HEALTH PROGRAMS, Wilsonville
Winter 2010

OVERVIEW

• Traditional Chinese Medicine- an overview,
focusing on child development

• Pediatric Hyperactivity & Attention Deficit
Syndromes(i.e., AD-HD): a developmental
condition affecting children

• Chinese medicine therapeutics for Pediatric
Hyperactivity & Attention Deficit Syndromes

Melethil Acupuncture & Chinese Medicine AD-HD Syndromes (2010)

Anthropological Record
Archaeological evidence: 10,000+ years.
Ma Wang Dui site: 2,000+ years
– clinical tools, philosophical and qigong manuscripts.

Written Texts: 2,000-3,000 years old.
– Herbal Medicine, Acupuncture, Body work

Medicine guided by empiricism
Daosim, Confucianism, Buddhism
Multiple overlapping and co-existing models
Shared knowledge with Yoga, Ayurveda (India)
Greek Influences
Conversations between Huang Di and Chih-Po

Background
• Harmony and Balance

• Movement of Qi and Blood
12 Primary Meridians- 6 on each side (symmetry)
8 Secondary (Extraordinary) Meridians

• Acupuncture Points (400-500 x 2)
Jing-Luo Network of points
analogy: a river and its tributaries, a net
Variable size, shifting locations
Ah-shi points

• Mechanism of Action- Contemporary Ideas
• Conductivity gradients (Prognos)
Electrochemical gradients
• Optical/Thermal gradients
• Acoustics- variations in visco-elastic properties of tissues

What is Qi?
• 5 functions of Qi
Source of all movement
Protects the body
Source of harmonious transformations
Ensures stability and governs retention
Warms the body

• 5 types of Qi
Organ qi
Organs are functional systems, not anatomical structures
Meridian qi
Nutritive qi
Protective qi
Ancestral qi

TCM Models of Pathology- “Disharmony”
Models of Pathology

Cold Induced Illnesses
Progresses from External (Yang) to Internal (Yin) channels- 6 Levels

Zang-Fu Theory
Based on Organ Disorders (Meridians)
Warm-Febrile Diseases
Progresses from Outer to Inner layers
Models: Triple Burner, 4 Levels

Causative factors

External /Environmental Pathogenic Influences
Damp, Cold, Heat/Fire, Wind, Dryness, Summer heat ACUTE

Internal Pathogenic Influences
Emotions (Stagnation) CHRONIC
Phlegm << Body Fluids + “Heat”
Deficiency Patterns

Diagnostics & Therapeutics
• Diagnostics
Interview
Palpation
Tongue
Pulse
vein along outer edge of index finger (< 3 y.o.)
• Therapeutics
Acupuncture
TuiNa (Medical Massage)
Internal Medicine Diet/Nutrition, Herbs, Minerals, Animal products
Qigong, Tai Ji Quan, meditation (Exercises)


Ma Wang Dui- Ancients Qi Gong


Pain
• Stagnation/Anisotropy
Qi, Blood

• Types of pain (paresthesias)
Sharp, piercing
Dull, throbbing
(Heaviness)
(Numbness)


Advantages of Acupuncture
Simple, Gentle

Painless (200-300 mm,
single-use needles)

Safe, Minimal side effects

Reduced use of narcotics &
other medications

Effective, Economical


Modern Applications of Acupuncture
Anesthesia for Breast Reconstruction Surgery, OHSU
Photo provided by Roger Lore, DAOM


Chinese/Asian Medicine: 2000+ years of realizations about health

growth-development
ex utero
Post Heaven
Shen
(Heaven) Heart
Liver
Qi
(Human) Spleen
wuji
Kidney
Jing Lung
taiji
(Earth)

Pre Heaven congenital
in utero

Macrocosm Microcosm

TCM Toolkit
• Acupuncture v. effective for cerebral palsy
• TuiNa digestive disorders
• Internal Medicine dominant strategy
Over 1000 herbs in TCM pharmacopoeia; formulas are well-tested,
hundreds to thousands of years old
Current herbal products manufactured under cGMP guidelines

• Qigong (exercise)


Development: a TCM perspective
• meridians are incompletely developed

• organs (Zang-Fu) are not fully formed

• Qi is weak, susceptible to external pathogenic influences
– e.g., cold, heat, dryness

• diseases generally due to deficiency
– transforms rapidly, but resolves quickly also

• AVOID exposure to cold, improper diet

• tian kui “dew of heaven” cycles: females-7 years, males- 8 years


Development: a TCM perspective (contd.)
• Excess of yang , relative deficiency of yin (viz. fast metabolism)
– Manifest as Taiyin “Great Yin” disorders, predominant in childhood
respiratory (Lu), digestive-assimilative (Sp) systems

• Congenital disorders , slow development (Jing <Earth> essence)
bones, organs, brain

Factors of relevance to AD-HD
• maternal health (diet, environment) Pre-Heaven (in utero)

• childs’ diet, psych-soc environment Post-Heaven (ex utero)


Treatment: a TCM perspective

Therapeutic focus
• Augment Qi
– strengthen digestive, assimilative functions
– Tonify Sp, Lu
– Increase Exercise, Activity (as appropriate)

• Nourish Yin
– Internal medicine
• Diet, Nutrition
• Herbs


Further Readings
• The Web That Has No Weaver, Ted Kaptchuk
• Medicine in China, Paul Unschuld
• Acupuncture: A Comprehensive Text, John O’Connor, Dan
Bensky
• The Practice of Chinese Medicine, Giovanni Maciocia
• The Psyche in Chinese Medicine, Giovanni Maciocia
• CDC (ADHD, LD)
http://www.cdc.gov/ncbddd/ADHD/
http://www.cdc.gov/nchs/data/series/sr_10/Sr10_237.pdf
National Center for Health Statistics
CDC-National Health Interview Survey


Pediatric Hyperactivity And Attention Deficit Syndromes 2010

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