CHINESE HERB Treatment ALZHEIMERS #4

USING DIFFERENTIAL DIAGNOSIS

Despite the fact that brain disorders can be described generally by the theoretical framework of traditional Chinese medicine, many physicians working in China continue to rely on differentiating cases. The particular disorder, Alzheimer's disease, may occur either from a variety of different causes or from a basic cause in a variety of constitutional situations. The primary differential categories used by Chinese doctors to describe senile dementia are:

1. Spleen qi deficiency, with phlegm and stagnating blood obstructing the orifices to the brain.
2. Liver qi stagnation, with entanglement of qi, accumulation of phlegm, and stagnating blood.
3. Hot phlegm clogging the orifices.
4. Spleen and kidney yang deficiency, with phlegm and stagnating blood obstructing the orifices to the brain.
5. Deficiency of liver and kidney yin, with phlegm and stagnating blood obstructing the orifices and with generation of internal wind.
6. Qi and blood stagnation, obstructing the orifices to the brain.

According to the category that seems most appropriate, one may tonify qi, yin, and/or yang, disperse qi and blood, and resolve phlegm accumulation. The tonic herbs to be used are the same as those commonly found in traditional formulas to treat problems of aging: ginseng, astragalus, atractylodes, dioscorea, rehmannia, lycium fruit, cistanche, and morinda. For unclogging the orifices, acorus, polygala, arisaema, typhonium, and alum are used in various combinations. Acorus and polygala are said to restore proper communication between the kidney and heart;. Alum (an aluminum sulfate compound) and arisaema are considered remedies for "mental phlegm." Sedative herbs are sometimes included in prescriptions for dementia, including zizyphus, fu-shen, biota, dragon bone, and oyster shell.

According to traditional Chinese medicine, the depletion of kidney-which is the dominant cause of symptoms associated with aging-can be largely overcome by regular ingestion of either Rehmannia Six Formula (Liu Wei Di Huang Wan) or Rehmannia Eight Formula (Ba Wei Di Huang Wan). Stagnation of blood can be limited by daily ingestion of salvia wine, or some other salvia-based herbal preparation. The obstruction by phlegm can be largely overcome by reducing fat in the diet (a health-promoting strategy that is recommended by all physicians today) and by using herbal formulas that aid the digestive process, such as Six Major Herbs Combination (Liu Jun Zi Tang) or a formula that contains herbs such as crataegus and shen-chu. Saponins from ginseng (and from several traditional anti-aging tonic formulas) have been shown to improve memory function. Sleep disorders-which may respond to the use of herb therapies-are commonly reported among the elderly and may contribute to worsening mental function.

A report in the Shanghai Journal of Traditional Chinese Medicine (1991) describes a study with 60 patients divided into a Chinese herb group and a control group (both used Western medications as needed). Six different herb formulas were used for the study, given according to the diagnosis of the patients' underlying conditions. Eighteen symptoms other than memory functions were monitored, including headache, dizziness, tinnitus, and head fullness; poor appetite and constipation; fatigue and leg weariness; fever and sweating; and so on. The Chinese medical treatment group showed improvements in all of the symptoms except tinnitus. There were also changes in the tongue (less redness) and tongue fur (less greasiness). When the symptom changes related to mental condition were compiled, 7 of 30 in the Chinese medical group showed marked improvement and 16 more showed some improvement. Thus, about 77% showed some degree of improvement, but there was no notable difference between these results for mental capabilities and those of the Western medical control group. The patients in this study were treated with herbs in capsules or tablets, in order to obtain good compliance, not higher-dosage decoctions as would have been preferred by the physicians. The dosage used began low and was increased gradually. Treatment time was six months, and the treatment then needed to be continued to maintain the benefits.

Based on a review of the literature on Alzheimer's disease and senile dementia, a general formula would be acorus, polygala, platycodon, ginseng, atractylodes, licorice, astragalus, citrus, pinellia, crataegus, shen-chu, curcuma, gastrodia, salvia, cnidium, red peony, zizyphus, rehmannia, lycium fruit, tang-kuei, cistanche, morinda, aconite, dioscorea, and hoelen (or fu-shen). Certain herbs could be deleted or added to focus the formulation on the exact needs of the patient.

Among the contributors to aging disorders are the cumulative impact of oxidation reactions (including the accumulation of lipofuscin) and the decline of hormones (it was recently shown that estrogen aids memory in women). Numerous antioxidants have been identified and are readily available in convenient tablet or capsule form (flavonoids, carotenes, Vitamins C and E, and certain minerals, such as selenium, and amino acids, such as glutathione). Several Chinese herbs have been shown to have antioxidant effects and reduce levels of lipofuscin; these include the tonic herbs ligustrum, lycium, cuscuta, psoralea, atractylodes, codonopsis, epimedium, ganoderma, polygonatum, and ho-shou-wu. Some of these herbs function by increasing levels of antioxidant systems, such as SOD (super oxide dysmutase). In addition to using Chinese kidney tonic herbs to enhance the body's production of hormones, exogenous sources of many hormones are now available, including growth hormone, DHEA (dehydroepiandrosterone), and melatonin, which could be administered along with the herbs initially to obtain more obvious early effects from the treatment.