Page 133 - WSAVA2018
P. 133

associates with water.14 Thus, abnormalities of ‘Kidney’ are believed to cause multiple disturbance of the body.14 Several clinical signs related to CRF were recorded, such as edema, ‘guan-ge’ (anuria with vomiting), ‘ni-du’ (stranguria), and ‘long-bi’.14
The general treatment principle for CRF is to:
• Drain Dampness to regulate immune system and promote urination
• Activate and nourish Blood
• Resolve Stasis
• Replenish vital energy
• Coordinate Yin and Yang
a) Common acupoints for seizures and its functions:
· Strengthen Kidney Qi: BL-23/52, BL-26, KID-3, Shen- shu
· Warm Kidney Yang: GV-3/4, BL-24, CV-6, Bai-hui, Shen-shu/peng/jiao
· Nourish Yin: BL-23, KID-1/3/7, SP-6/9, Shen-shu
· Benefit urination: BL-22/28, SP-9/15, GB-25, ST-28,
b) Additional acupoints for clinical signs:
· Poor appetite: Shan-gen, Jian-wei, BL-20/21, ST-36
· Poor digestion: BL-20/21, ST-25/36
· Nausea/vomiting: PC-6, BL-20/21, ST-36, GB-34
· Diarrhea: ST-36, SP-6, BL-25, GV-1
· Edema: GV-4, SP-6
· Stranguria: CV-3, BL-39
· Heat: LI-4, LI-11, GV-14, Er-jian, Wei-jian
· Abdominal pain: SP-6
· Restlessness/abnormal behavior: PC-6, HT-7
· Panting/coughing: CV-17, BL-43, BL-13
· Hearing loss: SI-9
· Anemia: BL-17, BL-20, BL-23, SP-10
· Hypertensive: PC-6, LI-4, KID-1, LIV-3, GB-20, GB-34
· Itchy skin: LI 11, St 36, GB-20, SP-10
c) Methods of Stimulation:
· Dry needle for 20-30 minutes
· Electroacupuncture, 20Hz for 10-15 minutes followed by 80-120Hz for 10-15 minutes
· Aquapuncture, vitamin B12 injected into 5-10 acu- points, 0.1-0.3 cc per acupoint
· Moxibustion at GV-4, BL-23/24, CV-6, KID-3, SP6 for patient with Kidney Yang deficiency or edema
· Acupressure or laser acupuncture d) Tui-na massage:
· Mo-fa (Touching Skin and Muscle) or Ca-fa (Rubbing) along the back-shu Bladder meridian (BL28 to BL11) and along the Conception Vessel meridian (CV8 to CV2) for 3-5 minutes
· Rou-Fa (Rotary-Kneading) along the back-shu Bladder meridian (BL28 to BL11) from caudal to rostral and along the Governing Vessel meridian (GV-2 to GV-14) back and forth 12 times
· Rou-fa along the Conception Vessel meridian (CV8 to CV2) back and forth 12 times
· Clockwise thumb Rou-fa to stimulate GV-4, GV-14 and GV-20 for 1-3 minutes
· Ca-fa and Rou-fa along the medial thigh over the 3 Yin channels (Kidney, Spleen and Liver) of the hind limbs, following the flow of the meridians (from foot to upper limb) for 3-5 min
· Clockwise thumb Rou-fa to stimulate KID-3 and KID-7 for 1-3 minutes
· Single-finger Ji-dian-fa (Dotting) to stimulate ST-36 for 1-3 minutes
e) 10 Common Chinese herbs for CRF:
Your Singapore, the Tropical Garden City
Huang-qi (Astragalus membranaces or Astragalus mongholicu), Chuan-xiong (Ligusticum chuanxiong), Dang-gui (Angelica sinensis), Da-huang (Rheum pal- matum), Dan-shen (Radix salvia miltiorrhizae), Dong- cong-xia-xao (Cordyceps sinensis), Di-huang (Salvia Miltiorrhiaei), Fang-ji (Stephania tetrandra), Fu-ling (Poria cocos), Lei-gong-teng (Tripterygium wilfordii)
There are hundreds of Chinese herbs used to treat chronic kidney diseases. Many of them have been shown to improve renal function in patients with CRF in a number of studies. Their mechanisms of action are mainly related to antioxidation, anti-fibrosis,
and improvement of metabolic disturbance in CRF. Unfortunately, the effective components or chemical compounds in most of these herbs remain unknown due to the difficulty of pharmacodynamic studies of herbs and the isolation of active ingredients from herbs or herbal mixtures.
Huang-qi (Astragalus membranaces or Astragalus mongholicu) has multiple beneficial effects on stimulation of the immune system, promotion of diuretic activity, antioxidation, anti-inflammation, and renoprotection. It decreases glomerular hyperperfusion and proteinuria, and improving the plasma levels of total cholesterol and albumin.
Da-huang (Rheum palmatum L) plant have been studied extensively in China.15 It was found that rhubarb lowers the serum creatinine level, increases inulin clearance, decreases urinary protein excretion, and attenuates lipid derangements.15 Some studies reported that rhubarb not only has an renoprotective effect by itself but also may have an additive beneficial effect with ACE inhibitors.15 In a systemic review of 18 randomized or quasi-randomized trials from 15 Chinese journals, rhubarb showed a positive effect on relieving uremic symptoms, lowering serum creatinine, improving hemoglobin levels, and adjusting disturbance of lipid metabolism in 1,322 human patients with CRF.16
Among other kinds of Chinese herbs used to treat CRF, Dan-shen (Radix salvia miltiorrhizae) relaxes vessels by enhancing microvascular protein synthesis of endothelial nitric oxide synthase, leading to an increase in nitric oxide production.17 Danshen, in combination with

   131   132   133   134   135