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V tem članku bom z vami delila primer zdravljenja migrene v moji ordinaciji in primer zdravljenja, ki je bil objavljen v medicinski reviji. V obeh primerih sta bili zdravljeni ženski z dolgo zgodovino migren in sta se na TKM zdravljenje zelo dobro odzvali.
Primer 1, ženska, 32 let [1]
Oktobra 2011 je v ordinacijo prišla 32-letna Etiopijka-Američanka z 10-letno zgodovino izčrpajočih migrenskih glavobolov. Opisala jih je kot najhujši možni občutek v svojem življenju, kjer jih je označila na lestvici moči od 1 do 10 z 10 (10 je najhujša stopnja bolečine). Med napadi je pacientka doživela ostro bolečino; fotofobijo; moten vid z vidnimi aurami; občutke potrtosti, vrtoglavice in razdražljivosti; občasne slabosti in bruhanje; hipersenzitivnost na zvok in željo po ležanju v temni, zvočno izolirani sobi. Bolečina se je pogosto pojavljala na desni strani glave, kar se je dogajalo na vsakih 7 do 10 dni. Slikovne obdelave niso pokazale nobenih nenormalnosti.
TKM diagnoza je pokazala, da ima pacientka mrzle roke in noge s toplim pasom. Pogosto se je potila in hrepenela po čokoladi, sladoledu in ocvrti hrani. Trpela je tudi zaradi zamašitve sinusov in alergij. Tedensko ji je bilo slabo in je bruhala. Enkrat do dvakrat na teden je bila zaprta z občasnimi sledmi krvi v blatu zaradi prekomernega napenjanja pri iztrebljanju. Nagnjena je bila k stresu in tesnobi.
Diagnoza je ‘gorela’ od močnega jetrnega ognja s kopičenjem vlažne sluzi. Princip zdravljenja se je usmeril proti zmanjševanju jetrnega ognja, izločanju vlažnosti, odstranitvi sluzi in izničenju bolečine. Protokol akupunkture je bil sestavljen iz tedenski zdravljenj v obdobju 6 tednov. Zdravljenje se je začelo s tedensko kavo in klistiranjem s kitajskimi zelišči. Program zdravljenja je bil sestavljen iz enega klistiranja prvi teden, drugi teden iz dveh in tretji teden iz treh. Pacientko so oskrbeli z vso opremo za klistiranje: vedrom za klistir s cevjo in sponko, nepredelano kitajsko zeliščno formulo (Zeng Ye Tang oz. Čaj kot prevretek za zviševanje ravni tekočin).
Po prvem tednu akupunkture, prvega klistiranja in preoblikovanja diete je pacientka poročala o odsotnosti migren. Resda je trpela za glavoboli, ki so trajali 2 dni, in bruhala v 1 tednu dvakrat. Glavobol je po bolečinski lestvici samokontrole od 1 do 10 ocenila s 5 (kjer je 10 najhujša bolečina). Prav tako je po klistiranju poročala o boljšem počutju z manj napihnjenosti.
Pacientka je po drugem zdravljenju poročala o izboljšanju zamašenosti sinusov. Njeni glavoboli so bili blažji in krajši. Nadaljevala je z zdravljenji s klistiranjem in svojo dieto še izpopolnila.
V 3. Tednu je pacientka poročala o zaprtosti 2 dni. Po tretjem klistiranju je poročala o popolnem iztrebljanju in boljšem počutju. Pred tem je še sporočila o glavobolu v desnem sencu.
V 4. Tednu je občutila vsesplošno izboljšanje. Uživala je v mastni ocvrti hrani, ki je bila v prejšnjih 3 tednih izločena iz njene diete. V desni strani glave je takoj imela migreno. Bruhala je zelen žolč in imela kislinski refluks.
V 5. Tednu se je vrnila k svoji preoblikovani dieti in se držala treh enem na teden. Poročala je o izboljšanju sinusne zamašenosti in samo o blagem glavobolu, ki ga je po številski lestvici pacientove samokontrole ocenila s 3.
Po 6 tednih tedenskih zdravljenj se je pacientka po 8 mesecih vrnila na kontrolo. Trdila je, da so ji preoblikovanje diete in terapije klistiranja spremenile življenje. Zdaj gre na dopust brez kakršnegakoli strahu pred migreno. Pacientka je obdržala prehranski in migrenski dnevnik, zaradi česar je lahko videla, katera hrana je vzpodbudila migreno, in se ji je tako lažje izogibala. Prav tako je poročala, da ji je akupunktura pomagala pri nujnih življenjskih potrebah in da sta preoblikovanje njene diete in klistiranje prispevala k olajšanju od migren.
(opomba: pravzaprav se ne strinjam z rednim pristopom klistiranja, ker prehitro pride do pretiravanja in se s tem poškoduje zdrave dele črevesja. V svoji ordinaciji uporabljam za zdravljenje zelišča, ki čistijo od znotraj navzven. Res je, da je počasnejše, a po mojem mnenju varnejše.
Primer 2, ženska, ob obisku 50 let
Ženska, ki je v delala v vlogi šefinje, se je pritožila glede dolge zgodovine migren, ki so izbruhnile vsaka 2 tedna v čelnem in senčnem predelu ter okoli desnega očesa. Prav tako je kazala znake menopavze, kot so vročinski oblivi, potenje in slab spanec.
Prvi del njenega zdravljenja je bil izveden pri drugem akupunkturistu z akupunkturo enkrat do dvakrat mesečno. Občasno je vzela standardno zeliščno formulo za čiščenje sistema žolčnika in jeter. Povedala mi je, da se je po 10 mesecih zdravljenja epizoda njene migrene zmanjšala s 3 dni na 1 dan in nato še redkeje.
Bila je ena mojih prvih pacientov v Sloveniji. Ko sem tukaj začela s svojo prakso, je bila moja zaloga zelišč izjemno omejena. Nisem ravno pristaš uporabe standardizirane zeliščne formule. Če že obljubljamo pacientom, da jim zagotavljamo individualizirano zdravljenje, potem ravno standardizirana formula uničuje fleksibilnost in izniči našo trditev ter obljubo. Običajno je v eni zeliščni formuli 4-12 zelišč z različnimi odmerki vsakega, tako da je pravzaprav neskončno možnosti kombinacij. Zelišča imajo med sabo interakcije, kjer nekatera zvišajo učinek in nekatera zmanjšajo toksičnost druge. Prav tako različna zelišča vstopijo v različne dele telesa in imajo tako edinstvene učinke. Torej da bi zagotovila pravo moč in učinek, sem počasi uvajala svojo formulo. Vendar sem šele po 2 letih imela večjo zbirko svojih zelišč in tako pripravila popolnoma prilagojene mešanice.
V tem primeru je šlo za tipično šibko Ledvično vodo in preveč aktiven Jetrni ogenj. Jetrni ogenj se je razplamtel in žgal meridian, kar je povzročalo bolečino. Za žensko v menopavzi je obvladovanje takšnega stanja še toliko zahtevnejše, ker se v tem obdobju Ledvična voda degenerira. Ledvična voda je zaloga energije za kompenzacijo, hranjene in vzdrževanje ravnotežja. Lahko si jo predstavljate kot led na polih ali visokih gorah. Ko se ta led stali, se zmožnost hlajenja in reguliranja toplote porazgubi.
O polnjenju vodne energije in čiščenju Jetrnega ognja je veliko lažje govoriti kot to dejansko storiti. Hiperaktivni Jetrni ogenj neprenehno žge vodno energijo. Ta vrsta ognjene energije ni takšna, ki greje vaše ognjišče. Je veliko bolj zapleten s kompleksnejšim gorivom. Imenujemo jo sluz oz. s terminom vlažna vročina v TKM.
Na srečo so se za ta primer, odkar sem iznašla in počasi uvedla svojo formulo, migrenski napadi zreducirali. Večinoma napadov ni ali pa so ti zelo blagi, brez potreb po zaužitju protibolečinskih zdravil.
vir: [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921614/
prevod: Tanja Topić
vir fotografij: internet
Real cases of migraine treatment by TCM
In this article, I will share a case of migraine treatment by myself and one case published on a medical journal. Both cases are women with long history of migraine and have very well response to TCM treatment.
Case 1, woman , 32 [1]
In October 2011, a 32-year-old Ethiopian-American woman with a 10-year history of debilitating migraine headaches. She described them as the worst feeling of her life, with a pain scale rating of 10 out of 10 (10 being the highest level of pain). During the attacks, the patient experienced sharp pain; photophobia; distorted vision with visible auras; a feeling of heaviness, dizziness, and irritability; occasional nausea and vomiting; hypersensitivity to sound; and a desire to lie down in a dark, noise-free room. The pain was often on the right side of her head, occurring once every 7 to 10 days. Imaging exam showed no abnormalities.
The TCM intake revealed the patient had cold hands and feet with a warm midsection. She sweated easily and craved chocolate, ice cream, and fried foods. She suffered from sinus congestion and allergies. She vomited and felt nauseated weekly. Once to twice a week, she was constipated with occasional blood in the bowl due to excessive strain to clear bowels. She was prone to stress and anxiety.
The diagnosis was flaring-up of liver fire with accumulation of damp phlegm. The treatment principle was to reduce liver fire, eliminate damp, resolve phlegm, and stop pain. The acupuncture protocol consisted of weekly treatments for 6 weeks. The treatment protocol started with weekly coffee and Chinese herbal enemas. The regimen consisted of one enema the first week, two enemas the second week, and enemas three times a week by week three. The patient was provided with an enema kit: an enema bucket with hose and clamp, a raw Chinese herbal formula (Zeng Ye Tang or Increase the Fluid Decoction tea).
After the first week of acupuncture, the first enema, and the diet modification, the patient reported no migraines. She did suffer from a headache that lasted 2 days, and she vomited twice throughout the week. The headache was a 5 on a patient self-report numeric pain scale from 1 to 10 (10 being the most severe pain). She reported feeling “better and less bloated” after the enema.
The patient reported improvement in sinus congestion after the second treatment. Her headaches were milder and of shorter duration. She continued her enema treatments and made further improvements in diet.
At week 3, the patient reported constipation for 2 days. After the third enema, she reported having a full bowel movement and feeling better. Prior to that, she reported one right temple–area headache.
At week 4, she felt overall improvement. She indulged in fatty fried foods that had been eliminated from her diet in the recent 3 weeks. She immediately had a migraine on the right side of her head. She vomited green bile and had acid reflux.
By week 5, she returned to her previously modified diet and maintained three enemas per week. She reported improvement in sinus congestion and only a mild headache, 3 out of 10 on a patient self-report numeric pain scale.
After 6 weeks of weekly treatment, the patient returned for follow-up after 8 months. She claimed the diet modification and enemas changed her life. She now goes on vacations without fear of migraine. The patient kept a food and migraine journal and was able to track the foods that triggered migraine and avoid them. She reported that acupuncture helped her immediate needs and the diet modification and enemas have contributed to her relief from migraines.
(Note: I actually do not agree with a regular enema approach because it is easily overdone and hurt the normal intestine structure. In my practice, I will use herbs for cleaning from inside. It is slower but safer in my opinion.)
Case 2, woman, 50 at her first visit
Chief complaint of long migraine history, with the outbreak once every 2 week, at the location on forehead, temple and around the right eye. She also show menopause symptoms like hot flashes, sweating and poor sleep.
The first part of her treatment was conducted by another doctor with acupuncture once to twice per month. Occasionally she took some standard herbal formula for cleaning the Liver and Gall-bladder system. After 10 months of treatment, she told me that her migraine episode reduce from 3 days to 1 day each time and less often.
She was one of my earliest patient in Slovenia. When I first started my practice here, the choice of herbs was extremely limited. I do not prefer using standardized herbal formula. If we promise our patient to provide individualized treatment for them, then standardized formula is killing the flexibility and we fail our claim. There are usually 4-12 herbs in one formula and different dosage of each herb so there are basically unlimited possibilities of combination. Herbs have interaction among themselves, some is to enhance the effect while some can reduce the toxicity from another. Also, different herb enter different part of the body and bring unique effect. Therefore, to ensure the true power and effect, I slowly introduced my own formula. But not until 2 years later when I started my own practice, could I have my own herbs collection to make fully customized mixture.
For this case, it is a typical weak Kidney water and overactive Liver fire case. The Liver fire flare up and burn the meridian causing the pain. Woman at her menopause is a more challenging condition to manage because their natural Kidney water energy is degenerating in this period. Kidney water energy is the storage energy for claiming, nourishing and balancing. You can imagine it as the ice in the poles or high mountains. When that ice melts, the ability of cooling and regulating heat is lost.
Filling up Kidney water energy, cleaning Liver fire is easier said than done. The hyperactive Liver fire is constantly burning out the precise water energy. And this kind of fire energy is not like your fireplace. It is way more complicated with a more complex fuel. We call them phlegm or damp-heat in TCM term.
Luckily for this case, ever since I pick up and slowly introduce my own formula, the migraine attacks further reduced. Most of the time there is no attack or only very mild ones without the need of painkillers.
source: [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921614/
source of photographs: internet
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