Arch Acupuncture and Health Center

Yong Xu

931 Arch St Philadelphia, PA 19107 phone: (215) 627-8209
Sunday, February 08, 2009

High blood pressure is frequently difficult to treat in a short time by acupuncture or herbs. Patients become discouraged and turn to western medicine. Some forms of Qigong can help lower blood pressure. However, most of these forms must be taught to the patient and are not simple to learn.

Most of these Qigong methods have a common factor. The rate of respiration is slowed down. This may be the chief parameter which accounts for their lowering of blood pressure.

Recent research shows that 3 or 4 15-minute sessions of slow breathing (less than or equal to 10 breaths per minute) can lower both systolic and diastolic blood pressure, usually within 8 weeks (1) – (19). In one clinical trial, some diabetics were not able to sufficiently lower their respiration rate. However, with a longer training period a lower rate of respiration might be achieved.

The breathing exercise should be performed using normal, Buddhist or diaphragmatic breathing, like opera singers. The Daoists thought that normal breathing was one of the secrets of longevity. If you look at a baby in its crib you will only notice its stomach move up and down as it breathes. By contrast, when most seniors breathe their upper chest heaves up and down and there is no visible movement of their abdomen, a consequence of shallow breathing. A Chinese doctor looks at the abdomen of a critically ill patient. If it moves up and down as the patient breathes, the patient has a better chance of surviving than a patient with no visible abdominal movement on breathing. Thus, you may have to instruct patients so that normal or diaphragmatic breathing is done automatically.

Normal or diaphragmatic breathing can be practiced lying down or sitting in a chair. The practice methods are similar. The method of practice while sitting in a chair will be described. Inhale and exhale gently, smoothly and continuously through your nose. Sit comfortably, with your knees bent and your shoulders, head and neck relaxed. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe. As you inhale, the hand on your chest must move as little as possible, while the hand on your abdomen must move outwards. When you exhale, the hand on your abdomen moves inward, which you can help by slightly and gently pulling your abdominal muscle inward. Once again, the hand on your chest moves as little as possible. At first, you’ll probably get tired while doing this exercise because an increased effort will be needed to use the diaphragm correctly. Keep at it, because with continued practice, diaphragmatic breathing will become easy and automatic. Practice this exercise 5-10 minutes a few times a day.

Slow breathing has the physiological effect of relaxing the muscles surrounding the small blood vessels, which allows the blood to flow more easily. Alpha blockers block receptors in arteries and smooth muscle. This action relaxes the blood vessels and leads to an increase in blood flow and a lower pressure for the control of hypertension. The action in the urinary tract enhances urinary flow for an enlarged prostate. Slow breathing seems to have the same effect as alpha blockers. Thus, it may also reduce the symptoms of an enlarged prostate. This conjecture has not been subjected to clinical trials, but has worked on two subjects.

There is another simple breathing technique purported to help eliminate and prevent heart attacks due to abnormal electrical events to the heart, and to generally enhance performance of the central nervous system (CNS) and to help eliminate the effects of traumatic shock and stress to the CNS. Most patients would prefer to try this approach rather than the risks of ablation or a cardiac pacemaker.

The method requires 1 breath per minute (BPM) respiratory exercise with slow inspiration for 20 seconds, breath retention for 20 seconds, and slow expiration for 20 seconds, for 31 consecutive minutes. Do not attempt to use the required time intervals to start. Use a time interval - say, 5 seconds, or even less, so that no straining is involved. Try to practice every day.

This technique produced favourable shifts in all hemodynamic variables measured for 4 subjects during the 1 BPM exercise and in the post-exercise resting period (20). The authors conclude that the long-term effects of this technique appear to reset a cardio-respiratory brain-stem pacemaker. This effect may be the basis for the purported health claim of this yogic breathing exercise. Large scale clinical trials seem warranted.

References

1. Device-Guided Breathing to Lower Blood Pressure: Case Report and Clinical Overview. W Elliott, J Izzo. Medscape General Medicine, 2006; 8(3).
2. Graded Blood Pressure Reduction in Hypertensive Outpatients Associated with Use of a Device to Assist with Slow Breathing. W Elliott, J Izzo, Jr., WB White, D Rosing, CS Snyder, A Alter, B Gavish, HR Black, J Clin Hypertens, 2004 6(10): 553-559.
3. Nonpharmacologic Treatment of Hypertension by Respiratory Exercise in the Home Setting. E Meles, C Giannattasio, M Failla, G Gentile, A Capra, G Mancia, American Journal of Hypertension 2004, 17:370–374.
4. Respiration and Blood Pressure. G Parati, JL Izzo Jr, B Gavish, in Hypertension Primer, Third Edition. JL Izzo and HR Black, Eds. Baltimore, Lippincott, Williams, and Wilkins, 2003; Ch. A40, p117-120.
5. Non-Pharmacological Treatment of Resistant Hypertensives by Device-Guided Slow Breathing Exercises. R Viskoper , I Shapira, R Priluck, R Mindlin, L Chornia, A Laszt, D Dicker, B Gavish, A Alter, American Journal of Hypertension 2003; Vol 16:484-487.
6. Device-Guided Breathing Exercises Reduce Blood Pressure - Ambulatory and Home Measurements. T Rosenthal, A Alter, E Peleg, B Gavish, American Journal of Hypertension 2001; 14:74-76.
7. Breathing-control lowers blood pressure.E Grossman, A Grossman , MH Schein, R Zimlichman, B Gavish. Journal of Human Hypertension 2001; 15:263-269.
8. Treating hypertension with a device that slows and regularizes breathing: A randomised, double-blind controlled study. M Schein, B Gavish, M Herz , D Rosner-Kahana, P Naveh, B Knishkowy, E Zlotnikov, N Ben-Zvi, RN Melmed , Journal of Human Hypertension 2001; 15:271-278.
9. The Changes of Noninvasive Hemodynamic Parameters after Device-Guided Slow Breathing Exercise in Hypertensive Patients. J Y Kim, M S Han, H H Yoo, H M Choe, B S Yoo, S H Lee, J Yoon, and K H Choe. Journal of Clinical Hypertension,2006, Vol 8, Issue 5, Suppl A.
10. Does Baseline Systolic Blood Pressure Affect Antihypertensive Efficacy with Device-Guided Breathing Exercise?Kim JY, Han MS, Yoo HH, Choe HM, Yoo BS, Lee SH, Yoon J, and Choe KH. Journal of Clinical Hypertension,2006, Volume 8, Issue 5, Suppl A.
11. Non-pharmacological treatment of hypertension in diabetics by device-guided paced breathing: A randomized controlled study. M H Schein, A Alter and B Gavish. Journal of Clinical Hypertension, 2006, Vol 8, Issue 5, Supl A,. P- 79.
12. Blood pressure change following 8-week, 15-minute daily treatment with paced breathing guided by a device: A korean multi-center study. J H Bae, J H Kim, K H Choe, S P Hong, K S Kim, C H Kim and W H Kim. Journal of Clinical Hypertension,2006, Vol 8, Issue 5, Suppl A,. P-86
13. Treating hypertension in diabetics with device-guided breathing: A randomized controlled study. MH Schein, A Alter and B Gavish. EGPRN 2005.
14. Treating high blood pressure by device-guided paced breathing in the home setting: Evidence-based approach. M Schein, E Grossman, T Rosenthal, C Giannattasio, W Elliott, R Viskoper, A Alter, B Gavish British Hypertension Society Annual Meeting, Cambridge, UK. Sept 2005
15. Reduction of home blood pressures and white coat effect after 8 weeks of device-guided paced breathing. W Elliott, B Gavish, A Alter, J L. Izzo, and H R. Black, American Journal of Hypertension, 2005, 18(5): 211A
16. Blood pressure reduction with device-guided breathing: Pooled data from 7 controlled studies. Elliott, HR Black, A Alter, B Gavish. Journal of Hypertension,
2004; 22(2): S116
17. Acute effects of device guided-breathing on cardiovascular parameters and baroreflex sensitivity in normal subjects. G Parati, F Glavina, G Ongaro, A Maronati, B Gavish, P Castiglioni, M Di Rienzo, G Mancia. American Journal of Hypertension
2002; 15(4,2)182A.
18. The pressure dependence of arterial compliance: A model interpretation. B Gavish, American Journal of Hypertension, 2001; 14:121A. 2004; 17(5):54A
19. Are breathing exercises an active component in reducing high blood pressure? A retrospective view. B Gavish. Journal of Hypertension 2001, Supplement 2, S79-S80.
Repeated blood pressure measurements may probe directly an arterial property. Gavish B., American Journal of Hypertension 2000; 13:190A.
20.. Hemodynamic Observations on a Yogic Breathing Technique Claimed to Help Eliminate and Prevent Heart Attacks: A Pilot Study. David S. Shannahoff, Khalsa, B., Bo Sramek, Matthew B. Kennel, Stuart

 

Friday, October 03, 2008
What are the Characteristics of TCM?

TCM, unlike western medicine, is holistic. The body is inseparable from the rest of nature. It automatically regulates its internal function to adopt to the regular changes that recur in the environment. Every part of the body, which includes the mind, is connected together. For example, if a patient has back pain, sore knees, and ringing in his ears, he might be advised to see an orthopedist, a neurologist and an ear doctor by his physician. A traditional Chinese doctor's diagnosis would be a malfunction of the Chinese organ-function known as the Kidney. TCM does not treat a single symptom like western medicine - for example, by giving an aspirin for a headache. TCM treats symptom-complexes to rebalance the body, as described below, so that the body can cure itself. A traditional Chinese doctor would rather prevent disease than cure it. In olden times, superior Chinese physicians were only paid when their clients were well and not paid when they were ill.

What is the basis of TCM?

Thousands of years of clinical experience led to effective treatment. Later, this knowledge was organized through Chinese philosophy using the concepts of energy (Qi) and change (Yin-Yang theory). If Qi is not excessive or deficient in any part of the body, a person is well. Disease is the result of unbalanced Qi.

Qi flows through channels or meridians which form a two-way communication between the organs and the surface of the body reached by these meridians. The energetic state of an organ can be determined by studying certain regions on the surface of the body. A similar concept, known as referred pain, appears in western medicine. For instance, a symptom of a heart problem can be pain radiating down the little finger side of the hand. TCM explains this pain by means of the Heart meridian that runs from the heart to the anterior and medial surface of the arms. The pain is the result of a Qi deficiency. Conversely, unlike western medicine, stimulating specific points on the body, called acupoints, influences the energy flow to the associated organs through their meridians. For example, some heart problems can be treated by stimulating certain acupoints on the Heart meridian.

What is Qi and how can it be balanced?

Scientists hypothesize that Qi can be explained by the equivalence of energy and matter or is a form of electromagnetic energy containing information or a yet to be discovered form of subtle energy. Even though Qi is still being investigated, it can be used, just as electricity was used before its nature was known. Like electricity, Qi is invisible. Although you cannot see an electric current, its presence can be detected through heat, magnetic effects and so on. Analogously, abnormal Qi variations can be detected by symptoms, such as heat, redness, diarrhea (too much Qi), or coldness, whiteness, constipation (too little Qi). Qi is balanced by eliminating these symptoms.

What are the causes of Disease?

Diseases can be caused by sex, exogenous climatic factors; epidemics, pathogenic factors, internal injury by the seven emotions; improper work, rest, exercise or diet; trauma, retention of phlegm, fluid and blood stasis. If a person's vital energy is strong enough, he will not become ill, because of his resistance to the disease factors.

What forms of treatment are used in TCM?

Different ways of stimulating acupoints lead to different types of treatment such as needles (acupuncture), heat (moxibustion), pressure and other forms of Chinese massage (Tuina), vacuum pressure (Cupping) and exercise (Qigong). Using modern technology, acupoints can also be stimulated by electricity, lasers, ultrasound, infrared and other forms of radiation.

Chinese breathing, herbal and dietary therapy are based on altering the body's Qi by using the Qi in the air, herbs and food, respectively.

How is the correct form of treatment determined?

It is determined by diagnosis. TCM has developed an extremely sophisticated system of correspondence between outward signs and internal organ. Accordingly, practically everything such as skin complexion, bones, meridians, smells, sounds, mental states, preferences, emotions, demeanor and body build reflect the state of the internal organs. Many of the so-called symptoms and signs of TCM would not be considered as conveying important information in western medicine. For instance, inability to make decisions, which confirms a weak Spleen, and so on.

From centuries of clinical experience, TCM also obtains information about the whole body by examining a small part of it. A striking example of this principle is Chinese pulse diagnosis. Detailed information about the whole body can be derived by palpating 12 pulses located on a small section of the radial arteries. Other examples of this principle are facial and tongue diagnoses.

The symptoms and signs are woven into a pattern called a "symptom-complex" which is a complete summary of the functional condition of the body at a particular stage of the illness. Symptoms are linked to a basic imbalance in the body's energy. This imbalance is the disease in TCM. The treatment restores the imbalance so that the body can then heal itself.

What is acupuncture?

It is a method of balancing the body's Qi by inserting needles and sometimes applying heat or electrical stimulation at precisely located acupoints. Once the Qi is balanced, the body heals itself naturally.

What is herbal therapy?

Herbal therapy is not directed to a single symptom or part of the body, but depends on a pattern of symptoms, called the symptom-complex. The aim is not to kill bacteria, viruses, cells, and so forth, but to rebalance the body so that it can heal itself. Recall that symptoms indicate an imbalance of Qi. For example, if one of the symptoms is fever (heat) then one of the herbs in the formula would have the property of coldness in order to normalize the patient's temperature. Centuries of clinical experience have led to the elimination of large doses of toxic herbs and dangerous prescriptions. A traditional Chinese formula is custom designed for each patient. After a short trial the formula is redesigned. Unlike drugs, proper herbal treatment is virtually free of dangerous side efects.

What is Tuina?

Tuina (Chinese massage) treats and prevents disease by massaging the body. It works by increasing blood circulation, correcting displacements of bones and soft tissues and stimulating nerves and meridians to influence the body's internal function and energy

What is Qigong?

Qigong is a combination of mental and breathing exercises used to treat and prevent diseases. Gong means hard work or task and Qigong is the task of learning to alter the Qi flow to correct Qi imbalances either in your own body, for self treatment, or in the patient's body. For more details click here.

Which form of treatment is best?

The type of treatment depends on the disease and the patient. For example, sometimes acupuncture is better than herbal therapy; other times the reverse holds. In some situations a combination of treatments is the best. For instance, in treating a frozen shoulder, acupunture migt be used to reduce the swelling, inflammation and pain. Then, Tuina could be used to correct displacements of soft tissue, nerves or bone; to increase the circulation of Blood and Qi and to increase the range of motion. Qigong is always helpful with any other type of treatment.

Does TCM have any advantage over western medicine?

Considering a disease as a symptom-complex has three important consequences. Some Western diseases, whose precise cause is unknown or complicated, cannot be treated effectively by western medicine, but can be alleviated by TCM - for example, arthritis. Other conditions which may require surgery - for example, protruding discs and pinched nerves, can often be treated, with good results, by acupuncture and Tuina.

Over the centuries, TCM has discovered how to eliminate symptoms. Once all of the symptoms of a symptom-complex are eliminated, the body's Qi is balanced and natural healing occurs. These techniques can also be applied to drug-induced symptoms, such as those resulting from cancer chemotherapy.

Another important consequence of the symptom-complex is in prevention. TCM can detect a "disease" (symptom-complex) when there is no corresponding western disease or any pathological changes. The patient may feel a little "out of sorts". By bringing the body back into balance, more serious illnesses are prevented. In China, people who appear well go to the doctor periodically to have their energy balanced, just like a tune-up for a car.

Is TCM archaic?

After the Communist Revolution in 1949, the Chinese wondered if TCM was really effective or just superstitious fokelore. To settle this question, they conducted thousands of experiments and clinical trials during the fifties, which verified the effectiveness of TCM. As a result, in 1958, the Central Committee officially sanctioned TCM and established five-year traditional medical schools. They decreed that traditional doctors had to study western medicine for one year and western doctors had to study traditional medicine for one year. The efficacy of TCM continues to be verified by clinical and scientific studies. TCM is now practiced worldwide. More people have been treated by TCM than by any other system of medicine.
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