Acupuncture & TCM Discussion Forum Weblog

May 14, 2006

Hi all, I need some help in this case study

by @ 4:46 am. Filed under General, Ask a Practitioner, Education

there is one patient, aged 54 years old, and had suffered from lower back pain and neck pain for two years due to a lot of computing work. The pain was mainly on lateral sides. She also had constipation with small and hard stools and normally had bowel motion every 3 days. Meanwhile, she was taking HRT because of menopause. She usually felt stressful about her teaching job. Her tongue was red with thin white coating. The left pulse was tense while the right was deep and weak.

diagnosis:Qi stagnation and kidney deficiency

acupuncture given on
GB-31 Fengshi
UB-40 Weizhong
Liver-11 Yinlian
Kidney-7 Fuliu
UB-23 Shenshu
UB-32 Ciliao

with Du Huo Ji Shen Tang combines with Zhi Bai Di Huang Wan (12 days dose)

—————————————————–

after two weeks:

pain was relieved within few days. Then, lower back pain recurred and started moving down the frontal and lateral parts of the right thigh and both knees. The pain was a kind of dull pain with burning sensation and was more severe when getting tired or in the morning. She had regular bowl motion as well as faeces became well-formed which was a marked improvement. She always felt thirst but did not have much drinking.

Tongue: red, short and tooth-marked tongue body with yellow coating in center.

Pulse: thin and rapid in deep level (left) and deep and weak (right).

——————————————————–

I just feel confused about the origin of pain. Is the pain due to kidney deficiency or Qi stagnation? and what does ‘dull pain with burning sensation’ indicate?

Also I have noticed the second consultation had revealed some heat signs. How can this happen? what does toothmarks indicate in this case?

Thank you for reading and answering

it is appreciated if someone could give me some help and that will be very helpful to my study

2513 Responses to “Hi all, I need some help in this case study”

  1. John Says:

    There has to be some deficiency heat

  2. Scott Says:

    tongue is indicative of damp heat (red with tooth marks) so is the thirst with out drinking. With qi stagnation can come heat. If qi dose not transform with come damness.

  3. Administrator Says:

    As long as computer work (one cause) is there back pain will persist.
    It is chronic so it may come and go, supplementing Kidney Yang and nourishing Kidney Yin over time would be beneficial (modified Du Huo Ji Sheng Tang).
    Coursing the Liver Qi, Quickening Blood, and supplementing Spleen (teethmarks) would also be advisable.
    It sounds like the moving painful signs could be attributed to an invasion of Wind Damp Heat.
    In this case it would be good to expel the excess pathogenic factor before strengthening to nurture the chronic condition.
    Think wholistically, check diet, ask about exercise (core) and stretching. Is her posture OK? Does she have a good chair? Ask her to watch for clotting factors and other adverse reactions to the HRT. Ask her to take a supplement called recovery (pain), and ensure her calcium intake is sufficient (watch for contributors to inhibited calcium uptake).

    TCM is wholistic. Make your diagnosis and treat accordingly. Conditions change from week to week. Ensure your client understands that chronic conditions take time and respond best to lifestyle changes.
    Look at the WHOLE picture,…this should be routine and instinct.

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    Thank you for reply!

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  6. Pharmamedics Says:

    I think only doctor can determine the origin of pain. Probably, you have to make definite analysis again.

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