TCM Acupuncture and Massage

Chapter 62 Nervous system diseases (4)
7. The difference between dementia and forgetfulness. Forgetfulness is a manifestation of weakened brain function in the elderly, while dementia is a pathological decline in brain organic intelligence. How to distinguish between the two, the following points can be used for reference:
(1) The difference between forgetting. The forgetful old people always forget what they have done partially; while the forgetting of dementia is completely malignant. They can't remember what happened, as if the matter has completely disappeared.

(2) Cognitive ability. Although the memory of the forgetful elderly has declined, their cognitive ability to time, place, relationship between characters and the surrounding environment has not diminished at all; however, the demented elderly have lost the cognitive ability to recognize the surrounding environment and cannot distinguish between the upper and lower. In the afternoon, I don't know the change of seasons, where I am, and sometimes I can't even find my way home.

(3) Ability to live. Although the forgetful elderly may remember the wrong date and sometimes forget it, they can still take care of their own lives and even take care of their family members. As the disease progresses, the demented elderly will gradually lose their ability to take care of themselves.

(4) Emotional changes, forgetful old people have seven emotions and six desires; while the emotional world of demented old people becomes "indifferent to the world" and insensitive.

(5) Changes in thinking. Forgetful old people are very distressed by memory loss. In order not to make mistakes, they often write a memo. However, demented old people have no worries, their thinking is getting slower and slower, their speech is getting poorer, they lack a sense of humor, and their reactions are slow.Whether the language is rich and humorous is one of the important signs to distinguish between physiological amnesia and dementia.

([-]) Diagnosis

1. Diagnostic criteria The diagnosis of AD must first recognize the clinical symptoms of AD, ask about the medical history in detail, and then conduct a careful mental state and nervous system examination. The diagnostic criteria formulated by my country in 1993 are as follows:

(1) Dementia confirmed by intelligence test.

(2) There are at least 2 identifying dysfunctions.

(3) Progressive aggravation of memory and recognition impairment.

(4) Unconscious disturbance.

(5) Onset at the age of 40 to 90.

(6) No other physical or brain disease can explain the above condition.

(7) Other supporting conditions:
① Progressive aphasia, apraxia, and agnosia.

② Daily life and behavior disorders.

③ There are similar patients in the family.

④ The cerebrospinal fluid is normal, the EEG has no specific changes, and CT shows brain atrophy, which is progressively aggravated.

2. Ten early warning signs of dementia

(1) Instant forgetting: Everyone forgets things, but normal people can recall them afterwards.People with dementia often forget things, never remember them, and may ask the same question over and over, forgetting earlier answers.

(2) Forget about the past and forget the future: Alzheimer patients may forget to serve the meal after preparing it, or even completely forget the meal that has been prepared.

(3) Words do not express meaning: patients may even forget some simple words, or cannot use appropriate words and phrases, and their language expression is obviously not as good as before.

(4) Confusion in the concept of time and place: patients may have confusion in the concept of time or get lost in the streets and gates of their own residence, forget how they got out of the house, and do not know how to go home.

(5) Decreased judgment: Even normal people may distract or forget the children they care for, but patients with dementia may completely forget the children they care for and leave the house.Or easily deceived into buying an obvious "fake".

(6) Loss of abstract thinking ability: patients often forget the passbook password they set, and the amount of their savings is also completely forgotten.

(7) Misplaced items: Patients often place items in inappropriate places, such as putting an electric iron in the freezer, or putting a watch in a biscuit box, or keeping a lot of waste products such as rotten paper and cloth heads as treasures , I don't know why.

(8) Changes in temper and behavior: people will have some emotional changes when they are old, but the behavior and mood of patients with dementia may change drastically, from a calm state to a tearful state in just a few minutes. , or rise up against the table and burst into anger.

(9) Personality changes: The patient's personality may undergo drastic and unreasonable changes, such as being prone to fear, or being suspicious, suspicious of others, etc., which is quite different from the original personality.

(10) Loss of initiative: often becomes lazier than before, unwilling to participate in any activities, even activities that were originally liked, and not enthusiastic about people.These are some of the early warning signs of Alzheimer's.Of course, not all patients with early Alzheimer’s disease will have all the above symptoms, maybe only some of them, and some symptoms may be more prominent, but family members or patients themselves must pay attention to these symptoms, seek medical treatment in time, and take care of them early to prevent problems before they happen.

([-]) Treatment

There is no sure effective or curative method for this disease at present.Drugs used to treat AD fall into two main categories:
1. Increase the function of the cholinergic nervous system in the brain, mainly cholinesterase inhibitors and M-choline receptor agonists.

2. A cell protective agent acting on the neurotransmission system to delay the degeneration process of brain neurons and achieve the purpose of preventing and treating AD.

Currently, there are only two drugs approved by the US FDA for the treatment of AD, namely tacrine (tacrine) and E-2020 (donepezi), both of which are cholinesterase inhibitors.

3. Other supportive therapies:

(1) Aluminum chelating agent (aluminum chelating agent): such as deferoxamine, can reduce the absorption of aluminum and the concentration of aluminum in brain tissue, and is well tolerated. There are some clinical and experimental evidences.

(2) Non-steroidal (NSAIDS) and steroidal anti-inflammatory drugs: they can alleviate the condition of some patients and are one of the candidate treatment strategies.

(3) Sex hormones: Supporters believe that estrogen replacement therapy for elderly women after menopause has a certain effect on dementia in elderly women.

(4) Drugs for improving brain metabolism: For example, Ginkgo biloba extract can improve neuron metabolism and have a positive effect on neurotransmitters; a large amount of Naofukang can delay the progression of AD patients and improve naming and near and far memory.

(5) Calcium ion antagonists: such as nimodipine, etc. Recent studies have shown that cell overload and calcium homeostasis imbalance caused by various reasons are the final general pathway of cell death.

(6) Gene therapy: the use of recombination technology to replace defective genes with normal genes to achieve the goal of eradicating gene defects is not yet possible.The input of exogenous nerve growth factor can effectively prevent the damage of the central cholinergic nervous system, and improve the learning and memory of animals; there has been the first report of using nerve growth factor to treat AD; 1 month after intracerebral injection, the memory of serial words Improvement, but no change in other cognitive functions.

(7) Acupuncture and moxibustion: Acupuncture, moxibustion, massage, massage, etc. are often used to stimulate the muscles of Baihui, Sishencong, Fengchi, Xinshu, Jueyinshu, Ganshu, Shenshu, Dazhong, Juegu, and Foot Sanli and other points.

([-]) Prevention

1. Daily life
① Have a regular life, ensure enough sleep, take a nap, watch TV for too long, and have a moderate sex life.

②The diet should be light, with a variety of varieties, ensure the supply of protein, eat more foods rich in vitamins and cellulose, eat less animal fat, eat a diet low in salt and sugar, and control aluminum intake.Eat in moderation and don't overeat.Quit smoking and drink alcohol in moderation.

③ Actively use the brain and combine work and rest.Generally, you should rest for 1 minutes after using your brain continuously for 15 hour.Diversified mental activities, such as reading books, playing chess, doing intellectual games, etc., or going to a university for the elderly to study subjects you like.If patients have sleep disorders, they need to arrange their work and rest time reasonably and gradually improve their sleep status in order to benefit their mental recovery.

④ Do appropriate physical exercise, step by step, stop in moderation, and avoid strenuous exercise.

⑤Maintain a warm and harmonious family atmosphere and a comfortable and beautiful living room environment, and carry out some beneficial activities at home, such as growing flowers, raising fish, drawing, etc.

2. Emotional conditioning
① Maintain an optimistic mood, participate in more group activities, and accept more beneficial external stimuli to delay brain function decline.Such as: reading, reading newspapers, playing chess, listening to music, etc., play an important role in preventing mental decline.

②Communicate more with others and maintain good interpersonal relationship.

③Create a harmonious family environment, it is recommended to live with children, maintain emotional stability, and try to avoid bad emotional stimulation.

④ Pay attention to intellectual training, including memory, comprehension, calculation, and orientation.

3. Qigong Therapy Qigong is an activity that achieves self-physical and physical exercise and physical fitness through regulating qi and calming the mind.After the human body enters tranquility, the spirit is stored in the heart, the essence is returned to the kidneys, the soul is returned to the liver, and the mind is kept in the dantian, so that the kidney essence is sufficient, the marrow sea is filled, the brain is enriched, and the memory can be restored.Modern research has found that qigong can order the electrical activity of cerebral cortex cells, coordinate the functions of the two hemispheres of the brain, provide a good environment for brain activities, tap the potential of the brain, adjust the function of autonomic nerves, create the best mood, and increase wisdom.

[-]. Point massage

([-]) Acupuncture therapy

1. Select acupoints from Baihui, Fengchi, Dazhui, Shenshu, Mingmen, Neiguan, Zusanli, Fenglong, Sanyinjiao, Taixi, and Yongquan.

2. Locate Baihui—on the midline of the top of the head, 5 inches in front of the hairline.

Fengchi - Neck, under the occipital bone, level with Fengfu, in the depression between the trapezius muscle and the upper end of the sternocleidomastoid muscle.

Dazhui—in the depression under the spinous process of the seventh cervical vertebra.Shenshu—below the spinous process of the second lumbar vertebra, 1.5 cun laterally.Mingmen—in the depression under the spinous process of the second lumbar vertebra.Neiguan—inner forearm, 2 cun above the transverse wrist crease, between the palmaris longus tendon and flexor carpi radialis tendon.

Zusanli - 3 inches below the calf's nose, a finger across from the front edge of the tibia.

Fenglong—8 inches above the tip of the lateral malleolus, two fingers apart from the front edge of the tibia.

Sanyinjiao—3 cun above the tip of the medial malleolus, on the posterior border of the medial tibia.Taixi—the midpoint of the line between the tip of the medial malleolus and the Achilles tendon.

涌泉—足底部，当足第2、3趾趾缝纹头与足跟连线的前1/3和后2/3交点上。

([-]) Self-massage

1. Push the head with two palms and four fingers on the ventral side, push from the front hairline through Baihui point, to the back hairline, then pass through Dazhui point, and press more forcefully on Baihui point and Dazhui point.Then push the Gallbladder Meridian of Foot Shaoyang on both sides of the head, from the front hairline to the back hairline, emphatically push the Fengchi point in it.Finally, wipe the forehead with four fingers, from Yintang to temple.Push each part for 5 minutes.

2. Dry face cleansing Put both hands flat on the face, put five fingers together, rub up and down, do face washing movements, and take the heat through the face as the degree.

3. Acupuncture Use the thumb, index finger or middle finger to rotate left and right and gently press Baihui, Shuangneiwaiguan, Shuanglaogong, Shuangzusanli and Shuangyongquan points 50 times each. 4. Wipe the soles of the feet with the Laogong point on the palms and the Yongquan point on the soles of the feet, with the degree of diathermy.

5. Kowtow Tap the whole head with the fingers of both hands for about 5 minutes.

(End of this chapter)