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OSTEOPOROSIS

GENERAL

Clinical Manifestations	Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Osteopenia, by definition, is a condition of bone that is slightly less dense than normal bone but not to the degree of bone in osteoporosis. Normal bone is composed of protein, collagen, and calcium, all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebrae of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis although osteoporosis-related fractures can occur in almost any skeletal bone.
Treatment Principle
Herb Formulas
Points

SPLEEN QI DEFICIENCY

Clinical Manifestations	Sallow complexion Fatigue Anorexia Four limbs feel tired and heavy Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose stools Shortness of breath T: Pale and flabby - may have teethmarks C: White P: Even, forceless and deficient
Treatment Principle	Strengthen the Spleen Benefit Qi
Herb Formulas	Shen Ling Bai Zhu San
Points	LIV-13, REN-12, SP-3, SP-5, SP-6, ST-36, UB-20

SPLEEN QI DEFICIENCY WITH KIDNEY YIN AND YANG DEFICIENCY

Clinical Manifestations	Lower and upper back soreness and limpness Fatigue Lassitude Weakness Malar flush Cold lower half of the body Dizziness Tinnitus Nocturia Decreased sexual desire Poor appetite Loose stools T: Thick and red C: Scanty P: Surging or Soggy or Thready and wiry or Deep, thready and floating
Treatment Principle	Strengthen the Spleen Tonify Qi Supplement Yin and Yang Clear Deficiency Heat Strengthen the low back and bones
Herb Formulas	Bu Yin Tang
Points	GB-39, KI-7, SP-6, UB-11 + Choose according to location: Ahshi, DU-3, DU-4, DU-5, DU-14, UB-22, UB-23 , UB-24, UB-25, UB-26, Yaoyan For severe Spleen Deficiency: + ST-36 For low back pain and digestive problems: + SP-4 For buttock pain: + UB-54 For cold pain in the low back, buttocks and lower limbs: + moxa or moxa needle UB-36, UB-54, UB-57 For lumbosacral and coccygeal pain: + UB-32, UB-33, UB-34, UB-35

SPLEEN AND KIDNEY YANG DEFICIENCY

Clinical Manifestations	Body cold Limbs icy Complexion white and shiny Low back, knees and abdomen feel cold and painful Lower abdomen feels cold and painful Fatigue Lassitude Lack of strength Poor appetite Loose stools containing undigested food “Cock-crow” diarrhea (occurs at about 5 am) Edema of face and limbs Dysuria Severe: Abdominal ascites T: Pale, moist and swollen C: Thin and white or White and greasy P: Deep, thready, weak and maybe slow
Treatment Principle	Warm and Reinforce the Spleen and Kidneys Tonify Qi Tonify Yang Strengthen the low back and bones
Herb Formulas	You Gui Yin modified
Points	Moxa or moxa needle GB-39, KI-7, UB-11 + Choose according to location: Ahshi, DU-3, DU-4, DU-5, DU-14, UB-22, UB-23 , UB-24, UB-25, UB-26, Yaoyan For severe Spleen Deficiency: + ST-36 For low back pain and digestive problems: + SP-4 For buttock pain: + UB-54 For cold pain in the low back, buttocks and lower limbs: + moxa or moxa needle UB-36, UB-54, UB-57 For lumbosacral and coccygeal pain: + UB-32, UB-33, UB-34, UB-35 Moxa or moxa needle REN-4, REN-12, SP-6, SP-9, ST-36, UB-20, UB-23

LIVER AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Osteoporosis Light-headedness Vertigo Tinnitus Soreness and weakness in low back and legs Spontaneous and nocturnal emissions Night sweats Dry mouth and throat Thirst with a desire to drink Dizziness Forgetfulness Deafness Rhinitis Dribbling of urine Malar flush Five Sole Heat Insomnia Hair loss Loss of teeth Infertility Amenorrhea Uterine bleeding Spontaneous perspiration Spermatorrhea Poor vision T: Red and shiny C: Little or None P: Thready and rapid
Treatment Principle	Nourish Yin Tonify the Kidneys Supplement Jing Benefit Marrow
Herb Formulas	Zuo Gui Wan
Points

LIVER BLOOD AND KIDNEY YIN DEFICIENCY

Clinical Manifestations	Lower and upper back pain Knee and lower leg pain and weakness Tinnitus Dizziness Insomnia A pale facial complexion Malar flush in the afternoon T: Red C: Little or None P:Thready, wiry and rapid
Treatment Principle	Tonify the Kidneys Nourish the Liver Strengthen the low back and knees
Herb Formulas	Zuo Gui Yin modified
Points	GB-39, KI-7, UB-11 + Choose according to location: Ahshi, DU-3, DU-4, DU-5, DU-14, UB-22, UB-23 , UB-24, UB-25, UB-26, Yaoyan For severe Spleen Deficiency: + ST-36 For low back pain and digestive problems: + SP-4 For buttock pain: + UB-54 For cold pain in the low back, buttocks and lower limbs: + moxa or moxa needle UB-36, UB-54, UB-57 For lumbosacral and coccygeal pain: + UB-32, UB-33, UB-34, UB-35

KIDNEY YANG DEFICIENCY

Clinical Manifestations	Osteoporosis Lumbago: low back feels cold, weak and aching Feeling chilled Aversion to Cold Cold limbs General debility Pale face Urinary frequency with abundant, clear urine or Oliguria with edema Maybe nocturia Lassitude Withdrawn, subdued behavior Knees feel cold and aching Dizziness Tinnitus Impotence Spermatorrhea Premature ejaculation Low libido Female infertility ("uterus cold and infertile") Maybe anorexia Maybe loose stools Maybe chronic diarrhea or "cock crow" diarrhea T: Pale and swollen C: Thin and white P: Deep and thready - maybe slow
Treatment Principle	Warm and Reinforce Kidney Yang
Herb Formulas	You Gui Wan
Points	Moxa or moxa needle DU-4, KI-3, REN-4, UB-23 For chronic diarrhea, rectal prolapse and Vanquished Yang: + moxa DU-20, REN-8 For Kidney Yang Deficiency impotence: moxa or moxa needle DU-4, DU-20, KI-3, REN-4, UB-23 For Kidney Yang Deficiency (Cock Crow) Diarrhea: moxa or moxa needle DU-20, KI-3, REN-4, UB-23

KIDNEY YANG DEFICIENCY WITH WATER FLOODING

Clinical Manifestations	Edema of whole body particularly at and below the waist Pitting edema Low back pain, aching and heaviness Abdominal distention with full sensations Oliguria Cold limbs Face gray and congested or pale Feeling nervous and cold with mental weariness In severe cases: Ascites Edema of scrotum T: Pale and swollen C: Thin, white or Thick, white and sticky P: Deep and thready With Water Flooding the Lungs: Cough with copious, thin watery phlegm Asthma with phlegmy sound (wheezing) Dyspnea Facial edema Edema of limbs Dysuria T: Pale and swollen C: White and moist or White and greasy P: Superficial and tight
Treatment Principle	Warm Kidneys Promote diuresis
Herb Formulas	Ji Sheng Shen Qi Wan Jia Wei Shen Qi Wan
Points	KI-7, REN-6, REN-9, SP-6, SP-9, ST-28, ST-36, UB-20, UB-22, UB-23, UB-39

KIDNEY YIN AND YANG DEFICIENCY WITH JING AND BLOOD INSUFFICIENCY IN THE DU, CHONG AND REN CHANNELS

Clinical Manifestations	Osteoporosis Emaciation Weakness Spermatorrhea Blurred vision Aching and weak low back and knees Daybreak diarrhea Weight loss Dizziness Nocturnal emissions T: Pink or Pale C: White or None P: Thready and frail or Deep, slow and weak
Treatment Principle	Nourish and replenish Yin Tonify Jing Augment Qi Tonify and strengthen Yang Nourish the Blood
Herb Formulas	Gui Lu Er Xian Jiao
Points

KIDNEY JING DEFICIENCY

Clinical Manifestations	Dizziness Tinnitus Low back and knees weak and aching In adults: Hair loss Graying or whitening of the hair Weak sexual function Atrophy and weakness of the feet with difficulty walking Poor memory Senility (premature or mature) Brittle bones Gradual deterioration of the hearing In children: Retardation in mental and/or physical development Failure to thrive Late or incomplete closing of the fontanel Poor bone development Brittle bones
Treatment Principle	Reinforce the Kidneys Benefit Jing
Herb Formulas	Zuo Gui Wan Gu An Fang With Liver Blood Deficiency: Qi Bao Mei Ran Dan Sheng Fa Yin
Points	DU-4, HT-7, KI-3, REN-4, UB-11, UB-15, UB-23 DU-4, KI-3, REN-4, moxa UB-11, UB-23

QI AND BLOOD STAGNATION

Clinical Manifestations	This syndrome may accompany any of the others but is not usually the causative factor Enduring bodily pain which may be fixed in location and/ or severe in intensity A dark, sooty facial complexion Age spots Varicosities Cherry hemangiomas Spider naevi Purple lips and nails T: Purple with possible static macules or spots C: White P: Wiry and choppy
Treatment Principle	Invigorate the Blood Unblock the channels Stop pain
Herb Formulas	Shen Tong Zhu Yu Tang
Points	DU-26, SI-3 + Choose according to location: Ahshi, DU-3, DU-4, DU-5, DU-14, UB-22, UB-23 , UB-24, UB-25, UB-26, Yaoyan For severe Spleen Deficiency: + ST-36 For low back pain and digestive problems: + SP-4 For buttock pain: + UB-54 For cold pain in the low back, buttocks and lower limbs: + moxa or moxa needle UB-36, UB-54, UB-57 For lumbosacral and coccygeal pain: + UB-32, UB-33, UB-34, UB-35