Left side face numbness for 2 weeks

Name of Student Clinician: Johnson Su

Name of Supervisor: Jessica

Patient: XXX

Date of First Visit: 3/6/08

Sex: M

Age: 26

	Description
CHIEF COMPLAINT:	Left side face numbness for 2 weeks.
DESCRIPTION: (4 diagnostic methods)	.
A) Asking
Present illness complaints:	The patient went to Rotorua for holiday and it is winter when the patient went there. He was in the spa for too long and the spa pool was outside. It was really cold and windy that day. After coming back to Auckland from Rotorua, the patient felt that the left side of the face is numb and he can not drink water and the water will leak out from the lips. The eyes can not close and tears will come out from the eyes when shitting the eyes. It is on the left side of the face, the patient can not frown and can not smile, only half of the face can smile and frown and other half can not. No chill or fever, appetite good, defecation normal and urination normal. Sleeping is good, but when the patient sleeps at night the eyes can not close properly. Sweating normal. Mild lower back pain. No tinnitus, no hot flushes, no cold limbs and no bitter mouth and no dry mouth. Sometimes thirsty and like to drink cold water and gets tired easily.
Past history including past health conditions and other previous illness:	NAD.
Life Style:	BUSY STUDENT.
Family history:	NAD
Menstruation, marital & obstetrical history / Men’s sexual health	SINGLE.
B) Inspection
General:	Small body built; normal facial complexion, normal moving states and body shape: small body built.
Others:	NAD
Tongue:	Red big swollen tongue body with big red Spots and yellow coating and red tip. Crack on center.
C) Ausculation / Olfaction
Sound:	Voice is normal and breathing is normal
Odours:	NAD
D) Palpation
Body Areas:	NAD
PULSE	wiry , thin and weak in chi ( kidney both side)

Case Summary

FACIAL PALSY:

Definition: A disease characterized by deviation of the mouth and eye due to motor impairment of the facial muscles.

BELL PALSY:

NON- SPECIFIC INFLAMMATION OF FACIAL NERVE

TCM ETIOLOGY AND PATHOLOGY:

· DEFICINECY OF DEFENDING QI AND EMPTY COLLATERAL

· INVASION OF PATHOGENIC WIND.

TCM SYDNDROME DIFFERENTIATION:

1. ATTACK BY WIND COLD

SUFFER COLD BEFORE

NORMAL TONGUE THIN WHITE COATING FLOATING AND TENSE PULSE

2. ATTACK BY WIND HEAT

HAD FEVER/ INFECTION HISTORY BEFORE

PAIN INSIDE EARS OR AROUND MASTOID PROCESS

RED TONGUE, THIN YELLOWISH COATING AND FLOATING AND RAPID PULSE.

DIAGNOSIS:
TCM Disease:	Wiry face / FACIAL PARALYSIS.
TCM type/pattern:	Qi and blood deficiency and invasion of the exogenous wind cold pathogenic attacking the exterior of the skin and kidney yin deficiency.
C) Explanation:	The wry face showed by deviation of eye and mouth means facial paralysis and mostly occurs during winter and autumn time, This patient happened in winter time and this can occurs any age and this patient is quite young to get this kind of disease. It is more frequently in males. When body is weak the meridians are empty, the pathogen gets inside and blocks the flow of Qi, this results in a lack of nourishment to the tendons and muscles. Can become chronic, this causes an eventual Yin deficiency with Heat and/or deficiency Wind. This condition may cause the deviation to move to the other side of the face. The deviation of the eyes and mouth is due to paralysis of the facial muscle caused by attack of the pathogenic wind and coldness when the patient went to Rotorua in cold and windy winter caused attack of the pathogenic factors on the yangming and shaoyang channel, which leads to malnutrition of the muscle and the channels. This is a sudden onset when patient came back from Rotorua and one side of the face which is the affected side ( left side mainly) has numbness feeling and even muscles paralysis unable to frown and eyes can not closed, inability to swallow. Etc…QI deficiency due to easily tired. Yin deficiency includes the red tongue body with big red spots and thin pulse. And crack in the center for tongue.
TREATMENT:
A) Treatment Principle	Dispelling pathogenic wind and cold and removing obstruction from the channels and tonify qi and blood, tonify kidney yin.
B) Treatment Method	.
1. Needling
Select techniques:	Filiform ( / ) three edged needle ( ) plum blossom ( ) intradermal ( )
Select Acu-points and Manipulation:	Hegu ( tonify ) Zusanli-( tonify_) Fenchi, ( reduce_ Xiaguan: tonify Weiguan: reduce Dicang: tonify Jiache: tonify Quanliao: tonify Sibai : tonify Cuanzhu: tonify
Explain the reasons for your selection:	Hegu ( tonify )- for used to promote the circulation of qi and large intestine and stomach channels and they can eliminates the pathogenic wind form the head and facial area. Used filform needling to promote qi in the large intestine and stomach channel. Zusanli-( tonify_)for used to promote the circulation of qi and large intestine and stomach channels and they can eliminates the pathogenic wind form the head and facial area. Used filform needling to promote qi in the large intestine and stomach channel Fenchi, ( reduce_- to eliminates pathogenic wind from San Jiao cahnnel and GB channel and stop pain, used filform needlng to eliminates the pathogenic wind. Weiguan: reduce_- to eliminates pathogenic wind from San Jiao cahnnel and GB channel and stop pain, used filform needlng to eliminates the pathogenic wind. Xiaguan: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face. Dicang: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face. Jiache: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face. Quanliao: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face. Sibai : tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face. Cuanzhu: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face.
2. Moxibustion
Select techniques:	moxa cone ( ) moxa roll ( ) indirect moxa ( )
Select Acu-points:
Explain the reasons for your selection:
3. Cupping	N/A
Select techniques:	Stationary ( ) mobile ( )
Select Acu-points retention time:
Explain the reasons for your selection:
4. Microsystem
Select Microsystems:	Ear ( ) hand ( ) foot ( ) scalp ( ) nose ( ) brow ( ) dentition ( )
Points	.
Diagnosis is confirmed by across checking with at least one other Microsystems system:
Explanation the reasons of your selecting:
5. Lifestyle Advice:	Do regular exercise. Massage the face to loose hardness. Avoid wind and cold weather we going out maybe needle something To cover the face area.

Follow Up Consultations

Patient Name: Treatment Number: 2

TCM Disease: WIRY FACE/ FACIAL PALSY.

TCM Types/Pattern: Qi and blood deficiency and invasion of the exogenous (cold and wind) pathogenic factor attacking the exterior of the skin and kidney yin deficiency.

Date: 5/06/08

Current Condition/Changes:

The palsy becomes better.

Before she smiles her feel stiffness on the face but now much better.

Treatment Principle Dispelling pathogenic wind and cold and removing obstruction from the channels and tonify qi and blood, tonify kidney yin.

Prescription This time I used electrical needling and to stimulate the effected area. I have connected mustly on the local area of the face.

Hegu (tonify)

Zusanli-( tonify_)

Fenchi, ( reduce_

Xiaguan: tonify

Weiguan: reduce

Dicang: tonify

Jiache: tonify

Quanliao: tonify

Sibai : tonify

Cuanzhu: tonify

Explanation:. Hegu (tonify) - for used to promote the circulation of qi and large intestine and stomach channels and they can eliminates the pathogenic wind form the head and facial area. Used filform needling to promote qi in the large intestine and stomach channel.

Zusanli-( tonify_)for used to promote the circulation of qi and large intestine and stomach channels and they can eliminates the pathogenic wind form the head and facial area. Used filform needling to promote qi in the large intestine and stomach channel

Fenchi, ( reduce_- to eliminates pathogenic wind from San Jiao cahnnel and GB channel and stop pain, used filform needlng to eliminates the pathogenic wind.

Weiguan: reduce_- to eliminates pathogenic wind from San Jiao cahnnel and GB channel and stop pain, used filform needlng to eliminates the pathogenic wind.

Xiaguan: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face.

Dicang: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face.

Jiache: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face.

Quanliao: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face.

Sibai : tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face.

Cuanzhu: tonify are local points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face.

Lifestyle Advice: Do regular exercise.

Massage the face to loose hardness.

Avoid wind and cold weather we going out maybe needle something

To cover the face area

WMS:

Bell's palsy

Bell's palsy is a paralysis of cranial nerve VII (the facial nerve) resulting in inability to control facial muscles on the affected side. Several conditions can cause a facial paralysis, e.g., brain tumor, stroke, and Lyme disease. However, if no specific cause can be identified, the condition is known as Bell's Palsy. Named after Scottish anatomist Charles Bell, who first described it, Bell's palsy is the most common acute mononeuropathy (disease involving only one nerve), and is the most common cause ofacute facial nerve paralysis.

Bell's palsy is defined as an idiopathic unilateral facial nerve paralysis, usually self-limiting. The trademark is rapid onset of partial or complete palsy, usually in a single day.

It is thought that an inflammatory condition leads to swelling of the facial nerve. The nerve travels through the skull in a narrow bone canal beneath the ear. Nerve swelling and compression in the narrow bone canal are thought to lead to nerve inhibition, damage or death. No readily identifiable cause for Bell's palsy has been found, but clinical and experimental evidence suggests herpes simplex type 1 infection may play a role.

Doctors may prescribe anti-inflammatory and anti-viral drugs. Early treatment is necessary for the drug therapy to have effect. The effect of treatment is still controversial. Most people recover spontaneously and achieve near-normal to normal functions. Many show signs of improvement as early as 10 days after the onset, even without treatment.

Often the eye in the affected side cannot be closed. The eye must be protected from drying up, or thecornea may be permanently damaged resulting in impaired vision.

Case Conclusion

The TCM diagnosis is wiry face or facial paralysis and TCM syndrome differentiation is Qi and blood deficiency and invasion of the exogenous (wind cold) pathogenic attacking the exterior of the skin and kidney yin deficiency. And treatment principle is dispelling pathogenic wind and cold and removing obstruction from the channels and tonifies qi and blood, tonify kidney yin. The wiry face is occurs mostly in the winter period. The patient went to Rotorua and was invaded by exogenous pathogenic attacking the exterior of the skin. The Mostly affects young adults, acute, usually one side of the face is affected, can’t close eye, or mouth, causes tearing and drooling. When body is weak the meridians are empty, the pathogen gets inside and blocks the flow of Qi, this results in a lack of nourishment to the tendons and muscles. Can become chronic, this causes an eventual Yin deficiency with Heat and/or deficiency Wind. This condition may cause the deviation to move to the other side of the face. I have treated this patient twice and the points used are Hegu Zusanli, Fenchi, and Xiaguan: Weiguan: Dicang: Jiache: Quanliao, Sibai and Cuanzhu. Hegu and zusanli for )- for used to promote the circulation of qi and large intestine and stomach channels and they can eliminates the pathogenic wind form the head and facial area. Used filform needling to promote qi in the large intestine and stomach channel. And Fengchi and Weiguan are used to promote the circulation of qi and large intestine and stomach channels and they can eliminate the pathogenic wind form the head and facial area. Used filform needling to promote qi in the large intestine and stomach channel. Xiaguan: Dicang: Jiache: Quanliao,Sibai and Cuanzhu are used for points they can promote the qi of the effected side. Used filfrom needling to promote the qi on the effected side of the face. The 2^nd treatment I used electrical needling to stimulate the effected area and good for treat numbness of the face, the points are mainly chosen for local area like Xiaguan: Dicang: Jiache: Quanliao, Sibai and Cuanzhu. I have learned that this case is very common case and this have to be treated as soon as possible, if no treatment ahs been done after 2 week or more, it main have side effect. Acupuncture is great for this kind of disease and good to stimulate the nerve around the face on the effected area. The stimulation can not be too strong maybe the patient will felt worse. Therefore lifestyle advice is given to patient after treatment. During the treatment avoid the wind cold to affect eh face and massage the face and warm the face will be really helpful. Prevention infection of the eyes is strongly considered, the patient can use eyeshade and eyes drop two or three times a day to avoid infection in the eyes. I would consider these points if the TCM diagnosis and TCM pattern are the same.

REFERENCE

SOURCE FROM WIKIPEDIA FOR WMS.

http://en.wikipedia.org/wiki/Bell's_palsy

.TCM SOURCE from

1. NZCCM AUCPUNCTURE THERPEUTIC- Disease of nervous /cardiovascular /blood/endocrine system and health care.

2. ACUPUNCTURE AND MOXIBUSTION- ACADEMY PRESS- BY BEIJING UNIVERSITY OF TCM. Printed in 1999 october.

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Ankle joint pain

Record of first visit: 2/03//2009 Name: xxx

Gender: Male Ages :

Address : XXXXXX auckland city

Chief complains:R. foot pain for 3 days

W.S :Ankle Bursitis

Descriptions /
Asking /
Present illness complains:

The patient felt very painful b/w 2'nd and 3'rd dorsal metatarsal bone of the right leg , he was difficult to walk about 3 days ago ,He felt distending pain and swollen from sole , dorsal and extend to beneath the lateral malleolus that felt congestion until now especially at 2pm to 6pm ,dislike to press ,no chill/fever ,normal sleeping (8 hours), thirsty but not drink more, prefer to warm drinks ,light yellow urine ,normal defecation sometimes loose stool but not serious ,normal appetite , a lot of dreams during sleeping ,no palpitation,or headache, take some painkillers to relieve pain due to the affected joint or joints become swollen, tender and red.

Past History: NAD

Lifestyle: full time student , optimistic

Family history: mother have hypertension for 15 years

Inspection

General: 8/10 vitality

Others: the complexion is luster

Tongue :dim red tongue body, thin- whitish coating

Auscultation/olfacation

Sound: NAD

Odours: NAD

Palpation
Body area: NDA
Pulse: Fast and slippery

Diagnosis: ankle joint pain

Syndrome Differentiation: wind cold dampness obstruct meridians

Treatment /

Principles: nourish blood/ yin, and activate / strengthen general qi to open channel , eliminate dampness

Methods:

Needling: TaiChong, yinlingquan, Xuehai , Wai guan , yangxi , yanggu (L .hand)

Explaination: TaiChong: soothing liver qi

yinlingquan to tonify body fliud ,

Xuehai reinforcing blood circulation

Wai guan :confluent point of yang-linking and sanjiao meridians ,

yangxi , yang gu : a pair of distal point to treat sick side area of the ankle
.
Life Style Advice: be prohibited to intake high greasy and high protein (high purine) food to prevent inflammation risk factors ,ask to drink more water to eliminate nitrogen wastes from urine , intake more fruits and vegetables to maintain the PH value balance of body ,

ALKALIZING FOODS
VEGETABLES Garlic Asparagus Fermented Veggies Watercress Beets Broccoli Brussel sprouts Cabbage Carrot Cauliflower Celery Chard Chlorella Collard Greens Cucumber Eggplant Kale Kohlrabi Lettuce Mushrooms Mustard Greens Dulce Dandelions Edible Flowers Onions Parsnips (high glycemic) Peas Peppers Pumpkin Rutabaga Sea Veggies Spirulina Sprouts Squashes Alfalfa Barley Grass Wheat Grass Wild Greens Nightshade Veggies	FRUITS Apple Apricot Avocado Banana (high glycemic) Cantaloupe Cherries Currants Dates/Figs Grapes Grapefruit Lime Honeydew Melon Nectarine Orange Lemon Peach Pear Pineapple All Berries Tangerine Tomato Tropical Fruits Watermelon PROTEIN Eggs Whey Protein Powder Cottage Cheese Chicken Breast Yogurt Almonds Chestnuts Tofu (fermented) Flax Seeds Pumpkin Seeds Tempeh (fermented) Squash Seeds Sunflower Seeds Millet Sprouted Seeds Nuts	OTHER Apple Cider Vinegar Bee Pollen Lecithin Granules Probiotic Cultures Green Juices Veggies Juices Fresh Fruit Juice Organic Milk (unpasteurized) Mineral Water Alkaline Antioxidant Water Green Tea Herbal Tea Dandelion Tea Ginseng Tea Banchi Tea Kombucha SWEETENERS Stevia SPICES/SEASONINGS Cinnamon Curry Ginger Mustard Chili Pepper Sea Salt Miso Tamari All Herbs ORIENTAL VEGETABLES Maitake Daikon Dandelion Root Shitake Kombu Reishi Nori Umeboshi Wakame Sea Veggies

ACIDIFYING FOODS
FATS & OILS Avocado Oil Canola Oil Corn Oil Hemp Seed Oil Flax Oil Lard Olive Oil Safflower Oil Sesame Oil Sunflower Oil FRUITS Cranberries GRAINS Rice Cakes Wheat Cakes Amaranth Barley Buckwheat Corn Oats (rolled) Quinoi Rice (all) Rye Spelt Kamut Wheat Hemp Seed Flour DAIRY Cheese, Cow Cheese, Goat Cheese, Processed Cheese, Sheep Milk Butter	NUTS & BUTTERS Cashews Brazil Nuts Peanuts Peanut Butter Pecans Tahini Walnuts ANIMAL PROTEIN Beef Carp Clams Fish Lamb Lobster Mussels Oyster Pork Rabbit Salmon Shrimp Scallops Tuna Turkey Venison PASTA (WHITE) Noodles Macaroni Spaghetti OTHER Distilled Vinegar Wheat Germ Potatoes	DRUGS & CHEMICALS Chemicals Drugs, Medicinal Drugs, Psychedelic Pesticides Herbicides ALCOHOL Beer Spirits Hard Liquor Wine BEANS & LEGUMES Black Beans Chick Peas Green Peas Kidney Beans Lentils Lima Beans Pinto Beans Red Beans Soy Beans Soy Milk White Beans Rice Milk Almond Milk

Case Summay

W.S : Ankle Bursitis
What is it? Bursitis (ber-SEYE-tis) is swelling and pain of a bursa. A bursa is a fluid-filled sac that acts as a cushion or shock absorber between a tendon and a bone. A tendon is a cord of tough tissue that connects muscles to bones. Normally a bursa has a small amount of fluid in it. When injured, the bursa becomes inflamed (red and sore) and may fill with too much fluid. Achilles (ah-KIL-eez) tendon bursitis is a type of ankle bursitis when the bursa between the Achilles tendon and the heel becomes inflamed. You may have Achilles bursitis and tendonitis (inflamed tendon) at the same time.

Cause and symptoms /
What causes ankle bursitis?

• Pressure on your ankle and heels. This is often caused by running or exercising on uneven ground. The way that you exercise may also cause ankle bursitis or make it worse. It may be caused by wearing poorly fitting shoes that constantly rub against the heel.
  

• Direct, hard hit to your heel.
• Infection (in-FEK-shun).
• Medical problems such as rheumatoid (ROO-ma-toid) arthritis (ahr-THREYE-tis) or gout.
• Over-using your ankles. This is caused by doing activities or sports that use the same motions (movements) over and over again. Examples of repeating motions are running, walking, or jumping.

• Sometimes people do not know how they developed ankle bursitis.

What are the signs and symptoms of ankle bursitis?

• Limping.
• Decreased movement. Your ankles may feel stiff or unable to move as well as they usually do.
• Pain or tenderness in the back of the ankle. It may be worse at the beginning of exercise, or when running uphill. You may also have pain when wearing shoes.
• Redness and warmth. If the bursa is infected, the skin over the heel may be red and warm. You may also have a fever.
• Swelling on the back of the heel.

Lifestyle Change

• Do not run if you have pain
• Stretch before exercising
• Wear heel protectors
• Wear well-fitting shoes

TCM
In Ankle joint pain,the procedures used in TCM to differentiate between disharmony patterns can be explained as follows:
Bi-syndrome due to wind, cold and dampness evils
From a TCM viewpoint, when the body's protective qi is weak, climatic and environmental factors (the exogenous evils such as wind, cold and dampness) can readily invade. They attack the superficial meridians and lead to stagnation of vital qi and blood. Although these three evils may make a combined attack on the body, one is usually dominant and different symptoms result:

	Wind evil causes migrating pain involving most limbs and joints.
	Cold evil results in localized and severe pain of the limbs and joints (which is relieved by heat and aggravated by cold) and impaired movement of the limbs.
	Dampness evil produces heaviness and numbness of the limbs, impaired movement of limbs, joint swelling (but without heat and redness) and localized pain.

On examination, the tongue is coated in a white thin fur. The pulse is tense and wiry, or taut and moderate.

Bi-syndrome due to wind, cold and heat evils
In the conflict between the exogenous evils and vital energy (qi), much heat is produced and the exogenous evils of wind and cold may be transformed into heat evil. Individuals not only suffer from joint and limb discomfort, but also present with general heat symptoms, such as hot and red joints, fever, thirst and sweating. On examination, the tongue is red and covered with yellow fur. The pulse is slippery and rapid.

Bi-syndrome due to phlegm and blood stagnation
In recurrent bi-syndrome, internal damage leads to the formation of phlegm and blood stasis, and symptoms become more serious. Joint pain can worsen and joints become deformed or swollen and movement is impaired. There is severe pain and numbness in the limbs and nodules form beneath the skin. On examination, the tongue is bulky and pink, with bruising, and covered with white and greasy fur. The pulse is thready and uneven.

Bi-syndrome with associated liver and kidney damage
When the circulation of blood and qi is affected over a long period, vital energy (qi) becomes exhausted. The accumulated evils then commonly damage organs such as the liver and kidneys. Individuals usually present with internal damage: fatigue, pallor, shortness of breath, spontaneous sweating, improper joint movement, and soreness and pain in the loin region. On examination, the tongue is pink in color. The pulse is fine or fine and weak.

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Fast weight gain for 4 years

Record of first visit: 5/03//2009

Name: xxx Gender: female Ages :45

Address :xxxxxxx

Chief complains : Fast weight gain for 4 years

Descriptions /

Asking /

Present illness complains:

Before she immigrant from China to New Zealand , Her's body weight was 52 kg only for four years ago ,now is fast

weight gain to 62 Kg ;

1.good appetite ,prefer to intake cold nature food ,chily , greasy food ,

2.no thirsty like to cold drinks , dislike to drink tea ,coffee , alcohol

3.easy sweating at day time , no chill or fever

4.normal urination

5.loose stool not watery , 2~3 days /week , 2~3 times /each day

6.tiredness , heaviness of whole body , can not talk a long time

7.no any pain feeling

8.fullness ,distention(abdominal ) after meal

Body Mass Index (BMI): 23.36 ( normal BMI 18~23)

Past History: R. shoulder pain

Lifestyle: full time student and part time job

Family history: mother have high blood pressure

Menstruation ,Marital and obsterical history : 13-5/28 , 14-02-2009 , married and one child

Inspection

General: 8/10 vitality

Others: pale complexion

Tongue :pale tongue body, whitish-thin coating , teeth mark

Auscultation/olfacation

Sound: lower voice

Odours: NAD

Palpation

Body area: NDA

Pulse: weak and deep(R) ; slippery (L)

TCM

According to TCM, the root of excess weight is an imbalance within the body caused by malfunctioning of the spleen and liver organ systems.

In five-element theory, the spleen is responsible for the proper functioning of the digestive system, ensuring that the food we eat is transformed into Qi — the vital substance of life. Disharmony of the spleen will have symptoms such as fatigue, slow metabolism, water retention, loose stool, and feeling of heaviness.

The liver’s job is to keep the flow of your body’s Qi and blood (as well as your emotions) running smoothly. Our modern, fast-paced lifestyle and chronic stress can negatively impact the liver’s ability to function properly and smoothly, which, in turn, can cause the spleen and the whole digestive system to function poorly and decrease your metabolism. Liver disharmony can also cause some of the “triggers” that lead to cravings and compulsive eating.

Diagnosis : Fast weight gain

Syndrome Differentiation: KI /SP yang def. , Qi & blood def.

Treatment /

Principles: for weight issues rooted in TCM promotes better digestion, smooths emotions, reduces appetite, improves metabolism, and eliminates food cravings.

Methods:

Needling: zusanli , tianshu , taixi, sanyinjiao,qi-hai, guanyuan

Explaination :

tianshu - Front Mu pt. of LI , ,improve loose stool, reducing heat
zusanli - strengthen Qi & blood , promote qi & blood circulation eliminatedampness in SP
sanyinjiao - tonify yin , nourish and keep calm HT/ brain , also strength ST/SP function
qi- hai - reiforce yang qi
guanyuan - front Mu pt. of LI for loose weight to ascending clear descending turbid

Life Style Advice:

Estimated Energy Requirement: 2235.0 (kcal /day ) should be reduce to 1500 ~ 1700( kcal / day) , if intake reducing down to 7500 kcal/week can loss equal 1 kg body weight , it is the best way to achieve the goal to (-)5~7 kg stay by stay, also need to intake nutrition balance and complete during the whole process.

Be prohibited to intake high greasy and high carbohydrate (sucrose , maltose) food ,drink more water and intake high crude fiber to eliminate nitrogen wastes from urine/stool , intake more vegetables to balance body PH value .

Your Recommended Ranges
Carbohydrate: 45 to 65% of total Calories
Fat: 20 to 35% of total Calories
Protein: 10 to 35% of total Calories

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