بیماری‌هامراقبت‌های بهداشتیپزشکی و سلامتتغذیهطب سنتی

EATING DISORDERS AND TRADITIONAL CHINESE MEDICINE

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EATING DISORDERS AND TRADITIONAL CHINESE MEDICINE

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Background: What is an Eating Disorder? Four types of eating disorders are looked at in this study: *Binge Eating Disorder (BED), *Bulimia Nervosa (BN), *Anorexia Nervosa (AN), *Eating Disorders Not Otherwise Specified (EDNOS).

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Anorexi a Nervosa Bulimia Nervosa Binge Eating Disorde

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WM Relationship of ED to each 2-2 ا ۱ (©000© عسوت) ناذا سج 00 تا

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Eating Disorders and Chinese Medicine *Eating disorders are a modern concept *Critical reviewed research * Anecdotal evidence

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To determine: * The patterns of disharmony involved in eating disorders *To develop a treatment model based on these findings to help guide practitioners to treat those with an eating disorder

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Methodology- PSI Data is obtained from two surveys Both surveys had questions on: + Individual’s age and gender * General health For those with an eating disorder additional questions on: * Diagnosis and treatment of their eating disorder * Specific signs

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Survey *333 respondents, 137 excluded remaining respondents, all female 0 + 13 BED (6.6%) + 26 EDNOS (13.3%) * 36 BN (18.4%) * 67 AN (34.2%) + 54 No ED ((21.4%) *67.6% had a formal diagnosis

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ل ایا 1192۵۸ *We identified the Patterns of disharmony relevant to Eating Disorders *Pattern allocation according to the three references: WHO (2007), Deng (2000) and Wiseman (1998) *Symptoms matched to a checklist according to Berle et al methodology. *The check list symptoms are counted (as a percentage) Berle, C., Cobin, D., Smith, N., Zaslawski, C. A novel methodological approach to Fee ete ne-feltetat-VM@iateet= Mee ettat emcee (enat ae cee ste eee ‏ا‎

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Thirst Foul Breath Hyperorexia Oliguria with dark urine Constipation Ulceration of the mouth or gingivitis Scorching pain of the Stomach that refuses pressure Preference for cold fluids Acid up flow Rapid hungering Swelling and pain of the teeth Scorched lips

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Thirst Foul Breath Hyperorexia Oliguria with dark urine Constipation Ulceration of the mouth or gingivitis Scorching pain of the Stomach that refuses pressure Preference for cold fluids Acid up flow Rapid hungering Swelling and pain of the teeth Scorched lips Total 6/12 Conversion to % 6/12 x 100 = 8

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تنا Table 1 has the mean PSI's for each of the specific patterns separately for each eating disorder and those with no eating disorder. For those without an eating disorder, the most strongly expressed patterns were: 1.Liver Qi Depression 2Spleen and Kidney Yang Deficiency 3.Liver Qi invading the Stomach

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Results For those with an eating disorder of any type, *Liver Qi Depression, *followed by Spleen and Stomach Deficiency Cold, are the two most strongly expressed TCM patterns Figures 1-21 shows the mean PSI for each pattern.

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Results Spleen Qi Deficiency ۳4

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Results: Comparing those with and eating disorder to no eating disorder The top three patterns for which the differences in mean PSI's are largest are: Spleen Qi deficiency, Spleen and Stomach Deficiency Cold, Heart Qi Deficiency Liver Qi Stagnation and Stomach Heat, Spleen Qi Deficiency, and Heart Qi Deficiency

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Results: Comparing those with and eating disorder to no eating disorder The top three patterns for which the differences in mean PSI's are largest are: Spleen and Stomach Deficiency Cold, Liver Qi Stagnation and Stomach Heat and Spleen Qi ۱9 ‏هریت هار3‎ Stomach Yin Deficiency, Liver Qi Depression and Heart Qi Deficiency

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Application to treatment Proposed treatment model: Combining * The sufferer’s top PSI patterns * And the patterns that in general present with the greatest difference in mean from those with no eating disorder.

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۸۵۵۵۱۱6۵۲۱۵۱ ۵ ۲ continued.. ¢ Liver Qi Stagnation and Spleen Qi deficiency * Spleen Qi deficiency, Spleen and Stomach Deficiency cold and Heart Qi deficiency

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86۱6۴۲ ۶۵۲ ۲۱۱5 ۲ protocol Method to focus treatment. Individual treatment. Easy to administer Doesn’t require extensive experience or understanding of eating disorders.

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Understanding Eating Disorders from a TCM perspective * Eating disorders can be identified as an autonomous TCM category. * Liver Qi stagnation and Spleen and Stomach Deficiency cold are strongly exhibited by sufferers of eating disorders of any type

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للة مغ لإاااهء أاععم 5 * Evidence that - Spleen Qi deficiency and ~ Heart Qi deficiency are involved in AN. (1+ and 3" highest deviations from those with no eating disorder) * Involvement of Spleen and Stomach Deficient Cold

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Specifically to BN * AN and BN present broadly similarly but... - Liver greater role in BN - Spleen and stomach greater role in AN * Stomach heat anecdotal pattern theory partially ‏يت‎

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Specifically to EDNOS and BED - Evidence supports WM theory that EDNOS is a way station from BN or AN to recovery - This could inform how treatment could help prevent relapses. - BED separate syndrome to EDNOS, BN and AN.

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Further Research Validating the survey An evaluation of the proposed treatment protocol Prevention of relapse Effect of emotional component

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Conclusion Added to knowledge on how eating disorders categories present in TCM. Support for the WM theory. Development of a treatment guide for eating disorder treatment. Support anecdotal evidence Spleen Qi Deficiency in AN Adds others patterns not previously mentioned (Spleen and Stomach Deficiency Cold)

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Acknowledgements VICTORIA ANEW UNIVERSITY | $001 oF * British Acupuncture Council- Particularly Nigel * Acupuncture Research Resource Centre- Particularly Mark Bovey

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