Anorexia

Anorexia is a syndrome manifested in body weight loss (below normal standard) due to initial fear of weight gain or excessive fear of obesity, resulting in inability to maintain the most basic normal body weight and causing dysfunction of the body in movement, amenorrhea, etc.

Anorexia

Related Health Condition
Introduction
Anorexia is a syndrome manifested in body weight loss (below normal standard) due to initial fear of weight gain or excessive fear of obesity, resulting in inability to maintain the most basic normal body weight and causing dysfunction of the body in movement, amenorrhea, etc. It is often seen in adolescent women and manifested in loss of appetite, or even aversion to food or inability to take food.
Etiology/Pathogenesis
Anorexia is mostly caused by limited food intake due to fear of obesity or to mental depression. It leads to deficiency of stomach-qi and spleen-qi, inability to take in food, and dysfunction of the spleen in transportation and transformation. In clinical practice, it is manifested in two types, deficiency-syndrome and excess-syndrome types.
Primary Treatments with Chinese Medicinal Herbs
Liao Wenhua, et al. treated 144 cases of infantile anorexia with a Jian Pi decoction. The decoction was made up of Tai Zi Shen (Pseudostellaria Root), Shan Yao (Dioscorea), parched Yi Ren (Coix), Shan Zha (Crataegus), Ji Nei Jin (Membrane of Chicken's Gizzard), Ban Xia (Pinellia), and Chen Pi (Citrus). The formula was modified according to the symptoms, and then decocted in water. The decoction was to be taken one divided dose a day (taken 3-4 times a day). One month constituted one therapeutic course of treatment. After treatment, 98 cases were resolved, 42 experienced improvement, and 4 had no apparent changes. The effectiveness rate was 97.2%.(1)
Other Treatments with Chinese Medicinal Herbs
Zhao Cheng Chun, et al. treated 118 cases of anorexia with a Kai Wei Jin Shi decoction. The decoction consisted of Ren Shen (Ginseng), Bai Zhu (White Atractylodes), Huang Qi (Astragalus), San Leng (Burreed Tuber), E Zhu (Zedoaria), Shi Chang Pu (Grassleaved Sweetflag Rhizome), Long Dan Cao (Gentiana Root), and Huang Lian (Coptis). For abdominal distension, Sha Ren (Amomum) and Hou Po (Magnolia Bark) were added. For vomiting, Sheng Jiang (Ginger) and Huo Xiang (Agastache) were added. For red tongue with little coating, Shi Hu (Dendrobium) was added. For thick greasy coating of tongue, Ji Nei Jin (Membrane of Chicken's Gizzard) and Cang Zhu (Atractylodes) were added. For constipation, Da Huang (Rhubarb) was added. These herbs were decocted in water to be taken once every other day. 3 doses constituted one course of treatment. The results followed after administration of 1-12 doses. 89 cases achieved normal appetite, gained body weight, and all their symptoms disappeared. 27 cases experienced improvement in appetite and most of the symptoms disappeared. 2 cases had no apparent changes in appetite and other symptoms.(2)
Liu Xi Yao, et al. used a Zi Shen pill to treat 20 cases of neurogenic anorexia with Shan Yao (Dioscorea), Sheng Di Huang (Rehmannia), Xuan Shen (Scrophularia), Fu Ling (Poria), Dang Gui (Chinese Angelica Root), Bai Zhu (White Atractylodes), Ji Nei Jin (Membrane of Chicken's Gizzard), and Niu Bang Zi (Arctium). These herbs were processed with honey into pills (1g/pill). These pills were taken orally, 10 pills a day, divided into 3 times per day. One month comprised one course of treatment. Psychological therapy was also conducted once a week. The patients were asked to write down their treatment experience and responses. Meanwhile, the patients' dependents were asked to change their emotional expression in their contact with the patients in daily life. The results indicated that 14 cases were resolved, 4 had remarkable improvement and the last 2 had some improvement.(3)
Xu Cheng Jiang, et al. treated 31 cases of anorexia who were receiving peritoneal dialysis using a Shen Qi Jian Wei decoction that was made up of Dang Shen (Codonopsis), Bai Zhu (White Atractylodes), Fu Ling (Poria), Niu Xi (Achyranthes), Dang Gui (Chinese Angelica Root), Bai Shao (White Peony Root), Gu Ya (Germinated Rice), Mai Ya (Malt), Huang Qi (Astragalus), Yin Yang Huo (Epimedium), Ban Xia (Pinellia), Pei Lan (Eupatorium), Rou Gui (Cinnamon Bark), Chen Pi (Citrus), and Ji Nei Jin (Membrane of Chicken's Gizzard). For severe abdominal distension, Mu Xiang (Aucklandia) and Da Fu Pi (Areca Peel) were added. For severe abdominal pain, Yuan Hu (Corydalis) was added. For severe vomiting, Zhi Shi (Immature Bitter Oranges) and Zhu Ru (Bamboo) were added. For constipation, Da Huang (Rhubarb) was added. These herbs were decocted in water to be taken once daily. Thirty patients in a control group were treated with an oral administration of Prepulsid 10mg and 3 times every day. Results from both the treatment and the control group were, respectively: 18 and 6 cases experienced noticeable improvement, 9 and 13 had some improvement, and 4 and 11 had no effect. The total effectiveness rates were 87.1% and 63.3%, respectively. There were significant differences between two groups in total effectiveness rate and significant effectiveness rate (P<0.05-0.01).(4)
Yang Xiong used a Jian Wei Xiao Shi decoction to treat 44 cases of infantile anorexia nervosa. This decoction was made up of Shen Qu (Leaven), Shan Yao (Dioscorea), Mai Ya (Malt), Shan Zha (Crataegus), Ji Nei Jin (Membrane of Chicken's Gizzard), Fu Ling (Poria), Chen Pi (Citrus), Sha Ren (Amomum), and Lian Qiao (Forsythia). The formula was modified according to patients' symptoms. For children 3-5 years old, 30ml of Jian Wei Xiao Shi was taken 3 times every day. For children older than 5 years, 200ml was taken 3-4 times daily. 5 doses constituted one therapeutic course of treatment. The results showed that after 2 courses of treatment, among the 44 cases, 13 showed effectiveness. After 3 courses of treatment, 23 showed slight improvement. After 4 courses of treatment, 5 cases showed slight improvement and 3 cases showed no effectiveness.(5)
Liang Huiying, et al used a Ban Xia Zhi Zhu pill to treat 38 cases of infantile anorexia. For 5 to 8 year-old children, the formula contained Bai Zhu (White Atractylodes), Zhi Shi (Immature Bitter Oranges), and Ban Xia (Pinellia). For patients between 9 and 12 years of age, Bai Zhu (White Atractylodes), Zhi Shi (Immature Bitter Oranges), and Ban Xia (Pinellia) were used with the following modifications. For sweating, Huang Qi (Astragalus) was added. For upper respiratory tract infections, Jin Yin Hua (Lonicera Flower) was added. For anemia, Dang Shen (Codonopsis) and Shou Wu (Fleece-Flower Root) were added. For pigeon breast, Long Gu (Dragon Bone) and Mu Li (Oyster Shell) were added. These herbs were decocted in water to be taken as one daily dose. In a control group, 38 cases were treated with oral administration of domperidone 1 tablet for 5 to 8 year-old patients and 1.5 tablets for 9 to12 year-old patients, 3 times a day. In these two groups, 7 days of treatment was considered one course of treatment. The results for the treatment and control groups were, respectively: 31 and 25 cases were resolved, 5 and 6 cases demonstrated effectiveness, 2 and 7 cases showed no effectiveness. The effectiveness rates were 94.7% and 81.6%, respectively (P<0.05).(6)
Other Treatments
Otopoint treatment
Li Jin applied an auricular plaster method to treat 100 cases of poor appetite using Spleen (MA-IC), Stomach (MA-IC), Spirit Gate (MA-TF1), Nao Dian, Xia Jiao Duan, Small Intestine points (MA-SC2), and supplemented with Liver (MS-SC 5) for improved coordination between the liver and the spleen, with Er Zhong point (MA-H1) for regurgitation and hiccup, and with Heart (MA-IC) for insomnia and dreaminess. After locating the sensitive points, vaccaria seeds were applied to these otopoints. The two ears were used alternately and the treatment was performed once daily, with 10 sessions being one therapeutic course. The results indicated that of the 100 cases, 69 were resolved, 26 had improvement, and 5 were ineffective, with the effectiveness rate being 95%.(7)

Li Xiou Fang treated 40 cases of child anorexia by external application of an herbal paste at the umbilicus. The herbs used were Cang Zhu (Atractylodis), Gan Jiang (Dried Ginger), Lai Fu Zi (cooked Raphanus), and Rou Gui (Cinnamon Bark) mixed with vinegar. The paste was changed once a day. 10 days constituted one course of treatment. After 2 courses of treatment, 27 cases had significant improvement, 11 had somewhat improved, and 2 cases were ineffective. The effectiveness rate was 95%.(8)

Massage treatment
Wang Sheng Lin, et al. treated 100 cases of infantile anorexia. The maneuvers employed were rubbing the abdomen for 5 min, kneading the umbilicus for 5min, pressing and kneading along the middle of spine from top to the bottom for 5min, and rubbing and kneading the acupoint Zu San Li (ST 36) for 2 min. In addition, for severe deficiency of both the spleen and stomach, Pi Shu (BL 20) and Wei Shu (BL 21) were used for rubbing. For retention of food, the practitioner also rubbed and pushed the abdomen with yin-yang method. In the treatment of children under 3 years of age, they applied the pushing manipulation to Pitu, Sihengwen and Banmen of the hand. This treatment was performed once daily, about 15~ 20 minutes every time. Additionally, equivalent doses of carbonized Baizhu (Rhizoma Atractylodis Macrocepgalae), Sharen (Fructus Amomi), Caoguo (Fructus Tsaoko), etc. were ground into powder, made into paste with an appropriate amount of wine, and applied to the umbilicus once daily. The results indicated that 86 cases were resolved, 11 had marked improvement, and 3 had improvement, with the total effective rate being 100%.(9)

Chen Jin Feng treated 82 cases of infantile anorexia by applying the reinforcing Spleen-Meridian method 100-300 times, kneading Zhong Wan (CV 12) about 100 ~ 200 times, rubbing abdomen 5 min, kneading along the middle spine part 3-5 cycles, and pressing and rubbing Zu San Li (ST 36) 50-100 times. In addition, for dysfunction of the spleen in transportation, he rubbed "Ban Men" 100-300 times, for deficiency of both spleen-qi and stomach-qi and Wai Lao 100-300 times, pushed "Three-Guan" (the "3 passes") 100-300 times; and for insufficiency of stomach-yin type, performed liver-heat eliminating manipulation 100-200 times. The treatment was performed once daily, with 7 days being one therapeutic course, continuously for 2 courses. In the control group, 40 patients were treated with an oral administration of Jia Ner Kou Fu Ye (a syrup for digestion) 3 times daily, continuously for 2 weeks. Findings illustrated that of the 100 and 40 cases in the treatment and control groups, 59 and 21 cases were resolved, 9 and 4 had marked improvement, 9 and 6 had some improvement, and 5 and 9 were ineffective. The total effectiveness rates were 93.9% and 77.5% respectively. There was a significant difference seen between the two groups in the effectiveness rate (P<0.01).(10)

Hu Ding Zheng applied the spine-kneading manipulation to treat 33 cases of infantile anorexia. The operator made a half-fix (by bending the index finger in a half way and extending the thumb against the patient's skin) and moved the thumb and ring finger forward, kneading and lifting the skin and muscles repeatedly. One application was performed 6 times altogether in every session of treatment. In the control group, 30 patients were asked to take Xiao Er Jian Pi Tang Jiang (child spleen-enhancing syrup) 5-10ml/day, 3 times a day. In this group, 10 sessions of treatment was considered to be one therapeutic course. After 3 courses of treatment, the results for the treatment and comparison groups were, respectively: 17 and 6 cases were resolved, 15 and 13 were improved, and 1 and 11 were ineffective. The effectiveness rates were 96.9% and 63.9%, respectively. There was a significant difference seen between both groups in their therapeutic effects (P<0.01).(11)

References
  1. Liao Wen Hua, et al. Treating 144 cases of child anorexia with Jian Pi Yin. China Journal of TCM Theories. 1999;5:168.
  2. Zhao Cheng Chun, et al. Treating 118 cases of anorexia with Kai Wei Jin Shi Tang. Journal of New TCM. 1996;28(6):49-50.
  3. Liu Xi Yao, et al. Treating neurogenic anorexia with Ping Shen Wan. Shandong Journal of TCM. 2000;19(3):159-160.
  4. Xu Cheng Jiang, et al. Clinical observation on using Sheng Qi Jian Wei Tang to treat 31 cases of anorexia who were receiving peritoneal dialysis. Journal of Traditional Chinese Medicine. 2000;41(9):547.
  5. Yang Song. Using Jian Wei Xiao Shi Tang to treat child neurogenic anorexia. Journal of Modern Integrated Medicine. 2000;9(10):947.
  6. Liang Hui Ying, et al. Treating 38 cases of child anorexia with Ban Xia Zhi Zhu Wan. Journal of Applied TCM. 2000;16 (10):12.
  7. Li Jin. Treating 100 cases of poor appetite with otopuncture. Shaanxi Journal of TCM. 1997;18(1): 29.
  8. Li Xiu Fang. Treating 40 cases of child anorexia with external application of Chinese herbs. Hebei Journal of TCM. 1998;20 (1):20.
  9. Wang Sheng Min, et al. Treating 100 cases of child anorexia with combination of massage and external application of Chinese herbs. China Journal of TCM Science and Technology. 2000;7(1): 58-59.
  10. Chen Jin Feng. Treating 82 cases of child anorexia with massage. Jiangsu Journal of TCM. 2000;21 (8):37.
  11. Hu Ding Zhi. Clinical observation on treating child anorexia with spine-kneadling method. Journal of Massage and Physical Excercise Therapy. 2000;21 (8):37.
This information is educational in context and is not to be used to diagnose, treat or cure any disease. Please consult your licensed health care practitioner before using this or any medical information.
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