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Chronic Urticaria


#1

I have been working on a patient with chronic urticaria, believed to be autoimmune related. The patient has hypothyroidism and increasing Synthroid has in the past helped with the hives; however, it no longer seems to be that way and her doctor is concerned about having her this dose for long. The hives are worse in any place where she has increased pressure for a period of time (i.e. along her waist band, when sitting for longer periods, tigh clothes, watches, purse, etc.).

I have used only acupuncture since the patient has reservation over using herbal medicines.

The main points I have used include: Li4, Li11, Sp10, Sp9, Sp6, St36, GB34, Ren15, TB5, Liv3, Liv2, Kid3, Du14, Du20, Du22, HTJJ T1-4, and ear: Shenmen, Thyroid, Liver, Spleen, Adrenal. Not all in the same treatment and with variation based on changing clinical presentation (tongue, pulse, etc.).

I have been treating her for ~ 2 months with great success, but I am hoping to get other peoples experience in treating this type of thing and about how long it takes to see complete resolution of this type of condition (as I don't have much experience with it). The hives a very minimal (~95% gone) but she will still get some with the increased pressure (from sitting, clothes, etc.).

Thanks for your thoughts!


#2

What does her tongue and pulse say? How has that changed as the symptoms have changed and what parts of the overall diagnosis have not improved (i.e. what signs have remained)? Is this patient overweight? If so, how much?


#3

Well her pulse is usually wiry on the left and slippery on the right. Sometimes the right chi pulse is weaker (which usually coincides with a more pale tongue). Her tongue is usually light red with a thin white coat, however at times the coating has been thicker and she usually has red points on it. The pulse overall is not as forceful as it used to be (used to be somewhat excess). The main symptom I am still seeing is hives where there has been greater areas of pressure, such as if she has been sitting in a hard chair for several hours or wearing tighter clothing or a purse. She is slightly overweight, probably 20-30 lbs.


It may be that I just need to treat longer, but I am looking for other suggestions or experience in treating this type of case.



Thanks!


#4

Personally without the patient taking herbal medicine I think you are doing well. Actually well regardless for someone with some obviously deep health issues. Often Xiao Feng Wan, if appropriate for their underlying diagnosis, can be helpful. You don&#39t say how often you&#39ve been treating over 2 months, but if it has been weekly I think you are right on target. From our system we usually use strong tuina and/or needling at the huatuo of T4 primarily which controls the sweat glands, hair follicles, etc. and is useful for all skin related conditions. Generally we would check the huatuo of T3, T4 and T7 and treat whichever points are the most sensitive to pressure palpation.


#5

I had originally been treating twice a week for the first few weeks and now am doing weekly now. There was a 3 week break in there while the patient was out of town, and the treatment didn&#39t seem diminished at all.


Thanks for you thoughts Chad. I am always looking for ways to improve or new ideas for treatment.


Is there a certain needle retention time you use for HTJJ points in the Tam Healing system?


Thanks again!


#6

Generally speaking we retain the needles for 25-30 minutes and then do about 10 minutes of tuina afterwards...


#7

Thanks again for your time!


#8

Add Ub17 for blood circle and St40 for clear phlegm may better.


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