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Time: 28th, Nov 2006
Place: Guilin International Intercommunion Center of Chinese Medical Culture
Quantity: 20 people
Countries: USA & Germany
Content:
General Description
Obesity is an increase of body weight 20% higher than the normal standard. It is caused by overintake of heat energy which is beyond the requirement of the human body and stored as excessive fat in the body. Usually it falls into two categories., simple obesity and secondary obesity. Simple obesity has no obvious endocrine metabolic disturbance but comes into being from childhood. Clinically it is manifested as overweight and fatigue accompanied by abdominal flatulence, heavy limbs, fullness over the chest, short breath, palpitation and hyperhidrosis. Though it may be seen at any age, obesity is mostly seen in middle aged and older groups. With the improvement of the living standards, more and more people suffer from obesity and its related diseases such as hyperlipemia, coronary atherosclerotic heart disease, hypertension, diabetes, fatty liver, cholelithiasis, apoplexy, etc., which has already aroused universal concern. Secondary obesity may have the symptoms of primary diseases like hypothalamic syndrome and Cushing's syndrome. Some related nervous, mental and endocrine examinations should be made to determine the diagnosis.
Obesity results from endogenous and exogenous factors. The former refers to various intrinsic factors (heredity, neuropychosis, metabolism, endocrine) which affect the regulation of the fat metabolism, and the latter includes hyperphagia and hypoactivity.
According to its clinical manifestations, obesity pertains to the categories of "fei pang" (overweight) or "tan yin" (fat man). Its etiology is related to congenital defect, overintake of greasy food, prolonged lying or sitting, deficiency of healthy qi due to protracted illness, and emotional upset. It mainly involves the spleen and muscles, but is closely related to the deficiency of kidney qi. Generally, its pathogenesis is principal deficiency and secondary excess. Principal deficiency is marked by qi deficiency, mostly deficiency of spleen qi and kidney qi, which may be accompanied with deficiency of heart qi and spleen qi and failure of the liver and gallbladder to control dispersion; secondary excess is mainly the retention of turbid phlegm and fat accompanied with dampness, blood stasis and qi stagnation.
Essentials for Diagnosis
(1) Overweight. Standard weight (kg) = [height (cm) - 100] x 0.9. If the actual body weight exceeds the standard weight by 20 % and muscularity and water retention are excluded, this can be diagnosed as obesity.
(2) Fat accumulation. Fat accumulation can be estimated by the thickness of skin fold. The average thickness of subscapular skin fold of a normal person aged 25 is
(3) It may be accompanied with the following syruptoms. listlessness, lassitude, drowsiness, palpitation, hyperorexia, hypologia, short breath, dyspnea, big belly and abdominal distension, or amenorrhea, impotence, aversion to heat, profuse sweating, pain of the back and loins, and arthragia.
Syndrome Differentiation and Treatment
The syndrome differentiation for this disease is mainly to determine which is predominant: principal deficiency or secondary excess. Accumulation of heat in the spleen and stomach, internal retention of phlegm and stagnation of qi and blood are characteristic of secondary excess, while dysfunction of the spleen in transportation and transformation, deficiency of spleen yang and kidney yang are typical of principal deficiency. The treatment is based on the principle of supporting healthy qi and eliminating pathogenic factors. The following methods can be adopted accordingly, recuperating and invigorating the spleen and kidney, dispersing the stagnated liver qi and gallbladder qi, dissipating dampness and eliminating phlegm, promoting diuresis to remove blood stasis, promoting digestion and purging fuorgans.
A. Accumulation of Heat in the Spleen and Stomach
Chief Manifestations: Polyphagia, polyorexia, fat physique, abdominal fullness and distention, rosy cheeks, dry mouth with bitter taste, restlessness, dizziness, burning pain and upset in the stomach relieved after eating, red tongue with yellow and greasy coating, wiry and smooth pulse.
Therapeutic Methods: To purge stomach fire and promote digestion as the auxiliary treatment.
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B. Dysfunction of the Spleen in Transportation
Chief Manifestations: Fat physique, listlessness, lassitude, bodily heaviness, chest distress and abdominal distention, slight edema of limbs which is alleviated in the morning and aggravated in the evening and after overwork, normal or impaired appetite, indulgence in eating and drinking, dysuria, loose stools or constipation, swollen pale tongue with teeth marks on its margin, thin and white or white and greasy coating, softsuperficial and thready pulse.
Therapeutic Methods: To invigorate the spleen, benefit qi, promote diuresis and eliminate dampness.
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C. Internal Retention of Phlegm
Chief Manifestations: Fat physique, bodily heaviness, lassitude of limbs, thoracic fullness, phlegm accumulation, dizziness, vomiting and lack of appetite, dry mouth with no desire for drinking, preference for greasy food and liquor, listlessness and somnolence, white and greasy or white and smooth tongue coating, smooth pulse.
Therapeutic Methods: To dry dampness, resolve phlegm, regulate qi and eliminate mass.
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D. Deficiency of Spleen Yang and Kidney Yang
Chief Manifestations: Fat physique, facial edema, listlessness and somnolence, short breath, abdominal distention, loose stools, spontaneous perspiration, dyspnea which becomes worse on exertion, aversion to cold, cold limbs, edema of lower limbs, oliguria during the day and nocturia, pale swollen tongue with thin and white coating, deep and thready pulse.
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E. Qi Stagnation and Blood Stasis
Chief Manifestations: Fullgrown physique, purplish red face or dull red face, chest distress and hypochondric distention, restlessness, irritability, sleeplessness or restless sleep, constipation, purplish red tongue with petechia or ecchymosis, or with engorged sublingual veins, deep and wiry pulse or unsmooth pulse.
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