Treating Hyper-salivation with TCM Herbal Medicine



ABSTRACT

Background: In Western medicine, the doctor looks for specific causes of diseases, and focuses on particular body components to treat. Traditional Chinese medicine (TCM) doesn't work in this way. There are fundamental differences in principles, diagnosis and treatment approaches between Western medicine and Chinese medicine. The body is an organic whole, all the component parts are interconnected, they dependent and restrict each other physiologically, influence each other pathologically. Therefore, TCM has strength for treating unknown and difficult diseases because when the body regains it’s normal balance and physiology, itself will treat the disease as long as it happened within the body.

Case Description: This single case reports on a 37-year-old male who presented with a 9-month history of hyper-salivation.

Methods: The patient was treated with only TCM herbal medicine for 8 weeks and applied TEM Classical Formula Selecting Method in order to find a suitable formula.

Results: The patient’s symptom has completely disappeared after 8 weeks of TCM herbal medicine and until 1 year later, the symptom has not come back.

Conclusion: This article may aid in expanding practitioners’ treatment options to include TCM herbal medicine more for unknown and difficult diseases. More research is needed to investigate the role of TCM herbal medicine.

BIOMEDICAL PERSPECTIVE

Hypersalivation (also called ptyalism[1] or sialorrhea[2]) is an excessive production of saliva. It has also been defined as an increased amount of saliva in the mouth, which may also be caused by decreased clearance of saliva.[3] Hypersalivation can contribute to drooling if there is an inability to keep the mouth closed or in difficulty in swallowing the excess saliva (dysphagia). Hypersalivation also often precedes emesis (vomiting), where it accompanies nausea (a feeling of needing to vomit).[4]

USUAL TREATMENT

Hypersalivation is optimally treated by treating or avoiding the underlying cause.[3] Mouthwash and tooth brushing may have drying effects.[3] In the palliative care setting; anticholinergics and similar drugs that would normally reduce the production of saliva causing a dry mouth could be considered for symptom management: scopolamine, atropine, propantheline, hyoscine, amitriptyline, glycopyrrolate.[5]

CASE REPORT

Dec 16, 2015, 37-year-old Caucasoid male with a body mass index (BMI) of 23.71 kg/m² (5’11”/170lb) and physically well-developed, presented with a 9-month history of hyper-salivation. The patient claims that this symptom has started since he was on a “bulk up diet (overly eating)”. He went to the family doctor and took anti-acid medication and it got better for 3months. However, this time he was on a “cutting down diet” and the symptom reappeared even worth than the last episode and medication from the doctor did not improve the patient’s condition this time. His symptom aggravated by eating grains and sugar and alleviated by consumes alcohol.

PATIENT OVERVIEW


Table 1.

TREATMENT PROCESS


Table 2. All TCM formulas are Sun Tan granules

DISCUSSION

TEM (Traditional Eastern Medicine) Charting with TEM Herbal & Formula Evidence

1. Patterns of the common cold that patients usually get.

  • Body Aches Pattern: Tai Yang Disease, Gun Zhi Tang group, Ma Huang Tang group, (Da & Xiao) Qing Long Tang

  • Fever: Tai Yang, Yang Ming, Shao Yang and rarely Shao Yin

  • Sore Throat: Ban Xia, Shao Yin sore throat issue

  • Respiratory (cough, asthma and sinus): Ma Huang, Xi Xin, Ting Li Zi, Ban Xia, Jie Geng, She Gan, Zao Jia etc.

  • Shao Yang: Sore throat + low-grade fever

2. Patterns of temperature sensitivity.

* Scales of how severally aversion to cold vs aversion to heat (1 - 10)

Aversion to Cold Scale Fu Zi: Mostly above 6 Wu Zhu Yu: Mostly above 5, sometime around 3 Gui Zhi: Around 5

* If patient specifically mentions lower abdomen cold sensation: Wu Zhu Yu, Gan Jiang (prone to get loose stool), Fu Zi + Honey (prone to get constipation), Cong Bai

Aversion to Heat Scale Chai Hu, Gan Sui, Huang Lian: Below 5 Shi Gao, Huang Qin, Zhi Zi, Huang Bai, Ge Gen: Above 5

* Chai Hu patients may feel aversion to heat more, however, they may feel aversion to both heat and cold.

* Hot Flush when a patient has/get (nervous, drinks, menopause, tired): Huang Lian, Zhi Zi + Dan Dou Chi, Gui Zhi

3. Perspiration

Patients feel good after the sweat: Tai Yang Disease Patients feel warm in general and sweating easily: Yang Ming Patients have a deficient body constitution who get very tired after the sweat Not sweating easily on the lower body but the upper body and has dryer and thicker skin texture: Ma Huang Spontaneous sweating: Gui Zhi and Huang Qi however, Huang Qi patient has obvious deficient body constitution.

4. Thirst and fluid intake

Shi Gao: (Polydipsia) The patient has hyper-metabolism that consumes body fluid fast therefore, the patient has a high energy level.

Gua Luo Gen (Tian Hua Fen) and Man Men Dong: The patient has a deficiency of the body fluid that induces thirst and dryness in the mouth and throat. Chai Hu: Dryness in the mouth with bitter taste due to decreased immunity (eg. Decrease IgA in the saliva may cause the bitter taste and burning sensation in the mouth)

Zhu Ling and Ze Xie: Thirst with urination issues.

5. Appetite and digestion

Indigestion affects epigastrium with poor appetite: Ren Shen Indigestion affects epigastrium with nausea and vomiting: Ban Xia, Sheng Jiang, Cang Zhu Indigestion affects chest with obstructed sensation: Ju Pi, Zhi Shi Eructation: Sheng Jiang Acid regurgitation gets worse with spicy food, alcohol and stress Abdominal Pain: Ren Shen, Gan Jiang, Fu Zi, Bai Shao Yao, Da Zao, Gan Cao, Barley Malt, Huang Lian, Chai Hu, Da Huang, Zhi Shi, Hou Po etc.

6. Bowel Movement

Constipation: Da Huang, Mang Xiao, Ma Zi Ren, Xing Ren Abdominal distention (bloating due to gas retention): Bai Shao Yao, Da Huang, Zhi Shi, Hou Po, Mang Xiao Diarrhea and loose stools (Cold type): Gan Jiang, Fu Zi and sometimes Wu Zhu Yu Diarrhea and loose stools (Heat type): Huang Qin, Huang Lian, Bai Tou Weng, Ge Gen Watery Diarrhea and bleeding (leaky gut): Bai Shao Yao, Chi Shi Zhi, Yu Yu Liang

7. Urination