Patient is a male,74 years. He has developed a cystlike growth on outer side of his right thigh. (Roughly between St 31 and Gb 30). Doctors have diagnosed it as begnine Lipoma (A fat accumulation) It is not cancerous, there is no growth for last about 3 months. There is no pain otherwise except on pressure.
He is treated on St and Gb meridians (ST 36,40 and Gb 34 )in addition to all homeostatic points but no change is found Can someone guide me in this matter?
Comment by Chad J. Dupuis, L.Ac.
What is the patients overall diagnosis? tongue, pulse? related symptoms?
Generally treating just locally like you appear to be doing will not work. You first need to treat the patient outside of this one symptom (i.e. completely based on an overall tcm diagnosis - dampness, lv stagnation, etc...) and then work in some local points. Generally I would focus (my bias) on huatuo point on the back, so in this case huatuo of L3-S2 depending on pressure sensitivity and exact location of the mass. You can also needle around the mass (literally placing the needles 4-6 or so depending on the size of the mass at the base and relatively deeply below it). Then do cupping and/or tuina above and below the mass.
Comment by Archived User
Thank you very much for the guidance. I will come back with feed back.
Comment by Archived User
Thank you very much. The Patient is having pain on Huatuo points near L3 and L4. Treatment is already started. also cupping will be done on the mass. Tongue appears to be normal. Frankly admitting I am not good in checking pulse. I will come back with further feedbak in the due course.
Thank you once again.
Comment by Archived User
Dear Chad Dupuis
Transformation being job of Spleen and Kid why not suggest
a) break stagnation
b) tone Spleen Qi
Being 74 Kid and Spleen may be deficient must be confirmed though
regards
K K Mishra
Comment by Archived User
Dear Chad,
As guided by you, The patient is being treated on Huatuo points (L3-L4) where he had pain on pressure. (He was not aware of this till I checked) In addition, he is been treated on following points Gb34, Liv3, SP6 for tonifying these meridians. Also cupping is done on the mass for around 7-10 minutes after acupuncture is done.
Within last week the mass has softened. and it appears that it may be absorbed in the due course. What can be done further that will accelerate the process?
Thank you for your valued guidence.
Comment by Archived User
I am sorry, I forgot to mention one important point that the patient is also a diabate. Suger levels are low but he is taking medication for that. This should have been mentioned in the initial report itself. I am sorry for that.
Comment by Chad J. Dupuis, L.Ac.
Lipomas are benign tumors composed of adipose tissue that appear to originate from an unknown cause from a western medicine perspective, but may arise from injuries in an area, even minor ones. There are, however, many different forms of benign growths and malignant growths so proper diagnosis from a western perspective is a good idea. On the western side, surgery and/or liposuction and other methods are often used with high success rates.
From a TCM perspective there can be multiple causes and they would be particular to the individual - generally some combination of qi and/or blood stagnation and/or dampness/phlegm leading to obstruction. In the majority of cases focusing on resolving dampness if appropriate and resolving qi stagnation would be the treatment of choice. Once they are fully formed, however, treatment can be more difficult than in the early stages. For some surgical removal followed by more constitutional acupuncture treatment to avoid re-occurences would be ideal, for others an appropriate combination of acupuncture, tuina, cupping, bloodletting and/or Chinese herbal medicine would be better, particularly in those with systemic outbreaks.
Comment by Archived User
Thank you very much.
I could get some knowledge about the problem.
Comment by Archived User
I use the Phlegm Resolving formula for lipomas a lot if it is in fact caused by phlegm.
Comment by Archived User
I wish to share with the members who guided me in this case that the Lipoma has almost disappeared after treatment of around 3 months. It was around 2 Sq. Inches in size and was hard to sense. Now we have to search for the mass before needling. for last around 5 days it is only a guess that it was 'here' I have advised the patient to carry out sonography to confirm that there is nothing inside now.
Thanks to all those who contributed to this post and enriched my knowledge.
Comment by Archived User
Dear Nepal,
Apart from Huato points what other points did you use and what was the frequency?
thanx
k k mishra