Integrating Traditional Chinese Medicine with Western Treatments for Stroke Recovery

Combined Traditional Chinese and Western Medicine Treatment for Father

Hello Doctor: My father is 73 years old and had a hemorrhagic stroke over ten years ago.
In recent years, he has experienced several minor strokes, with one confirmed case of thalamic occlusive stroke.
He has had episodes of dizziness and vomiting, but by the time he reached the emergency room, his condition had improved, making it difficult to determine the cause.
He also exhibits symptoms similar to Parkinson's-related dementia.
He was originally a hepatitis B and C patient (but recent tests show no detectable viral load for hepatitis C).
In April of this year, he underwent liver resection surgery due to a malignant liver tumor.
Currently, he has cirrhosis with mild ascites and slight edema, and his kidney function (creatinine) is 1.5, which is above the normal range of 1.2.
He has been receiving treatment from Western medicine and has taken many medications, but the effects have been unclear: 1.
Hepatitis B medication: Baraclude 2.
Diuretics: two types, Lasix and Spironolactone 3.
Parkinson's medication: Mirapex, half a tablet three times a day 4.
Anticoagulant: Xarelto (stopped after starting traditional Chinese medicine) 5.
Cerebral circulation medication: Huo Luo Ling (stopped after starting traditional Chinese medicine).
Recently, we considered trying traditional Chinese medicine from the same hospital to see if it could gradually replace the chemical Western medicine.
However, he is already on many Western medications, with specific instructions for before meals, after meals, and on an empty stomach, making it difficult to manage at home.
After discussing with the Chinese medicine doctor, it was suggested to stop the anticoagulant and circulation medications and replace them with herbal ingredients.
Some herbal medications for liver symptoms were also included, but after two weeks, we haven't noticed any differences.
I would like to ask: 1.
Can anticoagulants and circulation medications be completely replaced by traditional Chinese medicine? Is there a risk in not taking anticoagulants? 2.
Is it feasible to include the following herbs in the traditional Chinese medicine: processed Aconite, Chuanxiong, Gastrodia, Poria, Alisma, Magnolia Bark, Rhubarb, Asparagus, Eupatorium, and North Eupatorium? Taking these three times a day, along with the aforementioned Western medications, could it lead to excessive medication intake and increase the burden on the liver and kidneys? I have noticed that my father has developed edema post-surgery, his albumin levels are below normal, and he has lost weight, which is very concerning.
I hope you can help clarify my doubts.
Thank you very much.

An An, 40~49 year old female. Ask Date: 2015/08/17

Dr. Lin Qingzhong reply Traditional Chinese Medicine

Dear An-An / 45 / 1 netizen,
Hello.

1.
I apologize for the delayed response as I just returned from abroad.
The clinical issues you raised involve multiple organ conditions and the combination of Traditional Chinese Medicine (TCM) and Western medicine, making the situation quite complex.
Fortunately, I have participated in the holistic integration and deepening integration initiatives led by Director Li at Fengyuan Hospital, which have provided excellent treatment and improvement for many patients with extremely complicated and critical conditions.
2.
Your father's condition involves the brain, liver, and kidneys, with issues such as stroke, Parkinson's disease, hepatitis B and C, liver cirrhosis, liver malignancy, and early-stage chronic kidney failure.
These conditions are in a chronic phase rather than an acute phase, and continuous monitoring and treatment are necessary to prevent sudden deterioration.
Particularly, diseases like Parkinson's (with medications such as Madopar), hepatitis B, and liver cirrhosis (with medications like Baraclude) tend to worsen over time and are difficult to eradicate, so ongoing treatment is essential.
Liver malignancy may require surgery and also necessitates long-term follow-up treatment.
3.
Your father has a history of multiple strokes, so Western medicine has prescribed anticoagulants (such as Lovenox) and cerebral circulation medications (such as Cerebrolysin) to enhance cerebral blood circulation and prevent further strokes.
It is not advisable to discontinue these medications.
4.
There is a small amount of ascites due to liver cirrhosis and mild edema, so Western medicine has prescribed diuretics (such as Lasix) to promote fluid elimination.
5.
You may want to consult your TCM physician regarding the perspective on stopping Western anticoagulants and the use of Chinese herbal medicine.
Additionally, ask your Western physician if this is feasible.
TCM also has anticoagulant herbs, but their effects may not be as strong as Western medications.
Not taking anticoagulants could increase the risk of another stroke.
While taking anticoagulants does not guarantee a 100% prevention of stroke, medical literature indicates that anticoagulant therapy significantly reduces stroke risk.
6.
I cannot answer your question regarding the specific TCM herbs you mentioned (such as Fuzi, Chuanxiong, Tianma, Fuling, Zexie, Houpu, Dahuang, Tianmendong, Mianyinchen, and Beiyinchen) and their feasibility for three times a day.
TCM involves the differentiation of symptoms and treatment based on each physician's assessment of the patient's condition, and the choice of herbs can be quite nuanced.
You may need to consult your TCM physician and Western physician regarding this.
Some TCM practitioners may adopt a combined approach of both tonifying and purging.
7.
If you are concerned about taking too many medications, you might consider selecting one treatment approach.
Both TCM and Western medicine have their unique characteristics and patient preferences.
There is still room for discussion regarding whether your father's treatment should integrate both TCM and Western medicine.
Finally, I wish you well.
Dr.
Lin Qingzhong
Director of the TCM Department, Fengyuan Hospital / Associate Professor at the General Education Center, Chung Tai University

Reply Date: 2015/08/17

More Info

Integrating Traditional Chinese Medicine (TCM) with Western treatments for stroke recovery can be a complex but potentially beneficial approach, especially for patients with multifaceted health issues like your father. Given his history of hemorrhagic stroke, subsequent small strokes, liver cancer, and current medications, it is crucial to navigate this integration carefully.

1. Can anticoagulants and circulation medications be completely replaced by TCM?
Anticoagulants, such as the one your father was taking (利血達), are critical in preventing further strokes, especially in patients with a history of cerebrovascular events. While some TCM herbs, like Dan Shen (Salvia miltiorrhiza) and Chuan Xiong (Ligusticum chuanxiong), are believed to have blood-thinning properties, they may not be as effective or reliable as pharmaceutical anticoagulants. Discontinuing anticoagulants without proper medical supervision can significantly increase the risk of stroke. Therefore, it is essential to consult both a Western medicine physician and a qualified TCM practitioner before making any changes to his medication regimen. A collaborative approach can help ensure that the benefits of both systems are maximized while minimizing risks.

2. Is it safe to combine the listed TCM herbs with existing medications?
The herbs you mentioned—炮附子 (Aconitum), 川芎 (Chuan Xiong), 天麻 (Gastrodia), 茯苓 (Poria), 澤瀉 (Alisma), 厚朴 (Magnolia), 大黃 (Rhubarb), 天門冬 (Asparagus), 綿茵陳 (Eupatorium), and 北茵陳 (Eupatorium)—are commonly used in TCM for various purposes, including improving circulation and supporting liver function. However, combining these with Western medications can lead to interactions that may exacerbate your father's existing conditions, particularly concerning his liver and kidney function.

Given that your father has mild edema and low albumin levels, it is crucial to monitor his liver and kidney health closely. Some TCM herbs can be taxing on these organs, especially when combined with Western medications. Therefore, it is advisable to work with a TCM practitioner who understands your father's complete medical history and can tailor a treatment plan that considers both his TCM and Western medication needs.

3. Concerns about polypharmacy and organ burden
Your concern about the potential burden on your father's liver and kidneys due to polypharmacy is valid. The combination of multiple medications can lead to increased side effects and complications, particularly in older adults or those with pre-existing conditions. It is essential to regularly review all medications with healthcare providers to assess their necessity and effectiveness.
In cases where TCM is introduced, it is often beneficial to start with lower doses and closely monitor for any adverse effects or improvements. This cautious approach can help mitigate the risk of overwhelming the liver and kidneys while still providing therapeutic benefits.

Conclusion
In summary, while integrating TCM with Western medicine can offer a holistic approach to your father's recovery, it must be done cautiously and under professional guidance. Anticoagulants should not be discontinued without medical advice due to the risk of stroke. Combining TCM herbs with existing medications requires careful consideration of potential interactions and the overall health of the liver and kidneys. Regular consultations with both Western and TCM practitioners will be essential in creating a safe and effective treatment plan tailored to your father's unique health needs.

Similar Q&A

Can Traditional Chinese Medicine Help Post-Stroke Recovery at 65?

I would like to ask, my father is 65 years old and had a stroke, resulting in complete immobility of his left hand and left leg. He is already on a fixed regimen of Western medication. Can traditional Chinese medicine help with his condition, or is rehabilitation the only option ...

Dr. Ding Hanxiang reply Traditional Chinese Medicine
Hello: The golden period for stroke treatment is six months, and it also depends on the extent of brain damage. If it exceeds six months, it is more difficult to achieve significant improvement. It is recommended that Western rehabilitation should not be interrupted, and acupunct...

Exploring Acupuncture for Stroke Recovery After 15 Years

Hello Dr. He: I am a stroke patient who has been suffering for 15 years. My stroke was caused by a hemorrhage in the brainstem, and the blood clot has since been absorbed. In the past few years, I underwent rehabilitation at a Western medicine hospital, but the results were not s...

Dr. He Yujun reply Traditional Chinese Medicine
Hello: You may need to come to the clinic for a thorough assessment to understand your current physical activity status. Traditional Chinese medicine acupuncture can enhance the flow of Qi and blood by stimulating meridian points. While it may not provide immediate significant ef...

Integrating Western and Traditional Chinese Medicine: Scientific Perspectives

Is it not recommended to combine Western medicine and Traditional Chinese Medicine for treatment, and are there scientific blind spots regarding this?

Dr. Lin Qingzhong reply Traditional Chinese Medicine
Dear Mr. Lin, 1. I apologize for the delayed response as I only received the notification the day before. 2. Regarding whether Western medicine and Traditional Chinese Medicine (TCM) should be used together in treatment, and if there are any scientific blind spots, I would like ...

Can Traditional Chinese Medicine and Western Medicine Be Combined for Mental Health?

I visited a traditional Chinese medicine practitioner who said my pulse was very irregular. The prescription includes Huanglian Jiedu Decoction (for clearing heat and detoxifying), Longdan Xiegan Decoction (for draining liver fire and relieving damp-heat), Tianwang Buxin Dan (for...

Dr. Wu Enliang reply Psychiatry
Hello everyone, I will discuss this with him again. The journey of mental rehabilitation is long, and results may not be visible in a short period; it often takes years to see progress. We will accompany, support, and encourage him together. Dr. Wu En-Liang