🌿 Fengyang Daoist TCM Teaching Case: Polymyalgia
I. Basic Information
• Name: Confidential
• Gender: Female
• Year of Birth: 1967
• Occupation: Pet Groomer
• Referred by: Foula Kikis Mastromanolis
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II. Initial Consultation
• Date: May 25, 2024
1. Chief Complaint
Polymyalgia with generalized muscle and joint pain, accompanied by chronic fatigue for several years.
2. Associated Symptoms
• Obesity
• Acid reflux
• Varicose veins
• Hearing decline
• Dry skin
• Fatigue
• Abdominal bloating and belching
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III. Western Medical History
• Diagnosis: Polymyalgia
• Medications:
• Prednisone (tapering, 1 mg)
• Kevzara (Sarilumab)
👉 Patient’s Goal: To gradually discontinue corticosteroids and immunosuppressive therapy
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IV. Etiology & Pathogenesis (TCM Analysis)
1. Etiology
• Long-term overexertion (over 20 years)
• Heavy family responsibilities (caring for parents)
• Running a pet grooming and boarding business
👉 Classified as internal injury due to overstrain (劳倦内伤)
2. Four Examinations
• Pulse: Deep and weak
• Tongue: Pale with white coating
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V. TCM Pattern Differentiation
Syndrome Patterns
• Spleen and Kidney Yang Deficiency
• Cold-Damp Obstruction of the Channels
Pathomechanism Summary
Yang deficiency → internal generation of cold-damp → obstruction of meridians → “no free flow, no pain relief”
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VI. Treatment Principles
• Warm Yang and support vital Qi
• Strengthen the Spleen and tonify Qi
• Warm the Kidney and dispel cold
• Unblock channels and relieve pain
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VII. Treatment Plan
(1) Herbal Formula (Granules)
• Bu Zhong Yi Qi Tang (Evergreen) – 100 g
• Huo Xiang Zheng Qi San (Evergreen) – 100 g
• Zhen Wu Tang (Nong Ben Fang) – 200 g
Dosage:
3 g + 3 g + 6 g per dose, twice daily, dissolved in warm water
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(2) External Therapy
Fengyang TCM Tuina (Nine Meridian Lines), 1 hour per week
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(3) Therapeutic Exercises
• Jiaji Feijing Meridian Exercise (targeting Gaohuang area)
• Baduanjin – 30 minutes daily
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(4) Lifestyle Recommendations
Avoid:
• Flour-based foods
• Dairy
• Sugary foods
Encouraged:
• Meditation and sitting practice
• Balance between movement and rest
• Prioritizing personal health
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VIII. Clinical Outcomes & Follow-up
📅 June 24, 2024 (1 Month)
• Significant reduction in systemic pain
• Mild residual discomfort near LU1 region
👉 Assessment: Marked improvement
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📅 Key Steroid Withdrawal Process
After initial consultation (May 25, 2024):
• Gradual tapering of Prednisone
• Fully discontinued after ~3 months (August 2024)
Follow-up (as of March 26, 2026):
👉 Off corticosteroids for 1 year and 10 months
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📅 October 3, 2024
Hospitalization due to Diverticulitis
Post-discharge adjustment (Oct 28):
• Huo Xiang Zheng Qi San – 3 g
• Bu Zhong Yi Qi Tang – 2 g
Twice daily
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📅 March 26, 2026 (2-Year Follow-up)
Patient Feedback:
• Polymyalgia: significantly improved ✅
New concerns:
• Weight gain
• Difficulty losing weight
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IX. Stage Transformation of Pathogenesis
From:
👉 Yang deficiency with cold-damp obstruction (pain stage)
To:
👉 Spleen Qi deficiency with damp accumulation (metabolic slowdown, obesity)
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X. Ongoing Treatment Strategy
Shift in Focus
👉 From “pain relief” → “metabolic restoration”
Treatment Principles
• Strengthen Spleen and raise clear Yang
• Warm Yang and transform dampness
• Regulate Qi and enhance transport function
Herbal Direction
• Bu Zhong Yi Qi Tang (primary)
• Combined with Shen Ling Bai Zhu San
• Add Qi-regulating herbs
👉 Avoid overly cloying tonics
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Core Strategy (Fengyang Philosophy)
👉 Activate the restored Yang Qi
• Dynamic exercises (Baduanjin, walking)
• Morning sun exposure
• Regular daily routine
• Emotional stress reduction
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XI. Teaching Commentary (Key Value)
1️⃣ Successful Steroid Withdrawal
• Discontinued within 3 months
• Stable for 1 year and 10 months without relapse
2️⃣ Advantage of TCM (Root Treatment)
• Western medicine: controls inflammation (branch treatment)
• TCM: restores systemic balance (root treatment)
3️⃣ Key to Safe Medication Reduction
• Gradual tapering
• Simultaneous support of vital Qi
• Integration of internal and external therapies
4️⃣ Strength of Fengyang Daoist TCM System
• Herbal medicine + Tuina + exercises + mind regulation
👉 A holistic medical model
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XII. Appointment Information
👉 March 30, 2026 (Monday), after 12:30 PM
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🌿 Summary
This case demonstrates that through a comprehensive TCM approach, patients with polymyalgia may safely discontinue corticosteroids within approximately three months, maintain long-term stability (1 year and 10 months follow-up), and achieve significant constitutional improvement.
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