Brief
Summary: On Jan. 25, 2011, Manana, from Georgia,
who had suffered from amyotrophic lateral sclerosis (ALS) accompanied with
weakness in the neck since January, 2009, was hospitalized in our hospital. She
had achieved significant improvement after nearly 3 months TCM treatment.
Record of Hospitalization
Name:
Manana Sex:
Female
Age:
59
Marital Status: Married
Nationality: Georgia Date
of Admission: Jan. 25, 2011
Companion: Alone
First Medical Record
Date:
Jan. 26, 2011 Time: 11:00 am
Manana,
female, 59-year-old, had suffered from weakness in the region of neck, induced
without any evident reasons since January, 2009. And later, the patient felt
powerless in the two hands. In July, 2010, she began to feel weak on the part of
the lower jaw. After examined in the hospital in Germany, the final report of
his condition was ALS. The patient was hospitalized in our hospital for TCM
treatment at 10:30 pm on January 25, 2011.
Essential for Diagnosis:
1. The
patient had suffered from weakness on the neck for two years and from difficulty
in chewing for half a year.
2. The
patient had suffered from weakness in the region of neck induced without any
evident reasons since January, 2009. And later, the patient felt powerless in
the two hands. In July, 2010, she began to feel weak on the part of the lower
jaw. After examined in the hospital in Germany, the final report of his
condition was ALS. The patient did get good curative effect after taking the
medicine of Rilutek, and the side effect was that he had bad appetite. Quitting
using the Rilutek, he chosen herbal tea and acupuncture and massage for
treatment in the locality. The strength of the two upper limbs was stronger than
before.
3. When the
patient hospitalized in our hospital, she had thin face, weak neck and lower
jaw, and needed to hold her lower jaw often. She talked unclearly and the
movement of opening and closing her mouth was not flexible. Chewing was
difficult, and was not easy to eat hard food. No problem with swallow. There
were sense of numbness and a little jumpings around the nose and the lips and
the muscles on the lower jaw. She did not have much saliva, but had night
salivation often. She did not feel dry in the mouth and liked to drink warm
water. Urination was normal and 2 times night urination everyday. The strength
of the upper limbs was not so bad, and the lower limbs were normal.
4. T:
36.3¡ãC R: 20 times/minute P: 80 times/minute BP: 135/90mmHg
5. She had
chronic facial complexion. The patient was thin and had clear mind and spirit.
Sound of breathing in the lungs was clear, without any rhonchi. The heart rate
was normal without any heart murmur.
6. The
patient¡¯s cheek was thin and flesh-losing, with amyotrophy of the
sternocleidomastoid on both sides of the neck.
There was no amyostrophy on other part of the body.
7. The
tongue was light red with thin and yellow tongue coating, and there was a little
bit amyotrophy on the tongue. Pulse of the two hands was slippery.
Diagnostic Basis:
TCM:
The patient had suffered from neck weakness and chewing problem, accompanied
with muscle amyotrophy around the neck, which might be caused by spleen-qi
deficiency. The spleen-qi deficiency led to no muscle-nourishing. The
Yin-deficiency and endogenous heat led to light-red tongue, thin and yellow
tongue-coating and emaciation. In addition, the patient had slippery pulse,
numbness and jumping feeling on the facial muscles, which was caused by
obstruction of channels due to wind-phlegm.
So, the final diagnosis was atrophy disease, led by qi and yin
deficiency and obstruction of channels due to wind-phlegm.
Western
Medicine: The patient had suffered from neck
weakness for 2 years, and chewing difficulty for half a year. Combined with the
EMG check report done in Germany, the final diagnosis was ALS.
Diagnostic Differentiation:
TCM:
The patient¡¯s disease should be differentiated from impediment pattern or Bi
syndrome. To the atrophy disease, it is related to powerless of the muscles and
bones, so that the patient feels no use of his limbs, anyhow, there is no joints
pains and muscle pains. To the contrary, the impediment pattern is related with
great joint pains. So they are not difficult to be distinguished.
Western Medicine
diagnosis: The patient's condition should be
differentiated from myasthenia gravis. Myasthenia gravis would be aggravated
after exercise and it would be reduced after some rest. Almost no muscle atrophy
and muscle jumpings and also no pseudo muscle hypertrophy. But ALS is caused by
lesions of the central nervous system accompanied by muscular atrophy and muscle
jumpings. Therefore, there was no difficulty to differentiate them.
First
Diagnosis:
TCM:
atrophy disease
Symptom
identification: deficiency of qi and yin and obstruction of channels due to
wind-phlegm.
Western
medicine diagnosis: ALS
¡¡
Treatment strategy and nursing:
1. Routine
care of traditional Chinese internal medicine.
2. Grade
¢ò
care.
3.
Companion.
4. High
protein food and soft food.
5.
Pathogenesis: deficiency of qi and yin and obstruction of channels due to
wind-phlegm.
6. TCM
strategy: tonifying qi and nourishing yin, extinguishing wind and resolving
phlegm so as to smooth the channels.
7. Herbal
tea: one dosage a day and drink twice
8.
Acupuncture and massage: once a day
9. Have
more medical examination if necessary.
Date: Jan.
27, 2011 Time: 10:00 am
The patient
had suffered from neck weakness for 2 years and chewing difficulty for half a
year. In 2010, she went to Germany for EMG examination, and the diagnosis was
ALS. At present, the patient was flesh-loosing on the face, weak on the part of
neck and lower jaw, and the lower jaw needed to be held often. He couldn¡¯t speak
clearly, and was not flexible to open and close the mouth. Due to the chewing
difficulty, he could not eat hard foods, but with no problem in swallowing. No
respiration stress. There were numbness around the nose, the lips and lower jaw
muscles, accompanied with slight jumpings. Less saliva in the mouth, but
slavering during the sleep. She did not feel dry in the mouth, and liked
drinking warm water. Appetite was normal. Sleep was good. Night urination 2
times per night. There was amyotrophy of the facial biting muscle and of the
sternocleidomastoid on both sides of the neck. There was no amyotrophy on
other part of the body. The tongue was light red with thin and yellow tongue
coating. The tongue was a little bit atrophic. Professor Yang thought the
patient has suffered from atrophy disease, which was caused by the deficiency of
qi and yin and obstruction of channels due to wind-phlegm. Therefore, herbs of
tonifying qi and nourishing yin, extinguishing wind and resolving phlegm so as
to smooth channels would be selected for the treatment, such herbs as dangshen (gensing),
caihu (bupleuri), tianma (gastrodia), etc..
¡¡
Date: Jan.
29, 2011 Time: 10:00 am
The patient
said she needed less time to hold the lower jaw now. The tongue was still light
red but the tongue coating was thin and white. The pulse was slippery.
Date: Feb.
1, 2011 Time: 10:00 am
The patient
said there was less numb feeling on the part of the nose and the nearby of lips.
Less slavering during the night sleep. And the saliva had become clear and thin
from thickness and could be spit out. Some improvement of the chewing function.
Date:
Feb. 9, 2011 Time: 10:00 am
There was
almost no numbness on the nose. And the time to hold the lower jaw was reducing.
The chewing functions maintained progress. Appetite was better than before. The
patient gained weight of 1 kg.
Date:
Feb.11, 2011 Time: 10:00 am
The patient
felt better than before. She used to be spasmous when the hands were holding
things too long, but at present, no spasms any more.
Date: Feb.
16, 2011 Time: 10:00 am
The patient
felt better and was in good mood. Good appetite and sleep. There was distinct
alleviation about the stiffness. Some improvement on the flexibility of the
tongue.
Date: Feb.
26, 2011 Time: 10:00 am
The patient
gained another 1kg weight. Nights sleep was good. Some improvement of the lower
jaw movement. The tongue was a little red with thin and yellow tongue-coating.
Date:
Mar.1, 2011 Time: 10:00 am
The patient
complained too much saliva in the mouth, especially after meals, which might be
easy to cause choking. He still felt neck weakness.
Date: Mar.
6, 2011 Time: 10:00 am
The patient
said there was less phlegm in the mouth. When using the right hand with power,
it would sometimes tremble. His spirit was good.
Date: Mar.
11, 2011 Time: 10:00 am
The
condition of the patient was stable. There was distinct improvement on his
muscle movement of the face and mouth. The chewing function was improved also.
The
sternocleidomastoid on both sides of the neck
was a little bit thicker than before.
Date: Mar.
16, 2011 Time: 10:00 am
The patient
had good spirit these days. Great improvement had been achieved on the lower jaw
movement, with much less time to hold it. The chewing function also changed
better. The tongue was a little dark with thin and white tongue-coating.
Date: Mar.
21, 2011 Time: 10:00 am
Good night
sleep these days with less night-waking. One time urination per night. The
tongue was a little dark with thin and white tongue-coating. The pulse was mild
but a little weak.
Date: Mar.
26, 2011 Time: 10:00 am
Recently,
the patient felt feeble on the two upper limbs. The tongue was a little dark
with thin and white tongue-coating. The pulse was mild but a little weak.
¡¡
Date: Apr.
1, 2011 Time: 10:00 am
The patient
complained of weakness of the upper limbs and heaviness. It was a little hard
for him to raise them. Sleep was good. The tongue was a little dark and red but
better than before.
Date: Apr.
7, 2011 Time: 10:00 am
The patient
spoke much clearly than before. In addition, chewing and raising the head were
more powerful than before. The
sternocleidomastoid on both sides of the neck
and the left facial bite muscle were much more than the day coming to the
hospital. But, the neck was weak, and when she was laying down on the bed, and
wanted to get up, she needed someone or herself to hold her head. The tongue
coating was thin and yellow. The pulse was a little bit weak.
¡¡
Date: Apr.
14, 2011 Time: 10:00 am
The
condition of the patient was stale, continuing the treatment with the same
formula.
Date: Apr.
21, 2011 Time: 10:00 am
Today the
patient had been hospitalized in the hospital for 86 days. After nearly 3 months
comprehensive treatment of herbal tea, acupuncture and massage, she achieved
significant improvement as to her conditions. She could speak more clearly than
before and the volume of the phlegm in the mouth was almost normal. Head-raising
and chewing were of power. The sternocleidomastoid on both sides of the neck
and the left facial biting muscle were much more than the day coming to the
hospital, even though she still felt weak on the neck and when she was laying
down on the bed, and wanted to get up, she needed someone or herself to hold her
head. The strength of the four limbs was increasing, even though there was a
sense of feebleness of the two upper limbs. The patient now was in high spirit
with good sleep and appetite. She had gained 2.5 kg weight after coming to our
hospital.
Doctor¡¯s
advice after leaving hospital:
1. Take
care of the diet, maintain good moods, and avoid wind-cold.
2. Take 60
days herbal medicine back for continuing treatment.
3. Keep doing functional
exercise.¡¡
Please check the video on youtube or
check the video
on youku
¡¡
More ALS cases that we helped
well:
Video-1 on youtube or
Video-1 on youku
new
Video-2 on youtube or
Video-2 on youku
new
Video-3 on youtube or
Video-3 on youku
new
Video-4 on youtube or
Video-4 on youku
new
Video-4 on youtube or
Video-4 on youku
new
Case-1
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Case-37
