Brief
Summary: On January 02, 2011, Ribka, from the
United States, who had suffered from wilting pattern or muscle atrophy in
traditional Chinese medicine (TCM) or amyotrophic lateral sclerosis (ALS) in the
concept of western medicine for 2 months, accompanied by weak and heavy limbs,
was hospitalized in our hospital. She achieved significant improvement after 70
days TCM treatment.
¡¡
Record of Hospitalization
Name:
Ribka
Sex: Female
Age:
36
Marital Status: Married
Nationality: Dutch
Date of Admission: Jan. 2, 2011
Companion: Family
First Medical Record
Date:
Jan. 2, 2011 Time: 15:00 pm
This
36-year-old lady had suffered from weak and heavy limbs for 2 years, accompanied
by difficult walking and muscle jumpings all over her whole general body. The
patient was hospitalized in our hospital for TCM treatment at 15 pm on January
2, 2011.
Essential for Diagnosis:
1. The
patient had been suffering from weak and heavy limbs for 2 years, accompanied by
difficult walking and muscle jumpings all over her whole general body.
2. The
patient complained of weak lower limbs and difficult walking after childbirth in
February of 2009, and later developed into weakness of her upper limbs. On
October 10, 2010, her condition was diagnosed as ALS in her local hospital,
while she did not take any treatment for that.
3. When the
patient hospitalized in our hospital, she had weak four limbs and had difficulty
to raise her lower limbs. She could not walk by herself and when she walked, she
should be under the help of a walker. It was also difficult for her to stand up.
There were pains over her knees and spontaneous spasms over her lower limbs.
Fingers of both hands could not stretch straight. Fingers also were weak, but
the weak problem did not affect her daily activities at present. She felt a
sense of stiffness and heaviness over her whole general body. There were also
muscle jumpings over her whole general body and being severe during the night.
Sleep in the night was good, but it was difficult for her to turn over her body.
Appetite was good. She did not feel dry in her mouth and she liked hot drinking.
Urination was good. She suffered occasional constipation. During her
menstruation, she suffered occasional abdominal pains.
4. T:
36.2¡ãC R: 20 times/minute P: 80 times/minute BP: 120/80 mmHg
5. She had
a chronic diseased facial complexion, with a skinny body. Her spirit activities
were normal. The formation and size of the thorax were normal. The breathing
sounds of the lungs were clear, with no pathological murmurs. The heart rate was
regular.
6. The
movement of her four limbs was ok. Bending of both acrotarsiums was not good.
There were pains over the joints of her knees. She did not suffer weight loss.
Her tongue was slightly red with white and greasy tongue coating. Her pulse was
deep and thready.
Diagnostic Basis:
TCM:
The patient had been suffering from heavy and weak four limbs for 2 years since
her childbirth. She had a sensation of chill. Her tongue was slightly red with
white and greasy tongue coating. Therefore, the abovementioned conditions were
due to cold and dampness obstructing the channels. Because of deficiency of qi
and blood after child birth and improper nourishment of liver and kidneys, her
general body presented stiffness. Muscle jumpings over her body were caused by
wind-producing due to blood vacuity. From the principle of TCM, vacuity of blood
and qi, improper nourishment of liver and kidneys as well as cold-damp
obstructing the channels were the characters of atrophy disease.
Western
Medicine: The patient¡¯s four limbs were heavy and
weak for 2 year. She also suffered muscle jumpings. Meanwhile, according to
examination results from the local hospital of her country, she should have
suffered from ALS.
Diagnostic Differentiation:
TCM:
Atrophy diseases are usually differentiated with Bi syndrome or impediment
pattern. Atrophy diseases have such characteristics as atrophy of the limbs¡¯
muscles, the weakness of the limbs and the uselessness of the thin feet. The
muscular atrophy and muscle jumpings are the main symptoms of atrophy diseases.
The impediment patterns are reflected by the pains or tense pains on the body
joints. So it is easy to differentiate them.
Western Medicine
diagnosis: ALS should be differentiated with
myasthenia gravis. Myasthenia gravis would be aggravated after exercises and it
would be reduced after some rest. Almost no muscle atrophy and muscle jumpings.
But ALS is caused by lesions of the central nervous system, accompanied by
muscular atrophy and muscle jumpings. Therefore, there is no difficulty to
differentiate them.
First
Diagnosis:
TCM:
atrophy disease
Symptom
identification: vacuity of blood and qi, improper nourishment of liver and
kidneys as well as cold and dampness obstructing the channels.
Western
medicine diagnosis: ALS
Treatment strategy and nursing:
1. Routine
care of traditional Chinese internal medicine.
2. Grade
¢ò
care.
3.
Companion.
4. Diet
with low fat and high protein.
5.
Pathogenesis: vacuity of blood and qi, improper nourishment of liver and kidneys
as well as cold-damp obstructing the channels.
6. TCM
strategy: supplement qi and nourish blood, supplement
the liver and kidneys as well as warm yang to dispel dampness and open 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.
3, 2011 Time: 10:00 am
Professor
Yang, paid a visit to the patient. The patient complained of heavy and weak four
limbs for 2 years. Her condition was diagnosed as ALS at local hospital of her
country. At present, her four limbs were weak. It was difficult for her to raise
her lower limbs, to stand up as well as to walk by herself, if not with the help
of a walker. There were pains over her both knees and occasional spams on her
lower limbs. Fingers of both hands could not stretch straight. Fingers also were
weak, but did not affect her daily activities at present. She felt a sense of
stiffness and heaviness over her whole general body. There were also muscle
jumpings over her whole general body and severe during the night. Sleep in the
night was good, but it was difficult for her to turn over her body. Appetite was
good. She did not feel dry in her mouth and she liked hot drinking. Urination
was good. She suffered occasional constipation. Her tongue was slightly red with
white and greasy tongue coating. Her pulse was deep and thready. Professor Yang
thought from the TCM principle that the patient¡¯s conditions were due to vacuity
of blood and qi, improper nourishment of liver and kidneys as well as cold-damp
obstructing the channels. He suffered from atrophy diseases. The TCM formula
should have the functions of supplementing qi and nourishing blood,
supplementing the liver and kidneys as well as warming yang to dispel dampness
and quicken the channels.
Date: Jan.
4, 2011 Time: 10:00 am
Feedback of
examinations: Blood routine, urine routine as well as the functions of the liver
and kidneys were normal. ECG: sinus arrhythmia.
Date: Jan.
6, 2011 Time: 10:00 am
The patient
said muscles of the back of her shin were stiff, tense and jumping. Other
conditions were of no evident development. Last night, she began her
menstruation, and she had a little bit vomiting sensation. But now, there was no
such kind of symptom. Her tongue was slightly red with white tongue coating. Her
pulse was sunken and thready.
Date: Jan.
11, 2011 Time: 10:00am
The patient
said stiffness of muscles of her shins was reduced. Her lower limbs were
powerful than before. Muscle jumpings were reduced. On January 7, menses
stopped. She did not suffer breast pains and waist pains during the
menstruation. Her pulse was thready. Her tongue was slightly red with thin and
white tongue coating.
Date: Jan.
16, 2011 Time: 10:00 am
After more
than 10 days TCM treatment in our hospital, the patient felt her spiritual
activities were better than before. Strength of her body was increasing. Stiff
sense of the muscles was reduced. At present, her lower limbs were weak and
heavy. There were muscle jumpings over her body. Balance was better. She could
walk by herself without the walker for more than 10 steps. Her tongue was
slightly red with thin tongue coating. Her pulse was weak.
Date: Jan.
21, 2011 Time: 10:00 am
The patient
felt her hands still weak. There was numb sense on her finger tips. Both knees
were weak. It was difficult for her to stand up if without any other help. There
were muscle jumpings over her general body, sometimes more and sometimes less.
The above mentioned symptoms were much better than before. Her tongue was
slightly red with thin and white tongue coating. Her pulse was slight stronger.
¡¡
Date: Jan.
26, 2011 Time: 10:00 am
The patient
said stiff sense on the front part of her legs was reduced somewhat, but the
back part was still stiff. Muscle jumpings were reduced, and at present, muscle
jumpings mainly happened over her elbows and the knee joints. Strength of her
arms was increasing, while her hands were weaker than before. Her knees were
still powerless and she could not stand up by herself. She slept well at night.
Urination and bowel movement were normal. Appetite was good. Her tongue was
slightly red with white tongue coating. Her pulse was slight weak.
Date: Feb.
1, 2011 Time: 10:00 am
The patient
complained more muscle jumpings during the night of January 30. But now it was
the same as days before. Muscle jumpings still mainly happened over her elbows
and knee joints. Her tongue was slightly red with whit tongue coating. Her pulse
was slight weak.
Date: Fed.
6, 2011 Time: 10:00 am
Muscle
jumpings over her arms were reduced somewhat. Her lower limbs and knee joints
were still weak. She could not stand up by herself. Heavy sense of her general
body was reduced. Body movement was more flexible than before. Menses started on
Feb. 2 and stopped on Feb. 5. The quantity was still poor with dark color
discharge.
Date: Feb.
11, 2011 Time: 10:00 am
The patient
said strength of her upper limbs was increasing a little bit. She could do
exercise for a little longer time and she did not feel tired. Strength of her
lower limbs was also increased. There was no evident improvement in muscle
jumpings. Her tongue was slightly red with white tongue coating. Her pulse was
slightly weak.
Date: Feb.
16, 2011 Time: 10:00 am
The patient
complained of severe pains over the joints of her limbs without any cause at the
night of Feb. 13. Professor Yang gave her the medicine of Piaoyan Pain for oral
use, and now the pains almost dispelled. In the morning of today, she felt heavy
and weak lower limbs. Muscle jumpings were reduced a little bit. Her tongue was
slightly red with white and slightly thick tongue coating. Her pulse was weak.
Date: Feb.
21, 2011 Time: 10:00 am
The patient
complained of chest depression and burning sense in her gastric cavity. Other
conditions were stable. Her tongue was slightly red with white and slightly
thick tongue coating. Her pulse was weak.
Date: Feb.
23, 2011 Time: 10:00 am
Muscle
jumpings did not change much. Heavy sense of both legs still existed.
Date: Feb.
26, 2011 Time: 10:00 am
The patient
said chest depression and gastric discomfort disappeared. She still felt
weakness and heaviness over her lower limbs. There were cramps over her ankles.
Last night, muscle jumpings were a little bit more. Her tongue was slightly red
with white and slightly thick tongue coating. Her pulse was weak.
Date: Mar.
1, 2011 Time: 10:00 am
There was
no evident improvement in her conditions.
Date: Mar.
6, 2011 Time: 10:00 am
The patient
complained of chest depression again and these days her appetite was not good.
Muscle jumpings were less. Muscle jumpings over her shoulders and shoulder
blades were obvious. Her tongue was slightly red with white and slightly thick
tongue coating. Her pulse was weak.
Date: Mar.
11, 2011 Time: 10:00 am
Appetite
and sleep were good these days. Urination and bowel movement were normal. Muscle
jumpings were less. Her lower limbs were still weak. She would feel pains over
her knee joints after a little bit longer walking. Her tongue was slightly red
with white and slightly thick tongue coating. Her pulse was weak.
Date: Mar.
16, 2011 Time: 10:00 am
After more
than 2 months TCM treatment, the patient requested to leave hospital today.
After treatment in our hospital, the patient¡¯s conditions were much better than
before. Muscle jumpings over her whole general body were under effective control
now. Strength of her lower limbs was increasing. She now could walk for a short
distance even without the help of the walker. Her lower limbs were still weak.
Strength of her right hand increased somewhat, while her left hand did not
improve evidently. Stiffness and heaviness were reduced. Her four limbs were
warmer than before. Appetite and sleep were good. Urination and bowel movement
were normal. Her spirit was good. Her tongue was slightly red with thin and
white tongue coating. Her pulse was slightly weak.
Doctor¡¯s
advice after leaving hospital:
1. Maintain
good moods.
2. Take 90
days herbal medicine back for continuing treatment.
3. Avoid
wind-cold and be careful with the cold.
4. Keep doing functional
exercise of the limbs and the muscles of the tongue.
¡¡
Please check the video on youtube or
check the video
on youku
¡¡
More ALS cases that we helped
well:
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