Brief
Summary: On April 9, 2011, Daa, from Slovenia, 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 more than 2 years, developing into difficult walking problem for 10
months, was hospitalized in our hospital. She achieved some great improvement
after 31 days TCM treatment.
Record of Hospitalization
Name:
Daa
Sex: Female
Age:
47
Marital Status: Married
Nationality: Slovene Date
of Admission: April 9, 2011
Companion: Family
First Medical Record
Date:
Apr. 10, 2011 Time: 10:00 am
This
47-year-old lady had suffered from weak and powerless limbs for two and half
years, developing into difficult walking for 10 months. The patient was
hospitalized in our hospital for TCM treatment at 19 pm on April 9, 2011.
Essential for Diagnosis:
1. The
patient had been suffering from weak and powerless limbs for two and half years,
developing into difficult walking for 10 months.
2. The
patient complained of weakness and pains over her left upper limb without any
evident causes on October, 2008. Fingers of her left hand were also weak,
disabled to fix the fasteners on the clothes. She did not go to hospital for any
examinations. In November, 2009, her left little finger was out of movement;
left lower limb began to be weak; there were pains over her right wrist and
muscle jumpings over her whole general body. In June, 2010, the above mentioned
symptoms became severe, and the movement of dorsiflexion of her left foot was
reduced. The report of EMG presented that she was attacked by motor neuron
disease (MND), and according to the clinical symptoms of her condition, her
condition was diagnosed as ALS. The hospital only gave her some medicine
supplements for oral use, instead of any specific treatment.
3. When the
patient hospitalized in our hospital, she felt weak and strength-less over her
whole general body, particularly over her left-side body. There were muscle
jumpings over her whole body. She also had shortness of breath, much phlegm and
saliva, unclear speech, as well as pains over her shoulders and neck. She was
easy to be fatigued. Spirit and sleep were good. She could sleep for around 8
hours every night. Urine was yellowish and stool was dry. Because of a fall 2
months ago, phalanx of her left food was broken; therefore, when walking, she
suffered few pains. She could only walk for about 300 meters. Walking balance
was not good.
4. T:
36.5¡ãC R: 20 times/minute P: 80 times/minute BP: 120/70 mmHg
5. She had
a natural facial expression. Her spirit activities were normal. She grew
normally. The patient had walking problem. She showed active position. Grasping
power: right hand, 9.5kg, left hand 6.1kg. Her tongue was pale with thin and
white coating. Her pulse was weak and thready.
Diagnostic Basis:
TCM:
The patient had been suffering from weak and powerless limbs for 2 and half
years, developing into difficult walking problems for 10 months. The lungs
dominate respiration and control qi throughout the body. Shortness of breath was
due to deficiency of the lungs. The spleen governs the muscles and the four
limbs. The deficiency of spleen and lungs led to improper transmitting of water
and essence to the whole body, so muscle atrophy appeared. Yin deficiency of the
liver and kidneys leads to loss of nourishment of the vessels and channels as
well as muscles, therefore, muscle jumpings over her whole body and night
sweating appeared. From the principle of TCM, deficiency of the lungs and spleen
as well as yin deficiency of the liver and kidneys were the characters of
atrophy disease.
Western
Medicine: The patient suffered from weak and
powerless limbs for two and half years, developing into difficult walking for 10
months, accompanied by muscle jumpings and muscle atrophy. Meanwhile, according
to examination results of EMG and her clinical symptoms, 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: deficiency of the lungs and spleen as well as yin deficiency of
the liver and kidneys.
Western
medicine diagnosis: ALS
¡¡
Treatment strategy and nursing:
1. Routine
care of traditional Chinese internal medicine.
2. Grade
¢ò
care.
3.
Companion.
4. Common
diet.
5.
Pathogenesis: deficiency of the lungs and spleen as well as yin deficiency of
the liver and kidneys.
6. TCM
strategy: nourish the spleen and benefit the lungs,
nourish the liver and kidneys as well as nourish blood and soften the tendons.
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: Apr.
11, 2011 Time: 10:30 am
Professor
Yang, paid a visit to the patient. The patient felt weak and strength-less over
her whole general body, particularly over her left-side body. There were muscle
jumpings over her whole body. She also had shortness of breath, much phlegm and
saliva, unclear speech, as well as pains over her shoulders and neck. She was
easy to be fatigued. Spirit and sleep were good. Her stool was dry and urine
yellowish. She complained of pains over the back of her feet when walking. She
could only walk for around 300 meters, with bad balance. Physical check: The
functions of her heart and lungs were normal. There was muscle atrophy over
tucks muscles of her both hands, finger muscles and her left supraspinatus
muscles. Grasping power: right hand, 9.5kg, left hand 6.1kg. Her tongue was pale
with thin and white coating. Her pulse was weak and thready. Professor Yang
thought from the TCM principle that the patient suffered from atrophy disease,
which was due to deficiency of the lungs and spleen as well as yin deficiency of
the liver and kidneys. The therapeutic methods for the atrophy disease are to
nourish the spleen and benefit the lungs, nourish the liver and kidneys as well
as nourish blood and soften the tendons.
Date: Apr.
12, 2011 Time: 10:30 am
Feedback of
examinations: Blood routine, urine routine as well as the functions of the liver
and kidneys were normal.
Date: Apr.
13, 2011 Time: 10:00 am
The patient
said muscle jumpings over her whole general body were reduced. She was no longer
that easy to be fatigued even after some exercise. Sleep was good.
Date: Apr.
17, 2011 Time: 10:00 am
The patient
said symptoms of her whole body were changing better. Other conditions were good
except of much saliva in her mouth.
Date: Apr.
21, 2011 Time: 10:00 am
There was
no special improvement in the patient¡¯s conditions. Saliva was reduced somewhat.
There was sweating over her chest. Urine was yellowish. Pains over her left foot
back were reduced slightly when walking.
Date: Apr.
25, 2011 Time: 9:30 am
The patient
felt sever pains over her left foot back, since they had a tour of mountain
climbing. There was sweating over the front part of her chest. Strength over her
whole body was increasing. Muscle jumpings were reduced evidently. Saliva was
reduced.
Date: Apr.
30, 2011 Time: 9:15 am
The patient
said strength of her four limbs was increasing some bit. Grasping power: right
hand, 10.6 kg, left hand 6.4 kg. Now she could walk for around 400 meters. There
were slight edema and pains over her left foot back. She had chest oppression,
shortness of breath, sweating over her chest and occasional restless. Her tongue
was red with thin tongue coating. Her pulse was wiry.
Date: May
6, 2011 Time: 9:15 am
The
patient¡¯s conditions were stable. She had good spirit and good sleep. Her
appetite was normal. Bowel movement and urine were normal. Her tongue was red
with thin coating. Her pulse was wiry.
Date: Mar.
10, 2011 Time: 10:00 am
After one
month TCM treatment, the patient requested to leave hospital today. After
treatment in our hospital, the patient¡¯s conditions were much better than
before. Weakness and powerlessness of her four limbs were changing better. Chest
oppression and shortness of breath were reduced. Muscle jumpings over her whole
body and pains over her neck and shoulders were basically improved. Pains over
her left foot back were reduced when walking. Sleep, appetite and sleep were
good. She felt muscle-increasing on the tuck muscles of her left hand. Grasping
power: right hand 10.8 kg, left hand 6.8 kg.
Doctor¡¯s
advice after leaving hospital:
1. Maintain
good moods and be careful with the cold.
2. Take
herbal medicine back for continuing treatment.
4. Keep doing functional
exercise of the limbs.
¡¡
More ALS cases that we helped
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Video-2 on youtube or
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Video-3 on youtube or
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Video-4 on youtube or
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