Brief Summary:
On June
24, 2010, Pauline from Canada, who has suffered from ALS, was
hospitalized in our hospital. She has had the weakness of her
four limbs for one and half a year and accompanied with the
muscle atrophy for 8 months. After five months treatment, she
achieved a good result.
Record of
Hospitalization
Name:
Pauline Birthplace:
Canada
Sex:
Female Profession:
Web worker
Age:
43 Date of
Admission: June 24, 2010
Marital Status:
Married Date of Record: June 25,
2010
Nationality:
Canada Onset Season: Summer
Solstice
Major Complaints:
She has had the weakness of her four limbs for one and half a
year and accompanied with the muscle atrophy for 8 months.
Present Illness:
The patient found the obvious weakness on the left lower limb at
the beginning of 2008. Then this problem affected the four limbs
and muscle atrophy appeared. The local doctor diagnosed it as
ALS. The patient has received the acupuncture, but the treatment
effect was not so good. Now, she has the weakness of her four
limbs and atrophy on the part of the hand between the thumb and
the index finger. The muscles of the other parts are relaxant
but not apparently atrophic. She has no problem of walking, but
the long time walking will cause pains in the buttocks. She has
normal spirit but is easy to get tired. Both of her sleep and
appetite is good. Her swallowing and urination is normal and
stool is loose. Also, she has muscle jumpings, but it is not
very obvious.
Disease History :
Between 1983 and 1986, she had the mild enlarged thyroid. After
the treatment, it has recovered now. In 1986, she had the
ulcerative colitis and take medicine until 1991. She has no
tuberculosis, typhoid
and hepatitis. She is not allergic to any food but allergic to
erythrocin. She has no history of blood transfusion.
Personal History: She was born in Canada. No
contact history of schistosomiasis. No addiction to smoking and
alcohol. She has a even temper but much working pressure.
Marriage History: She get married and has two
children and a healthy husband.
Family History: No family members got the
similar disease before.
Physical Examination
T: 37.1℃
P: 80bpm R: 20bpm BP: 100/60mmHg
She was mid-nourished and normally developed.
Her mild was clear. Her skin was moist. Her neck was soft and
trachea
is in the midline.
No jaundice in the sclera. No superficial lymph-node
enlargement. No enlarged thyroid. Sound of breath was
bilaterally normal on auscultation. Heart border was normal.
Heart beat 80/min. Cardiac rhythm was regular. No pathological
murmurs on auscultation. Abdomen was flat and soft without
tenderness or rebound tenderness. Liver and spleen were not
palpable. Her four limbs are very weak, especially the upper
limbs. Muscles are
atrophic on the
part of the hand between the thumb and the index finger. At the
same time, she can not abduce her thumbs completely. The other
parts muscles are relaxant but not apparently atrophic. She had
the left foot drop. The
movement of the joints is normal. No check of her anus and the
two lower orifices. She has dark tongue body and whitish, thick
tongue coating and weak pulse..
First Diagnosis:
TCM diagnosis: Wei-syndrome (flaccidity
syndrome)
Symptom Diagnosis: Yin blood deficiency,
tendon and vessel malnutrition.
Western medicine diagnosis: ALS
Diagnosis Basis: TCM：
Wei-syndrome (flaccidity syndrome) refers to the softness of the
muscles and bones, and weakness of the limbs.
Western medicine: The patients who get MS
will get much more weaker after exercises, but after a short
time rest, the symptom will be reduced. Also, compared to ALS,
it is rare to see the muscle jumping, no pseudohypertrophy.
Plan of treatment and care
1. On routine
care of traditional Chinese internal medicine
2. On grade Two
care
3. Under care of
a companion
4. Low-fat
protein diet
5.
Pathogenesis: Yin blood deficiency,
tendon and vessel malnutrition
6.
Therapeutic Principle: Nourishing qi and blood, clear the
meridians
7. Herbal
tea: One dosage a day and drink twice, each time 180ml
8.
Acupuncture and massage: Once a day
9. Have
more medical examinations if necessary
Date: June 26, 2010 Time:
10:00 a.m.
The patient has had the weak
limbs for one and half a year, and muscle atrophy for 8 months.
The
local doctor diagnosed it as ALS. The patient has received the
acupuncture, but the treatment effect was not so good. Now, she
has the weakness of her four limbs and atrophy on the part of
the hand between the thumb and the index finger. The muscles of
the other partsare relaxant but not apparently atrophic. She has
no problem of walking, but the long time walking will cause
pains in the buttocks. She has normal spirit but is easy to get
tired. Both of her sleep and appetite is good. Her swallowing
and urination is normal and stool is loose. Also, she has the
muscle jumpings, but it is not very obvious.
She has dark tongue body and
whitish, thick tongue coating and weak pulse. According to her
pulse and tongue, professor Yang thought patient got
wei-syndrome (flaccidity syndrome). The symptom was yin blood
deficiency,
tendon and vessel malnutrition.
Date: June 27, 2010 Time:
10:00 a.m.
We got the results of the patient's body
check. It was, HGB=1838/L,
RBC 6.28/L
HCT 55.1
PDW 14.5
Routine urinalysis: normal
liver kidney function: normal
Date: July 1, 2010 Time:
10:00 a.m.
The patient was in stable condition, and she
found that muscle jumpings reduced slightly. Tongue was a
little dark, tongue coating was whitish and thin. She had
menstruation yesterday, but menstrual quantity was less. Patient
had no pains in waist, abdomen, and chest. So we decide to
change the formula by taking away Eupatorium, adding yimucao to
promote blood circulation by removing blood stasis. 5 dosages in
all.
Date: July 6, 2010 Time:
10:00 a.m.
The patient had
had stopped menstruation yesterday. The quantity was a little.
She had no power of her thumbs, especially the left one. The
muscle jumpings on the lower limbs reduced, but more appeared on
the back. So we decide to change the formula to achieve the aim
of nourishing yin and moving away fire in the body. 5 dosages in
all.
Date: July 11, 2010 Time:
10:00 a.m.
The patient had less muscle jumpings and a
litter more power of her lower limbs. Also, the left foot drop
was a litter better. But, she still felt the power of her thumbs
not strong enough. She could not hold the heavy things ,hooked
deftly and open the door with the key. So, we take the method
of nourishing yin blood and moving away fire in body as her
therapeutic principles. 5 dosages in all.
Date: July 16, 2010 Time:
10:00 a.m.
Except no big improvement of muscle
jumpings, the patient was in a stable condition. Today , she
had light reddish tongue nature and thin-whitish tongue coating.
Her pulse was a litter weak and the shape of pulse was not
clear. So, we take the method of nourishing yin blood and
moving away fire in body as her therapeutic principles. 5
dosages in all.
Date: July 21, 2010 Time:
10:00 a.m.
The patient had no obvious change of muscle
jumpings. She felt a litter uncomfortable after drinking herbal
tea in recent two days. So, we decided to nourish yin, move away
fire in body and regulate qi and the stomach to solve this
problem. 5 dosages in all.
Date: July 26, 2010 Time:
10:00 a.m.
After the treatment of supplementing qi and
nourishing yin, the patient found that a little improvement of
the power of her four limbs. At the same time, the muscle
jumpings on arms, legs and back were reduced. Her current
symptoms are weakness of the limbs, especially the thumbs; the
left crus was fatigued and weak; no good sleep recent days, dark
red tongue body, thin tongue coating and weak pulse. So, we
decide to take the method of supplementing qi and nourishing
yin, nourishing the heart to recuperate her body.
Date: August 1, 2010
Time: 10:00 a.m.
The patient had had her menstruation since
July 29.The volume, color, or quality were good. She felt aching
pains on her waist because that yesterday they moved house from
our old hospital to our new hospital. So we decide to change the
formula to strength the loins and invigorate the kidneys and
promote the qi circulation and relieve pains. 5 dosages in all.
Date: August 6, 2010
Time: 10:00 a.m.
The patient stopped her menstruation on
August 3. The period was shorter than last time. She still had
muscle jumpings. But, it was much less than before. The power of
the limbs was a little improved. The aching pains on the waist
have gone. Sleep and defecation were normal. She had light
nature body and whitish-thin tongue coating. Her pulse was
slightly slow. So, we take the method of nourishing yin blood
and moving away fire in the body as her therapeutic principles.
5 dosages in all.
Date: August 11, 2010
Time: 10:00 a.m.
The last few days, the patient found that the
frequent muscle jumpings on the quadriceps of the right upper
arm and lower limbs appeared again. The power of her four limbs
was ok. But, her left foot was still dropping. The way of her
walking was a little better than before. Her sleep and
defecation were normal. She had light tongue body and
whitish-thin tongue coating. Her pulse was fine slow. Because
that the effect of formula was not so good, we decided to
continue taking the prescription of August 6 which used the
method of nourishing yin blood and moving away fire in the body
as her therapeutic principles. 5 dosages in all.
Date: August 11, 2010
Time: 10:00 a.m.
The frequency of her muscle jumpings were
reduced but the intensity was increased. Today, her tongue body
was slightly reddish, tongue coating was thin and greasy. we
decided to continue taking the method of nourishing yin blood
and moving away fire in the body as her therapeutic principles.
5 dosages in all.
Date: August 26, 2010
Time: 10:00 a.m.
The frequency of
her muscle jumpings were reduced greatly. Now, the major area of
muscle jumpings focused on the quadriceps of the slightly pale
thigh. The power of her four limbs was ok. Sleep and defecation
were normal. She had slightly pale tongue body and whitish-thin
tongue coating. Her pulse was slightly slow. So we decide to
change the formula to achieve the aim of nourishing Yin and
promoting blood circulation. 5 dosages in all.
Date: September 1, 2010
Time: 10:00 a.m.
The patient's
muscle jumpings were remitted, but the power of her right upper
limb was a little worse than before. Her spirit was good. Sleep
and defecation were normal. She had slightly pale tongue body
and whitish-thin tongue coating. Her pulse was slightly slow. So
we decide to change the formula to achieve the aim of
nourishing the kidneys and liver,
nourishing Yin and generating body fluid. 5 dosages in all.
Date: September 6 2010
Time: 10:00 a.m.
The patient had cramps on her gastrocnemius
during night. So we decide to change the formula to achieve the
aim of enhancing the blood circulation. 5 dosages in all.
Date: September 11 2010
Time: 10:00 a.m.
Both of the intensity and frequency of her
muscle jumpings were reduced greatly. Now, the major area of
muscle jumpings focused on the quadriceps of thigh. Her sleep
and defecation were normal. She had slightly tongue body and
whitish-thin tongue coating. Her pulse was fine slow. We decided
to change the formula to achieve the aim of strengthening the
power of the limbs. 5 dosages in all.
Date: September 16 2010
Time: 10:00 a.m.
It is the 84th day the patient
stayed in our hospital. Her current symptoms are: The left foot
drop and the way of her walking was a little better than before.
The power of her lower limbs was slightly improved. The spirit
was getting better, and the fatigue disappeared. The muscle
jumpings were under control but not stable. Sometimes, the
muscle jumpings appeared on some parts of her body, but
sometimes it appeared on the whole body. The patient got more
power of her upper limbs during the first month after she came
to our hospital, but lost some strength during the last 20 days
and she also felt her upper limbs weak. She had no dramatic loss
of weight. Her appetite, sleep and defecations was normal. She
had slightly pale tongue body and whitish-thin tongue coating.
Her pulse was slightly slow. Also, her pulse was better than
before. Because no obvious effect during the last 20 days, we
made a analysis for her. We got the idea: The liver govern the
limbs, if the liver qi is weak, the pulse will be weak. The
problem of weakness of the limbs and muscle jumping was caused
by the liver wind agitation. So, we take the method of
fortifying the spleen and supplementing Qi, softening liver and
dispersing wind, promoting blood circulation and removing
obstruction in the channels as her therapeutic principles.
Date: September 21 2010
Time: 10:00 a.m.
The patient had less muscle jumpings, and
either the intensity or the frequency of her muscle jumpings
were reduced. Now, the major area of her muscle jumpings
appeared on the front of her thighs. She still had the muscle
jumpings on her arms and back.
Date: September 26 2010
Time: 10:00 a.m.
With the weather get colder, the patient
found that muscle jumpings increased a little bit. There was no
obvious improvement of her upper limbs. She had slightly pale
tongue body and whitish-thin tongue coating today. Her pulse was
slightly slow.
Date: October 1 2010
Time: 10:00 a.m.
After 3 months treatment, the patient had had a
big improvement of her spirit. The lower limbs got more
strength. Even after 30 minutes cycling exercises she did not
feel tired. The problem of her left foot drop was almost gone.
Her muscle jumpings were getting less, but the upper limbs were
still weak. The muscles on the thenar, hypothenar and the thumb
and index finger at the middle of the
Tucks muscle
was very relaxed. Her pulse was still very weak, especially the
right pulse. According to the theory of TCM, weak limbs and
right pulse are resulted from the deficiency of qi in
middle-jiao. So, we decided to supply more qi in the
middle-warmer for the patient.
Date: October 6 2010
Time: 10:00 a.m.
The patient had good spirit and ruddy and
luster complexion. Her hands got more power now. The grasping
power of right hand was 15.5kg, left was 13.9kg. The patient
still had muscle jumpings on the thighs and abdomen. Her tongue
body was slightly reddish, coating was whitish and thin. The
power of her pulse was a little better than before, especially
the right one. So, we decided to add some rhizoma gastrodiae to
calm wind and stop spasm.
Date: October 9 2010
Time: 10:00 a.m.
The patient had normal spirit, sleep,
appetite and defecations. Her four limbs got more power and
muscle jumpings were reduced. Today, she is going to Tibet for
traveling with her family. We wish her good luck.
Date: November 3, 2010
Time: 10:00 a.m.
The patient
returned from her traveling yesterday. She was absent for 24
days. Now, she had good spirit, sleep, appetite and defecations.
She had slight muscle jumpings. However, her grasping power was
a little decreased. Today, the test result was: right hand
15.0kg, left hand 12.6kg. She had slightly reddish tongue body
and whitish tongue coating and weak pulse today. So, we decided
to change her prescription to strengthen her sinews and bones. 3
dosages in all.
Date: November 6, 2010
Time: 10:00 a.m.
The patient was in a stable condition. She
had slightly reddish tongue body, a little yellowish and thick
tongue coating, and weak pulse. So, we decided to reduce her
phlegm and smooth the veins. 5 dosages in all.
Date: November 11, 2010
Time: 10:00 a.m.
Since the patient coming back from her
traveling, the whole situation of the patient was not as good as
before, it was a little down. The power of her two hands was a
little decreased. She had more muscle jumpings on her back and
abdomen, but she was normal in her spirit, sleep and
defecations. She had slightly reddish tongue body, a little
yellowish and thick tongue coating, and weak pulse. It due to
travel fatigue. So, we decided to invigorate the kidneys and
strengthen muscle and bone. 5 dosages in all.
Date: November 16, 2010
Time: 10:00 a.m.
Now, the patient she can do something like
holding knife and fork and, buttoning up much better than
before. The muscle jumpings were reduced and she was in a stable
condition.
Date: November 16, 2010
Time: 10:00 a.m.
The patient had been in hospital for 154 days.
Now, she had a very good spirit, and got more power of her lower
limbs. Also, the left foot drop got a big improvement. The
muscle jumpings were under control and less but not stable. The
upper limbs were still weak. The muscles on the thenar,
hypothenar and the thumb and index finger at the middle of the
Tucks muscle was very relaxed. She had normal spirit, sleep and
defecations. She had slightly reddish tongue body, a little
yellowish and thick tongue coating, and weak pulse. She had a
better pulse than before. The patient is going to leave. And our
suggestion for her:1. keep warm, take good food, keep good mood
2. do appropriate exercises 3. insist on taking herbal tea. (The
therapeutic principles is tonifying middle-warmer and Qi,
nourishing muscles, nourishing blood and liver) 4. continue
acupuncture and massage. (The therapeutic principles is to keep
high quality acupuncture and soft massage to avoid the muscle
fatigue.
More ALS cases that we helped
well:
Video-1 on youtube or
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Video-2 on youtube or
Video-2 on youku
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Video-3 on youtube or
Video-3 on youku
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Video-4 on youtube or
Video-4 on youku
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Video-4 on youtube or
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