Clinical experience in the treatment of multiple sclerosis by the method of cultivating and consolidating the essence

  Multiple Sclerosis (MS) is a kind of demyelinating lesion in the white matter of the central nervous system of unknown etiology, which is characterized by temporal multiplicity and spatial multifocality and occurs mostly in young adults. Western medicine mostly uses hormonal or immunotherapy, which has not yet achieved satisfactory results because it cannot effectively prevent recurrence and has large side effects. Since my mentor unfortunately suffered from this disease in 1975, the disease was controlled by Chinese medicine and hormone therapy and has not recurred since then. During his more than 40 years of medical practice, he has treated many MS patients with Chinese medicine and accumulated rich clinical experience, especially in improving symptoms and preventing recurrence. The main manifestation of MS is visual impairment, unfavorable limb movement or sensory impairment, and the remission and relapse of symptoms often alternate and get progressively worse. There is no corresponding disease name in Chinese medicine, but the main symptoms can be categorized, such as repeated colds, sweating when moving, and fatigue are mainly classified as “deficiency consumption”; visual impairment is “dim vision” in mild cases and “blue blindness” in severe cases. “The main manifestation of limb movement disorder or even paralysis is “impotence”, and those with unstable walking and ataxia are equivalent to “bone care”.  The teacher believes that although the clinical manifestations of MS are different, the root cause of the disease is the deficiency of positive qi, that is, “where the qi is deficient, the evil will come together”; positive deficiency is the root, the evil is the symptom, the deficiency is mixed with the real, the positive and the evil are mixed, the positive and the evil are mixed with each other, the mother is still ringed, Xin Sole winding toot, the key moisture Fu Fu Di Lao winding, the ticking second grasshopper, the gourmets spring anchor grain spring play the crop, take the borrowing people bath hammer to give the supper arm caries S Tossing ⒈ quietly. Huanwo nightmare bar terrier caijiao chain depression, if the spirit is too nervous, depressed or emotional restlessness, six desires, the seven emotions can be turned into fire, heat fury, Xuanfu closed, it becomes the trigger for the onset; spleen is the mother of all bones, the source of biochemical energy, the spleen is weak, biochemical energy and blood lack of source, can not be glorified on the eyes, the vision is blurred; qi deficiency is numb, blood deficiency is wood, so the perimeter of the skin sensory impairment, limb weakness; kidney is the innate essence. If the disease is prolonged and affects the kidneys, the kidneys do not store essence, and the loss of essence leads to the loss of nourishment of the head and eyes, which leads to atrophy; the lack of bone marrow, which leads to limb weakness; after the spleen and kidneys are damaged, it is more likely to relapse.  2. Understanding of MS treatment: According to the pathogenesis of MS, the instructor divided MS into three phases: acute phase, remission phase and recovery phase, and advocated treatment by phases, but all of them need to be given Yu Ping Feng San to support the positive and consolidate the surface, so as to prevent the disease before it occurs and prevent the change of the disease. In the acute stage, the main focus is on the actual evil, with emphasis on expelling the evil and supporting the righteous; in the remission stage, the deficiency is mixed with the actual, with a balance of supporting the righteous and dispelling the evil; in the recovery stage, the main focus is on the deficiency of the righteous, with emphasis on supporting the righteous and preventing recurrence.  2.1 Acute phase: At the beginning of the disease, most of the cases are caused by overwork or internal injury of emotion and will, which leads to depression of the Xuan Fu, the condition is acute and serious, and the medicine is valuable. The symptoms are fever, cough, irritability, sudden drop in vision, unfavorable limb activity or sensory disorders, etc. The treatment is to dredge the Xuanfu, support the righteousness and hold back the toxin; add or subtract Danjuania Prosperity San and Yu Pingfeng San; Danpi, Gardenia to disperse the depression and fire; Chai Hu, Angelica, Bai Shao, Poria to dredge the liver and strengthen the spleen; Jin Yinhua, Dandelion, Fishy Herb to clear heat and detoxify; Wei Ling Xian to clear heat and detoxify, dredge the meridians and open the channels; Huang Qi, Atractylodes, Fang Feng to benefit the Qi and hold back the toxin. For abdominal distension after eating, add green peel and Chen Pi; for abdominal pain and diarrhea, add Hou Pu, fried hawthorn and Shen Qu; for little sleep and dreaminess, add calcined dragon peony, raw fried jujube seeds and Xia Ku Cao; for heavy liver depression, add Tribulus terrestris and so on.  The treatment is to strengthen the spleen, benefit the qi and raise the yang, and add reduction of Yi Qi Smart Soup; ginseng and astragalus replenish the vital energy; Ge Gen, Sheng Ma, Manchurian Zi and Fang Feng lightly raise the hair and go up to the head and eyes. Then the nine orifices are clear, the eyes are bright and the ears are deaf; if the spleen qi is strong, the qi and blood are sufficient, the skin feels as usual, and the limbs are healthy and mobile; fried white peony and fried white atractylodes nourish the middle jiao and smooth the blood vessels; yellow cypress treats the deficiency of kidney water and bladder; epimedium and wei ling xian benefit the qi, strengthen the tendons and bones, and nourish the kidneys to hold the poison out [2]; if the tendons and veins are contracted, add centipede and whole scorpion; if the limbs are weak and the upper limbs are heavy, take gui zhi and mulberry branch, and if the lower limbs are heavy, add cow knee, mulberry and doklam, etc.  2.3 Recovery period: the onset of the disease is long, involving the liver and kidney, the treatment is based on nourishing the liver and kidney, with emphasis on preventing recurrence; the symptoms include recurrent external sensation, obvious girdling sensation, soreness and weakness of the waist and knees, depression, blurred vision, etc., with the addition of Liu Wei Di Huang Wan to nourish the liver and kidney and promote the vital energy; the kidney produces essence, and the fullness of the divine light depends on the superiority of the kidney essence, with Cuscuta, Raspberry and Fructus Lycii to nourish the yin of the liver and kidney and brighten the eyes, and Wu Wei Zi acid to collect the essence. The wind medicine such as fang feng, shengma, and geran dredge the xuanfu, carrying the medicine upward to benefit the essence of yin to reach the head and eyes; for those who are weak, give zihe che powder, which has the effect of “return to the original” and cure “all deficiencies and hundred losses”.  Prevention of recurrence: Recurrent attacks and progressive deterioration of the disease are the main reasons for poor prognosis [3]. The instructor emphasized that we must pay attention to our own care in daily life in order to effectively prevent recurrent attacks.  3.1 Beware of colds: this disease is an autoimmune disease, and external sensation is the main cause of recurrence. Overexertion, irregular life or imbalance in diet structure can lead to a decrease in immunity and susceptibility to external evil. Therefore, we should prevent cold and keep warm, exercise properly, pay attention to rest and prevent cold.  3.2 Keep your mood relaxed: Emotional and moral injury is a potential factor of this disease, and it is especially harmful. If you are emotionally tense, too excited or depressed and anxious all day long, the disease is easy to progress and not easy to retreat. Must maintain a relaxed mood, open-minded and optimistic. As the Yellow Emperor’s Classic of Internal Medicine says: “Tranquility and emptiness, the true energy from it, the spirit within the guard, the disease is safe from”.  3.3 Adherence to medication: After the acute phase of the disease, the condition tends to stabilize, but do not relax your vigilance. Adherence to Chinese medicine can reduce the side effects of hormones, improve systemic symptoms and prevent recurrence.  3.4 Cautious vaccination: Studies have found that influenza and hepatitis B vaccination can trigger the disease. Although it has not been widely recognized, it should be taken seriously by patients and vaccination should be administered with caution.  4. Case presentation: Gao Jiansheng, 38 years old, male, hospitalization date: November 1975, Guang’anmen Hospital, complaint: progressive numbness of both lower limbs for 4 months.  History: numbness of the right lower extremity appeared in July 1975 after overexertion at work, gradually expanded upward and spread to the left lower extremity, unsteadiness in walking, feeling of stepping on cotton, feeling of girdling gradually increased, wheezing, abdominal distension is obvious, bedridden, dysuria, weekly periodic fever, body temperature up to 39℃, dropping to 38℃ after war sweat; WBC: 29400/mm3; examination: insufficient rotation of the eye to the temporal side, nystagmus when looking to the left. Nystagmus when looking to the left; pharyngeal reflex disappeared, incomplete paralysis of the right hemithorax; pain and touch sensation below the right L6 and hypersensitivity below the left L2, loss of tuning fork vibration sensation below the right hip joint, loss of abdominal wall reflex and testicular reflex. The tongue is red, the coating is white and greasy, and the pulse is slippery.  Diagnosis and treatment: Diagnosed as multiple sclerosis. He was given penicillin and streptomycin intramuscularly and erythromycin intravenously; the TCM diagnosis was that dampness and heat were in the membranous origin, so he was treated with Dagenagen Drink and Sanren Tang, but his body temperature remained high; after consultation with TCM experts, he was considered to be caused by high fever and injury to yin, so he was given Bamboo Leaf and Gypsum Tang with addition and subtraction according to the Treatise on Typhoid Fever, and his body temperature dropped to below 38℃ after one dose, and his WBC dropped to 18000/mm3; he could get up by himself and go to the toilet with the support of others. Transferred to hospital 2 days later.  Date of referral: December 15, 1975 Inpatient Department of Neurology, PLA General Hospital Medical history and diagnosis as before. Further tests for B. burgdorferi, duodenal drainage fluid, and prostatic fluid were performed to rule out internal infection, all of which were unremarkable. Leukocytes: 18,000/mm3; body temperature fluctuated from 36-37.5°C. Dexamethasone tablets 1.5 mg were given orally 4 times a day and gradually reduced; oral azathioprine and vitamin B were also administered. After being discharged from the hospital on April 1, 1976, he insisted on taking Chinese herbal medicine for about 3 months every year, and the treatment was mainly to support the body and strengthen the spleen and kidney. He has not had any recurrence. At present, he is 72 years old, but still insists on attending outpatient clinics and various academic conferences.  The case was treated with a single dose of bamboo leaf and gypsum soup, which effectively stopped the disease from worsening; the remedial Chinese medicine cured prolonged low-grade fever; and the herbal medicine for strengthening the body effectively prevented recurrence, fully demonstrating the irreplaceable advantages of Chinese medicine in treating MS.  5.Experience: After more than 40 years of dedicated research in Chinese medicine, the mentor has understood the classics and integrated them. Through a deeper understanding of the doctrine of Xuanfu, he has flexibly applied the theory of benefitting qi to raise yang and essence to raise yin, as well as the idea of treating the untreated disease to the clinical practice of Chinese medicine in treating MS, and proposed that the method of cultivating and consolidating the essence should be used throughout the treatment of MS, which can effectively delay the development of the disease and prevent recurrence. This view elevates the understanding of MS in TCM and improves the treatment level of TCM, which has high academic and application value.