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 relapses. Hereby, she summarizes them as follows.
1. Understanding of the etiology and pathogenesis of MS
The main manifestation of MS is visual impairment, unfavorable limb movement or sensory disorder, and the remission and relapse of symptoms often alternate, and gradually worsen. There is no corresponding disease name in Chinese medicine, but it can be classified according to its main symptoms, such as repeated colds, sweating when moving, and fatigue as “deficiency consumption”; visual impairment is “dimness of vision” in mild cases and “blue blindness” in severe cases. “The main manifestation of the disorder of limb movement or even paralysis is “impotence”, and those with unstable walking and ataxia are equivalent to “bone care” [1].
According to the mentor, although the clinical manifestations of MS are different, the root cause of the disease is the deficiency of positive qi, that is, “where qi is deficient, evil will come together”; positive deficiency is the root, evil is the symptom, deficiency is mixed with reality, and positive and evil are mixed with each other. Tossing ⒈ quietly. The spleen is the mother of all bones, the source of Qi and blood biochemical, the spleen is weak, Qi and blood biochemical lack of source, can not be glorified in 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 origin of the innate, the collection of essence, marrow, the main bone. 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.Knowledge of MS treatment methods
According to the pathogenesis of MS, he divided it into three phases: acute phase, remission phase and recovery phase, and advocated treating it in stages, but all of them need to be treated with 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 after it has already occurred. 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 symptoms are caused by overwork or internal injury of emotion and will, resulting in depression of the Xuan Fu, the condition is acute and serious, and the medicine is valuable and quick. 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 positive and hold back the toxin; add or subtract Danjian Yiyao San and Yu Pingfeng San; Danpi and Gardenia to disperse the depression and fire; Chai Hu, Angelica, Bai Shao and Poria to dredge the liver and strengthen the spleen; Jin Yinhua, Dandelion and Fishy Herb to clear heat and detoxify; Wei Ling Xian to clear heat and detoxify, dredge the meridians and open the channels; Huang Qi, Bai Zhu and 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 take Yi Qi Smart Soup as an addition and subtraction; 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. If the spleen qi is strong, there will be sufficient qi and blood, the skin will feel as usual, and the limbs will be healthy and mobile; fried peony and fried atractylodes nourish the middle jiao and smooth the blood vessels; 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; if the lower limbs are heavy, add cow knee, sang fang sang and dou huo.
2.3 Recovery period The onset of the disease is prolonged and involves the liver and kidneys, so the main treatment is to nourish the liver and kidneys, with emphasis on preventing recurrence; the symptoms include recurrent external sensation, obvious banding, soreness and weakness of the waist and knees, depression and blurred vision, etc. Use Liu Wei Di Huang Wan to nourish the liver and kidneys and promote the vital energy; the kidneys produce essence, and the fullness of the light depends on the superiority of the kidney essence, so use Cuscuta, Raspberry and Lycium to nourish the yin of the liver and kidneys and brighten the eyes, and Wu Wei Zi acid to collect the essence; Fang Feng
3, prevention of recurrence of the disease recurrence, and the trend of progressive deterioration, is the main reason for poor prognosis.
The instructor emphasized that we must pay attention to our own care in daily life in order to effectively prevent recurrence of the disease.
3.1 Beware of colds The disease is an autoimmune disease, and the main cause of recurrence of the disease is external sensation. Overexertion, irregular life or imbalanced diet can lead to a decrease in the immunity of the body, making it susceptible to the onset of the disease. Therefore, we should prevent cold and keep warm, exercise properly, pay attention to rest and prevent cold.
3.2 Maintain a relaxed mood Emotional injury is a potential factor of this disease, and is particularly 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. Be sure to 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 safe from”.
3.3 Insist on medication After the acute period of the disease, the condition tends to be stable, 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 cause the disease, and although this has not been widely recognized, patients should pay attention to it and be cautious about vaccination.
4. Case presentation
Gao Jiansheng Male 38 years old Date of hospitalization: November 1975 Guang’anmen Hospital Complaint: Progressive numbness of both lower limbs for 4 months.
History: In July 1975, numbness of the right lower extremity appeared after overwork, which gradually expanded upward and spread to the left lower extremity, unstable walking, feeling of stepping on cotton, feeling of banding gradually increased, wheezing, abdominal distension was obvious, bed-ridden, 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 specialists, he was considered to be suffering from 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 dose of bamboo leaf and gypsum soup, which effectively curbed the deterioration of the disease; tonifying Zhong Yi Qi Tang cured the long-term low fever; and cultivating and consolidating the essence of the herbs effectively prevented the recurrence of the disease, fully reflecting the irreplaceable advantages of Chinese medicine in the treatment of MS.