I. Western medical treatment
There is no effective treatment in Western medicine, and the following treatments are often used.
(A) acute attack period
ACTH, methylprednisolone, or dexamethasone can be used intravenously, and dexamethasone can be used orally after 1-2 weeks of drip. Shen Xiaoming, Department of Encephalopathy, The First Affiliated Hospital of Henan College of Traditional Chinese Medicine
2. Immunosuppressants: ① Azathioprine, 50mg twice daily, orally, can reduce the number of seizures. ②Cyclophosphamide, 200-400mg intravenously 2-3 times a week, 2 weeks as a course of treatment. It is effective in chronic progressive MS, but oral treatment is not necessary. ③Cyclosporine-A, 5mg/kg×d, orally, better efficacy than azathioprine. (iv) Amethopterin. For each of the above immunosuppressive therapy, attention should be paid to liver and kidney function damage and white blood cell changes.
(ii) Treatment in remission is aimed at prevention, reduction of recurrence and improvement of residual function. Commonly used measures are.
1. Interferon-β1b, an immunomodulator, commonly used dose is 8 million units subcutaneously, once every other day, applied continuously for 6-12 months or long-term, which can reduce the number of relapses.
2. Copolymer-1, a compounded amino acid component. Subcutaneously injected.
3. Symptomatic treatment: select baclofen for hypertonicity, 5mg 1-2 times daily to start and gradually increase the amount. For muscle spasticity pain, carbamazepine is available. For epileptic seizures, sodium valproate or carbamazepine can be used. Intentional tremor can be treated with insulin and clonidine. Antibiotics should be given for secondary infection.
4. Rehabilitation therapy Acupuncture, physical therapy, and moderate exercise are very important.
Chinese medicine treatment
Modern Chinese medicine treatment for multiple sclerosis was first reported in 1962. Later on, there were data on the treatment of multiple sclerosis complicated by measles or herpes zoster, and the viewpoint of “disease caused by dampness and heat” was put forward in the pathogenesis. In terms of treatment, the method of treatment varies from place to place, with some being divided into four stages of treatment according to the extent of the lesion, while others treating from the kidney, or treating mainly with Yu Niu Decoction and Huang Qi Gui Zhi Wu Wu Yi Tang. In recent years, with the infiltration of modern medical knowledge, some people advocate the use of antiviral drugs such as Phellodendron, Atractylodes, Scutellariae, Panax notoginseng, Tiger Balm, Goldenseal and Dandelion in the acute stage, and the addition of blood-activating drugs such as Danshen, Chuanxiong and Angelicae to help nerve nutrition in the recovery period, which undoubtedly opens up ideas for Chinese medicine treatment.
(I) General treatment
1. Strengthen nutrition, eat high protein and high vitamin food.
2. Pay attention to keep warm and avoid cold.
3. Keep the skin clean and dry, keep the bed sheet dry, soft and flat; turn over regularly; keep the paralyzed limb in a functional position and do passive movement as early as possible; pad the sacrum, ankle and scapula with an air ring or soft cushion, and massage frequently, then apply safflower alcohol externally.
4. Keep the respiratory tract unobstructed and remove respiratory secretions in time. For those who have difficulty in breathing, administer oxygen as soon as possible; for those who cannot cough and cannot discharge sputum, promptly perform tracheotomy and use artificial ventilator if necessary. For patients who have used artificial ventilator, suction should be timely, not more than 15 seconds/time, and 3-5 minutes should be interval between two times; wetting solution should be dripped into the trachea, 2-5ml/time, once every 15 minutes; inner cannula should be changed twice/day, outer cannula should be changed once every half month, and gauze pad should be changed twice/day.
5. For those who have urinary retention, keep the catheter and open it once every 3-5 hours. And flush the bladder with o.1% furacilin or 3% boric acid solution, 1~2 times/day, 250ml/time, keep it for half an hour and then release it.
(B) Chinese herbal medicine treatment
1. Clear heat and detoxification oral liquid: has the effect of clearing heat and penetrating the surface, detoxifying and generating fluid. It is suitable for those who have a high level of evil heat at the beginning of the disease.
2. Ermiao Pill: Clears damp heat in the lower jiao. It is suitable for those who are impotent and weak in the lower limbs at the beginning of the disease and are suffering from damp-heat downward injection.
3. Zhi Kidney Pill: Nourishes Yin and clears the ribs, resolves Dampness and clears the passages. It is indicated for those with damp-heat accumulation and heat is more prevalent in this disease.
4. Zhi Bai Di Huang Wan: It has the function of nourishing Yin and lowering fire. It is suitable for those with Yin deficiency and fire.
5. Shrinking Spring Pill: function of warming the kidney and reducing urine. It is suitable for those who have urinary incontinence and have kidney deficiency.
(C) special prescriptions and experimental prescriptions
1. Deer horn gum pill: deer horn gum 30g, deer horn cream 15g, rehmannia 15g, angelica 12g, ginseng 9g, cow knee 9g, cuscuta 9g, poria 9g, atractylodes 9g, dulcimer 9g, tiger shin bone 3g, turtle plate 3g. first deer horn gum dissolved with ashless wine, tiger bone (dog shin bone instead of it) and turtle plate sizzling crisp, a total of finely ground, refined honey for pills, such as wuzi large. Take 20 pills each time with salt and ginger soup on an empty stomach. It is used in the recovery period of multiple sclerosis.
2. Impotence soup: Radix et Rhizoma Ginseng, Atractylodes Macrocephala, Radix Astragali, Poria, Osmanthus, Radix Angelicae Sinensis, Radix Paeoniae Alba, Radix et Rhizoma Chuan, Radix Achyranthes Bidentatae, Fructus Lycii, Cortex Eucommia Ulmoides (fried in salt water), Rhizoma Polygonati (swallowed), Radix Glycyrrhiza Uralensis. Adjust the dosage of the above herbs as appropriate, decoction in water, 1 dose daily. It is suitable for people with long duration of multiple sclerosis and limb paralysis.
3. Atractylodis Macrocephalae soup: Atractylodis Macrocephalae, Fructus coix seeds, Phyllostachys spp. Decoction with water, 1 dose daily. Applicable to the early and middle stages of multiple sclerosis. In case of heavy phlegm and dampness, add Semen, Yuan Zhi and Calamus; in case of meridian obstruction, add Silphium and Stretching grass.
4. Hyoscyamus Pill: 9g Sichuan Hyoscyamus, 0.2g Strychnine, fry yellow with oil, grind finely with Sichuan Hyoscyamus and mix with honey to form a pill, each pill weighs 3g. 1 pill is taken 2-3 times a day. It is used for people with multiple sclerosis recovery period or sequelae period and flaccid paralysis of limbs.
(iv) Acupuncture treatment
For upper limb paralysis, take Dadui, Shoulder K, Quchi, Waiguan, and Neck 5 to 7 points of the spine; for lower limb paralysis, take Mingmen, Huanjiao, Chibian, Foot Sanli, Yinlingquan, Guizhong, and Waist 1 to 5 points of the spine; for urinary obstruction, take Guan Yuan, Qihai, Yinlingquan, and Sanyinjiao. At the beginning of the disease, the diarrhea method is performed, with no or few needles left in place, once a day. Long-term frail patients perform the method of flat tonic and flat diarrhea, retaining needles for 15-20 minutes, once every other day, 14-20 times for a course of treatment.
(E) massage, massage the beginning of the disease to open the Heavenly Gate, transport the Sun, clear the Tianhe water, retreat the six internal organs, clear the Panmun, clear the Spleen meridian, transport the internal Bagua. Once a day, 7 times for a course of treatment; for those with prolonged disease, replenish the spleen meridian, replenish the kidney meridian, knead the dadui, take the shoulder well, press and knead the shoulder k, quchi, liver Yu, kidney Yu, take the commission, Chengshan, shake the Xiexi. Daily or every other day, 10 times for a course of treatment.