| Amyotrophic lateral sclerosis(ALS)is a chronic progressive neurodegenerative disease by the selective death of motor neurones. It is insidious in onset but the morbidity and mortality are extremely high. Up to now, the cause and pathogenesis are still unknown, and there isn't any effective therapeutic methods. Though previously studies showed that a variety of treatments in traditional Chinese medicine may be valuable for the disease, those studies are still in the primary stage as a whole. There is a lack of systematic research and relatively accordant understanding in the aetiology, pathogenesis, distribution of syndromes, characteristics of progress, and treatment with syndrome differentiation. As a starting point of the systematic research of ALS, this study aims at finding out the elementary syndrome in different stages, probing into the possible tendency in the regularity of evolvement, aetiology and pathogenesis. As a cross-sectional study, the author choosed adult sporadic ALS cases as the subject, and collected all sectional information (about demology, presently medical history, previously medical history, life habit, nervous system examination, four diagnostic methods of TCM, relatively physical and chemic examination, the ALS functional rating scale, and so on) in different time in 60 cases, including possible ALS, probable ALS and definite ALS. Basing on "the part of syndrome of clinical diagnostic and therapeutic terms of TCM " promulgated by State Technical Inspection Laboratory, we screened elementary syndrome, and established the corresponding diagnostic standard of syndrome. Through the data with the four diagnostic methods of TCM, deciding the patient's type of syndrome one by one, then taking the statistical method to analyze all informations comprehensively. Constituent ratio, tendency graph and correlation coefficient matrix are used to make clear the distribution of syndromes and possible tendency, in order to provide reference and clue for further study. The main results are as follows:With respect to the relatively short courses and milder condition of the 60 cases, the data here reflects the characteristic of syndromes distribution in the earlier period and metaphase. Five organs deficiency syndromes distribution: kidney deficiency is most common, up to 78.33%, with 47cases; then liver deficiency (56.67%, 34cases) and spleen deficiency (50.00%,30cases); lung deficiency and heart deficiency are comparatively less, with 25.00% (15cases) and 23.33% (14cases) respectively. Liver deficiency, spleen deficiency or kidney deficiency may manifest as themselves, or by other syndromes. Lung deficiency or heart deficiency, however, is always concomitant with other syndromes, which hints that ALS is correlated with the liver, spleen and kidney, and with kidney as the key organs. Besides, the average course is significantlyshorter in the cases with heart or lung deficiency than those without these conditions (P<0.05), which suggests that heart or lung deficiency usually appears in the later　stage, and may be involved by the illness itself. Lung deficiency is more common in elder patients, which may influence the prognosis. The relativity analysis shows that the progress of the asthenic syndromes between different organs follows the law of mother-child relationship.Among the cases of deficiency of Qi, Blood, Yin and Yang: Qi deficiency 91.67%(55cases), Yang deficiency 73.33%(44cases), Blood deficiency 35.00%　(21cases), Yin deficiency 21.67%(13cases). It is showed that Qi deficiency and Yang deficiency make up of the majority in these cases, and Blood deficiency is not seldom. these suggest that ALS is liable to impair Qi, Yang and Blood. Moreover, the study shows that although being observed only in a few cases, Blood deficiency may be related with the rapid progress of the illness. As a whole, Yang deficiency in the spleen, kidney and deficiency of Qi and Blood are most common. In mild cases or the early stage, the deficiency syndrome is simply constituted and not frequently observed. |
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