| Objective: To add the categorical identification for syndrome Differentiation of TCM in terms of the correlation of clinical scale and electrophysiology index of amyotrophic lateral sclerosis(ALS) with syndrome differentiation of TCM, and provide theoretical proof for combined diagnosing and treatment of TCM and Western Medicine.Methods:The 80 cases are selected from the second hospital affiliated Hebei Medicine University, consistent with the ALS diagnosis standard publicized by the Neurology branch of Chinese Medical Association in2000. Using the international and improved ALS function measuring scale,we give a mark.According to the score,we separate the ALS patient into three stages:the fiest stage:the score between 30 and 39;the second stage:the score between 10 and 29; the third stage:the score between 0 and 9.According to the teaching material of the high medicinal school《Diagnostics of TCM》and《Internal medicine of TCM》, we separate the clinical differentiation of disease nature into syndrome of deficiency of Qi and Blood,syndrome with Yin asthenic and Yang asthenic, wind syndrome,heat syndrome,phlegm syndrome,syndrome of blood stasis. Based on《the syndromes Character of disease location》and clinical feature of ALS, we separate the clinical differentiation of disease location into the liver,the spleen,the lung,the kidney, the meridian and the muscle. Using the EMG instrument of Dantec CantataTM,we determin the change of electric potential when the muscle stand still,light shrink and heavy shrink.The analysis of all the materials used the SAS6.12 statistics software.Results:1 The relation between Western Medicine staging and disease nature syndromes of TCM:In the first stage,the incidence of the syndrome with yin asthenia and wind syndrome(81.82%) is the highest, the incidence of the syndrome of deficiency of Qi(30.30%) is lower,but the incidence of the syndrome of deficiency of blood (3.03%),yang asthenia (6.06%) and phlegm syndrome (6.06%)is the lowest.In the second stage,the incidence of wind syndrome (90.48%) and the syndrome with yin asthenia (80.95%) is higher than the syndrome of deficiency of Qi (59.52%), phlegm syndrome(40.48%)and yang asthenia(30.95%).There is no the syndrome of deficiency of blood.In the third stage,the incidence of the syndrome with yin asthenia, yang asthenia,wind syndrome and phlegm syndrome is 100%.There is no the syndrome of deficiency of blood and Qi, possibly because the cases are few.2 The relation between Western Medicine staging and disease location syndromes of TCM:In the first stage,the incidence of the muscle(100%) is the highest, the incidence of the kidney(60.61%)and liver(42.42%)is lower,but the incidence of the spleen (18.18%),meridian(9.09%) and lung (6.06%) is the lowest.In the second stage,the incidence of the muscle is100%.The incidence of the spleen(85.71%),meridian (83.33%) and liver (71.43%) is higher than kidney (61.90%).But the incidence of the lung is the lowest. In the third stage,the incidence of the muscle,spleen,kidney and meridian is 100%.The incidence of the liver (80%) and lung (40%) is lower than them.Possibly because the cases are few,so the result is no statistically significant.3 The relation between the score of nerval function,the age,the course of disease,the electrophysiology and the differentiation of symptoms of TCM:(1)In the aspect of score of nerval function,the score of yang asthenia and phlegm syndrome is remarkably lower than others'. In the aspect of age, the result is no statistically significant.But there is the increscent tendency of the yang asthenia and the syndrome of deficiency of Qi. In the aspect of the course of disease, the course of disease of yang asthenia is remarkably longer than the yin asthenia, wind syndrome and the syndrome of deficiency of Qi.(2) Every type of syndrome of the first interosseus is no statistically significant,when the muscle stand still,light shrink and heavy shrink.Nevertheless,the incidence of the yang asthenia,which emerge the large spontaneous activity,is higher than others'. The incidence of the yang asthenia and phlegm syndrome,which emerge the pathological electrical silence,is higher than others'. (3)Every type of syndrome of the tibial muscleis is no statistically significant,when the muscle stand still,light shrink and heavy shrink.In the stage of the"++",the incidence of the syndrome of deficiency of Qi is descend,but the incidence of the yang asthenia and phlegm syndrome is higher than others'. The incidence of the phlegm syndrome,which emerge the pathological electrical silence,is higher than others'.(4) Every type of syndrome of the sternomastoid muscle is no statistically significant, when the muscle stand still,light shrink and heavy shrink.(5) Every type of syndrome of the lingual muscle is no statistically significant, when the muscle stand still and heavy shrink.There is statistically significant when the muscle light shrink.The phlegm syndrome is notably difference from the syndrome of deficiency of Qi, yin asthenia and wind syndrome,but the phlegm syndrome and the yang asthenia has no difference.Conclusions: There is a certain relation between ALS clinical scale,electrophysiological index and the syndrome TCM, they can be the reference basis of the differentiation of symptoms and signed of the TCM.They also can reinforce the objectivity of the differentiation of symptoms and signed of theTCM.1 The relation between Western Medicine staging and disease nature syndromes of TCM:The incidence of the syndrome with yin asthenia and wind syndrome is higher in three stages. Following the degree of the pathogenetic condition from slight to heavy, the incidence of the syndrome of deficiency of Qi has the tendency which rises first and lows later. Because the syndrome of deficiency of Qi develops to the the yang asthenia, following the pathogenetic condition more serious. However, the incidence of the yang asthenia and the phlegm syndrome has the obviously increscent tendency following the pathogenetic condition more serious.2 The relation between Western Medicine staging and disease location syndromes of TCM:Muscle,liver and kidney are the main disease location in the three stages. Spleen and meridian are the principal disease location in the second and third stages. the incidence of the lung in the third stage is higher than it in the first and second stages.3 The relation between the score of nerval function,the age,the course of disease,the electrophysiology and the differentiation of symptoms of TCM:the incidence of the yang asthenia and the phlegm syndrome has the obviously increscent tendency following the pathogenetic condition more serious. Variational tendency of the symptoms of TCM which is result of the differentiation of symptoms of TCM and judgement of the pathogenetic condition which is result of the electrophysiological evaluation reflect the severe degree of the pathogenetic condition. They can consult each other.In the course of the differentiation of symptoms of TCM, the score of nerval function, the course of disease and the age can be the reference basis of the differentiation of symptoms and signed of the TCM, the yang asthenia especially. |
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