Study On The Relationship Between Symptoms Of Amyotrophic Systolic Sclerosis And Infrared Thermal Image

Background:Amyotrophic lateral sclerosis （ALS） is a progressive neurodegenerative disorder, characterized by degeneration of motor neurons. ALS is the most common form of motor neuron disease （MND）. Although the cause of ALS is unclear, motor neuron degeneration is the main pathological mechanism. ALS is characterized by weakness of muscles all over the body, accompanied by atrophy. Riluzole is the only proven effective drug which can prolong the survival time of patients with ALS. However, it cannot improve patients’life quality. Some studies showed that Traditional Chinese Medicine （TCM） could improve life quality and survival time of ALS patients. Accurately identifying of syndrome is the key of syndrome differentiation and treatment of TCM. However, syndrome of TCM is still unknown due to lack of understanding of its underlying biology. As a result, using modern techniques to study syndrome has drawn more and more attention in this field. Infrared thermal imagine （IRTI）, with the ability of providing objective and visual thermal images, has been used on various conditions as well as diagnostics of TCM. However, there is lack of research on IRTI focus on syndrome of TCM in patients with ALS.Objective:The aim of this study was to find the characteristics of the whole surface body temperature of patients with ALS, as well as the relationship between distribution of surface body temperature and the syndrome of TCM.Method:In the first part, we retrospectively reviewed all the patients with ALS from Pro. GAO’s outpatient clinic of Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine （BUCM） from January 2011 to March 2016.According to the patient’s symptoms, tongue, pulse condition, we distinguished their TCM syndrome. Excel2003 was used to analyze the characteristics of the patient’s gender, age and TCM syndrome type.In the second part, we included twenty patients with ALS from Pro. Gao Ying’s outpatient clinic in international department of DongZhimen Hospital affiliated to BUCM from Sep.2015 to Apr.2016. Twenty asymptomatic healthy subjects were also incorporated at the same time. Medical history was collected immediately at the same time. Then, the facial、 inferior and posterior infrared thermograph of the whole body of both asymptomatic healthy subjects and patients were took by HIR-2000 infrared thermal imager. The highest and average temperature of the whole body, arms and legs, the triple burners, the du channel, the nose and the supraclavicular area were tested by TMI_W1.1 test software. We used independent sample Test to find the difference of characteristics of temperature distribution between patients with ALS and asymptomatic healthy subjects. We also conducted correlation analysis between the temperature and symptoms or syndrome factors.Result:1.175 patients from January 2011 to March 2016 were included in the study with an average age of 53, more concentrated between 50 to 60 years old. The male to female ratio is about 2:1.2. Of those 175 subjects, there was 1 case of pulmonary heat pattern,23 cases of damp heat,130 cases of spleen deficiency,136 cases of liver and kidney deficiency,14 cases of choroid blood stasis. Among them, the liver and kidney deficiency and spleen deficiency were of the highest.3. The average age of the 20 patients was fifty-eight, man was vulnerable to ALS, and the sex ratio was 5:3.4. There were no significant different in average temperature of the whole body and any part of the body between patients and healthy subjects, P>0.05.5. Compared with healthy subjects, those had statistically significant differences in the temperature difference of the inside and outside of upper limbs as well as the posterior of the legs, P<0.05.The difference was more significant in the outside of upper limbs, and most obviously between the inside of arms.6. The anterior of the legs had no significant difference in the temperature difference, P>0.05.7. Temperature of navel was 1.5℃ lower in patients with bulbar paralysis, P<0.05.8. The average temperature of patients and healthy people in twelve meridians were accord with normal distribution. Independent samples T test showed that patients’ lung, large intestine, spleen, bladder and du meridian had significantly lower temperature compared with healthy people, P< 0.05.The rest of meridians showed no statistic difference.Conclusion:Patients with amyotrophic lateral sclerosis are more likely associated with deficiency of liver and kidney as well as spleen. In the early course of ALS, there is no difference in temperature in the whole or any part of the body compared with healthy people. The overall and local temperature and function of the body might be in a state of compensatory. But early in the disease, its body temperature difference on both sides has obvious abnormal. The Yang Ming meridian in both lower limbs had no obviously difference. Since Yang Ming meridian owns abundant blood and qi, its compensatory ability is stronger, and the effect of the disease in lower limbs is small. So the average temperature difference between the anterior of legs valued of no significant statistical difference compared with healthy people. More cross-sectional studies are still needed to detect whether the disease affected the inside of arms earlier than other part of limbs. Acupuncture point temperature analysis showed that patients had lower temperature in large intestine meridian rather than the stomach, indicating that in the process of compensation, the meridian of Yang Ming in foot might play a main role. In addition, the tongue pharynx is related to the Yin meridians, so that CV 8 for Ren meridian had lower temperature. Patients’ spleen, bladder and du meridian temperature decreased obviously, which is in conformity with the basic theory of TCM.