A Chinese Medicine Understanding Of Metabolic Syndrome And A Case Report Of Cushing's Syndrome With Metabolic Syndrome

This dissertation is composed of two parts:the summary of documents and a clinical case report.Part one:the summary of documentsMetabolic syndrome(MS) is a clustering of central obesity(abdominal fat), hyperglycemia, hypertension, dyslipidemia and some other metabolic abnormal i t ies that coexis t in one person. It cons titutes the multiple risks which can lead to cardiovascular and cerebrovascular diseases, also it could predict the type2diabetes independently. In recent years, due to the economic level and lifestyle changes, the incidence of MS has a significant upward trend, and this causes widespread concern in the medical profession. The western medicine is researching MS deeper and deeper. It proposes a variety of pathogenic theories, however, the central obesity causing insulin resistance is the theory that has the most supporting evidences. Domestic and foreign medical institutions all proposed respect i ve diagnost ic cri teria of MS according to the differences among the regions, races and metabolic characteristics. The medical workers of different countries in the world have taken a large number of clinical studies about MS, and the results show the risk of cardiovascular and cerebrovascular disease in MS patients was significantly higher than the normal person. At the same time, basing on the theories of traditional Chinese medicine(TCM) and clinical practice, many scholars studying TCM have gradually increasing awareness and researches on MS. Although there is no MS nonaggressive in TCM, its related components such as obesity, diabetes, hypertension and dysl ipidemia have been documented and discoursed long ago. TCM scholars discuss the etiology and pathogenesis, diagnosis and treatment of MS according to the description of the classical medical books with their own clinical experience. They prove the integrat i ve treatment of MS is better than western medicine alone by cl inical researches. This article focuses on medical research progress of the etiology, pathogenesis and Chinese medicine treatment in MS.Part two:a clinical case reportIn clinical work, the endocrine diseases that can produce insulin resistance (such as Cushing syndrome, Primary aldosteronism, Pheochromocytoma) must be alert, because they often have the same manifestations as MS, like abdominal obesity,hypertension, diabetes and dyslipidemia. Some less severe diseases pat ients may not appear the characteristic clinical manifestations but one metabolic disorder only with a chief complaint, such as some Cushing's syndrome patients, especial ly the subcl inical pat ients, only show the uniformity of obesity, hyperglycemia or hypertension. So when we face the patients with MS manifestations, we should diagnose and distinguish very carefully, we can clear that the MS manifestations is primary or secondary in order to avoid delaying treatment and improper treatment. This patient has obesity, diabetes, hypertension, dyslipidemia and some other MS manifestations, at last he was diagnosed as Cushing's syndrome by learning more medical history,careful physical examination and auxil iary experiments. But the process of the diagnosis of cause is very tortuous. Initially it had a high index of suspicion for ectopic ACTH syndrome under laboratory and imaging studies. But we failed to clear tumor lesions. The results of IPSS measuring ACTH strongly suggested the Cushing's disease. It was confirmed the pituitary ACTH microadenomas by pathology at last. This case illustrates any of the inspection methods or means is omnipotent, and its specificity and sensitivityarelimited. Therefore, in the process of disease diagnosis,we should combine these ways and means with each other, reference each other and learn from each other. Only by this way can we improve the diagnostic accuracy.