Tcm Symptoms Of Demyelinating Disease Of The Preliminary Study

1.ReviewMultiple sclerosis is an autoimmune diseases which is characte-rized by demyelination in white matter lesions of central nervous system and occurrence in the role of the genetic susceptible in-dividual and environmental factors,and the exact pathogenesis is still not fully identified yet.The diagnosis of MS commonly used for the 2005 revision of the McDonald criteria,and it's divid into four types: relapsing-remitting,secondary progressive,primary progressive and relapsing progress,ncluding relapsing-remitting the most common type.Optic neuritis(optic neuritis,ON) refers to all of the optic nerve inflammatory lesions.One primary or idiopathic demyelinating optic neuritis(IDON) is the most common clinical type.The types of optic neuritis and central nervous system disease multiple sclerosis(MS) are closely related,both share a common pathological changes,some patients with the final evolution IDON for MS.The current treatment of multiple sclerosis and optic neuritis of western medicine are varied,but no specific treatment,glucocorticoid is used in the acute phase,and interferon,and other immunosu-ppressive agents are used in the ease period.Chinese medicine and acupuncture treatment of multiple sclerosis showed a certain degree of efficacy,which can improve the symptoms,signs,extend the remi-ssion period,and reduce the side effects of hormones and immuno-suppressive agents.But there is no uniform standard of Syndrome differentiation in TCM.Based on the determination of the concept of normative study and the mechanism of development of Chinese medicine,Chinese medicine will help to enhance the level of the treatment of multiple sclerosis,better play the positive role of Chinese medicine.There isn't the name of "multiple sclerosis" in Chinese medicine.This disease,according to the clinical manifestations,can be divided into an "hemiplegia after apoplexy ","Atrophy syndrome","hemiplegia","Vertigo","bone forced labor","gradual loss of vision without apparent cause","Bringing the faint vague vision"diseases,such as the scope. Combining the clinical practice and the disease occured in the "brain and marrow",Atrophy syndrome has more objective evidence.Based on the lack of blood and qi,organ dysfunction,this disease occured by the internal and exogenous factors,and the overstrain.Some resulted in the elements of exogenous heat and wet,which invade in the brain and cause blood and qi don't run which make limbs atrophy;or accumulation of heat and wet,sanjiao can not turn jin into qi which leads to sputum,qi stagnation and blood stasis,dystrophy evidence from atrophy. Summary of its etiology and pathogenesis are threefold:heat immersed, kidney-yin deficiency of liver,spleen and stomach deficiency.No matter what kind of reasons,are "sputum" relevant.Sputum production,and the spleen,lung,kidney dysfunction,and the sputum have stopped a block in the body meridian which leads to a series of symptoms.This disease has not yet been promulgated uniform standard syndrome, clinical reported that.there are generally types of asthe-nia of both the blood and QI,asthenia of both the spleen and kidney,wind and wet stasis in collaterals,sputum stasis in meridians and collaterals,immersing by heat and wet,paralysis by stasis of wind and sputum,blood stasis obstructing the collaterals,QI asthenia cau-sing blood stasis,asthenia of both the liver and kidney,asthenia of the kidney-YANG,hyperactivity of YANG due to YIN deficiency,full of sputum and wet,asthenia of both YIN of the liver and kidney with internal heat and sputum stasis,QI asthenia causing blood stasis,QI asthenia causing obstruction in the collaterals.2.BackgrandAt present,the literatures of Chinese medicine of the etiology, pathogenesisclinical or cilical reports about the demyelinating disease are rare.Research on TCM syndromes Types of the existence of more than dialectical standards and more personal experience,based on the lack of clinical investigations,such as lack of systems.Chinese medicine need to enrich the understanding of demyelinating disease,the characteristics of their syndrome,clinical syndrome differentiation for further accumulation of experience.In particular,clinical investigation in the syndrome on the basis of an objective description,for in-depth study Chinese Medicine Treatment of demyelinating disease have greater clinical significance.Clinical investigation of this topic based on the demyelinating disease multiple sclerosis and optic neuritis involved symptoms of common Chinese medicine,evidence-based distribution to give an objective description,and try on multiple sclerosis and optic neuritis to the TCM Syndrome quantitative analysis,with a view to further clarify the main points of differentiation of demyelinating disease, demyelinating disease of Chinese medicine practitioners to explore the objective study of Treatment for reference.At present,Chinese medicine for multiple sclerosis demyelinating disease and the etiology, pathogenesis and clinical reports in the literature are relatively small study of the existence of TCM Syndrome syndrome differentiation,and differentiation standards and more personal experience,the lack of clinical and so on the basis of lack of systematic investigation.Chinese medicine need to enrich the understanding of demyelinating disease,the characteristics of their syndrome,clinical syndrome differentiation for further accumulation of experience.In particular,clinical investigation in the syndrome on the basis of an objective description,for in-depth study Chinese Medicine Treatment of demyelinating disease have greater clinical significance. Clinical investigation of this topic based on the demyelinating disease multiple sclerosis and optic neuritis involved symptoms of common Chinese medicine,evidence-based distribution to give an objective description, and try on multiple sclerosis and optic neuritis to the TCM Syndrome quantitative analysis,with a view to further clarify the main points of differentiation of demyelinating disease,demyelinating disease of Chinese medicine practitioners to explore the objective study of Treatment for reference.3.Objects and methodsPatients from from the hospital wards and outpatient neurology clinic of Xiyuan Hospital and Tongren hospital.One group of 69 cases of demyelination and multiple sclerosis patients with optic neuritis; control group,30 cases of patients with non-demyelinating disease.The diagnostic criteria for multiple sclerosis in 2005 under the revised McDonald criteria.Diagnostic criteria for optic neuritis optic neuritis in the United States team ONTT raised the standard optic neuritis. Demyelinating group inclusion criteria:(1) Age 18～60 years old,both men and women(2) with multiple sclerosis or optic neuritis diagnosis. Exclusion criteria:(1) In addition to optic neuritis of multiple sclerosis and other demyelinating disease(2) within six weeks used immunosuppressant therapy(3) a serious mental illness who do not meet the clinical investigation(4) At the same time,other researchers.By the literature research,according to multiple sclerosis and optic neuritis attack characteristics and common symptoms associated with, characterized the composition of TCM Syndrome questionnaire.Meet the inclusion criteria of patients filled out questionnaires TCM Syndrome. Use SPSS13.0 statistical software to establish a database,survey all of the data entry database,statistical analysis,analysis of demyelinating disease characteristics of the syndrome.4.result69 cases of demyelinating group,male 20 cases,accounting for 29.0%, female 49 cases,accounting for 71.0%,male to female ratio is about 1:2.3; the control group 30 cases,12 cases of men,accounting for 40%,female 18 cases,accounting for 60%,male to female ratio is about 1:1.5.Demyelinating group aged 6to59 years old,which accounted for 30～39-year-old 50.8%,41～50-year-old 18.5%,51～60-year-old accounted for 20.0%,average 39.5 years old,6patients with multiple sclerosis 59 years old,average 40.9 years of age;in patients with optic neuritis,23～56 years old,average 37-year-old.Control group age 21 to 64 years old,average 32.5 years old.In Demyelinating group,optic nerve function deficit accounted for 63.1%,with the main vision loss.Numbness in limbs accounted for 46.2%.1n multiple sclerosis patients,accounting for 60.1%limb numb-ness.The third is paresthesia,accounting for 30.8%.In the control group,the physically unable to with a higher incidence of paresthesia,with respective shares of 30.0%and 43.3%.More than 50%of occurrence of the symptoms in Demyelinating group,for multiple sclerosis is the forgetfulness,for optic neuritis are anxiety and lazy statement.Rate of 40%-50%in persons with multiple sclerosis are upset,lazy statement,sore and weakness at waist and knees,depression,dreams,lassitude,shallow sleep and wake up repea-tedly;optic neuritis are moving the sweat,headache,weakness at waist and knees;occurrence rate of 30%-40%in those with multiple sclerosis are the protect against heat,less satisfied,dry stool,ringing in the ears;optic neuritis for the protect against cold, forgetfulness,depression.There are 46 symptoms have the total rate below 30%.There are 25 symptoms of multiple sclerosis have the occurrence of 20%,and in optic neuritis are 12 symptoms.Occurrence of more than 20% in the symptoms are the protect against cold,dry stool,urine short,dizziness,headache,upset,chest tightness,forget-fulness,lazy statement,sore and weakness at waist and knees,depressed,dreams.In Control group,the rate of traditional Chinese medicine symptoms is 0.0% between 26.7%and the occurrence of more than 20%of the symptoms,only two,and the rest were below 20%.the highest rate statistics of tongue are big fat tongue(26.5%),light tongue(32.7%),Big fat tongue(26.5%),short tongue(32.7%),thin white coated tongue(30.9%),followed by thin tongue,fat tongue with indentation,light red or red tongue,thin yellow coated tongue,yellow greasy coated tongue,white greasy coated tongue.In normal control group,the normal tongue with indentation,light red tongue,thin white coated tongue are the majority.Pulse Statistics shows that demyelinating group has five single pulse to a maximum of small pulse occur.Two kinds of composite pulse, sunken pulse is upmostly to see.Using SPSS13.0 of K-Means Cluster quick sample clustering(Q-type cluster), the final result:spleen and kidney deficiency(30.8%),qi and blood deficiency (32.3%),liver kidney-yin deficiency and Qi deficiency(36.9%).The use of contingency table test of independence shows that patients with multiple sclerosis in the third district with the largest category,accounting for 39.0%,optic neuritis patients in the second category,the highest proportion,accounting for 45.8%. Multiple sclerosis and optic neuritis syndrome patients the distribution of p values of 0.173.Patients taking hormone in the third district with the largest category, accounting for 44.1%,while patients not taking hormones in the second category,the highest proportion,accounting for 45.2%,of patients with steroid and non-use of hormone syndromes in patients with the distribution of p value of 0.105.5.DiscussionsDemyelinating disease in women is more than men,most patients aged 30 to 40.Clinical cases usually occur functional impairment of optic nerve, followed by limb numbness and paresthesia.Compared to other di-seases,the clinical symptoms of optic neuritis and multiple sclerosis have their own characteristic,and the consistency between the main symptoms,and their own emphasis,in patients with multiple sclerosis have more physical symptoms,but mainly in patients with optic neuritis have the optic nerve mainly damagement.Occurrence of clinical investigations revea ed that more than 20%in the symptoms of cold,dry stool,urine short,dizziness,headache, upset,chest tightness,forgetful,lazy statement,waist and knees weak, depressed,multi-dream.Multiple sclerosis syndrome patients in the distribution of steroid distribution of the patient's syndrome is similar to that long-term repeated application of hormones may lead to kidney-yin deficiency and liver permits an important factor.Neuritis syndrome patients did not take hormone distribution syndrome distribution of patients is similar to that with the progressive optic neuritis to multiple sclerosis development, the syndrome of multiple sclerosis gradually to the vesting of the syndrome.The results reported in the literature and in recent years,the result of differentiation there are some differences,there may be reasons:1, doctors do not grasp the dialectical differences in standards;2,doctors in the acquisition of symptoms may have a certain one-sidedness,causing differentiation of the same cases different types;3,the differentiation of existing elements in the evidence-based definition is not clear enough. On the other hand,the design of the subject 1,the selection of the cluster analysis of occurrence of greater than or equal to one-third of the characterization of the syndrome as a judge based on the suitability to be explored;2,to observe the contents of the table may still not comprehensive enough;3,significantly less than the number of cases,more samples need to verify.In any case,modern statistical methods summarized TCM methods still need to be treated with traditional Chinese medicine demyelinating disease of the convergence experience,this is the future for further study.