Brief Summary: On June 3, 2009, Dema from Romania, a 40-year-old male, who has suffered from ALS, accompanied with the symptom of the weakness of the whole body, was hospitalized in our hospital. The condition has worsened in the latest 2 year with the symptoms weakness of the upper and lower limbs in the left side of body. The activity of the body was difficult for 1 year. He has achieved much improvement after 84 days TCM treatment here. He could not walk when he arrived here. He could stand up from the wheelchair and walk 200 meters again. Compared with before, the weakness, pains and edema of the four limbs were disappeared. The weakness and activity of the upper limb in the right side of the body have got steady improvement. There were slight muscular jumpings of the arms. His lower limbs could walk around with the help of others. His weight kept the same, not reduced.

 

Record of Hospitalization

Name: Dema                                                                                                        Birthplace: Romania

Sex: Male                                                                                                             Profession: Businessman

Age: 40                                                                                                                Date of Admission: June 3, 2009

Religion: Romanians                                                                                             Date of Record: June 3, 2009

Marital Status: Married                                                                                        Onset Season: Summer begins

Complainer: The patient himself. The case was recorded by TCM group.

 

First Medical Record

Date: June 3, 2009                                       Time: 1: 00 a. m.

Dema, a 40-year-old male, has suffered from ALS, accompanied with the symptom of the weakness of the whole body. The condition has worsened in the latest 2 year with the symptoms weakness of the upper and lower limbs in the left side of body. The activity of the body was difficult for 1 year. He could not walk when he arrived here. He could stand up from the wheelchair and walk 200 meters again. He was hospitalized in our hospital at 24: 00 a. m. on June 3, 2009.

Essentials for Diagnosis:

1. The patient has suffered from the symptom of the weakness of the whole body. The condition has worsened in the latest 2 year with the symptoms weakness of the upper and lower limbs in the left side of body. The activity of the body was difficult for 1 year. He could not walk when he arrived here. He could stand up from the wheelchair and walk 200 meters again.

2. In May 2007, the patient began to feel the weakness of the whole body without obvious reasons, but he didn't pay much attention to this and hadn't taken any examination and treatment. Then the condition gradually became worse. In May 2008, the condition worsened. Both the upper and lower limbs of the left side of the body were weak. The activity was difficult for him. His weight was reduced 10 kg. There were obvious muscular jumpings of the whole body, sometimes there were spasms. He was given MRI examination in the local hospital and was diagnosed with ALS in October 2008. The doctor told him there was no treatment for ALS except for Rilutek capsules. Also, he didn't take any treatment. So he came to our hospital on June 3, 2009 for further treatment.

3. T 36.5≧, R 20 times/minute, P 80 times/minute, BP 130/90mmHg.

4. He grew normally with common nutrition. His mind was clear. He had an expression of chronic illness and tiredness. His body was cooperative with his mind.

5. No thoracic deformity. Sound of breath was bilaterally normal on auscultation. No sound of pleural friction. Heart border was normal. Heart beat was 80 times/minute. Cardiac rhythm was regular. No pathological murmurs on auscultation.

6. There were obvious atrophies of the biceps and tricepses on the two arms. The condition was the same with the supraspinatus and infraspinatus. His arms could not stretch or bend freely. The activity was difficult. The arms could not do some fine works. The fingers were weak. The fingers touching test was positive. The fingers touching test is to let the thumb touching the index finger, middle finger, ring finger and little finger orderly and then the order with the little finger, ring finger, middle finger and index finger repeatedly back and forth quickly. If the activities of the fingers can not be in a fast and flexible way to accomplish this action, the test is positive. The gripping power of the two hands was 0 kilogram (positive). The back of the left hand was swelling. The muscular tension of the upper limbs was lower, it was of Grade  = 1 \* ROMAN I. There was pitting edema in the lower limbs. The left lower limb was weak with poor activity. He could only use the wheelchair. There were obvious muscular jumpings of the whole body, sometimes there were spasms. The muscular tension of the lower limbs was weak, it was of Grade  = 2 \* ROMAN II. His tongue was reddish. His tongue coating was yellowish and slippery. There were teeth marks on the edge of the tongue. His pulse was wiry and slippery.

7. Accessory examination: None.

Diagnostic Basis:

TCM: The patient has suffered from the symptom of the weakness of the whole body. The condition has worsened in the latest 2 year with the symptoms weakness of the upper and lower limbs in the left side of body. There were obvious atrophies of the biceps and tricepses on the two arms. The condition was the same with the supraspinatus and infraspinatus. His arms could not stretch or bend freely. The activity was difficult. The arms could not do some fine works. The fingers were weak. The fingers touching test was positive. The fingers touching test is to let the thumb touching the index finger, middle finger, ring finger and little finger orderly and then the order with the little finger, ring finger, middle finger and index finger repeatedly back and forth quickly. If the activities of the fingers can not be in a fast and flexible way to accomplish this action, the test is positive. The gripping power of the two hands was 0 kilogram (positive). The back of the left hand was swelling. The muscular tension of the upper limbs was lower, it was of Grade  = 1 \* ROMAN I. There was pitting edema in the lower limbs. The left lower limb was weak with poor activity. He could only use the wheelchair. There were obvious muscular jumpings of the whole body, sometimes there were spasms. The muscular tension of the lower limbs was weak, it was of Grade  = 2 \* ROMAN II. His tongue was reddish. His tongue coating was yellowish and slippery. There were teeth marks on the edge of the tongue. His pulse was wiry and slippery. The patient was mainly characterized by weak and atrophic limbs. According to the symptoms of the tongue and pulse, he was diagnosed with wilting pattern.

Western Medicine: There were obvious atrophies of the biceps and tricepses on the two arms. The condition was the same with the supraspinatus and infraspinatus. His arms could not stretch or bend freely. The activity was difficult. The arms could not do some fine works. The fingers were weak. The fingers touching test was positive. The fingers touching test is to let the thumb touching the index finger, middle finger, ring finger and little finger orderly and then the order with the little finger, ring finger, middle finger and index finger repeatedly back and forth quickly. If the activities of the fingers can not be in a fast and flexible way to accomplish this action, the test is positive. The gripping power of the two hands was 0 kilogram (positive). The back of the left hand was swelling. The muscular tension of the upper limbs was lower, it was of Grade  = 1 \* ROMAN I. There was pitting edema in the lower limbs. The left lower limb was weak with poor activity. He could only use the wheelchair. There were obvious muscular jumpings of the whole body, sometimes there were spasms. He was given MRI examination in the local hospital and was diagnosed with ALS in October 2008.

Diagnostic Differentiation:

TCM: The patient's wilting pattern should be differentiated from impediment pattern. Wilting pattern is characterized by limp, weak and emaciated limbs with the numbness of the muscles. But the patient usually has no joint pains. On the contrary, impediment pattern is generally characterized by joint pains. So they are not difficult to be distinguished.

Western Medicine: ALS should be differentiated from tumor of spinal cord, which is characterized by nerve root pains of the upper limbs, but without extensive trembling of the muscle bundles. Besides, there is disturbance of sensation and obstruction of the subarachnoid cavity. The disease can be diagnosed clearly by the examination of CT or MRI.

First Diagnosis:

TCM diagnosis: Wilting pattern

Symptom identification: qi vacuity of the spleen, yin vacuity of the liver and kidneys, ascendant hyperactivity of liver yang.

Western Medicine diagnosis: ALS

Plans for treatment strategy and nursing:

1.  Routine care of traditional Chinese internal medicine.

2. Grade II care.

3. Under the care of a companion.

4. Low-fat and high-protein diet.

5. TCM treatment strategy: boost qi, fortify the spleen, supplement and enrich the liver and kidneys, calm the liver and subdue yang.

6. Herbal tea: one dosage a day and drink twice.

7. Acupuncture and massage: once a day.

8. Have more medical examinations if necessary.

 

Date: June 3, 2009                                       Time: 9: 00 a. m.

The patient has suffered from the symptom of the weakness of the whole body. The condition has worsened in the latest 2 year with the symptoms weakness of the upper and lower limbs in the left side of body. The upper and lower limbs of the right side of body also became weak gradually. The activity was difficult. His weight reduced 10 kg. There were obvious muscular jumpings of the whole body, sometimes there were spasms. In October 2008, he was given MRI examination in the local hospital and was diagnosed with ALS. Then he took Rilutek capsules for treatment, but without obvious improvement. His condition worsened quickly. There were obvious atrophies of the biceps and tricepses on the two arms. The condition was the same with the supraspinatus and infraspinatus. His arms could not stretch or bend freely. The arms could not do some fine works. The fingers were weak. The fingers touching test was positive. The fingers touching test is to let the thumb touching the index finger, middle finger, ring finger and little finger orderly and then the order with the little finger, ring finger, middle finger and index finger repeatedly back and forth quickly. If the activities of the fingers can not be in a fast and flexible way to accomplish this action, the test is positive. The gripping power of the two hands was 0 kilogram (positive). The back of the left hand was swelling. The muscular tension of the upper limbs was lower, it was of Grade  = 1 \* ROMAN I. There was pitting edema in the lower limbs. The left lower limb was weak with poor activity. He could only use the wheelchair. His tongue was reddish. His tongue coating was yellowish and slippery. There were teeth marks on the edge of the tongue. His mouth was dry and he liked cold drinks. His pulse was wiry and slippery. The urine was yellowish. The bowel movement was dry. He had the history of hypertension disease and was under medicines. According to the symptoms of the tongue and pulse, Professor Zhang believed that the patient had suffered from wilting pattern due to qi vacuity of the spleen, yin vacuity of the liver and kidneys, ascendant hyperactivity of liver yang. So the treatment strategy for him was to boost qi, fortify the spleen, supplement and enrich the liver and kidneys, calm the liver and subdue yang. The prescription was as follows: baizhu (ovate atractylodes root), chuanxiong (ligusticum root), etc. 4 dosages in total.

 

Date: June 4, 2009                                       Time: 9: 00 a. m.

The patient's lower limbs were weak and swelling. Especially, the ankle joints were stiff, could not stretch or bend. The patient could not raise his legs freely. Besides, he could not walk alone by himself, but used the wheelchair. The blood test shown the figures of the blood were high. The amount of calcium was low. The test result of urine was normal. The function of the liver and kidneys were normal too.

 

Date: June 6, 2009                                       Time: 9: 00 a. m.

The patient's whole body were weak, especially the four limbs. He could not lift the legs freely. The lower limbs were weak and stiff. He could not walk alone. The back of the left hand was swelling. His mouth was dry. His tongue coating was yellowish and slippery. The prescription was as follows: fuling (poria root), chuanxiong (ligusticum root), etc. 5 dosages in total.

 

Date: June 11, 2009                    Time: 10: 00 a. m.

The swelling on the lower limbs were disappeared. The weakness and stiffness of the body have got improvement. There were pains in the part of the muscles, when he moved his shoulders. There were muscular jumpings on the arms and chest. 5 dosages in total.

 

Date: Jun. 16, 2009                                       Time: 10: 00 a. m.

The weakness and stiffness of the body have got obvious improvement. He could walk about 10 meters long with the help of the companion. He could raise his right hand to the level of the back head. The prescription was made a little change. 5 dosages in total.

 

Date: June 21, 2009                                      Time: 10: 00 a. m.

Compared with before, the weakness and stiffness of the body have got further improvement. The activity of the limbs has increased. There were no pains on the joints. The prescription was changed. 5 dosages in total.

 

Date: June 26, 2009                                       Time: 9: 30 a. m.

The weakness and stiffness of the four limbs have got gradual improvement, especially for the lower limbs. The patient could go upstairs by himself to the 3^rd floor without feeling tired. But the blood pressure was slightly high, 140/90mmHg. The prescription changed a little. 5 dosages in total.

 

Date: June 30, 2009                                       Time: 9: 00 a. m.

The weakness and stiffness of the lower limbs have got obvious improvement. The patient could lift his legs up to 35 centimeters high. He could walk outside and do some activity without feeling tired. The blood pressure was reduced, compared with before. 4 dosages in total.

 

Date: July 6. 2009                                       Time: 9: 00 a. m.

The weakness and stiffness of the four limbs have got obvious improvement. But there were slight muscular jumpings. The prescription changed a little. 5 dosages in total.

 

Date: July 10, 2009                                       Time: 9: 30 a. m.

The weakness and stiffness of the four limbs have got obvious improvement day after day. There were still muscular jumpings. His tongue was yellowish and thin. The tongue coating was slippery. There were teeth marks on the edge of the tongue. His pulse was weak and thready. 5 dosages in total.

 

Date: July 15, 2009                                        Time: 10: 00 a. m.

The frequency of the muscular jumpings reduced. There was no obvious improvement with the upper limbs in the left side of body. But the strength of the upper limbs in the right side body has increased. The activity condition has improved. His speaking was more fluent, just a few words could not be understood. The other condition was normal. The prescription was changed a little. 5 dosages in total.

 

Date: July 21, 2009                                       Time: 10: 00 a. m.

The patient's condition was normal. Continue to take the prescription.

 

Date: July 24, 2009                                       Time: 10: 00 a. m.

The frequency of the muscular jumpings reduced. The stiffness and pains on the left arm were improved. The previous prescription changed a little. 5 dosages in total.

 

Date: July 31, 2009                                       Time: 10: 00 a. m.

The strength of the lower limbs has increased gradually. The condition of stiffness and activity of the joints has improved. The stiffness and pains of the upper limbs on the right side body also have got obvious improvement. The weakness of the upper limbs on the left side body also has also improved. But there was still difficulty to raise left hand freely. The other condition was normal. 5 dosages in total.

 

Date: Aug. 5, 2009                                       Time: 10: 00 a. m.

The symptom of the muscular jumpings was reduced. The prescription was made a little change. 5 dosages in total.

 

Date: Aug. 10, 2009                                       Time: 10: 00 a. m.

The patient had the major symptom of the muscular jumpings of the upper arms. But the strength has increased obviously on the right arm. Ha could raise the right hand up and down. However, the left hand could not do that. There was obvious muscular atrophy in the upper limbs. The patient should have more nourishing food. The prescription was made a little change. 5 dosages in total.

 

Date: Aug. 15, 2009                                       Time: 10: 00 a. m.

The symptom of the stiffness of the four limbs disappeared basically. The frequency of the muscular jumpings on the chest and lower limbs was reduced a lot. There were still some muscular jumpings on the arms. The lower limbs were trembling and weak, when he was walking. So our treatment is to boost qi and fortify the spleen, extinguish the wind and transform phlegm, supplement and enrich the liver and kidneys. The prescription was made a little change. 5 dosages in total.

 

Date: Aug. 20, 2009                                       Time: 10: 00 a. m.

The patient's condition was normal. The prescription was made a little change on the basis of the prescription on Aug. 15. 5 dosages in total.

 

Date: Aug. 24, 2009                                       Time: 10: 00 a. m.

The symptom of the weakness and stiffness on the lower limbs has improved quickly with the help of the comprehensive treatment here. Now, these symptoms have disappeared. Compared with before, the edema of the lower limbs and back of the hands was disappeared. He could raise the right hand freely. At the same time, the lower limbs could also stretch or bend smartly. After 20 days treatment, he could walk by himself without the wheelchair. The weakness and activity of the upper limb in the left side of the body still need to get steady improvement. There were slight muscular jumpings of the arms. The patient requested to bring 3 months of herbal tea for further treatment at home.

 

More ALS cases that we helped well:

Case-1  Case-2  Case-3  Case-4  Case-5  Case-6  Case-7  Case-8  Case-9  Case-10  Case-11   Case-12  Case-13  Case-14  Case-15  Case-16  Case-17  Case-18  Case-19   Case-20  Case-21  Case-22  Case-23  Case-24  Case-25  Case-26  Case-27   Case-28   Case-29  Case-30  Case-31