Brief
Summary:
Mr. Costica, from
Romania, had been suffering from diabetes in the concept of
western medicine and wasting-thirst disease (any disease with
the symptom of frequent drinking, eating and urination) in the
concept of TCM for years, accompanied by many times of bowel
movements every day and watery stool for 5 years as well as numb
feeling over the extremities of his four limbs for 3 years. He
was hospitalized in our hospital on February 9, 2011 for TCM
treatment. He achieved great improvement in his condition after
nearly one month TCM treatment with the help of herbal tea,
acupuncture, massage etc.
Record of
Hospitalization
Name:
Costica Sex:
Male
Age:
45 Marital Status: Married
Nationality:
Romanian Date of Admission:
Feb. 9, 2011
Companion:
Alone
First
Medical Record
Date:
Jan. 17, 2011 Time:
10:00 am
This 45-year-old
gentleman had been suffering from wasting-thirst disease or
diabetes for years, accompanied by many times of bowel movements
every day and watery stool for 5 years as well as numb feeling
over the extremities of his four limbs for 3 years. The patient
was hospitalized in our hospital for TCM treatment on Feb. 9,
2011.
Essential for Diagnosis:
1. The patient had been
suffering from wasting-thirst disease or diabetes for years,
accompanied by increasing times of bowel movements every day and
watery stool for 5 years as well as numb feeling over the
extremities of his four limbs for 3 years.
2. In the year of 2000,
the patient went to hospital for examination for the problem of
sudden increase of bowel movements. The examination showed that
his blood sugar was a little high, and then he was diagnosed as
diabetes of I type. Now he took the treatment of the insulin
injection regularly. Around five years ago, he gradually
suffered regular diarrhea. 3 years ago, extremities of his four
limbs showed numb feeling, and he did not take any effective
treatment for that. When he came to our hospital, he suffered
many times of bowel movement every day, up to 6 to 10 times per
day. His stool was loose. Each time he rushed into the toilet.
There was no burning sensation over his anus. He felt numb over
the finger tips and feet, especially over the toes. Both his
hands and feet were not sensitive to heat. His appetite was
good, but he still lost weight obviously, from 120kg in 1998 to
81.5kg now. He suffered occasional dryness and bitterness in his
mouth, spontaneous sweat and night sweat during the night. Sleep
was not good in the recent 3 years, with around 4-5 hours each
night. Urination was good. He felt easy to be tired with heavy
sense over his lower limbs. He had good sexual desire but the
amount of sperm was reduced.
3. T: 36.3¡ăC R: 20
times/minute P: 82 times/minute BP: 150/80 mmHg
5. His
spirit activity was good. He grew normally. His diet was of
common nutrition. He had fine sense.
Sound of breathing in the
lungs was clear, without any rhonchi. The formation and size of
his thorax were normal. His heart rate was 80 times per minute.
The rhythm of heart was regular without any murmurs. His tongue
was red with yellowish and greasy tongue coating. His pulse was
wiry and slippery.
Diagnostic Basis:
TCM:
Times of the patient¡¯s bowel movements were increasing. The
stool was watery. He had no burning pains around his anus. These
were due to devitalized spleen yang and dysfunction of
transportation and transformation. He felt heaviness over his
lower limbs and his tongue was yellowish and greasy, which was
due to dampness staying in the body. Tiredness and spontaneous
sweating were due to qi deficiency. Numbness over his fingers
and toes, night sweating as well as dryness and bitterness in
his mouth were due to yin deficiency and insufficiency of fluids
and blood. So his condition could be diagnosed as wasting-thirst
disease.
Western Medicine:
The result from the lab showed that his blood sugar was high and
the patient was dependent on the treatment of insulin injection.
Therefore, his condition could be diagnosed as diabetics.
Diagnostic Differentiation:
TCM: The patient¡¯s condition
should be differentiated with thirst disease. Thirst disease is
a clinical symptom when the patient is feeling thirsty and likes
to drink water. This disease can happen on various diseases,
especially on externally contracted heat diseases. There were no
such symptoms as polyphagia, diuresis and sweet urine.
Therefore, it was easy to differentiate them.
Western Medicine: His condition should
be differentiated from after-meal glycosuria. As to after-meal
glycosuria, glycosuria only occurs when the patient takes too
much food with sufficient sugar or when the body absorbs the
sugar too fast, therefore the blood sugar is temporarily higher
than renal glucose threshold.
The blood sugar rate will come to normal level when the stomach
is empty. So, it
was easy to differentiate them.
First Diagnosis:
TCM:
Wasting-thirst disease.
Symptom identification:
the deficiency of qi and yin, spleen deficiency and dampness
staying in the body
Western Medicine:
Diabetics.
Treatment strategy and
nursing:
1. Routine care of
traditional Chinese internal medicine.
2. Grade
¢ó
care.
3. Diet with lower sugar
and fat.
4. Pathogenesis: the
deficiency of qi and yin, spleen deficiency and dampness staying
in the body.
5. TCM strategy:
to boost qi and nourish yin as well as to fortify the spleen
and disinhibit dampness.
6. Herbal tea: one
dosage a day and drink twice
7. Acupuncture and
massage: once a day
Date: Feb. 12,
2011 Time: 10:00
am
The patient said he had
suffered from diarrhea for several years, with 7 to 8 times
bowel movement every day. His stool was loose. He also felt
numbness over the extremities of his four limbs. He always felt
exhausted and dryness in the mouth. His urine was yellowish. His
tongue was slightly red with slightly thick and yellowish
coating. The pulse was slippery. His condition was due to the
deficiency of spleen and dampness staying in the body.
Therefore, the treatment should be boosting qi and nourishing
yin as well as fortifying the spleen and disinhibiting dampness.
Date: Feb. 16,
2011 Time: 10:00
am
The patient said he had
two times of bowel movements and the stool almost formed. There
were no evident improvements in other conditions. The tongue was
slightly red with slightly yellowish tongue coating. Feedbacks
of the examination: Blood routine was normal. Urine routine:
glucose, 3+. Liver routine: total cholesterol: 7 mmol/L. The
function of kidneys was normal. Blood sugar (-). Glucose: 10.26
mmol/L.
Date: Feb. 21,
2011 Time: 10:00
am
In the
recent days, bowel movements of the patient were 1 or 2 times
per day. His appetite was good. Urination was normal. There was
no dryness in his mouth. He had a good spirit. His tongue was
slightly red with thin and yellow coating. His pulse was
slippery.
Date:
Feb. 26, 2011 Time:
10:00 am
The patient¡¯s condition
was stable. There was slight numb and itchy sensation over his
feet.
Date: Mar. 1,
2011 Time: 10:00
am
The patient¡¯s condition
was stable. His tongue was slightly red with thin and white
coating. His pulse was slippery.
Date: Mar. 4,
2011 Time: 10:00
am
After 22 days TCM treatment in our hospital, now bowel movements
of the patient kept at 1 to 2 times per day with formations. His
appetite was good. Night sleep was normal. Numb feeling over the
extremitas of his four limbs was better improved. He decided to
leave our hospital this afternoon. The doctor advised him to
avoid wind and cold, take care of the diet and keep good mood.
In addition, he had better improve the circulation of the end of
the limbs.
More
diabetes cases
that we helped well:
Case-1
Case-2
Case-3¡¡
