Investigation On The Etiology And Pathogenesis Of Fu Du Causing Multiple Sclerosis And Retrospective Analysis On Clinical Characteristics And The Rule Of Syndrome And Treatment Of MS

Objective:In order to provide more reference for the syndrome differentiation and treatment of Traditional Chinese Medicine(TCM)in multiple sclerosis(MS),this study discusses the etiology and pathogenesis of Fu Du,then summarizes clinical characteristics,syndrome element distributions and general patterns of TCM prescription through the investigation and analysis on clinical data of patients with MS in the neurology department of Jiangsu Provincial Hospital of Chinese Medicine.Methods:The data included in this study were derived from outpatients and inpatients in the neurology department of Jiangsu Provincial Hospital of Chinese Medicine from July 2016 to December 2020.Relevant information such as gender,age,TCM diagnosis,syndrome element and treatment are collected and analyzed retrospectively.Results:1.A total of 74 patients with MS is included in this study,containing 29 males(39.2%)and 45 females(60.8%),with a male-female ratio of 1:1.55.The number of males and females in each age group and their percentages are as follows:5 females(83.3%)and 1 male(16.7%)from age 1 to 25;34 females(64.2%)and 19 males(35.8%)from age 26 to 50;6 females(40.0%)and 9 males(60.0%)from age 51 to 75.The number of patients age from 26 to 50 is distinctly higher than that of other age groups,and the difference is statistically significant.The proportion of female patients in the age group of 26-50 is obviously higher than that of male patients,and the difference is statistically significant,while in the other two age groups,there is no significant difference in the prevalence between male and female patients.2.There are 9 TCM diagnosis are involved in patients with MS,names of these TCM diagnosis are arranged in frequency order from high to low:28 cases of flaccidity syndrome(46.7%),18 cases of arthralgia syndrome(30.0%),6 cases of dizziness(10.0%),3 cases of stroke(5.0%),1 case of insomnia(1.7%),1 case of spasm syndrome(1.7%),1 case of double visual images(1.7%),1 case of edema(1.7%),1 case of headache(1.7%),and the difference in distribution of TCM diagnosis of patients with multiple sclerosis is statistically significant.3.The syndrome elements mentioned in this study sum to be 17 kinds,including 6 pathogenic sites and 11 pathogenic factors.The frequency of pathogenic sites from high to low are:kidney(43.1%),liver(25.9%),spleen(17.2%),meridian(10.3%),stomach(1.7%)and heart(1.7%).The frequency of pathogenic factors from high to low are:dampness(16.9%),blood stasis(15.6%),qi deficiency(14.3%),phlegm(13.0%),blood deficiency(10.4%),wind(7.8%),heat(7.8%),coldness(5.2%),qi stagnancy(3.9%),yin deficiency(3.9%),yang hyperactivity(1.3%).The difference in distribution of both pathogenic sites and factors is statistically significant.4.The amount of traditional Chinese medicines used on patients with MS in this study is 167.A total of 35 medicines are used over 15%on frequency of utilization,from high to low are:astragalus root,cortex phellodendri,atractylodes,liquorice,cooked rehmannia root,rehmannia root,cornel,rhizoma atractylodis,coix seed,Chinese yam,root of herbaceous peony,pseudostellaria root,angelica,radix puerariae,medicinal indianmulberry root,rhizoma ligustici wallichii,poria cocos,thistle,radix bupleuri,medlar,caulis spatholobi,windproof,ginseng,rhodiola,twotooth achyranthes root,radix cyathulae,dodder,ganoderma lucidum,sophora,fenugreek,cassia twig,radix paeoniae rubra,codonopsis,salvia miltiorrhiza and malt.Conclusion:1.The number of patients in age group of 26-50 is distinctly higher than that of other age groups and the proportion of female patients in this age group is higher than that of male ones,while in other two groups the gender distribution difference is not obvious.2.The most common TCM diagnosis of MS is flaccidity syndrome.Arthralgia syndrome and dizziness are also familiar.3.The pathogenesis of MS is most closely related to the kidney,liver and spleen.The most common pathogenic factors are dampness and blood stasis.4.The general pattern of TCM prescriptions on MS is the common use of tonifying drugs.The majority of these drugs are aimed to reinforce liver and kidney,invigorate spleen and replenish qi.Also,clearing heat and eliminating dampness,and removing blood stasis and dredging collaterals are important rules.5.Results of this study are consistent with the etiology and pathogenesis of Fu Du,which indicates the reasonability of Fu Du explanation on MS and the treatment method of Fu Du should be more accepted and further studied in the future.