Clinical Observation On The Treatment Of Amyotrophic Lateral Sclerosis With Shengshen Guben Decoction Combined With Scalp Acupuncture Based On The Theory Of "Atmospheric Subsidence"

Purpose:Observing the clinical efficacy of Shengxian Guben Decoction combined with scalp acupuncture therapy in the treatment of amyotrophic lateral sclerosis(ALS),exploring the mechanism of using Shengxian Guben Decoction combined with scalp acupuncture therapy to treat ALS,providing new ideas for clinical treatment of this disease,and conducting infrared thermography feature analysis,providing a visual basis for observing ALS and evaluating the effectiveness of this therapy.Method:1.The study was conducted to observe the clinical efficacy of ALS patients who were admitted to the Second Neurology Department of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from July1,2021 to January 31,2023.A total of 42 patients were included.2.Counted and analyzed the general situation of the patients in the group.In the 4 weeks’ observation time,the method of combining Shengxian Guben Decoction with scalp acupuncture therapy was adopted on the base of foundational treatment.3.Comparing and analyzing the scores of ALSFRS-R,ALSAQ-40,and self-designed TCM symptom scales of ALS patients before and after treatment,the improvement of TCM symptoms was evaluated,and preliminarily judged the clinical efficacy of Shengxian Guben Decoction combined with scalp acupuncture therapy.4.Use the medical infrared thermal imager to take infrared thermograms,observed the changes of the average temperature and the average temperature difference between the two areas before and after the treatment of ALS patients in the precordial area and the Danzhong area,and summarized the characteristics of the infrared thermograms of ALS patients before and after the treatment through statistical analysis and processing,so as to provide a visual basis for the clinical observation and treatment process of ALS.Result:1.A total of 42 patients with ALS were included in this study.General information:(1)Gender: 25 men(59.52%),17 women(40.48%),the gender ratio of men and women is 1.47:1.(2)Age of onset: The average age of ALS patients is 57 years old,the minimum age is 37 years old,and the maximum age is 75 years old,the highest age of onset is 50-59 years old(54.76%).(3)Type of onset: 40 cases(95.24%)of limb onset and 2 cases(4.76%)of medulla oblongata onset.(4)Course of disease: The longest course of disease is 75 months,the shortest is only 2 months,and the average course of disease is 17.21 months.There are 33 patients(78.57%)within 2 years.(5)Clinic Symptoms at the time of treatment: All 42 patients presented with muscle weakness,followed by muscle atrophy and positive pyramidal tract sign in 20 cases(47.62%),dyspnea in 18 cases(42.86%),choking cough in drinking water and unclear speech in 15 cases(35.71%),dysphagia in 9 cases(21.43%).(6)Past medical history: Among42 patients,37 patients were found to have a past medical history,accounting for 88.10% of the total number,of which 16 patients(38.10%)had the highest proportion of hypertension,11 patients(26.19%)had cerebral infarction.(7)Personal history: no clear history of exposure to poison or chemicals;There were 6 cases(14.29%)with a history of drinking and 9 cases(21.43%)with a history of smoking.(8)Family history:there was no familial genetic history of ALS.2.ALSFRS-R scale score: After treatment,the total score of the ALSFRS-R scale decreased,and the difference was statistically significant(P<0.05).In terms of medullary function and respiratory function,there was no significant change in scores before and after treatment,and the difference was not statistically significant(P>0.05);After treatment,the score of limb function decreased with statistical significance(P<0.05).3.ALSAQ-40 scale: After treatment,the total score of ALSAQ-40 scale increased,and the difference was statistically significant(P<0.05);There was no statistically significant difference in the scores of physical exercise ability,self-care ability,diet and social interaction ability before and after treatment(P>0.05);In addition,the emotional response score increased,with a statistically significant difference(P<0.05).4.Comparison of Traditional Chinese Medicine Symptom Scale Points: Before and after treatment,there was a statistically significant difference in the total points of the Traditional Chinese Medicine Symptom Scale(P<0.05),with a decrease in points.After treatment,the patient’s scores for symptoms such as muscle peristalsis or spasms,limb spasms,language difficulties,chest tightness and shortness of breath,fatigue,dizziness,palpitations,sweating,loss of appetite,abdominal distension,and insomnia decreased and there was no statistically significant difference(P<0.05),while there was no statistically significant difference in scores between limb weakness,muscle atrophy and swallowing difficulties symptoms(P>0.05).5.Comparison of the average temperature of the infrared thermograms:There were statistically significant difference between the average temperature of the infrared calorific value of the anterior chest region and the Danzhong region of ALS patients before and after treatment(P<0.05),both of the two regions’ tenmperature difference.The average temperature of the infrared calorific value of the anterior chest region and the Danzhong region increased after treatment,and the temperature difference between the anterior chest region and the Danzhong region decreased after treatment.6.Correlation comparison: There was a significant positive correlation(P<0.01)(R>0)between the difference in ALSFRS-R scale scores and the difference in ALSAQ-40 scale scores,but there is no correlation(P>0.05)with the difference in traditional Chinese medicine syndrome scale scores.There was a positive correlation(P<0.05)(R>0)between the difference in ALSAQ-40 scale scores and the difference in traditional Chinese medicine syndrome scale scores;There was a significant positive correlation(P<0.01)(R>0)between the average temperature difference in the anterior chest area and the average temperature difference in the Danzhong area;There was a positive correlation(P<0.05)(R>0)between the average temperature difference in the anterior chest area and the difference in scores on the ALSAQ-40 scale and the Traditional Chinese Medicine Syndrome Scale,but there is no correlation(P>0.05)with the difference in scores on the ALSFRS-R scale;There was a positive correlation(P<0.05)(R>0)between the average temperature difference in the Danzhong area and the score difference on the Traditional Chinese Medicine Syndrome Scale,but there was no correlation(P>0.05)with the score difference on the ALSFRS-R scale and the ALSAQ-40 scale.Conclusion:1.The ALSFRS-R scale can to some extent reflect the degree of dysfunction and progression of the condition in ALS patients.The Shengxian Guben Decoction combined with scalp acupuncture therapy can stabilize the medulla oblongata and respiratory function of ALS patients to a certain extent,but has no significant delay or improvement effect on limb motor function.2.The ALSAQ-40 scale can reflect the daily living ability,social interaction situation,and psychological status of ALS patients,reflecting their quality of life.The Shengxian Guben Decoction combined with scalp acupuncture therapy can to some extent delay the decline in daily life ability and social interaction ability,improve the patient’s psychological state.3.The Traditional Chinese Medicine Symptom Scale can reflect the situation of traditional Chinese medicine symptoms in ALS patients.The combination of Shengxian Guben Decoction and scalp acupuncture therapy can improve some symptoms of traditional Chinese medicine in ALS patients,but the effect is not significant in terms of limb weakness,muscle atrophy and swallowing difficulties symptoms.4.There was a correlation between the ALSFRS-R scale and the ALSAQ-40 scale,and a correlation between the ALSAQ-40 scale and the TCM syndrome scale;The average temperature difference between the chest area and the Danzhong area was related;The average temperature of the chest area was correlated with the scores of ALSAQ-40 scale and TCM syndrome scale,and the average temperature in Dhanzhong district was correlated with the scores of TCM syndrome scale.5.From the characteristics of infrared thermograms,infrared thermograms can reflect the temperature changes in the anterior chest area and the Danzhong area of ALS patients before and after treatment,indicating that infrared detection technology can objectively evaluate the treatment effect of Shengxian Guben Decoction combined with scalp acupuncture therapy to a certain extent,and provide visual basis.