Collation And Analysis Of The Ancient And Contemporary Literature About The Treatment With Correlation Of Five Viscera On Amyotrophic Lateral Sclerosis (Atrophy Diseases)

BackgroundAmyotrophic Lateral Sclerosis(ALS) is a chronic and progressive disease about motoneuron degeneration.It's the commonest type of Motor Neuron Disease(MND), accounted for 80% of MND. At present, there're no specific treatments about this disease in western medicine. Based on its characteristics of clinical syndrome,most doctors of TCM consider ALS as Atrophy disease in TCM. There is a long history of cognition about Atrophy disease in TCM.It accumulates plenty of experience and effective prescriptions in traditional medicine. And it had formed the germ of treating flaccidity diseases under the theory about correlation of five viscera. Professor Dengtietao published a paper named the discussion on the correlation of five viscera replacing the theory of the five elements. He thinks the five internal organs with its corresponding tissue and organs of body building up five viscera system respectively. In the condition of physiology, the five-zang organs would advance and restrict each other,showing different functions to harmonize normal function of the body. In the condition of pathology, the five-zang organs affect each other. Briefly speaking, it's named the correlation of five viscera. There're distinctive advantages in treating flaccidity diseases with Chinese traditional medicine because this theory origin of the holistic concept and combining the correlation of five viscera. There is much recordation about the treatment of flaccidity diseases with the theory of zangfu-syndrome differentiation and treatment. But it has not formed a whole theory system. And there is few recordation about systemic literature study on the disease in TCM.PurposeOn the base of the disk(zhonghuayidian) and the contemporary literature databases, under the theory of the correlation of five viscera, collecting, analyzing and summing up the interpretation of the cause, the location of disease, the herbal medicine treatment about ALS(flaccidity diseases),it's wished to provide some references and bases for treating ALS(flaccidity diseases) with Chinese herbal medicine under syndrome differentiation and treatment of the correlation of five viscera.MethodsSearch the ancient literatures about flaccidity diseases through the disk named Zhonghuayidian, refer to the diagnostic studies of flaccidity diseases issued by State Administration of Traditional Chinese Medicine in 1994, throw off the literatures which are not accord with the diagnostic studies, extract the contents related to zangfu-organs. Search the contemporary literatures which published officially in the domestic journals about Amyotrophic Lateral Sclerosis of TCM through VIP Series database, the Chinese bio-medical literature database, the China national knowledge infrastructure literature database over the years. Divide the literatures into several sorts and set up the databases according to the interpretation of the cause, the location of disease, the herbal medicine treatment and make statistical analysis to the data. Design a questionnaire, fill by the neurologists who is Doctor-in-charge, associate chief physician or chief physician of the Guangdong Province Hospital of TCM, and then analyse the statistical data.Result1. Through the study of the ancient literatures,it show that the pathogenesises of Atrophy disease in TCM include steeped hot and humid, Yinkui-consumption; liver and kidney Yinkui, Guku by pulp;weak spleen and stomach;Feire of coke.The locations of the disease focus on the zangfu-viscera, at the same time, including the meridians and collaterals. Atrophy disease relate to the five zang organs. Its closest organs are the kidney, spleen and stomach, liver, lung.The collection of the herbal prescriptions are mainly in the Songjinyuan and Qing dynasty, the prescriptions of the two dynasties account for 73.43% in all of the prescriptions. The commonest form of the drug in use is pill, the second commonest form is decoction. In the field of using herbal medicine to treat the disease, the tonic takes up the first place. At the same time, the using of the heat-clearing drugs, drugs for relieving exterior syndrome, drugs for eliminating dampness, drugs for invigorating blood circulation is very common. The channel tropisms of the common use herbal medicine are to kidney meridian, liver meridian, spleen meridian, lung meridian, stomach meridian. In the clustering of the common use herbal medicine,it's suitable to clustering them into three sorts. At this point, the first sort is the drug strengthening the body resistance including drugs tonifying spleen, tonifying qi, nourishing the blood or tonifying the liver and kidney. The second sort is the drug eliminating evil energy including drugs expelling wind and removing damness, regulating Qi flow and invigorating blood circulation, eliminating phlegm and dredging collaterals. The third sort is the drug clearing heat and nourishing yin.2. Through the study of contemporary literatures on the TCM treatment of ALS, it shows that the reports of clinical and individual case were very few before 1990s. The literatures have increased gradually since 1990s. Most of the increasing literatures are clinical reports. The number of the cases reported is also more than that of before. And there are random or semi-random clinical trial research.The diagnosis tends to standardization too.In the collecting literatures,the pathogenesises of correlation of five viscera about ALS include asthenia of both the spleen and kidney, deficiency of body fluids;deficiency of spleen and stomach, non-distribution of refined nutritious substances;asthenia of liver and kidney,withering of Sui and flaccid of Jin;asthenia of liver, spleen and kidney, non-moistening and non-nourishing the muscle;endogenous liver wind. The locations of the disease related to the Zangfu-organs focus on kidney, spleen and liver. Most of the collecting herbal prescriptions are self-refit prescriptions.The commonest form of the drug in use is decoction. In the field of using herbal medicine to treat the disease, the tonic takes up the first place. At the same time, the using of drugs for calming liver to stop endogenous wind, drugs for invigorating blood circulation, drugs for rheumatism, drugs for relieving exterior syndrome, drugs for reducing phlegm and relieving cough, drugs for arresting discharge is common. The channel tropisms of the common use herbal medicine are to liver meridian, kidney meridian, spleen meridian, lung meridian, heart meridian, stomach meridian. In the clustering of the common use herbal medicine, it's suitable to clustering them into four sorts. At this point, the first sort is the drug for tonifying spleen and Qi, reducing phlegm. The second sort is the drug for tonifying the liver and kidney. The third sort is the drug for invigorating blood circulation and dredging collaterals. The forth sort is the drug for clearing heat and nourishing yin.ConclusionAmyotrophic Lateral Sclerosis (Atrophy disease) is closely related to the zangfu-viscera,especially to the spleen, kidney and liver. On the basis of this,it leads to a series of pathological changes in the body. Then it's due to the phlegm, dampness, blood stasis and heat forming internally. Or it's caused by the exogenous pathogenic factors based on the deficiency of the zangfu-organs. If respiratory failure appears in the later stage, it means that the heart and the lung is involved. As a result, the treatment of ALS in TCM, it is important to tonify the zangfu-organs, especially to strengthen the qi and yang of the spleen and kidney, the herbal medicines as Ginseng, Bighead Atractylodes Rhizome, Astragalus mongholicus, the Bark of Eucommia, Monkshood can be chosen. If it also shows deficiency of Yin-blood, the herbal medicines of tonifying the blood and nourish yin as Angelica sinensis, Radix Rehmanniae Preparata, Radices Paeoniae Alba, Liriopespicta can be chosen. At the same time, it should be chosen some drugs for eliminating phlegm(as Rhizoma Acori Graminei, Arisaema cum Bile, Rhizoma Pinellinae Praeparata), resolving dampness(as Poria Cocos, Rhizoma Atractylodis), invigorating blood circulation(as Radix Achyranthis Bidentatae, Ligusticum wallichii),clearing heat(as Amur Corktree Bark, Rhizoma Anemarrhenae).