The Dialectical Analysis Of Five Viscera Correlation In Clinical Symptoms Of Amyotrophic Lateral Sclerosis

Research objectiveTo sum up five viscera correlation's dialectical analysis of flaccid symptoms and the differentiation of symptoms and signs for classification of syndrome of amyotrophic lateral sclerosis(ALS) in the medical literature, to observe and study the chinese medical syndrome of ALS about the patients of our division in a retrospective way, to attempt and explore the status and the dialectical relationship of five viscera in this disease, to analyze the differentiation of symptoms and signs for classification of syndrome of five viscera atrophy about ALS.Research methodTo retrieve the related content about the syndrome and differentiation of ALS and flaccid symptoms through the electronic retrieve and manual retrieve integration in the medical literature, and then design clinical information table according to traditional chinese medicine diagnostic criteria. To collect the general information, medical history characteristics, clinical manifestations (symptoms, tongue, pulse and other four diagnostic information) about 59 patients with final diagnosis ALS by descriptive study. To complete the data entry and verification of observational data using statistical software SPSS13.0, and make statistics by descriptive analysis, cluster analysis and principal component analysis, then analyze and explore the differentiation of symptoms and signs for classification of syndrome about Five viscera atrophy of ALS.Research resultsThe male to female ratio is approximately 2:1, male sends much, the average age is 53.68±12.895 years, the average duration is 23.66±16.276 months. Long-term exposure to metal and harmful chemicals may evoke ALS, the disease also may be related to viral infection. According to frequency analysis, cluster analysis, principal component analysis and so on, summarize the clinical four big patterns of. syndrome:Spleen and stomach deficiency, with obstruction of collateral caused by windphlegm;Liver and kidney deficiency ,with obstruction of collateral caused by windphlegm and static blood;Spleen deficiency witn endoretention of damp heat;Five viscera deficiency, with retention in the lung caused by phlegm-heat.1 Spleen and stomach deficiency,with obstruction of collateral caused by windphlegmSymptoms:lusterless complexion, anorexia, limb weakness, muscle atrophy, paralalia, asyndesis, dysphgia, aphagia, dysdipsia, pale tongue, atrophic and soft tongue, shrinking tongue, trembling tongue, liver mosses white, fine pulse.Involving entrails:spleen, stomach and liver;related syndromes elements: qi asthenia, blood asthenia, sputum and endogenous wind.2 Liver and kidney deficiency, with obstruction of collateral caused by windphlegm and static bloodSymptoms:limb weakness, muscle twitching, muscle atrophy, astasia abasia, limb tendon spasm,dysphgia, aphagia, dysdipsia,short dark tongue, heavy fine pulse.Involving entrails:liver, kidney;related syndromes elements:yin deficiency, sputum, static blood, endogenous wind.3 Spleen deficiency, with endoretention of damp heatSymptoms:fatigue, limb weakness, muscle atrophy, pale tongue, liver mosses yellow, heavy slippery pulse.Involving entrails:spleen;related syndromes elements:moistheat, qi asthenia and blood asthenia.4 Five viscera deficiency, with retention in the lung caused by phlegm-heatSymptoms:fatigue, emaciation, pant, inability to lie horizontally, limb weakness, muscle twitching, muscle atrophy, lachrymation, sputum obstruction on throat, cough, expectoration, thick sputum, chest tightness, dyspnea, paralalia, asyndesis, dysphgia, aphagia, dysdipsia, waist/knee soreness, chills, pale tongue, liver mosses yellow, atrophic and soft tongue, shrinking tongue, trembling tongue, fine pulse.Involving entrails:spleen, lung, liver, kidney and heart;related syndromes elements:qi asthenia, yin deficiency, sputum, heat, blood stasis, and endogenous wind.Conclusionsspleen and lung deficiency in origin and liver wind and sputum excess in superficiality are the basical pathogenesis of ALS. Lung deficiency is throughout the whole process, spleen deficiency is in origin, both and more entrails'deficiency exists at the same time, lung and heart ofen appear fatal deficiency-excess mixing in the end-stage, and life encounters death at any time. Differentiations of symptoms and signs for classification of syndrome are Spleen and stomach deficiency, with obstruction of collateral caused by windphlegm; Liver and kidney deficiency, with obstruction of collateral caused by windphlegm and static blood;Spleen deficiency,with endoretention of damp heat;Five viscera deficiency, with retention in the lung caused by phlegm-heat. The former three patternts are common, and the last one generally happens in later stages of ALS.