hg6558 .com Catalogue of Deng Tietao's Famous TCM Experiences (6)

Catalogue of Deng Tietao's Famous TCM Experiences (6)

Source of information: Time: 2020-02-21 02:25:35

Millennium Tongzhou vitality north stream

8. Scleroderma case Zhang Moumou, female, 35 years old. Hospital No. 05854.
First diagnosis: November 3, 1971.
History: Skin is as hard as leather for more than 3 years.
From May 1968, the patient developed low fever, fatigue, edema on the face and both upper limbs, and then extended to both lower limbs. After 3 to 4 months, the skin gradually hardened like a leather, and white discoloration appeared on the neck. Hand and wrist movements are not working. In May 1969, she was diagnosed with "scleroderma" in a dermatology department of a hospital. After treatment with western medicine (prednisone, etc.) for 1 year, she did not improve significantly, but she still insisted on riding a bicycle to work. From 1970 to 1971, he was treated with traditional Chinese medicine in two hospitals, but the condition continued to develop. The range of skin stiffening and discoloration continued to expand, and he felt heartbeat, insomnia, difficulty opening, poor stomach appetite, and muscle atrophy throughout the body. , Numbness of hands and feet, no sweat in the lower body, pain in the joints of the limbs, etc. are required to be admitted to the hospital.
Diagnosis: Chronic illness, lack of facial expression, decalcification of bones, uneven skulls, hard skin on limbs, face, neck, and shoulders, waxy luster, difficult to pinch, dark brown, and mixed with large pieces Depigmentation spots. The limbs closed sweating, and there was no obvious hair loss. The apical region had systolic secondary whistle-like murmurs, the lungs were normal, the liver and spleen were not reached, and the knuckles and wrist joints were mildly rigid and stiff without pathological nerve reflexes. The tongue is light, thin and tender, but the tongue is not stretched, the moss is thin and white, the pulse is thin, and the pulse of two inches is weak. Laboratory tests: Blood, urine, stool routine, and liver function tests are normal. The red blood cell sedimentation rate is 27 mm / hour, the total plasma protein is 61.6 g / liter, the albumin is 36.4 g / liter, and the globulin is 25.2. G / l. X-ray examination: Chest and lungs were normal.
Diagnosis: Systemic scleroderma (sclerosis and atrophy).
Syndrome Differentiation: The disease belongs to the deficiency of lung, spleen and kidney (yin and yang deficiency).
Treatment: kidney and spleen, lungs and skin, supplemented with blood circulation.
Prescription: 6 grams of antlers gum (simmered), 6 grams of gelatin (simmered), 30 grams of tortoise shells (fried first), 24 grams of cooked land, 15 grams of yam, 9 grams of lycium, 9 grams of citronella, 9 morinda Grams, safflower 4.5 grams, cinnamon sticks 9 grams, codonopsis 15 grams, atractylodes 12 grams, red scallion 12 grams, 6 grams of licorice root.
Second diagnosis: Addition and subtraction on the basis of the above, one month after taking the medicine, joint pain reduced, but the amount of menstrual cramps, tongue red, thin, yellow fur, pulse deficiency. The card is characterized by yin deficiency, which is changed to Liuwei Dihuang Decoction plus Qi and Blood Activating Drugs.
Prescription: 9 grams of mangosteen meat, 18 grams of huai yam, 9 grams of Yunling, 18 grams of cooked land, 6 grams of paprika, 6 grams of diarrhea, 9 grams of lycium, 4.5 grams of antlers gum (coated), 15 codonopsis Grams, 12 grams of astragalus, 12 grams of angelica, 15 grams of salvia miltiorrhiza, 15 grams of malt.
The third consultation: the upper and lower services were discharged until April 1972. When discharged, hand and foot paralysis was relieved, the skin was softer, wrinkles and twists were visible on the face and left hand, and the movements of the wrist joints were more flexible and better. After leaving the hospital, it will still increase or decrease as above.
Governing Law: Nourish the kidney yin, strengthen the spleen and nourish qi.
Prescription: 15 grams of astragalus, 15 grams of cooked land, 15 grams of yam and yam, 9 grams of Yunling, 9 grams of mangosteen meat, 6 grams of antlers (peony), 12 grams of angelica, 15 grams of white peony, 9 grams of paeonia 9 grams of diarrhea, 9 grams of wolfberries, and 12 grams of grain buds.
Go up to Angelica, Baiji, add Morinda citrifolia, or Ejiao antler gum, take it for more than 4 months, and then change it to Liuwei Dihuang Tonga with 18 grams of Codonopsis for more than 4 months. During these 10 months, Jilin ginseng was stewed occasionally, 9 grams each time, and his condition improved. After 10 months of discontinuation of the drug for some reason, the condition was repeated. He returned to the clinic in August 1974, and continued to use Liuwei Dihuang Decoction with Astragalus, Codonopsis and Qizi. After a few months of taking the medicine, the tightness of the chest and legs had been removed, and I was able to squat slightly. The whole body skin could be twisted except for the fingers, and my forearms had sweated.
Starting from the second half of 1975, he still used the front plus and minus, taking 3 doses a week. Add 3g stewed rock candy served once a week from Northeast's field chicken oil, or boil lean soup with about 30g of dried sandworm from Hainan to replace the rare gelatin and antler gum, or stew 15g of white sugar ginseng . The general rule of treatment is still inseparable from nourishing yin. By September 1976, the patient had gained weight, had good mental and appetite, and was able to perform general domestic tasks. The face has expressions. The skin from the face to the arms and hands can be pinched and can squat. The joints are flexible, but the knuckles of the two hands are still not good. The original dark skin has turned to a normal color. Except for the white bleaching spots that are faintly visible on the neck, the bleaching spots on the back and buttocks have all disappeared. The movement of the mouth is flexible, and the tongue can extend beyond the lips.
[Analysis] The etiology and pathogenesis of scleroderma are not clear. At present, it is mostly considered to be related to immunity. It is mainly characterized by thickening and hardening of skin and other tissues, and finally atrophy. The most common early symptoms are Raynaud's phenomenon (about 90%), fatigue, weight loss, swelling of the face or both hands, joint pain, and a few patients with low fever. Then the skin thickens and hardens, like leather, with a waxy luster. In the later stage, the skin atrophies, the skin lines disappear, the hair is dry, smooth and thin, and the hair is shed, often with pigmentation and white spots, and capillary dilation can also be seen. The facial skin lines disappeared, the skin around the mouth tightened and it became difficult to open the mouth, and the face was dull. The skin lesions gradually spread to the arms, neck, chest, abdomen, and back, and even necrotic ulcers appeared on the fingertips. Scleroderma can be divided into two types, localized and systemic, according to its pathological characteristics. Systemic scleroderma not only damages the skin, but also affects internal organs, and severe heart, kidney, lung and other important organs. Damage can be life threatening. Although local scleroderma does not affect the internal organs, localized skin sclerosis can occur in multiple places, which can affect beauty or organ function, and even cause limb dysfunction and deformity.
There is no clear record of scleroderma in ancient Chinese medicine literature, but there are many similar descriptions. Such as "difficult classics and fourteen difficulties" has the "five losses" statement. Song Wu Yanzhang's "Applicants for Messaging" records: "People develop cold and heat more than a few days later, and their limbs are as firm as stones, struck by objects like clockwork, and they are getting thinner and worse." This description is quite different from modern medical scleroderma Similarity. Some people combined with the clinical manifestations of the disease, thinking that the disease should belong to the category of traditional Chinese medicine syndrome, skin, blood, and rheumatism. According to the pathological changes of the disease and clinical experience, Deng's thought that it should belong to the scope of deficient diseases of traditional Chinese medicine.
The patients in this case had symptoms such as skin, atrophy of muscles throughout the body, decalcification of bones, uneven skulls, apprehension, tender tongue, thin and short, pale color, thin pulses and weak two inches. The main skin of the lungs loses the Qi and Yin of the lungs, but loses the effect of "smoked skin and filled with hair, if the mist is exposed", so the skin loses its softness. The spleen has muscles and limbs, and the spleen is deficient and loses its health. Qi and blood are depleted. The diet can not be skin. Therefore, muscle atrophy and difficulty in extremities movement. "The kidney yin is losing money, so the bone damage is in line with the so-called evidence of so-called damage caused by traditional Chinese medicine. "Difficult sutra" said: "What is the reason for the damage of the pulse? Of course! One damage is caused by the fur, the skin gathers and the hair falls; the second damage is caused by the blood veins, and the blood veins are too few to be honored by the internal organs. The muscles lose weight, and the diet cannot be for the skin; the four damages are caused by the tendons, and the tendons can not be self-retained; the five damages are caused by the bones, and the epiphysis can not get up on the bed. Those who can't get up and die, from the upper and lower, the skin gathers and the hair falls off. "This patient's rise from the fur first and then the bone is evidence of damage from the upper to the lower. Although the disease first originates in the lungs, it has damaged the spleen of the acquired nature and the kidney of the innate nature. Therefore, it is considered to treat the kidney mainly, supplement the spleen, and promote blood circulation to treat skin. According to this principle, after one period of treatment with one side, the tongue was changed from tender to red, and the moss was yellow. The kidney yang deficiency was restored. Therefore, the kidney yin was mainly replaced, and the two parties were treated with Liuwei Dihuang Decoction plus qi for activating blood. . After discharged from the hospital, the principle of treatment was gradually reduced, and blood-activating drugs were gradually subtracted, and Jilin ginseng that nourished the vitality was added, so that the lung qi was filled and the fur was nourished. Tian chicken oil, dried worms, and Ejiao, antler gum also belong to "flesh and blood sentiment". This is according to Wu Jutong's suggestion of filling the yin and gully, and must use flesh and blood sentiment. According to the patients, after the two flavors, they feel very good and sleep well.
This disease has been treated for several years before and after, and the effect is slow, which shows that it is reasonable for the predecessors to name this kind of disease as deficient. For the treatment of deficiencies, the acquired essence-the spleen and the congenital essence-the kidney is the key. If the spleen is not healthy, the kidney is not easy to accept, but the disease will be difficult to heal without kidney. The kidney is especially important in this disease.

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