Mr. Costica, from Romania, had been suffering from diabetes
Mr. Costica, from Romania, had been suffering from diabetes in the concept of western medicine and wasting-thirst disease (any disease with the symptom of frequent drinking, eating and urination) in the concept of TCM for years, accompanied by many times of bowel movements every day and watery stool for 5 years as well as numb feeling over the extremities of his four limbs for 3 years. He was hospitalized in our hospital on February 9, 2011 for TCM treatment. He achieved great improvement in his condition after nearly one month TCM treatment with the help of herbal tea, acupuncture, massage etc.
Record of Hospitalization Name: Costica Sex: Male Age: 45 Marital Status: Married Nationality: Romanian Date of Admission: Feb. 9, 2011
Companion: Alone
First Medical Record
Date: Jan. 17, 2011 Time: 10:00 am This 45-year-old gentleman had been suffering from wasting-thirst disease or diabetes for years, accompanied by many times of bowel movements every day and watery stool for 5 years as well as numb feeling over the extremities of his four limbs for 3 years. The patient was hospitalized in our hospital for TCM treatment on Feb. 9, 2011. Essential for Diagnosis: 1. The patient had been suffering from wasting-thirst disease or diabetes for years, accompanied by increasing times of bowel movements every day and watery stool for 5 years as well as numb feeling over the extremities of his four limbs for 3 years. 2. In the year of 2000, the patient went to hospital for examination for the problem of sudden increase of bowel movements. The examination showed that his blood sugar was a little high, and then he was diagnosed as diabetes of I type. Now he took the treatment of the insulin injection regularly. Around five years ago, he gradually suffered regular diarrhea. 3 years ago, extremities of his four limbs showed numb feeling, and he did not take any effective treatment for that. When he came to our hospital, he suffered many times of bowel movement every day, up to 6 to 10 times per day. His stool was loose. Each time he rushed into the toilet. There was no burning sensation over his anus. He felt numb over the finger tips and feet, especially over the toes. Both his hands and feet were not sensitive to heat. His appetite was good, but he still lost weight obviously, from 120kg in 1998 to 81.5kg now. He suffered occasional dryness and bitterness in his mouth, spontaneous sweat and night sweat during the night. Sleep was not good in the recent 3 years, with around 4-5 hours each night. Urination was good. He felt easy to be tired with heavy sense over his lower limbs. He had good sexual desire but the amount of sperm was reduced. 3. T: 36.3°C R: 20 times/minute P: 82 times/minute BP: 150/80 mmHg
5. His spirit activity was good. He grew normally. His diet was of common nutrition. He had fine sense. Sound of breathing in the lungs was clear, without any rhonchi. The formation and size of his thorax were normal. His heart rate was 80 times per minute. The rhythm of heart was regular without any murmurs. His tongue was red with yellowish and greasy tongue coating. His pulse was wiry and slippery.
Diagnostic Basis:
TCM: Times of the patient’s bowel movements were increasing. The stool was watery. He had no burning pains around his anus. These were due to devitalized spleen yang and dysfunction of transportation and transformation. He felt heaviness over his lower limbs and his tongue was yellowish and greasy, which was due to dampness staying in the body. Tiredness and spontaneous sweating were due to qi deficiency. Numbness over his fingers and toes, night sweating as well as dryness and bitterness in his mouth were due to yin deficiency and insufficiency of fluids and blood. So his condition could be diagnosed as wasting-thirst disease. Western Medicine: The result from the lab showed that his blood sugar was high and the patient was dependent on the treatment of insulin injection. Therefore, his condition could be diagnosed as diabetics. Diagnostic Differentiation: TCM: The patient’s condition should be differentiated with thirst disease. Thirst disease is a clinical symptom when the patient is feeling thirsty and likes to drink water. This disease can happen on various diseases, especially on externally contracted heat diseases. There were no such symptoms as polyphagia, diuresis and sweet urine. Therefore, it was easy to differentiate them. Western Medicine: His condition should be differentiated from after-meal glycosuria. As to after-meal glycosuria, glycosuria only occurs when the patient takes too much food with sufficient sugar or when the body absorbs the sugar too fast, therefore the blood sugar is temporarily higher than renal glucose threshold. The blood sugar rate will come to normal level when the stomach is empty. So, it was easy to differentiate them. First Diagnosis: TCM: Wasting-thirst disease. Symptom identification: the deficiency of qi and yin, spleen deficiency and dampness staying in the body Western Medicine: Diabetics. Treatment strategy and nursing: 1. Routine care of traditional Chinese internal medicine. 2. Grade Ⅲ care. 3. Diet with lower sugar and fat. 4. Pathogenesis: the deficiency of qi and yin, spleen deficiency and dampness staying in the body. 5. TCM strategy: to boost qi and nourish yin as well as to fortify the spleen and disinhibit dampness. 6. Herbal tea: one dosage a day and drink twice 7. Acupuncture and massage: once a day Date: Feb. 12, 2011 Time: 10:00 am The patient said he had suffered from diarrhea for several years, with 7 to 8 times bowel movement every day. His stool was loose. He also felt numbness over the extremities of his four limbs. He always felt exhausted and dryness in the mouth. His urine was yellowish. His tongue was slightly red with slightly thick and yellowish coating. The pulse was slippery. His condition was due to the deficiency of spleen and dampness staying in the body. Therefore, the treatment should be boosting qi and nourishing yin as well as fortifying the spleen and disinhibiting dampness. Date: Feb. 16, 2011 Time: 10:00 am The patient said he had two times of bowel movements and the stool almost formed. There were no evident improvements in other conditions. The tongue was slightly red with slightly yellowish tongue coating. Feedbacks of the examination: Blood routine was normal. Urine routine: glucose, 3+. Liver routine: total cholesterol: 7 mmol/L. The function of kidneys was normal. Blood sugar (-). Glucose: 10.26 mmol/L. Date: Feb. 21, 2011 Time: 10:00 am
In the recent days, bowel movements of the patient were 1 or 2 times per day. His appetite was good. Urination was normal. There was no dryness in his mouth. He had a good spirit. His tongue was slightly red with thin and yellow coating. His pulse was slippery.
Date: Feb. 26, 2011 Time: 10:00 am
The patient’s condition was stable. There was slight numb and itchy sensation over his feet. Date: Mar. 1, 2011 Time: 10:00 am The patient’s condition was stable. His tongue was slightly red with thin and white coating. His pulse was slippery. Date: Mar. 4, 2011 Time: 10:00 am