The Saudi Arabian patient, Mr. Abdullah,
suffers from Parkinson’s disease. He has body trembling
accompanied by a progressive weakness for one year. His movement
is difficult and slow. After the comprehensive treatment here,
he has achieved obvious improvement.
Records of
Hospitalization
Name:
Abdullah
Sex:
Male
Age:
55 Nationality:
Saudi Arabia
Marital status:
Married
Onset
Season:
Summer
Date of Admission:
Feb. 26, 2007
Date of
Recoding:
Feb. 26, 2007
Complainer of
history:
The patient himself Reliability:
Reliable
Major complaint:
The patient was suffering from body trembling accompanied by an
aggressive weakness for one year.
Present illness:
Eleven years ago, without any obvious cause, the patient began
to have dizziness, dreaminess, slow response and a little bit
body trembling. At that time, he hadn’t done anything about his
illness due to ignorance, it progressively grew worse. In
February, 2006, the patient’s whole body trembling aggravated.
He got starting difficult, slow movement and response. Tonus on
his four limbs increased and he felt asthenia from the head to
foot. He checked in a local hospital (not in detail) and the
diagnosis for him is Parkinson’s disease. The doctors in the
hospital gave him L-dopa (3 times a day and each time 250mg)
which belongs to dopamine drugs and amantadine (twice a day and
each time 150mg) for orally taken until now. Because he had no
obvious improvement on his disease condition, he came to
hospitalize in our Traditional Chinese Medicine (TCM)
Department. Since he has the disease, his spirit was a little
worse; his appetite was good, but the quality of his sleep was
bad; his bowel movement and urination were normal.
Past history:
He was quite health before. No history of typhoid, tuberculosis,
diarrhea and hepatitis. No history of medicine or food allergy.
No history of traumatism or operation. No history of
preventive vaccination provided.
Personal history:
He was born in Saudi Arabia. No contact history of
schistosomiasis. He had regular diet and sleep. No addiction to
alcohol or smoking.
Marital history:
He married at 23 and has a
daughter and a son. His wife and children are all healthy.
Family history:
No family history of the similar or other special disease.
Disease statement:
From the patient himself. Consider it was reliable.
Physical
examination
T: 36.5℃，P:
78bpm, R: 20bpm, BP: 115/75mmHg
He is mid-nourished and normally developed. His mind is clear.
He is in a positive position and cooperative in examination. His
skin and sclera have no jaundice. His head, facial features are
normal. Bilateral pupils are round and symmetrical in size and
sensitive to light. No purulence from the external auditory
canal. No flaring of alaenasi. No cyanopathy in his lips and no
reddish in the pharynx. No swelling of the tonsil. Soft neck and
middle placed trachea. No swelling of the thyroid gland. No
thoracic deformity. His respiratory movement is smoothly.
Bilateral of his vocal fremitus are normal. Percuss sounds
clear. Sound of breath is bilaterally normal on auscultation. No
respiratory rales or pleural friction rubs. Heart border is
normal. Heart beat 78bpm. Cardiac rhythm is regular. No
pathological murmurs of heart on
auscultation. Abdomen
is flat and soft
without tenderness or rebound tenderness. Liver and spleen are
not palpable. No percussion pain on renal region. Bowel sound
is normal.
The anus and pudendum have not been checked.
No Spinal deformity. He can
move freely. He has obviously whole body trembling, starting
difficult, slow movement and response. Tonus on his four
limbs increased and he feels asthenia from the head to foot. He
has dizziness and dreamful sleep. The pathological signs are not
elicited out. Light red tongue, white and thin tongue fur, fine
and deep pulse.
Accessory
examination:
It is vacant at the moment.
First diagnosis:
TCM diagnosis: Trembling and numbness.
Symptom diagnosis:
Enrich the liver and kidney, extinguish wind and quicken the
network vessels.
WM diagnosis:
Parkinson’s disease.
Dr. Yan Zaoming/ Dr. DaiLei
First Medical Record
Abdullah, a 55-year-old male, has been suffering from whole body
trembling for about 11 years accompanied by an aggravated
acratia for one year. He was received by our staff in Zhijiang
Airport and arrived at our Huaihua Red Cross Hospital on
February 26, 2007.
Case
characteristics:
1.He
has suffered from whole body trembling about 11 years
accompanied by an aggravated acratia for one year.
2.Eleven
years ago, without any obvious cause，the patient began to have dizziness, dreamful
sleep, slow response and a little bit whole body trembling. At
that time, because he hadn’t done any examination and treatment
about his illness due to ignorance, it progressively grew worse.
In February, 2006, the patient’s whole body trembling
aggravated. He got starting difficult, slow movement and
response. Tonus on his four limbs increased and he felt asthenia
from head to foot. He checked in a local hospital (not in
detail) and the diagnosis for his disease was Parkinson’s
disease. The doctor in the hospital gave him L-dopa (3 times a
day and each time 250mg) which belongs to dopamine drugs and
amantadine (two times a day and each time 150mg) for orally
taken until now. Because he had no obvious improvement on his
disease condition, he came to hospitalize in our Traditional
Chinese Medicine (TCM) Department. Since he has the disease, his
spirit is a little worse; his appetite is good, but the quality
of his sleep is bad; his bowel movement and urination are
normal.
3. T: 36.5℃，P:
78bpm, R: 20bpm, BP: 115/75mmHg
4. He is mid-nourished and normally developed. His mind is
clear, chronic face mirroring difficult condition, languor
expression. He is in a positive position and cooperative in
examination.
5. He has obviously whole
body trembling, starting difficult, slow movement and response.
Tonus on his four limbs increased and he feel asthenia
from head to foot. He has dizziness and dreamful sleep.
6. Bilateral of his vocal fremitus are normal. Percuss sounds
clear. Sound of breath is bilaterally normal on auscultation. No
respiratory rales or pleural friction rubs.
7. Accessory examination: It is vacant at the moment.
Diagnosis
TCM:
He has been suffering from whole body trembling for about 11
years accompanied by an aggravated acratia for one year. The
disease is onset slowly after the middle or old aged people. He
has obvious whole body trembling, starting difficult, slow
movement and response. Tonus on his four limbs increased and he
feels asthenia from head to foot. He has dizziness and dreamful
sleep. The pathogenesis of this disease is liver-kidney yin
depletion.
Western medicine:
He has suffered from whole body trembling about 11 years
accompanied by an aggravated acratia for one year. The disease
is onset slowly. He has obvious whole body trembling, starting
difficult, slow movement and response. Tonus on his four limbs
increased and he feels asthenia from head to foot. He has
dizziness and dreamful sleep. The diagnosis for the patient was
Parkinson’s disease in his country.
Diagnostic
differentiation:
Differentiated with Qizong (tugging and slackening): Qizong is
also called clonic spasm. Usually, it was seen in acute fever or
some chronic diseases acute attack.
Mostly the patients twitched continually, sometimes it
accompanied by a short-term interval. Hands and feet bending and
stretching are in turn of tracing and slacking. Some of the
patients could have fever, two eyes looking upward or clouded
spirit symptoms. Trembling syndrome is a kind of chronic disease
procedure. The main symptoms present on the head, neck or four
limbs autonomously tremble or sharking. The trembling of the
hands and feet has a small extent, but a quick frequent. There
are no limbs twitching traction, fever or clouded spirit
symptoms, etc. After combined analyst with his disease history,
it was not hard to distinguish them from each other.
Western medicine
differential diagnosis should be differentiated from progressive
supranuclear paralysis.
Progressive supranuclear paralysis is also often onset during
the middle or odd aged people. The clinical symptoms have
extrapyramidal symptoms, such as myotonia, tremble, etc. But
this disease has a prominent obstacle on eyeballs staring.
Myotonia is mainly on the trunk of the body. Because the limb
muscles are less troubled, it keeps a good flexibility of the
limb movement. The tension of neck extensor muscle increased
lead to neck hyperextension and this is different from neck
stretching of Parkinson’s disease. It should be differentiated
in clinical examination.
First diagnosis:TCM
diagnosis:
Trembling and numbness.
Symptom diagnosis:
Insufficiency of the liver and kidney; liver wind enters the
network vessels.
WM diagnosis:
Parkinson’s disease.
Treatment strategy
and daily care
1. On routine care of traditional Chinese internal medicine
2. On grade II care
3. Regular diet
4. Herbal tea: enrich the liver and kidney, extinguish wind and
quicken the network vessels. The prescription is to enrich yin
and extinguish wind decoction. Such as Shoudi (cooked
rehmannia), Guiban (tortoise plastron), Tianma (gastrodia
root). One dosage a day and drink by twice, five days.
5. Massage: once a day
6. Acupuncture: once a day
7. Have more medical examinations if necessary
8. Have a positive and optimistic attitude towards the disease
Dr. Yan Zaoming/ Dr. Dai Lei
Date: 26th
of February 2007
Time: 9:00 a.m.
This morning is Deputy Chief Physician Yan
Zaoming’s ward-round. The patient complained that he has
obviously whole body trembling and feelsasthenia from
head to foot. He gets starting difficult, slow movement and
response. He has dizziness and dreamful sleep. Physical
examination: T: 36.5℃，P: 78bpm, R:
20bpm, BP: 115/75mmHg, heart and lung (—), Abdomen is flat and
soft (—).
Dr. Yan’s analysis:
1. The patient has suffered from whole body trembling about 11
years accompanied by an aggravated acratia for one year.
2. Physical examination seen the upward recordings.
3. The patient got the definite diagnosis in a local hospital
(not in detail) was Parkinson’s disease.
Based on the upward materials, we considered it is “Tremor&
paralysis” in TCM diagnosis. “Tremor& paralysis” is also called
“Parkinson’s disease”. This kind of disease usually onset the
middle aged or elder aged men. The characters which show in
clinical practice are trembling, tonus and reducing movement.
Liver-kidney yin depletion is the main pathogenesis of this
disease. The old people mostly have blood vacuity and essence
depletion, and plus they do not absorb enough nutrition, or
damaged by disease, lead to liver-kidney yin depletion, and
sinew and vessels deprived of nourishment. Because it can not
control liver yang, and liver wind stirring internally, it lead
to tremble or hypertonicity rigidity. The differentiation of
symptoms and signs is: insufficiency of the liver and kidney,
liver wind enter vessel. The principle of
treatment:
Enrich the liver and kidney, extinguish wind and quicken the
network vessels. The prescription is to enrich yin and
extinguish wind decoction. Such as Shoudi (cooked rehmannia),
Guiban (tortoise plastron), Tianma (gastrodia root). One dosage
a day and drink by twice, five days.
Massage and Acupuncture: once a day. Have more medical
examinations if necessary
Dr. Yan Zaoming/ Dr. Dai Lei
Date: 27th
of February 2007
Time: 9:00 a.m.
Today the patient still complained that he has
obviously whole body trembling and feels asthenia from head to
foot. He gets starting difficult, slow movement and response. He
has dizziness and dreamful sleep. Physical examination: Heart
and lung (—), Abdomen is flat and soft (—). He has no other
special discomfort. He presented with a bad spirit. His appetite
is good. His bowel movement and urination are normal. Red
tongue, white and thin tongue fur, deep and fine pulse. The
doctor asked him to do active movement often, to take more
vegetables and fruits, and to avoid irritation food. Observe the
patient’s condition. Continue using the same prescription.
Dr. Yan Zaoming/ Dr. Dai Lei
Date: 28th
of February 2007
Time: 9:00 a.m.
Today the patient said he feels less asthenia
from head to foot and whole body trembling. He still gets
starting difficult and still slowing in movement and response.
There is no dizziness on him and he had a good sleep.Physical
examination: Heart and lung (—), Abdomen is flat and soft (—).
He presented with a good spirit. His appetite is good.
His bowel movement and urination are normal.
Light red tongue, white and thin tongue fur, deep and fine
pulse. The doctor asked him to build up his confident and
continue to do exercise. Observe the changes of the patient’s
condition. Continue using the same prescription.
Dr. Yan Zaoming/ Dr. Dai Lei
Date: 4th
of March 2007
Time: 9:00 a.m.
Today the patient said he feels much less
asthenia from head to foot and whole body trembling. He gets
less starting difficult. He is a little less in slow movement
and response. Dizziness and dreamful sleep are nearly
disappeared. Physical examination: Heart and lung (—), Abdomen
is flat and soft (—). He presented with a good spirit. His
appetite is good.
His bowel movement and urination are normal.
Light red tongue, white and thin tongue fur, deep and fine
pulse. The doctor asked him to cooperate with the treatment in
order to get a much better therapeutic effectiveness. Continue
using the same prescription. Such as Shoudi (cooked rehmannia),
Guiban (tortoise plastron), Tianma (gastrodia root). One dosage
a day and drink by twice, five days.
Dr. Yan Zaoming/ Dr. Dai Lei
Date: 8th
of March 2007
Time: 9:00 a.m.
Today the patient said he feels obvious less
asthenia from head to foot and whole body trembling. He gets
obvious less starting difficult and less in slow movement and
response. No aversion to cold, fever, headache, dizziness,
nausea, or vomit. He presents with a good spirit. His sleep is
good. His bowel movement and urination are normal. Physical
examination: Heart and lung (—), Abdomen is flat and soft (—).
Light red tongue, white and thin tongue fur, deep and fine
pulse. Continue using the same prescription. Observe the changes
of the patient’s condition.
Dr. Yan Zaoming/ Dr. Dai Lei
Date: 12th
of March 2007
Time: 9:00 a.m.
Today the patient said he feels obvious less
asthenia from head to foot and whole body trembling. He gets
obvious less starting difficult and less in slow movement and
response. Physical examination: Heart and lung (—), Abdomen is
flat and soft (—). He presents with a good spirit. His sleep is
good. His bowel movement and urination are normal. Continue
using the same prescription. Such as Shoudi (cooked rehmannia),
Guiban (tortoise plastron), Tianma (gastrodia root). One dosage
a day and drink by twice, four days.
Light red tongue, white and thin tongue fur, deep
and fine pulse.
Dr. Yan Zaoming/ Dr. Dai Lei
Date: 16th
of March 2007
Time: 9:00 a.m.
Today the patient said he feels obvious less
asthenia from head to foot and whole body trembling. He gets
obvious less starting difficult and less in slow movement and
response. No aversion to cold, fever, headache, dizziness,
nausea, or vomit. He presents with a good spirit. His sleep is
good. His bowel movement and urination are normal. Physical
examination: Heart and lung (—), Abdomen is flat and soft (—).
Light red tongue, white and thin tongue fur, deep and fine
pulse. The patient is going to leave the hospital today.
Dr. Yan Zaoming/ Dr. Dai Lei
Another Parkinson case that we helped well:
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