Analysis:
Overview of muscular dystrophy
Muscular dystrophy is a group of primary skeletal muscle necrosis diseases caused by genetic factors and characterized by progressive skeletal muscle weakness. Clinically, the main manifestations are progressive skeletal muscle atrophy and weakness in different degrees and distributions. It may also involve the heart muscle.
Etiology of muscular dystrophy
The cause of muscular dystrophy is genetic abnormality, and different types can be carried out in different ways, but the mechanism of genetic factors leading to muscle degeneration is still unclear.
Symptoms of muscular dystrophy
According to the typical genetic forms and main clinical manifestations, muscular dystrophy can be divided into the following types:
(1) Pseudomegacolon: X-linked recessive inheritance is the most common type. According to clinical manifestations, it can be divided into Duchenne type and Becker type.
1, Du Xing's malnutrition (DMD): also known as severe pseudoobesity malnutrition, almost only found in boys. If the mother is a gene carrier, 50% of male offspring will get sick, often starting from 2-8 years old. At first, they felt awkward walking, easy to fall, unable to run and unable to climb upstairs. When standing, the spinal cord protrudes, the abdomen protrudes, the feet are separated, and walking is slow. It can also be seen in proximal limb muscles, quadriceps femoris and arm muscles.
2. Becker type (BMD): Also known as benign pseudohypertrophic muscular dystrophy, it often occurs after 10 years old. The first symptom is weakness of pelvic girdle and thigh muscles, slow progress and long course of disease. It takes 25 years or more after symptoms appear, and most of them will not be paralyzed when they are 30-40 years old. The prognosis is good.
(2) facioscapulohumeral muscular dystrophy: Both men and women suffer from it in their youth. At first, facial muscle weakness is often asymmetrical. They can't show their teeth, protrude their lips, close their eyes and frown. The orbicularis oris muscle may be pseudo-hypertrophy, which makes the lips bulge, and some shoulder and brachial muscles are affected first, so that the two arms can not be lifted to form a hanging shoulder, and the upper arm muscles atrophy, but the forearm and hand muscles are not violated. The course of the disease progresses very slowly, often frustrated or relieved.
(3) Limb-girdle muscular dystrophy: It can be seen by both men and women, and it usually occurs in children or young people. First, it involves pelvic girdle muscles and psoas major muscles, so it is difficult to walk, unable to climb stairs, swaying gait and often falling down. Others only involve quadriceps femoris. The progress of this disease is very slow.
(4) Other types: quadriceps femoris type, distal type, progressive extraocular muscle paralysis type, oculomotor nerve-pharyngeal muscle type, etc. This is rare.
Examination of muscular dystrophy
(1) determination of serum enzymes;
1. Serum creatine phosphokinase (CPK): The increase of CPK is an important and sensitive index for the diagnosis of this disease, which can be increased after birth or before clinical symptoms appear. It's a good idea to take care of it when the course of the disease is prolonged. Hey? Hey? Moon ornaments? 0-80%。
2. Serum myoglobin (MB): It also increased significantly in the early stage of the disease and among gene carriers.
3. Serum pyruvate oxidase (PK): It is also very sensitive. The serum PK value of normal men and women under 20 years old is 1 19.00, while that of men over 20 years old is 84.30 and that of women is 77.50. The positive rates of CRK and PK in the above three serum enzymes are higher than Mb, and the comprehensive detection rate of the three enzymes is about 70%.
4. Other enzymes such as aldolase (ADL), lactate dehydrogenase (LDH), aspartate aminotransferase (GOT) and alanine aminotransferase (GPT) can also be increased, but they are not specific changes of myopathy and are insensitive.
(2) Urine test: urinary creatine excretion increased and creatinine decreased.
(3) EMG.
(4) Muscle biopsy: The above lesions can be seen. If conditions permit, the degree and scope of muscle degeneration can be found by X-CT or nuclear magnetic resonance, so as to provide the preferred site for muscle biopsy in clinic.
Western medicine treatment of muscular dystrophy
1. At present, there is no specific treatment method in western medicine, and all kinds of therapies are ineffective, such as allopurinol, nifedipine, energy mixture, inosine, galanthamine, bifendate, donkey-hide gelatin, insulin glucose therapy, parotid hormone, high-dose VitE, hyperbaric oxygen chamber therapy, etc., but the recent application of external counterpulsation has a certain effect. Physical therapy, physical therapy and other supportive therapies, as well as surgical correction of stents and deformities, can be used as adjuvant therapy.
Second, TCM etiology and syndrome differentiation treatment
1, the kidney is the foundation of congenital, storing essence, leading to bone marrow. Kidney hides Yuan Yin and Yuanyang. If the congenital endowment is insufficient, the kidney is deficient, the essence and blood are insufficient, and the bones are malnourished, the bones are dry and the marrow is empty, and the symptoms are that the feet do not take care of themselves, and the waist and spine do not lift, resulting in bone flaccidity. Syndrome differentiation treatment, spleen and kidney deficiency.
2, the spleen and stomach are the foundation of the day after tomorrow, the source of blood, body fluid and biochemistry, and the main muscles and limbs. The weakness of the spleen and stomach leads to the lack of spirit in the five internal organs, and Shui Gu's subtlety can't reach the muscles of the limbs, which leads to weakness. If the deficiency of Yuan Yang precedes the kidney, it will lead to the decline of life, the spleen yang is not warm, the spleen and stomach are deficient in cold, the transport function is out of order, and the biochemical sources of qi, blood, body fluid are insufficient to moisten the muscles, so the muscles of the limbs are weak, leading to muscle weakness.
3, congenital endowment is insufficient, both qi and blood are deficient, bones and muscles are not nourished, but limbs are weak and muscles are atrophied. Due to congenital deficiency, acquired malnutrition and deficiency of qi and blood, internal injuries of five zang-organs and dysfunction of qi and blood of zang-fu organs are caused, which makes qi and blood more deficient and muscle weakness and weakness continue to progress.
Treatment of muscular dystrophy with traditional Chinese medicine
Many diseases in modern medicine, such as polyneuritis, syringomyelia, muscular atrophy, myasthenia, lateral sclerosis, motor neuron disease, periodic paralysis, muscular dystrophy, hysterical paralysis and sequelae of central nervous system infection, all belong to the category of "flaccidity syndrome", which is a symptom of weakness and disuse of limb tendons.
"flaccidity syndrome" refers to a kind of diseases such as weakness of bones and muscles, emaciation of muscles, numbness of skin and disuse of hands and feet. Clinically, patients with soft feet and inability to voluntary movement are more common, so they are called "Ruanjun".
Muscle degeneration, abnormal muscle structure, heredity, poisoning, abnormal metabolism, infection and allergic reaction caused by motor neuron disease, systemic malnutrition, disuse and endocrine abnormality can all cause muscle atrophy.
The expert group consulted the classics of Chinese medicine, assiduously studied, absorbed the experience and lessons of experts at home and abroad, and worked out the best treatment plan for myasthenia gravis, muscular dystrophy, muscular atrophy and other flaccid syndromes. More than 30 kinds of precious and special Chinese herbal medicines were screened out, and a series of prescriptions for treating myasthenia gravis, muscular dystrophy and muscular atrophy were developed. The formula has the effects of invigorating middle energizer, invigorating qi, strengthening yang, relieving depression, nourishing liver and kidney, inducing resuscitation, and enhancing human immune function and disease resistance. Make the disease recover at an early date.