Patient, Zhang Moumou, male, 59 years old. First visit on May 27th, 2009.
In June, 2004, he was admitted to Shandong Provincial Hospital 10 day, and was diagnosed as MDS-RA. Western medicine, such as Kanglilong, tretinoin, prednisone, etc. There is no good effect, and the hemogram shows a downward trend with obvious side effects. To maintain a normal life, we must regularly transfuse red blood cells and platelets, and occasionally take traditional Chinese medicine for nourishing blood and tonifying kidney, which has poor effect. On May 23rd, 2009, blood routine: white blood cell 1.5× 109/L, hemoglobin 35g/L, platelet 2×109/L. Symptoms include fatigue, dizziness, dry mouth and thirst, palpitation, chest tightness, nausea and vomiting, and dull complexion. Syndrome belongs to stomach heat and intestine cold, mixed with cold and heat, and Wu Mei Pill is used to add flavor. Prescription: Mume 15g, Asarum 3g, Zingiberis Rhizoma 6g, Radix Aconiti Lateralis Preparata (parched first) 10g, Ramulus Cinnamomi 5g, Zanthoxylum bungeanum 3g, Rhizoma Coptidis 10g, Cortex Phellodendri 5g, Radix Paeoniae Alba 10g, Radix Codonopsis 12g, and Herba Epimedii 650. 7 doses, decocted in water. Ziyin Shengxue Capsule 6 capsules each time, 3 times a day, and insist on taking it.
Second diagnosis on June 7th, 2009: The effect of taking the prescription is not good, and the symptoms are basically the same as before. The dialectical medication in the prescription is correct. It should be related to drugs such as Epimedium, Semen Cuscutae, Cortex Lycii, and Colla cornus Cervi. The cold and heat in the prescription are uneven, so I ordered to remove four flavors and continue to use five doses.
The third diagnosis in June 65438+April 2009: The chief complaint was that the above symptoms were relieved, diarrhea had stopped, abdominal pain, falling sensation, pale tongue, thin yellow fur, and slippery pulse, which was stronger than before, so I knew that Zhongjing prescription was accurate and could not be increased or decreased at will. Continue to take more than 7 doses.
On June 23, 2009, the fourth diagnosis: routine blood examination: white blood cells 1.8× 109/L, hemoglobin 60g/L, platelet 4× 109/L, the chief complaint was that the upper part was effective, but the pathogen of wind and cold, cough and eating raw cold led to diarrhea like water. Please come to the clinic if you don't feel well.
July 2009 12, the fifth diagnosis: the upper part was effective, diarrhea stopped, but gingival bleeding was not easy to stop. The tongue is pale white, the coating is white and thin yellow, and the pulse is thin and strong. Because cassia twig hurts yin and moves blood, it is removed and 8 grams of cinnamon is added. Keep taking it. Please come to the clinic if you don't feel well.
September 2009 10 Six consultations: The chief complaint was that the interval between blood transfusions was gradually prolonged, and no blood transfusions were given for more than 60 days. I have no symptoms of diarrhea and abdominal pain recently, and I can stop bleeding occasionally, and I have not complained about other abnormalities. Blood routine: WBC 1.9 × 109/L, hemoglobin 67g/L, platelet12×109/L. The hemogram is better than before, although it is still lower than the normal value, but there are no abnormalities such as infection and bleeding. Tell them to continue taking it to consolidate the curative effect. Follow-up for 6 months, no blood transfusion, stable condition and hemogram.
Myelodysplastic syndrome (MDS) is a group of heterogeneous clonal diseases originating from hematopoietic myeloid directional stem cells or pluripotent stem cells. Its main feature is that ineffective hematopoiesis and high-risk patients develop into acute myeloid leukemia, and its clinical manifestations are abnormal changes in the quality and quantity of hematopoietic cells in different degrees. 1982, FAB collaboration group suggested to establish disease names and divide MDS into five types, and MDS-RA is one of them.
MDS-RA belongs to the category of "exhaustion", "heat exhaustion" and "anemia" in traditional Chinese medicine, and the general treatment of traditional Chinese medicine is mostly based on spleen and kidney. In this case, the patient's condition is complicated and it is difficult to recover. Late persistent diarrhea, mixed symptoms of cold and heat. The pathogenic factors have spread from Taiyin and Shaoyin to Jueyin, so it should be treated from Jueyin. Jue Yin is also called Yin Qi, and its viscera are embodied in the liver and pericardium. Both the liver and pericardium hide fire, because there is yang in the yin and yang in the yin. It is important to dress, to reach the goal, and to live endlessly. Therefore, Zhongjingzhi Wu Mei Pill and Ziyin Shengxue Capsule, a pure Chinese medicine in our hospital, are selected as prescriptions. Wu Mei Pill combined cold and heat, clearing away heat and dispelling cold, soothing the liver and relieving depression, and compressing pericardium, all symptoms disappeared by themselves. Ziyin Shengxue Capsule can benefit qi and nourish yin, help shaoyang grow qi and blood, cool blood and detoxify and clear shaoyang depression. As Tang Rongchuan said in "On Blood Syndrome of Yin and Yang, Fire, Water, Qi and Blood": "Blood color, the color of Rise of the Legend, is also the master of fire heart, and it turns into blood to moisten the whole body. Fire is yang, blood is yin, and fire is nourished by yin blood. The combination of all kinds of drugs makes yin and yang alternate, so that the qi of shaoyang can be reached and endless, but when applied to the body, yin gets the warmth of yang, yang gets the nourishment of yin, yang becomes stronger and stronger, and qi and blood begin to grow. After taking the medicine, the patient's symptoms improved, his condition was stable, and his hemogram picked up, with remarkable effect. The magic of the classic prescription can be seen.