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Differential Treatment of radiation myelitis_2457

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Differential Treatment of radiation myelitis_2457

Differential Treatment of radiation myelitis

    [ABSTRACT] in cancer patients receiving radiation therapy for spinal cord caused by inflammation from a Chinese point of view a preliminary clinical study. From the Chinese point of view of etiology and pathogenesis Arthralgia was discussed, the

    radiation damage to the human body called 'toxic cloud' proposed 'marrow Bi' new ideas, and Chinese medicine treatment carried out exploratory syndrome differentiation, divided into four major card type and three subtypes for syndrome

    differentiation.

    [Key words] radiation myelitis; Differential Treatment

    Clinical radiation myelitis is a cancer radiation therapy in severe complications. The author in recent years, clinical diagnosis and treatment of cancer patients caused by

    radiation myelitis flaccid paralysis occurs limbs, numbness, pain, embolism, and accumulated some experience. This paper would like the system from the traditional Chinese medicine diagnosis and treatment of the disease angle, a preliminary study

    with a view to initiate the correction to be fellow.

     1 Overview

     Radiation myelitis refers to cancer patients in radiation therapy, because patients are particularly sensitive to radiation, or tumors near the spinal cord, or excessive

    radiation dose, resulting in spinal cord damage resulting from inflammatory response is tumor radiotherapy concurrent irreversible severe disease, its occurrence rate of about 1% to 3% [1], generally occurs in radiation therapy after 2 ~ 4 months, symptoms usually subside spontaneously in a few weeks to several months. Clinically, radiation myelitis often divided into short-term, acute and chronic three categories: (1)

    transient radiation spinal cord inflammation, see: sensory abnormalities such as limb

    numbness, tingling, tenderness, burning neck shoulder pain, as well as A typical song neck bow shock-like symptoms (lhermitte's syndrome), that is when the bow appeared along the back of the spine from the neck to the lower limb or limbs, a sense of radioactive electrocuted, head reset, the symptoms disappeared; this type may be used as chronic progressive radiation The first signs of a spinal cord disease occurs; (2) acute radiation myelitis relatively rare, its rapid onset, often developed within a few

    hours to days as paraplegia, or quadriplegia, multiple performance for upper motor neuron damage characteristic of pairs of lower limb muscle tension increased, tendon hyperreflexia, pathological damage associated with positive reflection plane decreased below the depth of feeling; (3) chronic progressive radiation myelitis, also known as cross-sectional nature of delayed radiation myelitis, multiple long-term radiation injury

    to the spinal cord response often appear one or both lower limbs sensory disturbances,

    and then gradually progress appear movement disorders and spinal cord hemi-or

    complete cross-sectional nature of the damage, Zheng Jian pairs of lower limb weakness, numbness, muscle atrophy.

     Occurrence of the disease means the amount of radiation received and the amount

    of immune status, and disease duration and many other factors. Early mainly spinal cord hyperemia, edema, demyelination and nerve cell degeneration and other changes, mainly the spinal cord late necrosis, liquefaction, cystic changes, gliosis, and changes in

    secondary atrophy. Diagnosis related to radiation therapy and have a medical history, symptoms, signs, current magnetic resonance imaging (MRI) is a diagnosis of radiation myelitis of the most reliable method, the imaging findings of T1, T2 signal extension.

    Mainly in the treatment of dehydration, promote nerve cell recovery, improve microcirculation and blood vessels activating agent, hyperbaric oxygen therapy, as well as hormones to lift the spinal cord edema and anti-inflammatory role, with the active

and passive functional exercise.

     Two Chinese pairs of basic knowledge of radiation myelitis

     Radiation myelitis in patients with common clinical symptoms of pairs of lower limb weakness, numbness, muscle atrophy, pain, and therefore I believe that radiation

    myelitis course ought to Chinese Arthralgia and atrophy permit areas.

     Bi Bi is unreasonable resistance means, atrophy refers to the limb tendons and flaccid, weak, falling into need, muscle atrophy, or paralysis of a disease. As early as

    2000 years ago, the Chinese traditional medicine in the 'Nei Jing' there is a more profound understanding. Such as the 'Su-Bi on the''wind cold dampness asked three to

    combined into hybrid gas-Bi', 'an emergency occur in winter were to bone weakness, in

    order to spring an emergency occur, who is gluten weakness, in order to encounter this summer were the vein weakness, as well as Yin In such persons as muscle weakness, to fall for this person as a leather case of Bi ',' Gubi endless, complex sense in the evil

    inside homes in the kidney; tendons Bi endless, complex sense in the evil inside homes in the liver; pulse endless paralysis , complex feeling in the evil inside homes in the heart; muscle Bi endless, complex feeling in the evil inside homes in the spleen; leather Bi endless, complex feeling in the evil inside homes in the lungs'. Fully expounded the cause of the Bi Syndrome, will Arthralgia is divided into five categories, and described in detail Arthralgia falling into unhealed, Evils Deep into the inside from the table, from the meridian to the organs, the five internal organs to become numb. Also 'Suwen angry sky-theory' goes like this: 'because in the wet, the first such wrap, hot and humid does not throw into confusion, large bars of soft short, small muscle relaxation length, soft short of arrest, relaxation length wilt'. Also according to the five internal organs of the Lord, raised atrophy lame, pulse atrophy, muscle atrophy, meat atrophy, bone atrophy five categories, and made a 'rule atrophy who was given the National Yang-

    Ming' and 'the make up and pass their Yu-rong, adjusting its actual situation, and its

    good times or bad 'governance of atrophy Dafa acupuncture.

     Discussed in this chapter is due to radiation myelitis after suffering from various

    types of cancer receiving radiation therapy, cancer, can damage the body's qi of yin and yang original righteousness, and we again hurt the radiation on the human body called 'toxic cloud', a foreign evil, so we think that radiation myelitis of the etiology and pathogenesis are: body upright deficiency, such as blood stagnate, liver and kidney lack of yin and yang imbalance, but also exogenous Feng Xie intrinsic phlegm, spinal cord Bizu, limbs, tendons and loss of support, and meridian caused by unreasonable,

    ranging from arthralgia syndrome between patients with atrophy.

     At present, the disease has not yet see the reports of clinical syndrome differentiation system, so the author for many years through the combination of the

    above analysis of clinical practice, will be attributable to radiation myelitis Chinese arthralgia areas, called 'pulp Bi', and therefore the treatment of cancer patients according to the particularity of it is necessary to dispel the poisonous evil alien, but

    also to keep attention to nourishing Qi, gluten bone health, both righting another evil, and to righting the main.

     3 Differential Treatment

     Four major sub-license type and three subtypes.

     3.1 The four major card type (1) Exogenous Feng Xie, Yin and Yang imbalance, toxic cloud immersed. Symptoms: the shoulder and neck and limb numbness, pain, wandering uncertain, when a sense of evil, cold, dry mouth bitter, food can be satisfied, two will be transferred, tongue red, moss Baini, pulse floating tight. Governing law: Qufeng solution form, Tongluo pain relief, detoxification Huazhuo. Recipe: 9 mei Notopterygium Tonga mulberry stalk, single live, Achyranthes bidentata, ground dragon, Eupolyphaga insects, Poria. Analysis: This type of early radiotherapy for

    cancer patients, due to physical weakness, easy to cold, often due to a cold treatment and both the table evil. (2) blood stagnate, Meridian unreasonable, poison cloud immersed. Symptoms: the shoulder and neck and limb numbness, tingling, or

    tenderness, joint flexion and extension unfavorable rather then muscular atrophy, tendons and rigid, anus tightened sodium food is acceptable and normal urine, stool obscure, dark red tongue, sublingual ecchymosis or stasis point, pulse thin astringent.

    Governing law: blood circulation of qi, Tongbizhitong, detoxification Huazhuo. Recipe: Body pain Zhuyu Tonga Wujiapi, Zaocys, Eupolyphaga insects, Millettia, soil Fuling. Analysis: This type is the mid-radiotherapy cancer patients, drugs, evil gradually

    against the human body, healthy atmosphere gradually empty, or when severe Xiezheng pay dispute, but also a critical period of treatment will take an active treatment to anti-virus deep into the disease. (3), qi and blood deficiency, Meridian

    unreasonable, poison cloud immersed. Symptoms: the shoulder and neck and limb insensitive, or limp, general muscle atrophy, weakness, less gas lazy words, looking Shaohua, torpid intake eat less, two will be incontinence, mamillata thin white fur,

    pulse Shen slim and fragile. Governing Law: Supplementing Qi and blood, dredge meridians, detoxification Huazhuo. Recipe: Bazhen Tonga pig spinal cord, Wujiapi, Achyranthes bidentata, Eupolyphaga insects, Millettia, soil Fuling, to dragons,

    independent living. Analysis: This type of tumor in patients with post-radiotherapy, the

    patient upright on virtual and physical worsened, their evil can no longer resist the invasion of radiation poisoning, treatment should be actively nourishing blood to

    rousing. (4), liver and kidney loss, toxic cloud immersed. Symptoms: the shoulder and neck and limbs insensitive, limb flaccid paralysis, especially in lower limbs mainly Yaoxisuanruan, or accompanied by dizziness, impotence and premature ejaculation nocturnal emission, or irregular menstruation, leg tibia big meat off gradually, two will incontinence, mamillata less moss pulse Shen breakdown. Governing law: replenishing liver and kidney, gluten bone health, detoxification Huazhuo. Recipe: Tiger submarine

    Maruka pig spinal cord, Wujiapi, Achyranthes bidentata, Woodwardia, Eupolyphaga insects, Millettia, soil Fuling, ground dragon, living alone, Astragalus. Analysis: This type common in end-stage cancer patients with radiotherapy, and healthy trends of extreme weakness, need to actively replenishing liver and kidney, gluten health bones, can only improve the patient quality of life and prolong patient's life. Reposted elsewhere in the paper for free download http://

     3.2 3 subtypes (1) intrinsic phlegm, meridian unreasonable, poison cloud

    immersed. Symptoms: the shoulder and neck and limb numbness, pain, weight forward, limbs limp, muscle atrophy, dizziness Mongolia, chest Zhongwan full nausea, Oue spiting, two will be incontinence, tongue Indented much fat, thick white greasy fur

    pulse string slide. Governing Law: Spleen phlegm, dampness Tongluo, detoxification Huazhuo. Recipe: Pinellia Atractylodes macrocephala Tianma Tonga Notopterygium, single live, Wujiapi, Achyranthes bidentata, Eupolyphaga insects, Millettia, soil Fuling,

    and earthworm. Analysis: This type is also the mid-radiotherapy cancer patients,

    drugs, evil gradually against the human body, healthy atmosphere gradually empty, or when severe Xiezheng pay dispute, when the critical period of treatment still need

    active treatment to anti-virus evil in-depth body, sicker . (2), spleen and stomach

    weakness, poison cloud immersed (subtype). Symptoms: limb numbness and weakness on limp weight, muscle atrophy, eat less torpid intake, abdominal distension and loose

    stools, shortness of breath, fatigue, Shenpi lazy words, China is not looking, pale tongue, thin white fur, thin or weak pulse, Shen. Governing Law: Spleen Qi gluten, detoxification Huazhuo meridians. Recipe: Xiangsha Liujun Decoction plus

    SHENLINGBAISHU San Wujiapi, Achyranthes bidentata, Eupolyphaga insects, Millettia, soil Fuling, ground dragon, Notopterygium, independent living. Analysis: This type is also a mid-and late radiotherapy cancer patients, particularly severely damaged spleen and stomach, diet to reduce the patient upright on virtual and physical worsened, their evil can no longer resist the invasion of radiation poisoning, treatment should be actively spleen, nourishing blood in order to rousing, more common in patients with gastric cancer after radiotherapy. (3) Hyperactivity-chun, injury,

    meridian unreasonable, poison cloud immersed. Symptoms: fever or heat back shoulder and neck and limb numbness, weakness, skin dry, upset thirsty, throat choking cough with little phlegm, a short red urine, constipation, mamillata moss

    yellow, pulse slim and fragile. Governing law: heat lungs, Ru Yang tendons, detoxification Huazhuo. Recipe: Qingzao to save lung Tonga Wujiapi, Achyranthes bidentata, Eupolyphaga insects, Millettia, soil Fuling, to dragons, independent living.

    Analysis: This type of tumor patients with mid-and late radiotherapy, the patient

    upright on virtual and physical worsened, their evil can no longer resist the invasion of radiation poisoning, treatment should be actively nourishing blood to rousing, more

    common in lung cancer patients after radiotherapy .

     Four typical cases

     Patients, male, 65 years old, because of the right lung of central type lung cancer after 5 years after radiotherapy and chemotherapy, both lower extremities numb and

    limp weakness a year admitted to hospital. This was five years ago, suffering from fever, chest pain patients at the Affiliated Hospital of Zunyi Medical College by bronchoscopy, CT examination diagnosed as 'central-type lung cancer', biopsy showed

    'well-differentiated squamous cell carcinoma'. After the treatment at the Beijing Cancer Hospital, later diagnosed to be in parallel PET Gamma Knife treatment, specific unknown in a stable condition after the turn of Zunyi Medical College

    Hospital-line chemotherapy for three courses, programs for the 'TP', total: paclitaxel 630 mg, cis-platinum 300 mg. 1 year ago in patients with no obvious incentive to self-

    inductance of pairs of lower extremity numbness, weakness limp and can not walk Zun

    Yi Fuyuan subsequently sought treatment at the line of MRI examination revealed: T8 spinal cord below the level of the generally long-T2 signal, extensive degeneration of the

    thoracolumbar spinal cord, spinal cord radiation to consider Yan. Admission Zheng

    Jian: Two lower extremity numbness, limp weakness, Yaoxisuanruan, cough cough, thick sputum, from time to time Chuancu, soft-body fatigue, less gas lazy words, body

    weight loss, sodium can still eat, sleep better, urinary incontinence, bowel dry, pale red

    tongue, thin white fur, pulse Shen slim and fragile. Physical examination: Life levy normal, carried into the wards, emaciation, skin, sclera (-), no palpable superficial

    lymph node enlargement, right thorax collapse, breathing low dull sound, lungs have

    not heard, and wet and dry rales, heart and lung (-), plain abdominal soft, no

    tenderness, rebound tenderness and muscle tension, less than liver and spleen, shifting dullness (-), kidneys district without percussive pain, spinal deformity without limbs,

    waist 3 ~ sacral tenderness, umbilical below the skin depth of feeling and lower limbs disappeared, significantly lower limbs muscle wasting, muscle strength 0, Pap sign (? ), hit the top test (), straight leg raising test (). Laboratory tests: blood count WBC 7.6 *

    109 / L, HGB 107 g / L, GRA 0.85, LYN 0.13, MON 0.04, urine: yellow brighter, Pr (? ), WBC 4 ~ 7 Ge / HP; stool routine: Yellow hard it is hoped, microscopic examination no abnormalities; liver and kidney function normal, albumin 34.5 g / L, serum electrolytes

    normal, magnetic resonance imaging (MRI) T8 spinal cord below the level of the generally long T1, T2 signal. Diagnosis of Western medicine: (1) right lung, central lung cancer patients after radiotherapy and chemotherapy; (2) radiation myelitis.

    Chinese: (1) lung cancer (blood deficiency, yin-yang balance, toxic cloud intrinsic); (2)

    cord paralysis (loss of blood deficiency and liver and kidney, toxic cloud immersed). Treatment plan: doctors to be anti-inflammatory, and promote nerve cell recovery,

    symptomatic support; in the treatment method: Qi replenishing the blood and liver and kidney, gluten bone health, detoxification Huazhuo. Recipe: Ba Zhen Tang, Fu Qian Wan-Fang Canadian pig spinal cord, Wujiapi, Achyranthes bidentata, Eupolyphaga

    insects, Millettia, soil Fuling, ground dragon, single live, Woodwardia. Prescription is as follows: Codonopsis 15 g, Atractylodes macrocephala 15 g, Poria 15 g, Rehmannia 20 g, Chinese angelica 15 g, Radix Paeoniae Alba 15 g, Chuanxiong 15 g, turtle shell 15

    g, Treats 10 g, Zhimu 10 g, Achyranthes 20 g, Cynomorium 15 g, pig spinal cord 100 g, Wujiapi 15 g, Eupolyphaga insects 12 g, Millettia 30 g, soil Poria 15 g, earthworm 12 g, Woodwardia 15 g, Heracleum 15 g. Even after the sense of serving 10 pairs of lower

    extremity numbness, Yaoxisuanruan reduced, limp weakness weakens, the body soft weakness improved, tired and shortness of breath by breath, the tongue vein with the former, the former side following the appointment after serving 20: Two lower limbs

    numb and big reduction, Yaoxisuanruan addition exhausted, physically getting stronger, the spirit of significant improvement in the top 30 following the post-Zhu

    Zheng In addition to serving exhausted, got better.

    [References]

     1 Feng Qin Fu, Yang Yi, Wang Mei, et al. Radiation myelitis and prognostic analysis of the incubation period. China Radiation Medicine and Protection, 2003,23 (2) :104-

    105. Reposted elsewhere in the paper for free Download Center http://

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