The Treatment of Modern Western - Biblio.nhat-nam.ru

25CUSHING’S SYNDROMECushing’s syndrome is a constellation of clinical abnormalitiesdue to chronic exposure to excesses of cortisol or related corticosteriods.This chronic excessive exposure may be due to hypersecretionof ACTH by the pituitary, secretion of ACTH by anon-pituitary tumor, or administration of exogenous ACTH.Its clinical manifestations include fatigue, a rounded, moon-likeface, fluid retention, truncal obesity with prominent supraclavicularand dorsal cervical fat pads, muscular weakness and wasting,thin, atrophic skin, poor wound healing, easy bruising,excessive sweating, and purple striae on the abdomen.Psychiatric disturbances, especially irritability, are common,while females usually have menstrual irregularities.The Western medical diagnosis of this condition depends onseveral different laboratory tests: dexamethasone test,metyrapone test, ACTH stimulation test, and CRF test. Inaddition, CT scans may be used to determine the presence ofpituitary or adrenal tumors. When Cushing’s syndrome is dueto prolonged administration of exogenous corticosteroids,there is an obvious history of their use. When Cushing’s syndromeis due to hyperfunction of pituitary or adrenal glands,surgery is often used to excise or oblate tumors. When thiscondition is due to prolonged, excessive administration ofexogenous corticosteroids, the patient should be weaned fromthis medicines. Unfortunately, however, these medicines maybe necessary to control other disease processes in the body.CHINESE DISEASE CATEGORIZATION: The main clinicalmanifestations of this condition are categorized as neng shi shanji, ability to eat with rapid hungering, shui zhong, water swellingor edema, fei pang, obesity, yi nu, easy anger or irritability, zi han,spontaneous perspiration, dao han, thief sweating, i.e., nightsweats, and shi mian, loss of sleep, or bu mian, insomnia.DISEASE CAUSES: Former heaven natural endowmentinsufficiency, internal damage by the seven affects, unregulatedeating and drinking, over-taxation, aging, enduring disease,and iatrogenesisDISEASE MECHANISMS: The clinical manifestations ofthis condition divide into two main categories. On the onehand there is spleen qi and kidney yang vacuity with dampnessand phlegm, while, on the other, there is yin vacuitywith effulgent fire. Spleen-kidney vacuity may be due tofaulty diet, over-taxation, aging, enduring disease, and/oriatrogenesis. Kidney yin vacuity is commonly due to formerheaven natural endowment insufficiency, aging, enduringdisease, and/or iatrogenesis. Phlegm may be due to faultydiet. However, it may also be due to either long-term accumulationand congelation of water dampness in turn due tospleen-kidney vacuity or long-term heat stewing and steamingthe fluids, thus also congealing phlegm.When Cushing’s syndrome is due to iatrogenesis, its mechanismsare essentially similar to overprescribing acrid, windynatured medicinals. Corticosteriods, such as prednisone, clearheat by out-thrusting it, while they stop pain by forcefullymoving the qi. In this way, prednisone is something similar toRadix Bupleuri (Chai Hu). When acrid, windy, exteriorresolvingmedicinals are wrongly or overused, they A) outthrustand, therefore, damage yang qi and B) plunder andconsume yin fluids. Thus their side effects are to cause qi andultimately yang vacuity on the one hand, and yin vacuity withvacuity heat on the other, with phlegm congelation beingassociated with either or both of these two mechanisms.TREATMENT BASED ON PATTERNDISCRIMINATION:1. YIN VACUITY WITH ASCENDANT LIVERYANG HYPERACTIVITY PATTERNMAIN SYMPTOMS: Obesity, a red, flushed face or malarflushing, dizziness or vertigo, headache, clouded spirit, tinnitus,oral dryness, rapid hungering, low back and knee sorenessand limpness, scanty sleep, a red tongue with scanty fur,and a fine, bowstring, rapid pulse