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

46LYME DISEASELyme disease is a tick-transmitted, spirochetal, inflammatorydisorder causing a characteristic rash that may be followedweeks or months later by neurologic, cardiac, or joint abnormalities.The disease was first recognized in 1975 because ofa close clustering of cases in Lyme, Conneticut. It has sincebeen reported in 49 states, but more than 90% of cases occurfrom Massachusetts to Maryland, and in Wisconsin andMinnesota, and in California and Oregon. Lyme disease alsooccurs in Europe, across the former Soviet Union, and inChina and Japan. Onset is typically in the summer and fall,and most patients are children and young adults living andplaying in heavily wooded areas.There are five groups of symptoms in Lyme disease. Thehallmark and best clinical indicator of this disease is erythemamigrans which develops in at least 75% of patients. Thisbegins as a red macule or papule between the third and 32 ndday after being bit by the tick. The erythematous areaexpands, often with central clearing, up to a diameter of50cm. Soon thereafter, 50% of untreated patients developmultiple, smaller lesions without indurated centers. The secondgroup of symptoms are flu-like. These include malaise,fatigue, chills, fever, headache, stiff neck, and muscle-jointpain. These symptoms are characteristically intermittentand changing, and malaise and fatigue may linger for weeks.The third group of symptoms are neurological abnormalities,such as lymphocytic meningitis, meningoencephalitis,and cranial neuritis. These only affect 15% of patients. Thefourth group of symptoms are myocardial abnormalities,such as A-V block. These only affect 8% of patients. Andthe fifth group of symptoms all have to do with arthritis.Sixty percent of Lyme’s disease sufferers develop intermittentswelling and pain of the large joints, especially theknees, within weeks to months of onset. Affected joints arepainful, swollen, hot, but rarely red. Baker’s cysts may formand rupture. About 10% of patients develop chronic kneeinvolvement.The Western medical diagnosis of Lyme’s disease in patient’swith typical erythema migrans in an endemic area usuallydoes not require laboratory confirmation, However, this diseasemust be distinguished from a host of others, includingReiter’s syndrome, RA, Bell’s palsy, and chronic fatigue.Cryoprecipitates and circulating immune complexes oftenoccur early, and the ESR may be elevated. Hematocrit andWBCs are usually normal. Rheumatoid and antinuclear antibodiesare rarely present. X-ray findings are usually limited tosoft tissue swelling. The Western medical treatment of Lymedisease rests mainly on the administration of various antibioticsdepending on the presence or absence of the above fiveclasses of abnormalities. Unfortunately, the time to completeresolution of this disease may extend well beyond the periodof antibiotic treatment which may last anywhere from 21-30days depending on the regime. Aspirin and other NSAIDsare administered for symptomatic relief. Complete heartblock may require a temporary pacemaker. Aspiration of synovialfluids and crutches may be used for tense knee joints.Patients with arthritis of the knee that persists despite antibiotictherapy may respond to arthroscopic synovectomy. Avaccine for prophylaxis against Borrelia burgdorferi is currentlyunder investigation.CHINESE DISEASE CATEGORIZATION: The erythemamigrans of Lyme’s disease is categorized as huo dan, firecinnabar, or dan du, cinnabar toxins. The flu-like symptomsfall under the category of gan mao, i.e., flu, but, literally, contractionand encroachment. The joint pain of Lyme’s diseaseis categorized as bi zheng, impediment condition. Facial neuritiscomes under the category of mian tong, face pain, andmian tan, facial paralysis.DISEASE CAUSES: External contraction of wind, damp,heat evilsDISEASE MECHANISMS: Wind, damp, heat evils enter