CCTV International 2004-11-11 15:52

　　1. Xiao Zhengquan, Chief Physician, President of Beijing Beiya Hospital and Executive Director of Bone Disease Teaching Base of China Academy of Traditional Chinese Medicine, has undertaken demonstrative research for projects under the National R&D Program set by the Ministry of Science and Technology for the “10th Five-Year Plan” period and written Modern TCM for Femoral Head Necrosis, Practical Traumatology & Orthopaedics Dictionary, Illustrated Muscle and Bone Diseases and other works.
　　 2. Gao Qinan, Chief Physician, Director of Orthopaedics Department of Beijing Beiya Hospital and Leader of Femoral Ankylosing Spondylitis Discipline Team, has been a doctor for more than 40 years. He has deeper studies on difficult and complicated bone injuries, ankylosing spondylitis, femoral head necrosis, bone joint diseases and bone tumor, shows unique expertise at treating difficult and complicated orthopaedic diseases through integration of TCM and Western Medicine and has published dozens of theses.
　　 Presenter: hello, audience! Here is CCTV Health Road live broadcast program. Today, we will talk something about treatment of ankylosing spondylitis with TCM.
　　 Aside: this year, the 14-year-old Zhang Yonggang, a primary six student, had to drop out. One year ago, he began to feel ache at hipbone and knee joints for some reasons unknown. Sometimes, the pain was too serious to bear. His parents brought him to every hospital in the county. But no hospital could give a definite examination result. What is worse, the condition was deteriorating after taking medicine prescribed by the hospitals. The pain gradually deprived him of mobility. He had to stay indoors all the day long and live in agony.
　　 Aside: Zhang Yonggang told us his pain became increasingly serious in recent two months, hip and knee ache had developed into leg, ankle and heel pain, and a few days ago, his shoulders started aching all the time. His elder brother suffered hydrocephalus at birth and became mentally retarded. Yonggang was carefully attended by his two elder sisters at his childhood, but due to poor economic condition, his eldest sister got married at 20. His second eldest sister dropped out after junior middle school, left home and found a job in other place in order to support Yonggang’s study. In the past years, his parents spent up all of his family’s savings. In this half year, the treatment of Yonggang’s disease brought heavy debt to his family. For his family, Yonggang attempted time and again to give up treatment. His parents worked very hard and wished their son could live in health and safety. But when they saw the pain was getting more serious day by day, they felt helpless. Fortunately, experts from Beijing came to Yonggang’s home and brought some medicine for him. Before leaving, they urged him taking medicine and paying attention to nourishment.
　　 Xiao Zhengquan: Yellow Emperor’s Internal Classic has some record about ankylosing spondylitis and says people with ankylosing spondylitis will become “hunchbacked” and have difficulty in walking. In essence, ankylosing spondylitis is not an orthopaedic disease but a hereditary immune-related disease belonging to internal medicine of orthopaedics. That is to say it is an immune-related disease partially manifested by walk difficulty and mostly manifested as a disease of immune system.
　　 Gao Qinan: Western Medicine believes ankylosing spondylitis is a hereditary and comprehensive disease invading bone joints and internal organs of the whole body and bringing down auto-immunologic function.
　　 Xiao Zhengquan: no matter what disease we treat, we should see essence through phenomena. Only in this way, we can cure both the symptoms and the disease. Ankylosing spondylitis has certain nature of heredity. 90% of patients get the disease from heredity.
　　 TCM interpretation on the pathogeny of ankylosing spondylitis
　　 1. Deficiency of congenital innate endowment
　　 2. Deficiency of Du Meridian
　　 3. Damage by six climate exopathogens
　　 4. Attack by damp, heat, toxin and evil
　　 5. Postnatal malnutrition and excessive labor
　　 Presenter: if without prompt treatment on ankylosing spondylitis, what will happen?
　　 Gao Qinan: without prompt treatment, ankylosing spondylitis will develop further from early stage, middle stage to late stage. Zhang Yonggang’s case belongs to early-middle stage. The disease is yet to invade skeleton and internal organs. Treatment can achieve a very good effect. The serious clinical case I experienced is a 27-year-old rural patient. Due to poverty, his disease has never been diagnosed and treated since the first attack at 4 till 27. When he was 27 years old, his father held him to our hospital. After examination, we found no part of his body could move except eyes and his mandibular joint was partially stiffened. From this case, we can see the harm of no treatment is very serious.
　　 Presenter: what are the early signs when a teenager gets ankylosing spondylitis?
　　 Xiao Zhengquan: the early signs are very obvious, for example: cyclitis and iritis mostly in a single eye, whereas common epidemic conjunctivitis appears in two eyes. The disease is also manifested by frequent attack by common cold, pale complexion, weakness of the whole body and occasional pain.
　　 Gao Qinan: there are a variety of early symptoms. At childhood, the early symptoms mainly affect peripheral joints such as commonly ankle joint, knee joint, elbow joint and shoulder joint as well as occasionally hip joint. These peripheral joints will appear swelling and ache; at adulthood, the main early symptoms are related to morbidity of spinal joints mainly including sacroiliac, lumbar, chest and neck positions. All these symptoms are chronic and occult. It is difficult to find them but easy to make wrong diagnosis. The main symptoms are swelling and pain accompanied by stiffness. Certainly, both teenagers and adults may suffer an acute attack by this disease. The acute attack is very fierce and accompanied by fever, high fever, joint swelling, ache and motion dysfunction and even paralysis in a short time. The ratio of the acute attack is very small, about 5%, while most cases are chronic.
　　 Xiao Zhengquan: the incidence of ankylosing spondylitis is 0.3%. It is very high.
　　 Presenter: how should we distinguish the joint swelling caused by rheumatoid arthritis and by ankylosing spondylitis?
　　 Gao Qinan: rheumatoid arthritis mainly invades small joints of the whole body. For young and mid-aged women, the main symptom is repetitive pain with the possibility of deformed small joints.
　　 Xiao Zhengquan: early accurate diagnosis is vital. The current science and technology make it very easy to diagnose ankylosing spondylitis. Firstly take an X-ray photo or a CT of sacroiliac joint. The disease can also be judged from the perspective of immunology by doing blood test to assay HLB27. This assay is a principal diagnostic means. If B27 is positive, it can be concluded the patient is with ankylosing spondylitis.
　　 Presenter: let's see the cases of a few patients:
　　 Patient 1: shoulder, leg and wrist are painful, while spine is movable.
　　 Patient 2: waist and back are stiff. It is painful when turning over or squatting.
　　 Patient 3: waist and hip are painful. There is difficulty in walking and inability in squatting.
　　 Patient 4: it is difficult to turn neck and face. Legs can’t be stretched. There is no problem with waist.
　　 Gao Qinan: the development of spondylitis follows a course from early stage, middle stage and late stage. In mid-late stage, the symptoms are comparatively conspicuous, neck suffers ankylosing deformity, patients are unable to lower and raise their heads, hunchback is developed, and hip joint appears ankylosing deformity that disables the movement of squat and seriously affects life quality. In late stage, the disease not only invades bone joints but also internal organs, for example: resulting in blindness, pneumonia, valvular changes and renal changes.
　　 Presenter: how long will it take from the early stage to late stage?
　　 Xiao Zhengquan: it varies with persons. Some people need only a half year from the first stage to late stage, while some need forty years from early stage to late stage. The development of illness state has something to do with patient’s immune function. The illness state of people with sound immune function develops slowly, while that of people with poor immune function will quickly develop from the first stage to late stage. Therefore, early and quick treatment to control immune function is necessary.
　　 Gao Qinan: hereditary gene of ankylosing spondylitis was discovered in 1950s. It is HLB27. This gene is only a carrier and not in morbid state. According to clinical statistics, only 20% of people with this gene suffer ankylosing spondylitis.
　　 Presenter: how does TCM treat ankylosing spondylitis?
　　 Xiao Zhengquan: TCM differentiation typing of ankylosing spondylitis
　　 1. type of deficient renal yang and blood stasis
　　 2. type of deficient Qi and blood
　　 3. type of deficient liver and kidney
　　 4. type of deficient yang Qi
　　 Xiao Zhengquan: TCM is dedicated to treatment aiming at its root causes. Although the Yellow Emperor’s Internal Classic has some fragmentary record about ankylosing spondylitis, but it doesn’t have any record about its theory. Therefore, in medical history, there is no relevant theory. Through research, we created a theory called "4 Tonics Benefiting Du Meridian” Therapy.
　　 "4 Tonics Benefiting Du Meridian” Therapy
　　 4 Tonics: tonify Qi, blood, renal yang and renal yin
　　 Benefit Du Meridian: warm kidney, reinforce yang and replenish and benefit Du Meridian
　　 Dredge channel: promote blood circulation, remove stasis and dredge channels
　　 Presenter: let's see what changes have happened on Zhang Yonggang after receiving the "4 Tonics Benefiting Du Meridian” Therapy:
　　 Aside: after a month, we came to Zhang Yonggang’s home again.
　　 Zhang Yonggang: I feel better now than before. Now I can walk 500-1000m. I can do squatting, too.
　　 Aside: Yonggang now can ride bicycle, too. He also told us he would go to school after a half month.
　　 Presenter: well, will this therapy generates same curative effect on patients in mid-late stage?
　　 Gao Qinan: Zhang Yonggang is a patient in early-mid stage. The therapy generates very good effect on him. For patients in mid-late stage, the disease has invaded bone joints. This therapy will help them restore blood movement and immunity and regenerate and restore bone, and finally control the root of stiffness. The therapy can stop further development of late-stage ankylosing spondylitis.
　　 Xiao Zhengquan: Zhang Yonggang shouldn’t have leaped and jumped. At that time, he did it due to excitement, but I didn’t agree him to do so, because after one month’s treatment, it is still in convalescent period. During this period, although joint swelling was controlled, immune function was resumed to some extent, complexion became better, and he can move and walk at present, he shall not walk too long and riding bike and running and jumping are absolutely forbidden.
　　 Presenter: what cautions should a patient take during convalescent stage?
　　 Gao Qinan: functional exercise is very important for ankylosing spondylitis patient. It doesn’t work simply by drug treatment. As the saying goes “recovery from a disease consists of 30 percent of treatment and 70 percent of nourishment”. When the condition is severe, patients can do exercise in bed. When the condition is getting better, they can do exercise on the ground. We recommend patients do exercise to an extent that no sweat comes out, i.e. patients may move their joints but shall not sweat. They are forbidden to do violent movement, such as: running, jumping, throwing, climbing and swimming. All in all, joint movement is necessary, while excessive exercise is harmful.
　　 Presenter: what cautions should a patient take in daily life?
　　 Xiao Zhengquan: ensure enough nutrient intake and sleep and don’t have too frequent sex.
　　 Presenter: clinic time: Xiao Zhengquan: Monday; Gao Qinan: Monday-Friday; hospital contact number: (010) 81389995