Aplastic Anemia
Aplastic anemia
is a clinical syndrome caused by a variety of etiological factors (some of them
are unknown) which lead to hematopoietic disorder of bone marrow. Clinically,
it is characterized by panhematopenia resulting in anemia, hemorrhage and infections.
The disease often occurs in young adults. It is more common in males than in female.
In TCM, it is categorized as "xu lao" (consumptive disease), "xue
zheng" (blood trouble), etc.
Main Points of Diagnosis
According
to the clinical features and pictures of bone marrow, the disease can be divided
into two types-acute and chronic.
1. Acute aplastic anemia: The onset is abrupt
with rapid progress of the disease. There are marked symptoms of anemia, hemorrhage
and infection, particularly symptoms of severe and extensive bleeding. Intracranial
hemorrhage is the leading cause of death.
2.Chronic aplastic anemia: The onset
of the disease is slow, and the course is persistent. Anemia is the major symptom,
while the symptoms of hemorrhage and infection are relatively mild and easy to
be controlled.
3. Physical examination generally finds no enlargement of liver
and spleen except the manifestations of anemia and hemorrhage.
4. The blood
picture shows the decrease in whole blood cells, normochromic anemia, reticulocytopenia,
thrombocytopenia and increased serum iron. the picture of bone marrow in acute
type presents obvious hypoplasia, characterized by the decrease of three blood
cell systems and elevation of non-producing blood cells. In chronic type, relatively
mild retardation of proliferation may be the feature in bone marrow, associated
with right shift of classification.
Differentiation and Treatment of Common
Syndromes
1. Deficiency of Both Qi and Blood
Main Symptoms and signs: Slow
onset ,dizziness, palpitation, shortness of breath, fatigue and weakness, pale
complexion and pale tongue with white fur, deep and thready pulse.
Therapeutic
Principle: Supplementing qi and nourishing blood.
Recipe: Modified Eight Precious
Ingredients Decoction.
salvia root
white atractylodes rhizome
poria
prepared licorice
Chinese angelica,
prepared rehmannia root
white
peony root
astragalus root
donkey-hide gelatin
All the above ingredients,
except donkey-hide gelatin which is to be melted in the finished decoction, are
to be decocted din water for oral administration.
In addition to the above
ingredients, 30 grams of hairy vein agrimony and 10 grams of stir-baked argyi
leaf ought to be employed if there is bleeding; 10 grams of bupleurum root, 10
grams of scutellaria root and 20 grams of honey-suckle flower be administered
if the case is accompanied with fever.
2. Deficiency of the Liver-Yin and
Kidney-Yin
Main Symptoms and Signs: Dizziness, tinnitus, aching pain of the
waist and knees, hot sensation in the palms and soles, or low fever in the afternoon,
dry mouth, night sweat, insomnia, excessive dreaming, menorrhagia, red tongue
with little fur, thready and rapid pulse.
Therapeutic Principle: Nourishing
the liver and kidneys.
Recipe: Modified Prescriptions of Decoction for Invigorating
Primordial Qi and of Glossy Privet Fruit and Eclipta Pill.
codonopsis root
dried rehmannia root
prepared rehmannia root
Chinese angelica
siberian
solomonseal rhizome
wolfberry fruit
glossy privet fruit
eclipta
cornus
fruit
fleece-flower root
mulberry
prepared licorice root
All the
above herbs are to be decocted in water for oral administration.
For the case
with fever, 12 grams of sweet wormwood, 12 grams of wolfberry bark and 10 grams
of anemarrhena rhizome should be added; For the case with marked bleeding, additional
drugs are stir-baked sanguisorba root 12g, donkey-hide glue 10g and biota tops
10g.
3. Deficiency of the Spleen-Yang and Kidney-Yang
Main Symptoms and
Signs: Mental debility, disinclination to talk, aching pin of the waist and weakness
of the legs, aversion to cold, cold limbs, spontaneous perspiration, edema, loose
stool, pale complexion, corpulent and pale tongue with thin and white fur, deep
and thready pulse.
Therapeutic Principle: Invigorating the spleen and warming
the kidneys.
Recipe: Modified Prescriptions of Decoction of Four Noble Ingredients
and Kidney-Yang-Reinforcing Bolus.
codonopsis root
astragalus root
white
atractylodes rhizome
Chinese yam
tangerine peel
prepared rehmannia
root
Chinese angelica
psoralae fruit
antler glue
cinnamon bark
morinda
root
epimedium
All the above herbs are to be decocted in water for oral
administration.
By
Dr. Ming's TCM Medical Center,
Hua Xi Xiao Yuan, Hutian
Developing Area,
Huaihua city, Hunan province
China