December 6, 2013

December 6, 2013

1. zhaojunping: I am a patient with hepatitis B (small three positive). Recently, I’ve been feeling discomfort under my left rib cage, with a burning sensation in my stomach, occasional acid reflux, and bloating. When I visited you for a consultation, I forgot to mention these symptoms due to nervousness. Could I have other underlying conditions? What tests should I undergo to get a clear diagnosis?

Answer: Long-term liver disease can affect gastrointestinal function. According to “Jingui Yaolue,” “When you see a liver disease, know that it can spread to the spleen; therefore, you should first strengthen the spleen.” Here, the “spleen” refers to the gastrointestinal system. You should undergo an abdominal ultrasound and liver function tests, and if necessary, a gastroscopy as well.

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2. Qingzhengueshengzhai Lamb Slices Daily Group Buy: I have a small lump under the skin on the inner side of my left calf, with limited mobility and obvious tenderness upon palpation. I often experience low-grade fever, peaking at 37.8°C. Whenever I feel headache or joint pain, I develop chills and fever, with my temperature rising to about 37.3°C. I’m 175 cm tall and weigh 93 kg, and I often get short of breath when climbing stairs. Could you please analyze what might be causing this?

Answer: Your symptoms of chills, fever, and shortness of breath suggest chronic infection. If you’re female, consider the possibility of gynecological inflammation; if you’re male, rule out rheumatism or rheumatoid arthritis by conducting a rheumatoid factor test and, if possible, a calcitonin test.

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3. Yuanlong: Under what circumstances does coronary heart disease require bypass surgery, and how long can such a bypass procedure last? If the previously stented vessel becomes blocked again, is bypass surgery the only option?

Answer: Only acute coronary syndromes require intervention. Acute coronary syndromes include unstable angina, ST-segment elevation myocardial infarction, and non-ST-segment elevation myocardial infarction. The American Heart Association has introduced FFR (fractional flow reserve), which serves as the gold standard for determining whether intervention is necessary. As for how long a bypass procedure can last, it depends on multiple factors, such as the patient’s overall health, the rate of arterial sclerosis, the duration of postoperative antiplatelet therapy, and the nature of the patient’s work.

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4. FENGCUNCUN: A little girl, 1 year and 1 month old, has unexplained deafness. The Zhengzhou Children’s Hospital recommends either hearing aids or cochlear implants. Can this condition be treated with TCM?

Answer: First, we need to determine the exact cause of the deafness. If the cause remains unclear, it means the diagnosis is inaccurate, and using hearing aids or cochlear implants without a clear diagnosis lacks reliability.

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5. Yingfuduo: Where can I buy black bean distillate ointment? Can lung cancer patients take donkey-hide gelatin after chemotherapy? If so, what precautions should be taken?

Answer: You can purchase black bean distillate ointment at most pharmacies. There are many medications that lung cancer patients can take after chemotherapy, such as Shengmai San, Dushen Tang, Buzhong Yiqi Wan, Guipi Tang, and Buxue Tang, all of which are highly effective. However, donkey-hide gelatin alone is not suitable for use after lung cancer chemotherapy.

December 9, 2013

Question and Answer One

LiuLang: Female, 20 years old, constantly losing hair—every wash results in a large amount of shedding—and also developing a lot of white hair. What should I do? What medication should I take?

Answer: White hair is caused by congenital genetic factors, while hair loss is due to acquired factors. The latter can be treated, with TCM’s syndrome differentiation and treatment being the most effective approach; as for the former, there is currently no good treatment method, so there’s no need to take random medications.

Question and Answer Two

LiuChuang: I’ve been coughing frequently over the past two years, with wheezing symptoms but no sputum, and the cough worsens during colds. Could this be chronic bronchitis? What should I pay attention to in daily life? What medication should I take? Can it be cured?

Answer: Since the 21st century, people’s understanding of chronic bronchitis has changed. One fundamental aspect that was previously overlooked is the existence of upper airway cough syndrome, cough variant asthma, and postnasal drip syndrome caused by chronic pharyngitis and chronic rhinitis. These conditions account for more than two-thirds of the original definition of “chronic bronchitis.” You urgently need to check whether you have chronic pharyngitis or chronic rhinitis before a definitive diagnosis can be made. Only after a clear diagnosis can treatment be discussed.

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December 11, 2013

Question and Answer One

WangXiaodong: Must perianal abscesses be treated surgically? Are there any good TCM treatments?

Answer: If the abscess has matured, it must be incised and drained; otherwise, allowing it to rupture on its own may lead to the formation of an anal fistula. If it hasn’t matured yet, it can be treated with Western anti-inflammatory therapy, along with TCM methods that clear heat, detoxify, and promote pus drainage.

Question and Answer Two

PengHuiling: Whenever I eat a bit too much or consume hard-to-digest foods, my stomach feels bloated, and I can’t eat raw, cold, or spicy foods. Could this be spleen-stomach weakness or indigestion? How should I treat it?

Answer: The TCM standard for spleen-stomach weakness is pale complexion, poor appetite, fatigue, and lack of energy. More than half of patients experience epigastric distension and pain. I wonder if you fall into this category. If you exhibit these symptoms, it’s recommended to regularly take Xiangsha Liujun Wan.

Question and Answer Three

Qingzhengueshengzhai Lamb Slices Daily Group Buy: My grandfather passed away from pulmonary tuberculosis, and now my younger brother has renal tuberculosis complicated by renal failure. Out of concern about possible transmission, I went to the city tuberculosis hospital for a skin test and a chest CT scan, but neither revealed any abnormalities. What does checking calcitonin mean?

Answer: To be precise, it should be called procalcitonin. A positive result indicates bacterial infection, and it may also be positive for tuberculosis bacteria, but it doesn’t carry any special diagnostic significance.

Question and Answer Four

Yingszi: Male, 36 years old, occasionally experiences pain in his finger joints. A hospital test showed four rheumatoid markers, with C-reactive protein at 8.5. Does this qualify as rheumatoid arthritis?

Answer: Pain in the finger joints is a common symptom of rheumatoid arthritis and often the earliest manifestation. Initially, rheumatoid factor may be negative, while CRP is a nonspecific indicator of reactive inflammatory diseases. It merely shows that the patient has reactive inflammation, but cannot confirm the diagnosis.

Question and Answer Five

Wangdefu: Female, 32 years old, frequent urination, abdominal distension, excessive dreaming, and yellowish vaginal discharge. A TCM doctor diagnosed her with spleen-kidney yang deficiency and prescribed kidney-tonifying and spleen-strengthening herbs for half a year. When she stopped taking the herbs, she often experienced recurrent frequent urination. What could be the reason?

Answer: If there is urgency or pain during urination, it indicates damp-heat descending; occasional yellow discharge also points to this issue. If it’s purely frequent urination accompanied by lower back pain, dizziness, or tinnitus, it can be diagnosed as kidney yang deficiency; if accompanied by abdominal distension, pale complexion, poor appetite, and fatigue, it can be diagnosed as spleen-kidney yang deficiency. TCM diagnosis is very strict—don’t lump everything together. Mistaking damp-heat descending for spleen-kidney yang deficiency can lead to incorrect treatment.

Question and Answer Six

Hehe: Is black bean distillate ointment purely herbal? Does it contain hormones?

Answer: The beauty of black bean distillate ointment lies in the word “distillate”—it’s not oil pressed from black beans, but rather black beans heated above 100°C until they’re in a semi-combustion state, and their volatile components are pre-cooled and condensed. This single ingredient makes it the best choice for treating eczema, with nothing else added.

Question and Answer Seven

Mengchi Comment: Male, 40 years old, has had no eardrum for 20 years. Can cochlear implantation restore his hearing?

Answer: For patients like this, cochlear implantation is highly suitable. If cochlear implantation isn’t an option, tympanic membrane transplantation or repair surgery should also be effective.

Question and Answer Eight

ZhaoYingzhi: My child is 5 years old, with morning bad breath, white tongue coating, white palate, picky eating, dark-colored stools, and occasionally undigested food in them. How should I adjust their diet or what medication would be best?

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Answer: If the palate appears white, consider the possibility of a fungal infection; it is recommended to consult a specialist. If a fungal infection is ruled out, the issue may be indigestion. Try taking multi-enzyme tablets or yeast tablets. If these do not help, seek treatment from a traditional Chinese medicine practitioner for syndrome differentiation and tailored therapy, which generally yields the best results.

Question and Answer 9

Xiao Jiu: What are the manifestations of organic intracranial lesions? If a lump can be felt on the scalp surface, does this fall under the category of such lesions?

Answer: A diagnosis can only be made through cranial CT, MRI, or PET-CT scans.

Question and Answer 10

Su Yan: I had an upper respiratory tract infection last week, and the symptoms have eased in recent days, but my throat is still itchy and I have a dry cough. What can I do?

Answer: You likely have chronic pharyngitis. Remember that chronic pharyngitis serves as the gateway to the upper respiratory tract, so it must be thoroughly treated. You can try taking Yangyin Qingfei Pills. If the effect is not satisfactory, it is recommended to see a specialist.

Question and Answer 11

Ma Wenya: My uncle underwent total gastrectomy due to gastric cancer and is now undergoing chemotherapy. He has heard about the possibility of implanting a prosthetic stomach. Could you please advise on the feasibility of this procedure and what foods are best to eat?

Answer: There is no such thing as a prosthetic stomach. The functions of the stomach include digestion, absorption, and propulsion, all of which involve countless endocrine factors. These activating factors collectively form the powerful functions of the stomach, intestines, and pancreas. Therefore, while most of the stomach can be removed, it cannot be completely replaced by other organs. Patients after gastric cancer surgery should strictly control their diet, avoiding meat, eggs, and dairy products, and focusing on light, bland meals.

Question and Answer 12

Yue: A child around 5 years old has been shaking his head frequently lately. Is this a serious issue?

Answer: This is called childhood hyperactivity, a common condition primarily caused by autonomic nervous system dysfunction. There are treatments available, and traditional Chinese medicine tends to be more effective than Western medicine in treating this condition, though syndrome differentiation and tailored therapy are essential.

Question and Answer 13

Ai Zai Zuo Qing Zai You: I have three lumps behind my left ear that keep recurring—they heal only to reappear. There are also one or two on the right side. What could be causing this?

Answer: In your case, it is most likely postauricular lymphadenitis. You should check whether there are any inflammatory conditions in your inner ear, middle ear, or throat.

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December 16, 2013

Question and Answer 1

Ai Mei Li: I am 24 years old and have had "big three yang" for over ten years. Should I choose traditional Chinese medicine or Western medicine for treatment?

Answer: When it comes to treating hepatitis B, to be honest, traditional Chinese medicine is superior to Western medicine. Western medicine offers effective drugs like entecavir, lamivudine, and adefovir dipivoxil for viral suppression, while traditional Chinese medicine excels at overall regulation of liver function and halting the progression of cirrhosis.

Question and Answer 2

Yun Ze’s Father: A child was accidentally scalded by boiling water. How should this be handled?

Answer: It depends on the degree of the burn and the extent of the affected area. For first-degree burns covering no more than 1% of the body, you can apply purple gromwell oil. If the area is very small or there are only one or two small blisters, you can use gentian violet topically. If the burn covers a larger area, you should go to a hospital's burn specialty department for treatment.

Question and Answer 3

E Mei Pai: Female, 20 years old. Since July this year, she has developed numerous red rashes with pus on her face for unknown reasons. The rash becomes itchy when exposed to hot or cold air. She has tried many acne-fighting cosmetics, but there has been no improvement.

Answer: Acne combined with allergy and eczema responds best to oral traditional Chinese medicine, but it must be treated based on syndrome differentiation.

4. Wang Xiuzhen

During four months of breastfeeding, she has constantly had lumps in her breasts. Despite multiple massages and herbal lactation-promoting treatments, the lumps have not completely disappeared. Can she take some medicine to disperse the lumps?

Answer: Yes, you can. It is recommended to purchase a high-quality breast pump and express any remaining milk daily. If there is still localized pain, treat it as mastitis.

5. LMw

Male, 33 years old. There has been white discharge on the outer sides of both eyes, resembling milky white, and it increases after eating spicy or irritating foods. This has been going on for about 10 years. What could be the cause?

Answer: This indicates local inflammation. One option is to use topical eye drops. Inflammation of the cornea or eyelids often has an allergic tendency, and corticosteroid eye drops work well. Traditional Chinese medicine treatment based on syndrome differentiation is also quite effective.

6. Yang Xuefang

My sister has experienced two spontaneous abortions despite not being exposed to any harmful substances and resting at home. However, the pregnancies ultimately ended in miscarriage. Western medical examinations showed everything to be normal. What might be the general causes?

Answer: The causes of miscarriage include: ① Endocrine disorders, such as low estrogen levels; ② Impaired follicular maturation; ③ Other organic diseases in the body; ④ Improper rest and care during pregnancy.

7. After the Curtain Falls

Many patchy red areas have appeared on the chest and back, with white scales on the surface. They flake off when touched accidentally. Could this be psoriasis, and what would be the best treatment?

Answer: This is very similar to psoriasis. Psoriasis is characterized by: ① White scales; ② Nail-like plates at the base of the white scales; ③ Bleeding when the plates are removed; ④ Itching.

8. Yi Yi

Female, 28 years old, unmarried, with no sexual activity. For the past three to four years, her menstruation has been irregular, occurring only once every six months with a small amount of flow. An ultrasound and hormone level tests revealed elevated androgen levels, indicating polycystic ovary syndrome. She was prescribed progesterone, as prolonged absence of menstruation may lead to endometrial abnormalities. What is going on here?

Answer: Polycystic ovary syndrome not only causes menstrual cycle irregularities but can also lead to amenorrhea, hirsutism, obesity, moon-faced appearance, and buffalo hump. For such patients, treatment with only estrogen and progesterone is insufficient. Traditional Chinese medicine uses methods to activate blood circulation, remove stasis, and regulate the Chong and Ren meridians, which can restore normalcy in some cases and even result in pregnancy and childbirth.

9. Wuhan 110402 Teng Mama

Pale complexion, frequent dreaming, and cold hands and feet in winter. Traditional Chinese medicine says it's qi deficiency, but I don't have symptoms like loss of appetite or fatigue. My period lasts for more than ten days before finally stopping, with a slow, dripping flow. I've taken traditional Chinese medicine for a while, but there's been no improvement. What could be the problem?

Answer: You have spleen and stomach qi deficiency, and the prolonged menstruation is due to "qi failing to control the blood." According to traditional Chinese medicine syndrome differentiation and treatment, the approach should focus on tonifying qi and nourishing blood, with possible additional measures to activate blood circulation, remove stasis, and stop bleeding if necessary.

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December 18, 2013

1. Welcome

Male, 28 years old, diagnosed with vitiligo. After taking methylprednisolone tablets and compound ziling capsules for a while, he now wants to have children. Hospital tests show elevated ALT levels. Can he still have children?

Answer: If you want to have children, you should stop taking methylprednisolone. Vitiligo does not affect children, and you can continue treatment after giving birth. This disease is a chronic, long-lasting skin condition with a genetic predisposition, making it difficult to cure and requiring a lengthy process.

2. Cao Haizhou

The baby is less than two months old, and the left and right legs are uneven in thickness, with a difference of 1 cm in diameter. Hospital examination shows no problems with bones or development. During delivery, the amniotic fluid broke first, followed by induction, and the labor lasted for twenty to thirty hours, with the baby finally delivered after more than three hours in the delivery room. Could this be due to compression? Will it have any impact later on?

Answer: This situation is quite common. Different fetal positions during pregnancy, maternal habits, and work conditions can all affect intrauterine development. However, after birth, the baby will gradually correct itself during the long developmental process. Rest assured and feed the baby well; as the child grows, things will get better. Of course, some infants with organic diseases are exceptions.

3. Tian Kong

My son, who is 9 years old, often wets the bed. What could be the reason?

Answer: This is a common occurrence. With syndrome differentiation and treatment using traditional Chinese medicine, most children can see improvement. Only a small number of children whose bedwetting is caused by pituitary posterior lobe antidiuretic hormone secretion disorders are harder to treat.

4. Let Dreams Fly

After a cold and fever, I experience abdominal distension, loss of appetite, dry mouth, and night sweats, along with a sticky tongue coating. What medicine should I take?

Answer: During fever, sympathetic nerve function dominates, also known as increased sympathetic tension. After the fever subsides, there is a period of parasympathetic tension, during which the gastrointestinal smooth muscles are in varying degrees of tension, leading to symptoms like abdominal distension and belching. Generally, oral administration of Xiangsha Yangwei Wan or Xiangsha Liu Jun Wan can be effective. Of course, severe cases require consultation with a gastroenterology specialist.

5. Drifting Across the Sea

Male, 24 years old. Has had lower abdominal pain for half a year, accompanied by painful urination and difficulty starting to urinate. Examination reveals a 0.8 cm prostate cyst and prostatitis. Hands and feet are cold, prone to sweating, eyes are red and swollen, and there are floaters. Also experiences frequent dreaming and irritability. Some doctors diagnose blood stasis, while others say it's blood deficiency and liver fire, plus kidney yang deficiency. Which condition do you think applies to me?

Answer: You have typical prostatitis. The worst aspect of prostatitis is that it can be accompanied by severe systemic autonomic nervous system dysfunction. This is because increased prostaglandins affect the entire autonomic nervous system. Prostaglandins were first discovered in the prostate, but they can actually be produced in all organs. When prostaglandin levels rise locally, the effects ripple outwards, impacting overall bodily functions. It is recommended to treat prostatitis as soon as possible, as this will resolve the autonomic nervous system dysfunction.

6. Du Haiping

Female, 25 years old. Diagnosed with hyperthyroidism. How should it be treated?

Answer: Primary hyperthyroidism is rare nowadays; 70%–80% of cases arise from subacute thyroiditis. Therefore, the first step is to treat the subacute thyroiditis. Treatment usually involves oral administration of corticosteroids. If hyperthyroidism develops, medication should be stopped immediately, as discontinuation can easily lead to rebound symptoms. Thus, treatment of this condition requires a physician with extensive experience.

7. Traitor

Female, 50 years old. Numbness and pain in the right leg and foot, along with pain on the right side of the waist. Hospital examination diagnosed lumbar disc herniation. Can traditional Chinese medicine help regulate this condition? How should it be treated?

Answer: Lumbar disc herniation is a common and frequently occurring disease, and its incidence has been increasing in recent years. Treatment mainly relies on traditional Chinese medicine syndrome differentiation, physiotherapy, acupuncture, tuina, and massage. For severe cases, surgery may be considered.

8. Three Locks and Keys

Diagnosed with dry eye syndrome, with dry and irritated eyes. How should this condition be treated? What specific medications are best?

Answer: Your description of dry eye syndrome is not entirely accurate. If it's Sjögren's syndrome, there will be dry eyes, nose, and throat, and most patients will also experience joint pain and oral ulcers. If it's purely dry eyes, consider trachoma first. Open the eyelids to take a look. In clinical practice, I've seen many patients with dry, sore eyes, and even after slit-lamp and ophthalmoscope examinations, they still haven't opened their eyelids, resulting in missed diagnoses of common trachoma. This reflects the current over-reliance on equipment, creating a "dark spot under the lamp" phenomenon.

9. Literary Garden

What should I do about constipation? I already eat plenty of green vegetables and fruits, but still have trouble having regular bowel movements. I'm thinking of trying moxibustion. Which acupoints are best to choose?

Answer: Moxibustion is not the best choice for treating constipation. Some people find it effective, while others do not, and most do not. The preferred acupoint is Zusanli. It is recommended to take Maziren Wan orally.

10. Let Me Hide From the Wind in Your Arms

Female, 28 years old. Anal pain, swelling, and itching, with a feeling of dampness. Severe cases affect work and sleep. Previously, doctors diagnosed eczema. I hope you can offer some advice.

Answer: You may have hemorrhoids. This condition is highly contagious and often accompanied by eczema. Here's a prescription for you to try sitz baths:

Sitz Bath Formula

• Glauber's salt 30g
• Borax 20g
• Alum 10g

Boil 2000 ml of water, let it cool slightly, then soak for 30 minutes.

December 20, 2013