II. Ankylosing Spondylitis

II. Ankylosing Spondylitis

Previously, it was mistakenly believed to be a central-type form of rheumatoid arthritis; in the 1980s, it was completely separated.

• Genetic predisposition
• Sacroiliac joint involvement
• Women are particularly prone to cervical spine involvement. Treatment: In addition to ibuprofen, methotrexate and sulfasalazine have proven effective.

Penicillamine is a derivative of penicillin; because it can bind to various heavy metal ions, increasing their excretion, it was historically used to treat hepatic chorea and heavy metal poisoning—such as mercury, lead, and copper poisoning—with greater efficacy than dimercaprol. In recent years, it has been discovered that this drug possesses distinct immune-regulatory properties, essentially inhibiting antigen-antibody reactions, making it suitable for treating rheumatoid arthritis, ankylosing spondylitis, and other conditions. Methotrexate can also be taken orally at 2.5 mg once daily or every other day.

Treatment of Breast Diseases—Part One, January 19, 1994

Treatment for this condition often involved using Chai Shan Ji, and almost all patients saw positive results. Japanese practitioners have also found efficacy in treating this condition using Gui Zhi Fu Ling Wan, Chai Hu Shu Gan San, and Tao Ke Cheng Qi Tang. Statistical analysis showed that all three formulas were superior to commercially available medications, with notable differences between them.

New Uses for Yibo Ding, January 19, 1994

This medication acts as a Ca²⁺ ion blocker, reducing the influx of Ca²⁺ from outside the cell into the cell, thereby lowering the conduction system of the heart and reducing cardiac stress. This leads to prolonged atrioventricular nodal refractory periods, reduced atrial action potential amplitude, slowed myocardial contraction, and decreased myocardial oxygen consumption. Based on these mechanisms, this medication can treat various arrhythmias, but it is strictly contraindicated in patients with bradycardia, heart failure, or cardiogenic shock. This medication should not be used in conjunction with beta-blockers (such as Bisoprolol). In recent years, it has been discovered that this medication is effective for the following conditions: women with neurosis, schizophrenia, tardive dyskinesia, mania, acute biliary colic, and stuttering in adults. The clinical dosage of Yibo Ding is typically 40 mg, taken three times daily orally; the average dosage is 80 mg, taken three times daily orally; for intravenous infusion, 10 mg can be administered via small-volume infusion or slow intravenous push, with repeat administration after half an hour.

Coagulation and Inflammation in Nephritis, January 19, 1994

1. Platelet activation and coagulation factor activation lead to capillary obstruction.
2. Neutrophils and macrophages—along with other inflammatory cells—and the inflammatory mediators they secrete are the fundamental causes of coagulation and inflammation. The Chinese medicine Yi Shen Tang combines blood circulation promotion and detoxification, making it an excellent formula for treating this condition.

Whether purslane and leeches can be used for nephritis patients is an important question for future treatment strategies.

Acute Leukemia with Elevated White Blood Cell Count, January 21, 1994

ALL and ANLL patients with white blood cell counts exceeding 100 × 10⁹/L are classified as such. Their characteristics include rapid onset and severe illness, often due to the accumulation of a large number of primitive cells. Accumulation in the lungs and brain can lead to central nervous system symptoms and pulmonary manifestations; accumulation in peripheral vessels may result in DIC. The breakdown of a large number of immature white blood cells releases nucleic acids, potassium, and phosphorus ions, causing metabolic disturbances and leading to hyperuricemia, hyperkalemia, and other conditions. All of these symptoms collectively constitute the syndrome of elevated white blood cell count. Due to these underlying causes, this condition is clinically severe, with a high mortality rate in the short term. Treatment: Do not rush into high-dose chemotherapy; if used, it may lead to extensive leukocyte necrosis, exacerbating the accumulation and increasing mortality. For acute lymphoblastic leukemia, the VP regimen is recommended. For acute non-lymphocytic leukemia, it is advisable to first reduce the chemotherapy dosage during the first course, then increase the dosage once the white blood cell count has declined. When conditions permit, leukocyte removal surgery (LP) can be performed—using a leukocyte separator to remove a large portion of the white blood cells. LP cannot cure the disease, but its therapeutic effect still relies on chemotherapy. Blood transfusions can increase microcirculatory congestion, so they should be avoided; instead, ensure adequate hydration and alkalization, and administer allopurinol 0.1 g orally three times daily to prevent hyperuricemic nephropathy.

Captopril, January 22, 1994

This is an angiotensin-converting enzyme inhibitor with a pronounced hypotensive effect and significant efficacy in treating congestive heart failure.

Integrated Chinese and Western Medicine Treatment for Supra-Sacral Nerve Injury Syndrome, January 22, 1994

This condition is indeed a distinct entity; its diagnostic criteria include: ① a history of lumbar and leg trauma; ② marked tenderness and muscle tension at the supra-sacral nerve site, located 3 cm below the midpoint of the iliac crest. Traditional Chinese medicine treatment involves taking Chinese herbal remedies: Dang Gui, Di Long, Hong Hua, Wei Ling Xian, Chuan Niu Xi; for severe cases, add San Qi. A popular saying goes: “Chuan Di Gen, Tian Hong Niu, Wei Ling Xian,”—this is a practical formula passed down through experience. Use 10 g of Chuan Di Gen, 15 g of Di Long, 20 g of Ge Gen, 3 g of Tian Qi, 3 g of Hong Hua, 10 g of Chuan Niu Xi, 10 g of Wei Ling Xian, 10 g of Dang Gui, 10 g of Danshen, and 3 g each of Lu Xiang and Mo Yao; after decocting the herbs in water, apply the residue as a warm compress, followed by massage. Another formula uses Huang Qi, Gui Zhi Wu Wu, and Bu Yang Huan Wu Tang, with a heavy emphasis on Huang Qi, Dang Gui, Chi Shu, Hong Hua, Di Long, and Chuan Niu Xi, along with Jiang Xue Teng.

Classification of Acute Leukemia (National Hematology Conference, 1980, Revised in 1986), January 26, 1994

Any patient with ≥30% primitive cells in the bone marrow can be diagnosed.