Status

Current conditions ICD-9-CM:
2003
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
2010
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
2012
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
375.15 TEAR FILM INSUFFICIENCY,UNSPECIFIED
367.89 OTHER DISORDERS OF REFRACTION AND ACCOMMODATION
377.61 ASSOCIATED WITH NEOPLASMS
729.1 MYALGIA AND MYOSITIS, UNSPECIFIED
719.39 PALINDROMIC RHEUMATISM,MULTIPLE SITES
680.0 CARBUNCLE AND FURUNCLE, FACE
378.41 ESOPHORIA
311 DEPRESSIVE DISORDER, NOT ELSEWHERE CLASSIFIED
523.8 OTHER PERIODONTAL DISEASES(PERIODONTAL POCKET,GINGIVAL POLYP)
681.02 ONYCHIA AND PARONYCHIA OF FINGER
2013
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
704.8 OTHER DISEASES OF HAIR AND HAIR FOLLICLES
706.1 OTHER ACNE
444.22 ARTERIAL EMBOLISM AND THROMBOSIS OF LOWER EXTREMITY
375.15 TEAR FILM INSUFFICIENCY,UNSPECIFIED
367.89 OTHER DISORDERS OF REFRACTION AND ACCOMMODATION
377.61 ASSOCIATED WITH NEOPLASMS
378.41 ESOPHORIA
728.85 (728.850) SPASM OF MUSCLE
353.4 LUMBOSACRAL ROOT LESIONS,NOT ELSEWHERE CLASSIFIED
780.52 (780.520) OTHER INSOMNIA
788.43 NOCTURIA
2014
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
374.05 TRICHIASIS WITHOUT ENTROPION
372.72 CONJUNCTIVAL HEMORRHAGE
375.15 TEAR FILM INSUFFICIENCY,UNSPECIFIED
367.89 OTHER DISORDERS OF REFRACTION AND ACCOMMODATION
377.61 ASSOCIATED WITH NEOPLASMS
378.41 ESOPHORIA
2015
225.0 BENIGN NEOPLASM OF BRAIN
345.90 UNSPECIFIED EPILEPSY WITHOUT MENTION OF INTRACTABLE EPILEPSY
705.83 HIDRADENITIS
698.8 OTHER PRURITIC CONDITIONS
686.9 UNSPECIFIED LOCAL INFECTIONS OF SKIN AND SUBCUTANEOUS TISSUE
686.09 OTHER PYODERMA
272.0 PURE HYPERCHOLESTEROLAEMIA (FAMILIAL HYPERCHOLESTESTEROLEMIA)
729.1 MYALGIA AND MYOSITIS, UNSPECIFIED
719.39 PALINDROMIC RHEUMATISM,MULTIPLE SITES
377.61 ASSOCIATED WITH NEOPLASMS
311 DEPRESSIVE DISORDER, NOT ELSEWHERE CLASSIFIED
307.48 REPETITIVE INTRUSIONS OF SLEEP
705.81 DYSHIDROSIS
372.72 CONJUNCTIVAL HEMORRHAGE
680.2 CARBUNCLE AND FURUNCLE, TRUNK
523.3 ACUTE PERIODONTITIS(ACUTE PERICORONITIS)
Current conditions ICD-10-CM:
2016

E780 Pure hypercholesterolemia
G40.909 Epilepsy, unspecified, not intractable, without status epilepticus
L301 Dyshidrosis [pompholyx]
F32.9 Major depressive disorder, single episode, unspecified
D33.2 Benign neoplasm of brain, unspecified
H04.123 Dry eye syndrome of bilateral lacrimal glands
H47.529 Disorders of visual pathways in (due to) neoplasm, unspecified side
H02.052 Trichiasis without entropian right lower eyelid
H11.31 Conjunctival hemorrhage, right eye
H52.6 Other disorders of refraction
H50.51 Esophoria
H02.055 Trichiasis without entropian left lower eyelid
H47.099 Other disorders of optic nerve, not elsewhere classified, unspecified eye
F51.8 Other sleep disorders not due to a substance or known physiological condition
G40.901 Epilepsy, unspecified, not intractable, with status epilepticus
L0881 Pyoderma vegetans
B009 Herpesviral infection, unspecified
J069 Acute upper respiratory infection, unspecified
M79.1 Myalgia
M12.39 Palindromic rheumatism, multiple sites

Current treatment centers:
GP/ The department of Neurosurgical emergency & Critical Care of Chang Gung Memorial Hospital Linkou Branch/ TCM oncology of China Medical University Hospital Cancer Center/ and Taichung Hospital, Ministry of Health and Welfare

Contents of reference sources:
MIMS- Search drug information/ interaction/ images & medical diagnosis.
Complementary and Alternative Healing University- Dictionary of Chinese Herbs. http://alternativehealing.org
Database 醫砭‧沈藥子 http://yibian.hopto.org
Traditional Chinese Medicine (TCM) Wiki http://www.tcmwiki.com/

Wednesday, July 25, 2012

Formula 17 for Benign Neoplasm of Brain

Formula 17 for Benign Neoplasm of Brain/ Chinese Herbs Therapy

Syndrome:
脈弦浮而數 floating tight and rapid pulse

Composition:
四逆散 sini powder 4.5g
溫膽湯 wen dan tang 4g
天麻粉 tian ma powder 2g
肉桂粉 rou gui powder 0.5g
白芥子 bai jie zi 1.5g
附子(焙) fu zi(bei) 1g
厚朴 hou po 2g
黃連 huang lian 1g
乾薑 gan jiang 1g

si ni san (sini powder) 四逆散

【方名】:四逆散
【出處】:《傷寒論》
【分類】:和解劑-調和肝脾
【組成】:柴胡(6克) 枳實(6克) 芍藥(6克) 炙甘草(6克)
【方訣】:
【功用】:透邪解鬱,疏肝理脾。
【主治】:1.陽鬱厥逆證。手足不溫,或腹痛,或泄利下重,脈弦。2.肝脾氣鬱證。脅肋脹悶,脘腹疼痛,脈弦。(本方常用於慢性肝炎、膽囊炎、膽石症、膽道蛔蟲症、肋間神經痛、胃潰瘍、胃炎、胃腸神經官能症、附件炎、輸卵管阻塞、急性乳腺炎等屬肝膽氣鬱,肝脾(或膽胃)不和者。)
【用法】:水煎服。
【禁忌】:斟酌。
【附方】:柴胡疏肝散(《證治准紀》引《醫學統旨》方)、枳實芍藥散(《金匱要略》)
【方解】:四逆者,乃手足不溫也。其證緣於外邪傳經入裏,氣機為之鬱遏,不得疏泄,導致陽氣內郁,不能達於四末,而見手足不溫。此種“四逆”與陽衰陰盛的四肢厥逆有本質區別。正如李中梓雲:“此證雖雲四逆,必不甚冷,或指頭微溫,或脈不沉微,乃陰中涵陽之證,惟氣不宣通,是為逆冷。”故治宜透邪解鬱,調暢氣機為法。方中取柴胡入肝膽經,升發陽氣,疏肝解鬱,透邪外出,為君藥。白芍斂陰養血柔肝為臣,與柴胡合用,以補養肝血,條達肝氣,可使柴胡升散而無耗傷陰血之弊。佐以枳實理氣解鬱,泄熱破結,與柴胡為伍,一升一降,加強舒暢氣機之功,並奏升清降濁之效;與白芍相配,又能理氣和血,使氣血調和。使以甘草,調和諸藥,益脾和中。綜合四藥,共奏透邪解鬱,疏肝理脾之效,使邪去郁解,氣血調暢,清陽得伸,四逆自愈。原方用白飲(米湯)和服,亦取中氣和則陰陽之氣自相順接之意。由於本方有疏肝理脾之功,所以後世常以本方加減治療肝脾氣鬱所致脅肋脘腹疼痛諸症。
【化裁】:若咳者,加五味子、幹姜以溫肺散寒止咳;悸者,加桂枝以溫心陽;小便不利者,加茯苓以利小便;腹中痛者,加炮附子以散裏寒;泄利下重者,加薤白以通陽散結;氣鬱甚者,加香附、郁金以理氣解鬱;有熱者,加桅子以清內熱。
【附注】:本方原治陽鬱厥逆證,後世多用作疏肝理脾的基礎方。臨床應用以手足不溫,或脅肋、脘腹疼痛,脈弦為辨證要點。
     
     方劑比較:
      本方與小柴胡湯同為和解劑,同用柴胡、甘草。但小柴胡湯用柴胡配黃芩,解表清熱作用較強;四逆散則柴胡配枳實,升清降濁,疏肝理脾作用較著。故小柴胡湯為和解少陽的代表方,四逆散則為調和肝脾的基礎方。
【文獻】:方論 吳謙,等《醫宗金鑒·訂正仲景全書·傷寒論注》卷7錄李中梓:“按少陰用藥,有陰陽之分。如陰寒而四逆者,非薑、附不能療。此證雖雲四逆,必不甚冷,或指頭微溫,或脈不沉微,乃陰中涵陽之證,惟氣不宣通,是為逆冷。故以柴胡涼表,芍藥清中。此本肝膽之劑而少陰用之者,為水木同源也。以枳實利七沖之門,以甘草和三焦之氣,氣機宣通,而四逆可痊矣。”
     
     《傷寒論·辨少陰病脈證並治》:“少陰病,四逆,其人或咳,或悸,或小便不利,或腹中痛,或泄利下重者,四逆散主之。”

si ni tang 四逆湯
Application: cardiac exhaustion. It can improve the contraction of the heart muscles and improve the peripheral circulation. It did not show any obvious side effect when used with proper diagnosis.
Composition: gan jiang 12 g, zhi gan cao 7.5 g, fu zi  12 to 19 g.
Soak fu zi in water until thoroughly wet then add gan jiang and zhi gan cao and simmer another half hour. Drink while warm.
Note: fu zi is cardiac stimulant.  Boiling it for long time will reduce its toxicity but also will lessen its effectiveness.
Combining this formula with tao hong si wu tang with niu xu, jie geng becomes xue fu zhu yu tang.
Caution: Use care in case of pregnancy.
 【方名】 四逆湯
  功能與主治:
急性熱病,體溫低落,脈搏沉微,手足厥冷,身體疼痛,下痢
清穀及霍亂吐瀉,或大汗出,心臟猝衰者。 用附子以回陽逐寒,
鼓舞身體陽氣,增強機體生命活動力。
四逆湯可增加心收縮力及心率,並擴張週邊血管,如對癥用藥無明顯副作用。
  處方: 乾薑三錢﹐炙甘 草二錢﹐附子三錢至五錢
  先將附子浸透,加其餘藥物,煎30分鐘。溫服。
  註:附子有强心作用。久煎可降低其毒性,但是也降低其藥力。本方合桃紅四物湯加懷牛膝,桔梗 而成  血府逐瘀湯 
  注意: 孕婦慎用。