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, September 26, 2012

chai hu jia long gu mu li tang 柴胡加龍骨牡蠣湯

Application: vertigo; sensation of fullness in the below the heart area, mainly in the abdomen and especially above the navel area where it pulsates, sensation of heaviness in the entire body; difficult to rotate trunk; habitual insomnia; difficulty in urination; mild constipation; irritability; delirious speech; palpitation; nervousness in children; mental instability; hysteria; startles easily; night terror. Tongue is usually red with a slippery coating. Pulse is usually tight and rapid.
Name of Formula: chai hu jia long gu mu li tang (Shang Han Lun)
Composition:
long gu  9 g , chai hu   6 g, sheng jiang 3 slices, mu li   9 g, da huang   3 g, hong zao  3 pieces (remove of seeds) , fu ling  9 g, gui zhi    9 g, ren shen 9 g, huang qin  6 g.
For Generalized Anxiety Disorder
Formula: chai hu jia long gu mu li tang with adjustments
long gu  30 g , mu li   30 g, zhen zhu mu 30 g, chai hu  10 g, sheng jiang 3 slices, fu xiao mai 30 g,  gan cao 10 g, da huang   10 g, da zao  5 pieces (remove seeds) , fu ling  9 g, gui zhi 10 g, ren shen 9 g, huang qin  10 g. jiang ban xia 10 g, suan zao ren 10 g.
Adjustments:
1. with phegm heat﹕add dan nan xin, zhu ru, or tian zhu huang
2. liver heat high﹕add long dan cao, zhi zi
3. yinxu (yin deficient) with heat﹕remove gui zhi, add zhi mu, huang bai.
4. liver and stomach yinxu (yin deficient) : remove  gui zhi, and  sha shen, mai dong.
5. chronic sickness with qixu (qi deficient)   : add dang shen 10g.
30 doses is one therapy period. Total therapy periods is 3 months.

方名﹕ 柴胡加龍骨牡蠣湯 (傷寒論)
(傷寒論)原用於治療傷寒誤 下,邪熱内陷﹐表里俱病﹐煩驚谵语等症。
功用﹕和 解內外,鎮靜安神。
主治﹕眩 暈, 心下部脹滿,多 在腹部尤其是臍上有動悸,失眠,心神不寧,煩悶憂鬱,易驚恐,焦燥易怒,情緒無常,甚至呈現狂亂、痙攣等症狀;又身體易疲勞,一身極重,致不能轉側而動作 不靈活,並伴有尿不利﹐尿量減少與便秘傾向者,亦適用之。舌紅苔滑。脈相一般弦數。
適用症﹕
神經衰弱症、癲癇、神經質失眠、更年期障礙、神經性心悸亢進症、神經性陰萎、動脈硬化症、高血壓、腦出血、心 臟瓣膜症、狹心症、慢性腎炎、萎縮腎、水腫、尿毒症、腳氣、半身不遂、中暑、肩胛痠痛症、肝硬變症、禿頭症。
現有臨床上用此方治療失眠﹐心悸﹐耳鸣﹐眩晕﹐唇颤﹐手麻不用﹐癫痫﹐廣 泛性焦慮症等 疑難雜症療效顯著。
組成﹕
龍 骨  9 克 , 柴胡  6 克,  生 薑 三片, 牡蠣  9 克 , 大 黃  3 克,  紅 棗 三 枚(去 核) , 茯苓 9 克, 桂 枝 9 克 , 人參 9 克, 黃芩 6 克
廣泛性焦慮症﹕
{辨別} 
大柴胡湯(肝鬱,寒熱症,心下急,鬱鬱微煩,神經症狀輕微) 
苓桂朮甘湯(癇症,心下悸,胃內停水,脈沉) 
苓桂甘棗湯(癇症,臍下悸,脈沉數) 
抑肝散加陳皮半夏(癇症,腹動,神經症狀,左臍傍大動悸,虛證) 
柴胡薑桂湯(肝鬱,腹動,虛證) 
甘麥大棗湯(狂症,急迫,騷狂,神經症狀甚,腹肌拘急) 
桂枝加龍骨牡蠣湯(精神神經症狀與柴胡加龍骨牡蠣湯相同,但體質虛弱,過勞的人,無胸脅苦滿)
柴胡加龍骨牡蠣湯加減
組成:
龍骨  30 克 (先煎) , 牡蠣  30 克 (先煎), 珍珠母 30 克 (先煎), 柴胡  10 克,  生 薑  三片,  浮 小 麥 30 克﹐甘 草 10g,大 黃   10 克,  大 棗 5 枚(去 核) , 茯苓 9 克, 桂枝  10 克 , 人參 9 克, 黃芩  10 克﹐ 姜半 夏 10 g﹐熟 酸 棗 仁10g。
加减:
1. 夾痰熱者 ﹕加 胆南 星、竹 茹或天竺黄;
2. 肝火熾盛﹕加 龍 膽草、梔 子;
3. 陰虛火旺者﹕去 桂枝, 加 知母、黃 柏;
4. 肝胃陰 虛﹕去 桂枝, 加 沙參、麥 冬;
5. 久病氣 虛者﹕加 黨參10g。
30劑為1療程。總療程為3個月。
本组服完3個 療程的共63例,2個療 程的共9例。其中8例因服完3個療 程病情不穩定,仍用本方加减隔日服1劑,共15 劑。症状基本控制稳定,後均改服逍遥丸(濃縮丸,每次8粒,3次/日)3个月,其中8例病人服完6个月, 以資鞏固。 對安定類依赖及失眠交嚴重的患者,仍给予原劑量减半治療。

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