Syndrome differentiation

In the sections Associated disorders in western medicine, some disease names are mentioned. However, it should be borne in mind that a disease in western medicine may involve more than one syndrome in traditional Chinese medicine. As such, the diseases mentioned here are only intended to help the reader to understand the syndrome and to have some corresponding orientation in western medicine. The principles, methods and strategies introduced in each chapter of this book are abstracted from a large number of formulas, integrating the knowledge of single herbs, herbal combinations, syndrome differentiation, treatment methods and treatment sequence. They are the essential part of this book. 

This book is intended to introduce a new method of creating appropriate formulas according to syndrome differentiation. It is not... 

Composing a formula is a process where several conditions must be fulfilled. First, one must make a clear syndrome differentiation, establish the treatment principles, select treatment methods and figure out the most suitable strategies. One should then follow the model of formula structure, selecting appropriate herbs to play specific roles in the formula and ensuring that treatment strategies are fully expressed. 

Clear and correct syndrome differentiation is very important for selecting a suitable treatment method and creating an effective formula. Detailed differen-... 

Following the treatment principle, which is established in accordance with the syndrome differentiation, a formula can be composed. A formula is neither a group of herbs that treat all symptoms nor a combination that only treats the main syndrome. It has a structure where herbs are organized in order to meet the needs of the treatment. The structure of a formula contains four parts, namely the chief, the deputy, the assistant(s) and the envoy. Each of these has specific functions in the formula. 

Ben is more important than Biao, but the concepts are relative. In syndrome differentiation ... 

For patients who take antidepressants from these last two groups, TCM treatment should be applied according to careful syndrome differentiation, to remove the obstruction, harmonize the Qi and blood, and balance the Yin and Yang in order to prevent and reduce the side effects of the drugs. 

St John s wort and Ginseng are also frequently suggested for treating mild depression. According to syndrome differentiation in TCM, they are only suitable for treating patients who suffer from depression due to deficiency of Qi and Yang. If the patients have a Yin deficiency, internal heat or constrained heat due to stress and anxiety, these herbs may lead to restlessness and insomnia, and may make the condition worse. In this case, a Chinese herbal formula based on syndrome differentiation is more effective than that of using only these herbs. 

Elstner S, Sperling W. Das Carbamazepin-Hypersensitivitats-Syndrome. Differentialdiagnostische Erwagungen an einer exemplarischen FaUvorstellungo. [The carbamazepine hypersensitivity syndrome. Differential diagnosis and a representative case history.] Fortschr Neurol Psychiatr 2000 68(4) 188-92. 

Table 4-K Table 4-L Potential BW Agents by Predominant Clinical Finding or Syndrome Differentiation Among Botulinum, Nerve Agent, and Atropine 4-29 4-30...

Androgens act via the AR and play an important role in the development and differentiation of the male sexual organ. Furthermore, they are involved in several diseases, the most important being partial and complete androgen insensitivity syndrome (AIS formerly known as the testicular feminization syndrome), spinal and bulbar muscle atrophy (SBMA Kennedy s disease), and the neoplastic transformation of the prostate. The two natural occurring androgens are testosterone (T) and the... 

This form of myositis stands apart from the classical PM/DM syndromes on account of its distinctive clinical and histopathological features. There is no clear difference in incidence between males and females and the disorder is typically one of middle or old age. In the majority of cases, progression is slow and skin involvement is not seen, so that the main question of differential diagnosis is its distinction from chronic PM. Unlike classic PM, weakness involves distal muscles as frequently as proximal muscles. CK levels are usually only moderately raised. A common finding which leads to the correct diagnosis of this condition is its nonresponsiveness to steroid treatment or other forms of immunosuppression. 

Myers RD, Melchior CL Differential actions on voluntary alcohol intake of tetra-hydroisoquinolines or a beta-carboline infused chronically in the ventricle of the rat. Pharmacol Biochem Behav 7 381-392, 1977 Naranjo CA, Sellers EM Clinical assessment and pharmacotherapy of the alcohol withdrawal syndrome, in Recent Developments in Alcoholism, Vol 4. Edited hy Galanter M. New York, Plenum, 1986... 

Weber KS, von Hundelshausen P, Clark-Lewis 1, Weber PC, Weber C (1999) Differential immobilization and hierarchical involvement of chemokines in monocyte arrest and transmigration on inflamed endothelium in shear flow. Eur J Immunol 29(2) 700-712 Wesselingh SL, Power C, Glass JD, Tyor WR, McArthur JC, Farber JM, Griffin JW, Griffin DE (1993) Intracerebral cytokine messenger RNA expression in acquired immunodeficiency syndrome dementia. Ann Neurol 33(6) 576-582... 

Differentiate between the pathophysiology of chronic stable angina and acute coronary syndromes. 

Tension-type headache (TTH) is the most common primary headache disorder. It is often underrepresented in clinical practice, as many patients do not present for care.6 The term tension-type headache is used to describe all headache syndromes in which muscle contraction is the most significant factor in the pathogenesis of pain. The 1-year prevalence of TTH in the population ranges from 30% to 90%.6 It is more common in adult females. Environmental factors, as opposed to genetic predisposition, play a more central role in their development. Tension-type headaches can be further divided into episodic or chronic the mean frequency of attacks is 3 days per month in episodic disorders, and chronic TTH is defined as 15 or more attacks in a 1-month period.7 The estimated prevalence of chronic TTH is less than 5%.6 Some researchers believe that chronic TTHs represent a continuum of headache severity with migraine headache.8 When severe headaches are difficult to differentiate clinically, treatment should initially target TTH. 

Differential diagnoses include diabetes mellitus and metabolic syndrome because patients with these conditions share several similar characteristics with Cushing s syndrome patients (e.g., obesity, hypertension, hyperlipidemia, hyperglycemia, and insulin resistance). In women, the presentations of hirsutism, menstrual abnormalities, and insulin resistance are similar to those of polycystic ovary syndrome. Cushing s syndrome can be differentiated from these conditions by identifying the classic signs and symptoms of truncal obesity, "moon faces" with facial plethora, a "buffalo hump" and supraclavicular fat pads, red-purple skin striae, and proximal muscle weakness. 

Initial screening tests to confirm the presence of hypercorti-solism and differentiate Cushing s syndrome from conditions with similar presentations include 24-hour urinary free cortisol determination and overnight low-dose dexam-ethasone suppression test (DST) (Table 42-9). 

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