Diagnostic basis for progressive peroneal muscle atrophy

(1) Adolescents, progressive distal lower limb muscle atrophy with insidious onset, with atrophy ranging from The lower 1/3 of the thigh is limited, showing a typical "crane leg".

(2) The disease progresses slowly, and even if there is obvious muscle atrophy, you can still walk and work with appropriate intensity.

(3) Muscle atrophy accompanied by cavus foot and loss of tendon reflexes,

(4) With or without peripheral sensory impairment and distal skin dystrophy.

(5) Electromyography shows denervation and motor conduction velocity is prolonged.

(6) Pathology shows onion skin-like changes in peripheral nerves.

(7) Family history.

Diet therapy for muscular atrophy

This therapy is beneficial to the treatment of muscular atrophy:

(1) Composition: 1 sheep spine, 30 grams of Cistanche deserticola, green onions 3 stems, 3 grass fruits, 6 grams of long pepper.

Method: Wash the lamb spine, pound it into pieces, and boil it with Cistanche deserticola, grass nuts, and peppercorns to make a juice. Then add green onion, take the juice soup and an appropriate amount of flour to make a soup. You can add appropriate amount of refined salt or sugar to taste.

Indications: Liver and kidney deficiency syndrome.

(2) Modified Ermiao Powder

Main components: Cortex Phellodendron, Atractylodes Rhizoma, Fangji, Angelicae Sinensis, Achyranthes Achyranthes, Turtle Ban.

Clinical syndrome modification: If dampness is excessive, accompanied by chest and epigastrium tightness, and heavy and swollen limbs, Magnolia officinalis, Coix seed, Poria cocos, and Alisma can be added; during the long summer rainy season, Agastache rugosa, Agastache rugata, and Agastache can be added. Peilan; if the body is emaciated, the shins are hot, upset, and the tongue is red and peeling, the heat is very harmful to the yin. Remove the Atractylodes above and add Rehmannia glutinosa and Ophiopogon japonicus. If the limbs are numb and the joint movement is unfavorable, add red peony root, salvia miltiorrhiza, peach kernel, and safflower. .

Note: ① This syndrome is caused by immersion in dampness and heat. Do not rush to replenish it to avoid adding dampness. ② To remove dampness, use pungent, warm, bitter and dry products with caution to avoid damaging yin.

(3) Composition: 500 grams of sea cucumber, 30 grams of cooked rehmannia, 30 grams of yam, 15 grams of cornus, 120 grams of lean pork fat, 250 grams of cabbage heart, 25 grams of Shaoxing wine, 50 grams of garlic sprouts grams, 40 grams of watercress, 50 grams of soy sauce, 5 grams of wet starch, 2 grams of salt, 2 grams of MSG, and 5 grams of sugar.

Method: Dry the rehmannia glutinosa, yam, and cornus and grind them into powder. Wash the sea cucumber and cut it into axe-shaped slices; wash the fat and lean meat and cut it into pieces; chop the watercress into fine pieces; wash the garlic sprouts and cut them into small sections; wash the cabbage heart. Place the casserole on a high fire, add 250 grams of water, 0.5 grams of sea cucumber, Shaoxing wine, and refined salt. After boiling, simmer for a short time, then pour out the soup in the pot; repeat the above method and simmer 2 to 3 times. Add 50 grams of cooked lard to the pot, and when it is cooked, add pork, Shaoxing wine, and 0.5 grams of salt. Stir-fry the meat until it is loose, and put it on a plate. Add 50 grams of cooked lard into the pot. When it is cooked for 5 seconds, add cabbage heart, Shaoxing wine and 0.5 grams of salt. Stir-fry until the cabbage is just removed and then put it on the plate. Add 50 grams of lard, add watercress and stir-fry. When the oil turns red, add clear soup and concoction, bring to a boil, remove the bean paste, then add sea cucumber slices and meat cubes, add Shaoxing wine, soy sauce, monosodium glutamate, and garlic sprouts and cook until the juice is bright, add wet starch and thin sauce, and finally Place cabbage hearts on top and serve.

Indications: Liver and kidney deficiency syndrome.

Symptoms and clinical manifestations of muscle atrophy

1. Neurogenic muscle atrophy: caused by lower motor neurons and their damage. When the anterior horn cells and brainstem motor nuclei are damaged, muscle atrophy is segmentally distributed, more common in the distal limbs, symmetrical or asymmetrical, without sensory impairment, often with fasciculations, muscle strength and tendon reflexes impaired. related to the degree. Electromyography shows muscle fiber tremor potential or high-amplitude motor unit potential. Biopsy showed muscle atrophy and thinning. Fascicular atrophy changes were seen under the microscope. {Clinical manifestations and symptoms of muscle atrophy}

2. Myogenic atrophy: caused by the disease of the muscle itself. The atrophy does not follow the distribution of nerves. It is often symmetrical muscle atrophy of the pelvic girdle and shoulder girdle of the proximal type, and a few are of the distal type. Accompanied by muscle weakness, without myofibrillar tremors and sensory impairment. Serum creatine phosphokinase, lactate dehydrogenase, aspartate aminotransferase, phosphoglucomutase, aldolase, etc. were all increased to varying degrees, and muscle phosphokinase was the most sensitive. The characteristic change in electromyography is the occurrence of short-duration polyphasic potentials. {Clinical manifestations and symptoms of muscle atrophy}

3. Others: Central muscle atrophy is usually accompanied by hyperreflexia or pathological reflexes. Ischemic muscle atrophy is mostly caused by muscle ischemia and aseptic necrosis such as arteritis and thrombosis. Disuse muscle atrophy is related to long-term inactivity. And most of them are reversible.

Muscle atrophy must be distinguished from six diseases:

Muscle atrophy is an acquired and pathological decrease in muscle volume, which is a pathological state in the disease process. Therefore, any reduction in the volume of the limbs is not a sign of muscle atrophy. Clinically, it often needs to be distinguished from the following six conditions. (1) Weight loss: Weight loss refers to a loss of more than 10% of normal body weight, and is often characterized by rough skin, reduced elasticity, slender muscles, and reduced subcutaneous fat, resulting in the appearance of bone shapes. Wasting is generally divided into two categories. 1. Constitutional weight loss is related to genetic predisposition and individual physiological characteristics. It is non-progressive and can be considered physiological. 2. Disease-induced weight loss is caused by related diseases.

(2) Pseudomuscle atrophy: refers to the reduction of muscle volume but no corresponding decrease in muscle strength but relatively maintained. Microscopically, the muscle fibers showed no other structural damage except their slender shape.

Mainly seen in severe weight loss, cachexia, lipodystrophy, etc.

(3) Progressive lipodystrophy (or lipodystrophy syndrome). Mainly distributed on the face, neck, shoulders, trunk and limbs. The main manifestation is local (often patchy) collapse of the limbs, generally ranging from a few square centimeters to dozens of square centimeters, with no change in skin color and normal feeling. The collapsed area does not conform to the anatomical distribution of nerve distribution and muscle groups. Some patients are accompanied by autonomic nervous system dysfunction, such as vasogenic headache, tachycardia, and hyperhidrosis.

(4) Lipoatrophic diabetes: Type 1 diabetes is more common in young children, more common in women, or with a family history. It manifests as systemic fat atrophy and regression, often accompanied by xanthomas and hyperlipidemia.

(5) Congenital muscle deficiency: (1) It is due to abnormal intrauterine development. (2) The muscle loss is usually limited to part or one limb. Occasionally, it is also seen in eye movement muscles, facial muscles, sternocleidomastoid muscle, trapezius muscle, pectoralis major, pectoralis minor, serratus anterior, semimembranosus, latissimus dorsi, deltoid, quadriceps and some other muscles. Abdominal muscles etc. (3) Non-progressive, but also irreversible; the lost muscle status remains unchanged. Except for the involvement of a few important parts (such as the diaphragm), the prognosis is generally good.

(6) Gower's generalized atrophy syndrome: The cause is unknown. The main pathological change is atrophy of all layers of skin (epidermis, dermis, subcutaneous tissue). It is more common in women and usually starts between the ages of 10 and 40. .