Experience of WANG Baoliang in Treating Multiple System Atrophy by Stages

CHEN Yuanpeng; MA Xiaohong; YUAN Zhaoyu; GUAN Yunxiang; WANG Baoliang

doi:10.16295/j.cnki.0257-358x.2023.10.017

Abstract：Multiple system atrophy(MSA)is a series of neurodegenerative diseases with unknown causes,and there is no specific treatment by western medicine.Professor WANG Baoliang holds that MSA is of deficient root and excessive branch.The root involves deficiency of zang-fu organs,while the branch involves wind stirring,phlegm and stasis and damp heat.MSA usually manifests as deficiency of qi,blood,yin and yang.He holds that MSA should be treated according to the stages.In the early stage,wind phlegm and stasis heat are the primary disease mechanism,mainly involving shaoyang,unsmooth movement of gallbladder qi,phlegm and stasis blocking collaterals,liver wind stirring up internally,and therefore harmonizing shaoyang,and unblocking triple energizer should be applied,usually with Chaihu Jia Longgu Muli Decoc-tion(柴胡加龙骨牡蛎汤)being applied.In the middle stage,yin(blood)fluids deficiency is the primary disease mechanism,mainly involving liver and kidney,accumulation of phlegm and stasis,injury of yin for a long time,malnutrition of muscle and vessels,up stirring of liver yang,and generation of internal wind,and therefore the treatment should be nourishing yin and supplementing essence,tonifying blood and activating blood,with Zhengan Xifeng Decoction(镇肝熄风汤)plus Guilu Erxianjiao Decoction(龟鹿二仙胶)with modification being applied;in the late stage,yin damage affects yin,resulting into deficiency of both yin and yang,mainly involving spleen and kidney,deficiency of healthy qi and accumulation of damages,deficiency of kidney essence leading to insufficient generation of yang qi,with deficiency of spleen and stomach leading to insufficient generation of tendons,bones and muscles,and insufficient body and weakness of muscle,and therefore invigorating spleen and tonifying kidney,warming yang and benefiting qi should be applied,with Buzhong Yiqi Decoction(补中益气汤)or Dihuang Yinzi(地黄饮子)with modification being applied.