Dihuang Yinzi, a Classical Chinese Herbal Prescription, for Amyotrophic Lateral Sclerosis

Abstract

Amyotrophic lateral sclerosis (ALS) is a devastating progressive neurodegenerative disease with no effective treatment and death within 2 to 5 years after symptom onset. Here, we reported a case of ALS patient using modified Dihuang Yinzi (DHYZ), a classical traditional Chinese medicine (TCM) prescription, who has survived 12 years with significant improvement in bulbar paralysis.A 41-year-old Chinese Han nationality woman was admitted to the hospital with complaints of weakened bilateral grip, slurred speech, stumbling, and muscle twitching for 3 years. The electromyography showed neurogenic injury in bilateral upper limbs and tongue. She was diagnosed with ALS according to the revised El escorial criteria. The patient was orally administrated with Riluzole 100 mg daily for 10 months and then stopped. Subsequently, she resorted to TCM. Based on the TCM theory, the patient was diagnosed with Yinfei syndrome because of kidney deficiency. DHYZ was chosen because it has the function of replenishing kidney essence to treat Yinfei syndrome. Up to now, she has been using modified DHYZ continuously for 12 years. The patient survived with ALS and did not require permanent continuous ventilator. In addition, the symptoms of choking on liquids are improved, and the utility of 30 mL water swallow test was improved with grade 2. The symptoms of muscle fibrillations of limbs are also reduced. However, muscle strength worsened slowly. The repeated electromyography showed motor conduction amplitude reducing gradually and velocity not changing more when compared with the initial electromyography.Our findings suggested that DHYZ can be potentially used in ALS patients because of its multi-targeted neuroprotection and general safety, although ALS does not have a cure. In addition, we identified the area that is worthy of further study and DHYZ as a promising candidate for further clinical application and ALS trials. Rigorous randomized controlled trials are needed in the future.

Pharmakologische und nicht pharmakologische Symptomtherapie bei amyotropher Lateralsklerose

“…Qiu et al skizzierten den Effekt von Dihuang Yinzi (DHYZ), einem klassischen Rezept der traditionellen chinesischen Medizin (TCM), bei einer Patientin mit bulbärer ALS in einem Fallbericht über 12 Jahre. Die Autoren sahen einen potenziellen Nutzen in dem be schriebenen Fall hinsichtlich Überlebenszeit und Verzögerung der Beatmungspflichtigkeit [35].…”

Complementary and alternative medicine for treating amyotrophic lateral sclerosis: a narrative review

“…In a case report, Qiu et al showed that DHYZ extended the survival and improved symptoms of muscle fibrillation and low muscle strength in a female ALS patient. This result suggested that DHYZ could be helpful for the treatment of ALS patients, and further rigorous randomized controlled trials are needed 50 …”

A Novel Supplement Attenuates Oxidative Stress-Induced TDP-43-Related Pathogenesis in TDP-43-Expressed Cells

“…Herbal medicines, such as the Huolingshengji formula and Jiawei Sijunzi, have been shown to improve neurological and muscle function in patients with ALS [ 16 , 17 ]. In patients with ALS, herbal medicines, such as the Huolingshengji formula and Jiawei Sijunzi, have been shown to improve neurological and muscle functions [ 16 , 17 ]. Chang et al showed that berberine could be a potential therapy as an activator of mTOR-autophagy signals TDP-43-related neuropathology [ 18 ].…”