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PubMed2006

[A multi-centeric epidemiological survey on TCM syndrome in 1016 patients with IgA nephropathy and analysis of its relevant factors].

OBJECTIVE: To investigate the distribution pattern of TCM syndrome in patients with IgA nephropathy and its relationship with the main clinical prognostic indexes to provide a basis for the standardization of integrative medicine in diagnosis and treatment of IgA nephropathy. METHODS: Multi-centeric epidemiological field survey was adopted to collect the materials of 1016 IgA nephropathic patients, including demography, TCM syndrome and laboratory findings, for exploring the distribution pattern of TCM syndrome of IgA nephropathy patients. RESULTS: Probability of over 10% could be found in the TCM syndromes as yin deficiency, qi deficiency, yang deficiency, damp-heat and blood stasis syndrome, the highest (41.5%) was found in qi-yin deficiency syndrome and the lowest (8.1%) in yang deficiency of Pi and Shen. Along with the increasing of age, the percentage of patients with Pi-Fei qi asthenia syndrome descended while those with Pi-Shen yang asthenia ascended. In the accompanying syndromes, damp-heat syndrome and blood stasis syndrome, with the proportion of 32.6% and 28.9% respectively, were the most frequently encountered. The levels of 24 h urinary protein, serum creatinine and urea nitrogen in patients with Pi-Fei qi asthenia syndrome, qi-yin deficiency syndrome and Gan-Shen yin asthenia syndrome were significantly lower than those in patients with Pi-Shen yang asthenia syndrome, respectively (P < 0.05), while the blood pressure in patients with Pi-Fei qi asthenia syndrome, and qi-yin deficiency syndrome were significantly lower than that in patients with Gan-Shen yin asthenia syndrome and Pi-Shen yang asthenia syndrome (P<0.01). CONCLUSION: Qi-asthenia and yin deficiency is the principal clinical manifestation of IgA nephropathy. TCM syndrome types are closely related with the prognostic indexes as urine protein, hypertension, renal lesion, etc.

Adolescent↗
PubMed1988

[Torpid schizophrenia with a predominance of asthenic disorders].

The article deals with the typology of asthenic disturbances that determine for a long time the clinical picture of slowly progressive schizophrenia. Two types of asthenia (extensive and limited) have been identified as a result. With regard to clinical peculiarities these manifestations can be collated respectively with "pseudoneurasthenia" and "autochtonous asthenia". The author has analyzed the dynamics of these variants of the asthenic symptom complex to which, with the progression of the process, disturbances of the non-delirious hypochondria type are added. The author has established the relationship between clinical features of asthenia and the degree of progression of the process and a differing structure of negative changes formed at late stages of the disease. The first type (extensive asthenia) is observed in the framework of slowly progressive neurosis-like schizophrenia with manifestations of a moderate asthenic defect. The second type (limited asthenia) is noted in psychopathy-like slowly progressive schizophrenia associated with signs of greater progression and psychopathy-like changes of the "verschoben-type" with intellectual reduction.

Adult↗
PubMed2000

Modalities of fatigue in multiple sclerosis: correlation with clinical and biological factors.

Although different factors are probably involved in the etiology of fatigue in multiple sclerosis patients, no definite mechanism has been proposed. We have proposed that fatigue is a complex symptom that includes three clinical different entities (asthenia, fatigability and worsening of symptoms with effort). The goal of this study is to demonstrate if there is a peculiar mechanism for each of the different varieties of fatigue. A control sample of 155 patients (105 women, 50 men) with clinically definite MS was studied. Fatigue was measured using the Fatigue Descriptive Scale (FDS) and the Fatigue Severity Scale (FSS). Treatment, depression, anxiety, sleep and cellular immune status were studied too. Fatigue was a symptom in 118 patients (76.13%); 26 patients (22.03%) described it as asthenia (fatigue at rest); 85 patients (72.03%) as fatigability (fatigue with exercise), and seven patients (5.9%) as worsening of symptoms. The severity of pyramidal involvement was significantly more severe in patients suffering from fatigue; some immunological parameters were associated with fatigue as well. The discriminant analysis of the data shows that some of the immunoactivation parameters are associated with asthenia (F=21.5, P<0.001), and pyramidal tract involvement is associated with fatigability (F=10.5, P<0.001). Sleep disorders, anxiety and depression were linked with fatigue in a few patients. No relationship with treatment was proven. In conclusion, fatigue in MS seems to be a heterogeneous entity. Asthenia and fatigability may be different clinical entities. Certain immunoactivation parameters correlate with the presence of asthenia while pyramidal involvement is associated with fatigability.

Adolescent↗
PubMed2005

[Epidemic survey on TCM syndrome typing and preliminary discussion on TCM etiology and pathogenesis of fatty liver].

OBJECTIVE: To investigate the common TCM syndrome types of fatty liver by way of epidemic questionnaire, their occurrence ratio, and the correlation between various syndrome types and objective indexes. METHODS: A total of national wide 503 subjects with fatty liver were enrolled, the TCM syndromes, body mass index (BMI), abdominal perimeter/hip circumference, liver function, blood lipids, B ultrasonic examination and CT in them were observed and recorded. RESULTS: In the 46 symptoms investigated in total, the first ten symptoms in order of appearing rate were lassitude, obese, oral dryness, vertigo, hypochondriac distending pain, soreness and pain in loin, spiritlessness, oral bitterness, aching and weakness in knee and abdominal distention. The mostly appeared tongue figures were pale and corpulent or pale dim tongue proper, white greasy or yellow greasy tongue coating, and the mostly appeared pulse figures were taut, taut-thin and taut slippery. Statistical cluster analysis showed that syndromes of fatty liver could be typed into 4 TCM types, the asthenia Pi-Shen with Gan-stagnation type, the asthenia Pi-Shen type, the asthenia Pi with phlegm-heat type and the unclassified type. Among them the asthenia Pi-Shen with Gan-stagnation type was the commonest one, which accounted to 62.32%. CONCLUSION: The mostly appeared syndrome type of fatty liver was asthenia Pi-Shen with Gan-stagnation type. The TCM pathogenesis of fatty liver was deficiency of origin, mainly deficiency of Shen, involving Pi, with excess superficiality, the turbid-phlegm and blood stasis.

Adolescent↗
PubMed1989

[Classification of asthenic conditions (reactions, phases) in psychopathy].

Analysis of asthenic reactions and phases that occur periodically in persons suffering from psychopathies of the sthemic pole (33 cases) has demonstrated that the structure of the syndrome is determined by the combination of the two signs: phenomena of irritative weakness and symptomatology of the somatopsychic circle. Two types of asthenic conditions were distinguished: conversion and psychovegetative asthenia. As to the first type, the asthenic manifestations proper were of the demonstrative-exaggerated character, whereas somatopsychic disorders occurred in accordance with the hysterical conversion mechanism. Consequently, the structure of the syndrome is marked by the predominance of characteristic abnormalities in the sphere of somatopsychics (bodily hysterical stigmas, with the intensity of ergic disorders being minimum). As to the second type, asthenia was marked by relatively uniform ergic and somatopsychic manifestations. The latter ones (algias, sleep disturbances, "pseudosomatic" crises) as if masked asthenia proper. The typological differentiation of asthenic disorders provided here is adequate to the nature of the constitutional proneness as a system of factors that determine the clinical differences. Conversion asthenia occurs preferably in persons of the histrionic and excitable mould whereas psychovegetative asthenia in persons showing the predominance of anancastic and expansive schizoid traits.

Adult↗
PubMed1984

[Clinical features of asthenic conditions in young persons].

On the basis of examining 293 young patients (predominantly individuals with intelectual occupations) with asthenia the authors have established the clinical characteristics of asthenic states of various genesis. Psychogenic asthenias, asthenias in patients with a history of a craniocerebral injury and so-called adaptation asthenias are described in greater detail. The data obtained are important for the diagnosis, treatment and prophylaxis of the asthenic syndrome of variable genesis.

Adaptation, Psychological↗
PubMed1999

Pharmacologic and therapeutic features of sulbutiamine.

Asthenia is the most frequent medical reason for people seeking help from their physician. In 75% of cases, the cause is functional (either reactive or psychiatric) and in 25% it is organic. In order to provide patients with rapid relief of symptoms, appropriate antiasthenic treatment should be initiated immediately, while at the same time, adequate clinical and laboratory assessments should be performed to detect the underlying cause of asthenia. Sulbutiamine, a highly lipophilic thiamine derivative, is the only antiasthenic compound known to cross the blood-brain barrier and to be selectively active on specific brain structures directly involved in asthenia. This article reviews the current knowledge on the effects of sulbutiamine in animal models and in various forms of human asthenia.

Journal Article↗
PubMed1991

[Relation between chronic hepatitis and cirrhosis in the type of differentiation of symptoms and signs and endocrine hormone].

In order to investigate the objective index of the type of differentiation of symptoms and signs between chronic hepatitis and cirrhosis, the levels of serum Tes, ALD, HCT, INS, GR, gastrin, T3, T4, TSH were tested in the chronic hepatitis and cirrhosis of 27 cases of sthenia-syndrome and 61 cases of asthenia-syndrome. Meanwhile, 30 cases of healthy people were taken as the control. The results indicated that the levels of serum Tes, T3, T4, gastrin in the group of asthenia-syndrome (P less than 0.01, P less than 0.05). The levels of serum T4 and gastrin were increased in the group of sthenia-syndrome than in the groups of asthenia-syndrome and control (P less than 0.01). The levels of serum ALT, HCT, INS, and GR were significantly different between the group of asthenia-syndrome and that of sthenia-syndrome. This suggests that clinic symptoms were concerned with the level of serum endocrine on chronic hepatitis and cirrhosis, such as the function of genital, thyroid, adrenal gland and pancrease. The observation of the levels of serum Tes, T3, T4, ALT, INS, GR and gastrin may be an objective index to differentiate the chronic hepatitis and cirrhosis.

Adult↗
PubMed1989

Observations on clinical therapeutic effect in treating soft tissue injuries by acupuncture, with pain threshold and electromyography as parameters.

360 observations were made on 120 cases of soft tissue injury divided into groups. 1. Among the 100 patients in the acupuncture treatment group, 300 observations were made; among the 20 controls there were 60 observations. The effective rate in the acupuncture treatment group was 85.00%; in the control group it was 41.67%, a very significant difference (P less than 0.01). 2. Relationship between therapeutic course and effect. The effective rate for the first course was 74.00%; it was 90.50% when more than two courses were given, a very significant difference (P less than 0.01) indicating the marked effect of acupuncture treatment. 3. Based on the therapeutic theory of TCM syndrome differentiation and reinforcement method in the asthenia state, and reducing method in asthenia state, different manipulations were used for asthenia-heat and asthenia-cold types with good clinical results. There was no significant difference (P greater than 0.05) between the effective rate in these two types, pointing up the significance of the TCM syndrome differentiation theory in clinical acupuncture. 4. There was very significant difference (P less than 0.01) in the degree of pressed pain on the patient's tender spot before and after acupuncture treatment, also (P less than 0.01 and P less than 0.001 respectively) in the EMG amplitude on the affected side of the lumbar area before and after acupuncture treatment during light and heavy force in extension action of back muscles. Acupuncture treatment on soft tissue disease based on TCM syndrome differentiation theory is thus shown to be effective.

Acupuncture Therapy↗
PubMed2005

Muscle damage induced by black cohosh (Cimicifuga racemosa).

Extracts of black cohosh (Cimicifuga racemosa) are commonly used for the treatment of symptoms associated with menopause. Adverse events with black cohosh are rare, mild and reversible. A few number of serious adverse events, including hepatic and circulatory conditions, have been also reported, but without a clear causality relationship. We report the case of a woman with severe asthenia and very high blood levels of creatine phosphokinase and lactate dehydrogenase. The patient referred to take a dietary supplement derived from black cohosh for ameliorating menopause vasomotor symptoms. To exclude a possible involvement of this product, the patient was suggested to discontinue this therapy. After suspicion the patient showed a progressive normalization of biochemical parameters and improvement of clinical symptoms. We can hypothesise a causative role for black cohosh in the muscle damage observed in this patient. Factors suggesting an association between black cohosh and the observed myopathy included the temporal relationship between use of herbal product and asthenia and the absence of other identified causative factors. Rechallenge with the suspected agent was inadvisable for ethic reasons because of the risk of a serious relapse. This is the first time that asthenia associated with high muscle enzymes serum levels by black cohosh has been reported. In our opinion, this report is of interest because of the widespread diffusion of use of black cohosh as an alternative medicine for relief from menopausal symptoms.

Asthenia↗
PubMed1996

The rise and fall of the chronic fatigue syndrome as defined by Holmes et al.

This paper is a sequel to my monograph on neurocirculatory asthenia and chronic fatigue syndrome. It pays special attention to the nature of chronic fatigue syndrome, to the forms of neurocirculatory asthenia, and above all to the 6th form in which profound fatigue is the dominant symptom. All forms including the 6th are characterized by the presence of concomitant symptoms due to dysfunction of the autonomic nervous system. Chronic fatigue syndrome as defined by Holmes et al is devoid of these symptoms. Up till the present day no case histories of it have been published. It is argued that chronic fatigue syndrome sensu Holmes et al does not exist, the 6th form of neurocirculatory asthenia having to take up its place.

Diagnosis, Differential↗
PubMed1992

[Psychosomatic disorders in patients with neurocirculatory dystonia and their correction in the day hospital].

Clinical and psychological tests were used to examine 77, 31 and 32 patients with normotonic, hypertonic and hypotonic neurocirculatory asthenia, respectively. Compared to control subjects, 80% of the patients responded to stress with psychic and social dysadaptation (psychic asthenia, frustration, emotional lability, hypothymism) as well as depression with visceral manifestations: cardialgia, extrasystole, lability of arterial pressure. Chemotherapy, physical and psychological treatment in day hospital produced a response in 89.2% of neurocirculatory asthenia sufferers.

Adult↗
PubMed1990

[Type 6 human herpes virus and chronic asthenic syndrome].

Chronic asthenia syndrome has been associated with Epstein-Barr virus (EBV). To investigate the possible role in this syndrome of human herpesvirus type 6 (HHV-6), a new herpesvirus discovered in 1986, we performed a serological study of 44 patients diagnosed of chronic asthenia syndrome and 50 controls. Fifty healthy controls (34%) and 44 patients (54.5%) had positive serological tests for HHV-6. This difference was significant (p less than 0.05). The rate of positive serological studies for CMV and EBV was higher in healthy controls (n = 50) than in patients (n = 37) (96% vs 67.7% for CMV [p less than 0.001] and 92% vs 78.4% for EBV [non significant difference]). We conclude that HHV-6 may play a role in the pathogenesis of chronic asthenia syndrome. In our group of patients there were no significant differences in the presence of anti EBV capsid antibodies.

Antibodies, Viral↗
PubMed1990

Asthenic symptoms in a rural family practice. Epidemiologic characteristics and a proposed classification.

Asthenic symptoms (eg, fatigue, lassitude, weakness) are of major concern in family practice setting, yet relatively little research has addressed this issue. A retrospective chart review over a 10-year period was conducted to better characterize these symptoms in a rural family practice providing health care to 508 adult patients. Asthenic complaints were recorded at least once in the medical charts of 164 patients (32%) with a preponderance of female patients. Peak prevalence occurred in the third decade of age and during the summer months. Associated symptoms, mainly pain and dizziness, were reported in 75% of the cases. A cause or diagnosis was not identified by the practicing physician in nearly 50% of the encounters; nevertheless, most episodes resolved spontaneously. Patients could be subclassified into three categories according to the recurrence pattern of their asthenic symptoms during the study period. The largest category (64%) included patients who had a single or two episodes and was thus termed "episodic asthenia." Forty-five patients (27%) with recurrent episodes (mean 4.4, range 3 to 10) were classified as having "recurrent episodic asthenia." A third small group (14 patients, 9%) with persistent complaints over the years but no evidence of the chronic fatigue syndrome were classified as having "chronic persistent asthenia." The proposed classification may help future research of asthenic symptoms in the family practice setting.

Adult↗
PubMed1995

[The prediction of asthenic states in persons working under conditions of partial sensory isolation].

Work in partial sensory isolation (buildings without windows and illumination) induces marked asthenia. Data obtained by questionnaires and intentional medical examination helped to define risk ranges for the asthenia occurrence. The group of unfavorable outcome appeared to include operators aged 20-39, white-collar workers aged 30-39 and 40-49, packers (age range of 30-39). The asthenia together with other occupational factors reliably influences the level of morbidity with transitory disablement due to allergic diseases, cardiovascular illnesses, malignancies (the shares of the influence and 25.3%, 27.0%, 23.1% respectively).

Adult↗
PubMed1997

[Experience in treating patients with cardiovascular diseases by means of adaptation to periodic barochamber hypoxia].

Adaptation to periodic hypoxia (decompression 490 mm Hg) in a multiplace medical pressure chamber of patients with hypertension, cardial neurocirculatory asthenia, coronary heart disease produced a persistent hypotensive effect with improvement of central and peripheral hemodynamics, oxygen homeostasis, electrolyte balance of blood. In patients with neurocirculatory asthenia associated with ventricular and supraventricular extrasystole positive hemodynamic changes accompanied a persistent antiarrhythmic effect. In addition to the latter, CHD patients experienced improvement in myocardial contractility. Clinical effect of baroadaptation to hypoxia manifesting in symptom relief permitted the physicians to diminish the intensity of chemotherapy and to abolish it in patients with neurocirculatory asthenia.

Adaptation, Physiological↗
PubMed1999

Concurrent twice-a-week docetaxel and radiotherapy: a dose escalation trial with immunological toxicity evaluation.

PURPOSE: In vitro studies show that docetaxel (Taxotere) is potent radiosensitizer. In a previous study we observed a 27% complete response rate after radiotherapy and weekly docetaxel for non-small-cell lung cancer. In this dose escalation study we investigated the feasibility of a twice-a-week docetaxel regimen together with conventionally fractionated radiotherapy for brain, chest, and pelvic tumors. METHODS AND MATERIALS: Nine patients with stage IIIb lung cancer, 9 with stage IVa pelvic tumors, and 9 with brain glioblastoma were recruited. The starting dose was 15 mg/m2 (twice a week) and was escalated by 4 mg/m2 increments every 3 patients with chest, pelvic, and brain tumors. RESULTS: The maximum tolerated dose of docetaxel was 15 mg/m2 (twice a week) for chest and pelvic cancer patients. The dose-limiting toxicity (DLT) was asthenia and mucosal toxicity (esophagitis or diarrhea in chest and pelvic tumors, respectively). Patients with glioblastomas received 23 mg/m2 (twice a week) without toxicity. Complete response of the chest disease was observed in 3/9 (33%) patients and partial response in 4/9 (44%). Three patients with glioblastoma had a partial response. In pelvic malignancies a high complete response rate was observed (4/9; 45%). Severe monocytopenia and lymphocytopenia were observed during the fourth week of treatment. IgG and IgA immunoglobulins were also reduced. This coincided with the onset of asthenia and severe mucosal toxicity. Asthenia was absent in patients treated for brain tumors, and lymphocyte toxicity was less pronounced. CONCLUSIONS: Docetaxel radiochemotherapy is a promising therapeutic approach for locally advanced cancer. The recommended dose of docetaxel for chest and pelvic cancer patients is 15 mg/m2 twice a week. Patients with brain tumors can be safely treated with higher doses of docetaxel (23 mg/m2 twice a week) without toxicity. The severe immunologic toxicity observed suggests that granulocyte-macrophage colony-stimulating factor (GM-CSF) and immunoglobulin administration may be important in the efficacy and tolerance of taxane-based radiochemotherapy. Randomized trials are required to assess whether the efficacy of docetaxel radiochemotherapy depends on the frequency of docetaxel administration during radiation treatment.

Adult↗
PubMed2001

Phase I trial of weekly gemcitabine at 3-h infusion in refractory, heavily pretreated advanced solid tumors.

Gemcitabine (2',2'-difluorodeoxycytidine) is a nucleoside analog with antitumor activity against a variety of malignancies. The critical enzyme cytidine kinase is saturated at plasma concentrations achieved after a 30-min infusion at conventional doses. Prolonged infusion time may yield higher intracellular dFdCTP concentrations. A phase I study was designed to determine the maximum tolerated dose (MTD) of gemcitabine, given by infusion for 3 h, in heavily pretreated patients. Twenty-seven patients (13 head and neck cancer, seven sarcoma, three esophageal cancer, three non-small-cell lung cancer and one ovarian cancer) were enrolled. Twenty patients were defined as refractory at first- or second-line chemotherapy. Four different entry dose levels (300, 400, 450 and 500 mg/m(2)) were evaluated for gemcitabine administered on days 1, 8 and 15 of a 28-day cycle. The MTD was defined as 450 mg/m(2), with granulocytopenia, thrombocytopenia and asthenia being dose limiting. The maximum grade III/IV patient toxicities for hemoglobin, leukocytes, neutrophils and platelets for all doses were 7, 19, 19 and 11%, respectively. Non-hematological toxicities included asthenia, nausea/vomiting and diarrhea. Thus, gemcitabine administered at a fixed 3-h infusion was well tolerated up to 450 mg/m(2) in heavily pretreated patients. Myelosupression and asthenia were dose-limiting toxicities.

Adult↗