Academic Thought And Clinical Experience Study Of Professor Shan Zhaowei Treatment Of Chronic Atrophy Gastritis

BackgroundIn China the incidence rate of Chronic atrophy gastritis (CAG) is very high, and the literature reported that the annual cancerous rate is about0.5%to1%and a higher rate with intestinal metaplasia and dysplasia. In order to prevent and treat gastric cancer, the researches generally focus on improving the clinical efficacy of traditional Chinese medicine (TCM) diagnosis and the treatment of CAG.Professor Shan Zhaowei studied under Professor Zhang Zesheng, best heritage of Menghe medical faction over20years, and he is good at a variety of gastrointestinal diseases treatment. Besides, learning from the national TCM expert on Digestion, the Bethune medal winner, Chinese medicine Master Professor Xu Jingfan in1994, he embraced all and studied abundantly. Professor Shan has engaged in digestive disease research over four decades, and he is learned and rich in clinical experience. He specializes in the treatment of various difficult diseases of digestive department and has a unique experience in Chinese medicine diagnosis and treatment on chronic atrophic gastritis and precancerous lesions. The clinical efficacy is good, and Professor Shan is high praised by the majority of patients and peers.ObjectiveThe academic thought, clinical thinking mode and medication experience of Professor Shan's treating CAG are summarized, and the unique feature of Professor Shan's using the theory of Chinese medicine to treat the disease are analyzed. Thus, it will help to promote the inheritance of famous TCM expert clinical experience and academic thought and guide more young and primary physicians, so that more patients benefit. Moreover, it highlights the advantages of Chinese medicine treatment for CAG and improves the clinical efficacy of TCM Treating for CAQ better inheritance and development of the Chinese medicine.MethodThrough the study of the literature of Professor Shan's treatments of CAG, the clinical observation of Professor Shan's treatment on CAG patient, combined with Professor Shan's guide and my reflection on his experience, the etiology and pathogenesis, therapy characteristics, herbal prescription are respectively analyzed, and then his mode of thinking and the experience of medication of CAG are summarized.ResultPart One:Professor Shan Zhaowei's Academic ThoughtProfessor Shan Zhaowei graduated from Nanjing TCM University in1965, studied under Professor Zhang Zesheng of Menghe Medical faction (Ma Peizhi～He Jiheng～Zhang Zesheng-Shan Zhaowei). After completing the rigorous institutional education (19591965) to lay his solid Chinese medicine rationale, he continued to accept traditional apprenticeship education, fully adopted the academic thought of mellow theory, mild prescription, ethereal medication, appropriate simplicity and focusing on syndrome differentiation.Professor Shan believes that syndrome differentiation system of TCM is formed by long-term accumulation of study. To be an excellent TCM doctor, it is a must to study the "Inside Classics","Treatise on Febrile Diseases","Synopsis of the Golden Chamber","Odes of the Nature of the Medicine" and other classics, and to achieve mastery through a comprehensive study of them, including finding out the abnormal condition from normal state. In addition, with advances in technology, the extensive use of modern medical examination equipment, there are many patients were diagnosed to be sick yet without TCM syndromes to be differentiated, therefore we must study and unify the modern medical knowledge and the experimental research methods and means of detection, to explore a new way of TCM. Only in this way, the ancient and modern can be merged, TCM and Western Medicine diagnosis and treatment methods can be integrated flexibly.Part Two:Study on Professor Shan Zhaowei's Clinical Experience of CAG TreatmentBased on TCM theory, after years of clinical practice and research, combined with the macrocosmic syndrome differentiation of TCM and microcosmic diagnosis of Western medicine, Professor Shan pointed out that the key pathogenesis of CAG is "spleen and stomach qi deficiency" and "qi stagnation and blood stasis.""Spleen and stomach qi deficiency" is the Ben of CAG, and "qi stagnation and blood stasis" is the Biao of CAG. Qi deficiency and blood stasis are the reciprocal causation for each other. He emphasizes that "spleen and stomach weakness" is its main pathological basis and "qi stagnation and stomach estrangement" is the main pathogenesis of this disease. Blood stasis is gradually formed in the CAG's long-term development of chronic degenerative process, and it is also CAG's main pathological factor of development and malignant transformation. Invigorating the spleen, activating the blood and regulating Qi are established as the treatment principles.Professor Shan treats CAG dialectically, often combined macrocosmic syndrome differentiation of TCM (inspection, auscultation, interrogation and palpation) with microcosmic diagnosis of Western medicine (endoscopic mucosal manifestations and histopathological lesions). They complement each other. This not only extends new trains of thought of clinical diagnosis to guide the treatment but also improves the curative effect. I Ie advocated that for clinical medication we should pay attention to protect stomach Qi, nourish the stomach yin and restore the function of stomach. He also emphasizes that the balance is the aim of medicating and the deviation to cold, cool, warm or hot is not expected.CAG formation is a slow process of the lesions, and damaged mucosal cells can not restore in a day. Therefore, Professor Shan stressed that slow treatment is more important rather than pursuing present effect, and be alert to the regular examination, combined with psychological counseling and balanced diet which also helps to control the development of the disease.The main prescription of the syndrome of Virtual stagnation of Qi is Sijunzi with Maimendong decoction; the main prescription of the syndrome of Damp-heat of spleen and stomach is Pingwei Powder; the main prescription of the syndrome of Liver stomach disharmony is Chaihushugan Powder; the main prescription of the syndrome of Stomach yin deficiency is Shashen Maidong decoction. Moreover, the drugs commonly flexibly used in prescription for disease and syndrome differentiation are also cited.Part Three:Research on Professor Shan Zhaowei's Medication Experience of CAG Treatment80cases were collected with226prescriptions,128drugs and2500frequencies. From the dosing frequency we may discover that the clinical commonly used medicines are Yiyiren, Xianhecao, Baihuasheshecao, Baizhu, Taizishen, Banxia, and Maidong. The major commonly-used methods are replenishing Qi and invigorating the spleen, dehumidification, promoting blood circulation, clearing heat, nourishing yin, and assisted with soothing the nerves, suppressing the acid, protecting mucous, curing diarrhea, digesting, regulating Qi, and so on.