Mania Etiology And Pathogenesis Of Research And Treatment Of Law

Dian and Kuang are emotional diseases in TCM, they are not differentiated from each other sometimes. Scholars of TCM have been studying these diseases for 2000 years, and created a unique theory system including etiology, pathogenic mechanism, pathogenesis, prevention and therapy. It is the first time that this article studies by the numbers not only the history of cognition on etiology and pathogenic mechanism, but also the diagnosis and treatment regularity of Dian and Kuang via literature research and mathematical statistics, and tries creationarily to understand Dian and Kuang from the view of descendling and ascending of qi activities, to provide useful reference and clew to prevent and cure Dian and Kuang. This article includes three sections.The first section: Literature ResearchThis article collects the archaic literatures of Dian and Kuang, reviews and summarizes scholars'points according to the order of history using the method of literature research. It analysis the development of the disease name, symptom, etiology, pathogenic mechanism, therapy principle and herbs systematically, tries to understand syndrome differentiation and treatment laws of these diseases generally, to lay a literature foundation of further study for both clinical and theory research. This section can be divided to two parts:1. A brief history of Dian and KuangThis article studies Pre-Qin period, Qin and Han dynasties, Wei to Song period, Jin and Yuan dynasties, Ming and Qing dynasties to review and summarize the history of cognition of Dian and Kuang, finds that the ancients among Pro-Qin period had some understanding of these diseases; Their knowledge increases in the period of Qin and Han dynasties, this knowledge includes symptom, etiology, pathogenic mechanism, therapy principle and method; Between Wei and Song dynasties, classification of these diseases developed, understanding on symptom, etiology and pathogenic mechanism went further, and therapy theory made a great progress; There were a lot of great doctors in JIN and Yuan dynasties, and they had gained lot's of achievements in many fields, including clinical symptom, etiology, pathogenic mechanism, therapy and so on, they gained great achievements in etiology and pathogenic mechanism, especially in the understanding of"sputum"and"fire", which has great influences to the later doctors; The greatest contribution of doctors in Ming and Qing dynasties were differentiating Dian from Kuang, which had been considered to be one disease, doctors also cleaned up the syndrome differentiation and treatment system systematically, which brought the understanding to maturity.2. Research on ancient understanding2.1 DianThe Chinese name of"Dian"was recorded in the Silk Manuscript from Tomb of Ma Wang Dui, according to the symptoms which ancient doctors described, it covered schizophrenia, mood disorder (depression), hysteria and posttraumatic stress disorder. Doctors in different times emphasized different factors in etiology and pathogenic mechanism, between Qin and Han dynasties, they considered the most important factors are congenital factor, exogenous pathogenic factors, seasonal regulation, blood deficiency, qi deficiency; Between Wei and Song dynasties considered exogenous pathogenic wind, deficiency of qi and blood, imbalance of yin and yang, injury from seven emotions; But in Jin and Yuan period, they emphasized emotions and syndromes based on emotions, such as syndrome of heat disturbing heart-mind, syndrome of heart spirit confused by phlegm, syndrome of heart spirit confused by blood stasis; In Ming and Qing period, they emphasized compositive factors, including syndrome of stagnation of phlegm and qi, heart-mind disturbed by phlegm and fire, syndrome of coagulated cold and phlegm, syndrome of wind and phlegm, syndrome of qi stagnation and blood stasis. There were puncture, moxibustion, herbs and psychotherapy in treatment.2.2 KuangThe Chinese name of"Kuang"was recorded in"Shangshu·Weizi", which is a book completed in later period of Yin dynasty. According to the symptoms which ancient doctors described, it covered schizophrenia, mood disorder (mania), hysteria and posttraumatic stress disorder. Doctors in different times emphasized different factors in etiology and pathogenic mechanism. Between Qin and Han dynasties, they emphasized injury from seven emotions, seasonal regulation, excess of yang, reversed flow of qi; Between Wei and Song dynasties, they emphasized exogenous pathogenic wind, injury from seven emotions, stagnated blood syndrome, mania of toxic heat; In Jin and Yuan dynasties, they emphasized syndrome of heat disturbing heart-mind, syndrome of heart spirit confused by phlegm, syndrome of heart spirit confused by blood stasis, yin excess cold in interior; In Ming and Qing dynasties, they emphasized compositive factors, including syndrome of heat disturbing heart-mind, heart-mind disturbed by phlegm and fire, yin excess cold in interior, syndrome of qi stagnation and blood stasis. There were puncture, moxibustion, herbs and psychotherapy in treatment.The second section: Statistics ResearchThis article analyses the ancient prescriptions of Dian and Kuang using modern mathematical statistics method, tries to find the theory of etiology, pathogenic mechanism, symptom and therapy related. This section can be divided to three parts:1. Application of modern mathematical statistics method in literature research of TCMThis part lays a theory and technology base for the article to use modern mathematical statistics. It discusses three topics: the necessity of modern mathematical statistics method in literature research of TCM, design and application of modern mathematical statistics method, design schemes of modern mathematical statistics method in literature research of TCM.2. MethodsThis article collects 334 prescriptions of Dian and 391 prescriptions of Kuang after selected with inclusion and exclusion criteria. The prescriptions are recorded in the literatures completed between"Neijin"period and the Republic of China Period. According to history, they were divided to be three stages: before Song dynasty, Jin-Yuan-Ming dynasties, Qing dynasty. Data about Dian and Kuang which from SPSS 13.0 is stored in two data-bases, frequency analysis, factor analysis and cluster analysis are performed to mine the information and principles of contained in the prescriptions, then, to find the ancients'understanding about etiology, pathogenic mechanism, symptom and therapy of these diseases.3. Results3.1 DianDoctors before Song dynasty considered the most important factors in etiology and pathogenic mechanism were exogenous pathogenic wind, deficiency of qi and blood, deficiency of yang, by contraries, heat in heart and stomach, heart-mind disturbed by phlegm and fire, syndrome of qi stagnation and blood stasis were secondary; In Jin-Yuan-Ming dynasties, doctors emphasized deficiency of qi and blood, heart spirit confused by phlegm, syndrome of heat disturbing heart-mind, deficiency of yang, showed that doctors attention begin to turn from exogenous pathogenic factors to interior factors; In Qing dynasty, doctors emphasized heart spirit confused by phlegm, deficiency of qi and blood, syndrome of heat disturbing heart-mind, yin excess cold in interior, they paid lots attention to the therapy methods of regulating qi-flowing and removing phlegm in this period, which was more flexible than before.3.2 KuangDoctors before Song dynasty considered the most important factors in etiology and pathogenic mechanism were deficiency of qi and blood, syndrome of heat disturbing heart-mind, exogenous pathogenic wind, by contraries, heart-mind disturbed by phlegm, syndrome of qi stagnation and blood stasis were not primary factors; In Jin-Yuan-Ming dynasties, doctors emphasized syndrome of heat disturbing heart-mind, heart spirit confused by phlegm, deficiency of qi and blood, cluster analysis couldn't get a significative synergy about syndrome of qi stagnation and blood stasis although it appeared in factor analysis; In Qing dynasty, doctors emphasized syndrome of heat disturbing heart-mind, heart spirit confused by phlegm and fire, deficiency of qi and blood, syndrome of qi stagnation and blood stasis , yin excess cold in interior, which was similar with Jin-Ming-Yuan dynasties, but paid more attention to the therapy method of lowering fire and removing phlegm, and considered promoting blood and removing blood stasis were extremely important, and in their mind, syndrome of yin-cold disturbing heart-mind need pay more attention to.The third section: Theory ResearchThis section combines literature research, statistics research and self clinical experience, tries to explain the etiology, pathogenic mechanism and therapy of empress Dian and Kuang from the view of descendling and ascending of Qi activities, hopes to provide useful reference and clew to prevent and cure Dian and Kuang. This section includes two parts:1. A brief discussion about qi activitiesThe discussion includes source of theory, understanding of physiology and pathology, understanding of nature and function of herbs, clinical application of herbs, it aims for a theory base of Dian and Kuang in the view of descendling and ascending of Qi activities.2. A discussion of Dian and Kuang in the view of qi activitiesThis part discusses the relationship between occurrence of the diseases and pathogenic factors, which include seasonal factor, emotional factor, deficiency, pathogenic fire, phlegm, stagnated blood and pathogenic cold, and discusses the therapy from the views of puncture and herb, the herb therapy, which includes method of lowering adverse qi, ascending, astringing, benefiting, inducing resuscitation, is discussed detailedly. This part also gives a brief introduction about ancient doctors'points and analysis of some famous cases about Dian and Kuang from the view of qi activities.According to the theory research,this article hold that the theory of qi activities could be use to catch on Dian and Kuang and form a system about syndrome differentiation and treatment laws to them.