Zhou Dean Academic Thoughts And Clinical Experience And Isolate Salt, Ginger Moxibustion Method Of Cv 8 Clinical Research For The Treatment Of Urination Disorder After Stroke

This paper is a systematic summary of what I have learned in the past three years from Dr. Dean Zhou’s academic thoughts and clinical experience. This paper mainly focuses on four aspects:Zhou Dean academic origins and an overview of how Chinese medicine cure children with tic disorders, Zhou Dean " six cure of acupuncture " theory, "Zhou’s major prescription of acupuncture" academic standpoint, and the results & observations in Zhou Dean’s " treatment for abnormal movement " acupuncture method of treatment in children with tic disorder.1 Academic origin of Dr. Zhou DeanIn the process of academic thought formation Dr. Zhou Dean emphasised on the study of "the medical classic of the yellow emperor", "Jiayi Classic of Acupuncture and Moxibustion", "Compendium of Acupuncture and Moxibustion" and other famous Chinese Medicine books and records, Under the influence of Wang Leting, the National Medical Masters He Puren, Xia Shouren and many other predecessors from the acupuncture departmentment of Beijing TCM Hospital, combined with years of practice experience, gradually formed the treatment with acupuncture of spirit, treatment of phlegm, treatment of pain, treatment of wind, treatment of deafness, treatment of abnormal movement" six cure of acupuncture " theory.2 The basic contents of "six cure of acupuncture " theoryThe treatment with acupuncture of spirit, treatment of Phlegm, treatment of pain, treatment of wind, treatment of deafness, treatment of abnormal movement " six cure of acupuncture " theory, is the essence of what Dr. Zhou has accumulated over the years in the study of acupuncture. Dr. Zhou has named the treatment of spirit the first treatment of the Six cure, put forward the theory of "to treat disease first treat spirit ", is the gist of acupuncture treatment; based on "difficult disease often caused by phlegm" he proposed the method of acupuncture treatment of Phlegm, which became widely used for difficult disease; Acupuncture excels at treatment of pain, but disease with pain are complex, what guide is to be used in diagnosis and treatment of these diseases? Dr. Zhou uses differential diagnosis of deficiency and excess, differential diagnosis of blood and Qi, and location of pain different type of needles in combination. Wind, abnormal movement and deaf summarizes the three types of disease Dr. Zhou specializes in, treatment of wind, treatment of abnormal movement, treatment of deafness including stroke, dizziness which are common diseases among elderly, common children diseases ADHD, Tourette and the high morbidity rate, difficult to treat nerve deafness, tinnitus and other unique theories and methods in diagnosis and treatment.2.1 Treatment of spiritDr. Zhou emphasis the importance on the "spirit" factor during the occurrence and development of disease and the "treatment of spirit" method of the treatment process. Dr. Zhou believes that spirit is the physiological function of organs, the crucial external manifestation of pathological conditions, mental stability and emotionally relaxed are important prerequisites for effective treatment, proposing the "f to treat disease first treat spirit" academic standpoint, the creation of Zhou acupuncture "four shen prescription" and expanded the area of application for Wang Leting" wuzangshu and geshu prescription ""thirteen points of Dumai prescription" and the traditional "kaisiguan" methods of treatments, widely used in various diseases associated with mental and emotional factors, and achieved good results.2.2 Treatment of phlegmDr. Zhou proposed the need to fully understand the unique pathological product to traditional Chinese medicine-"phlegm", the role of it in the diseases, and to establish effective acupuncture treatment. Dr. Zhou believes that "phlegm" most likely cause blocking to Qi, blood vessel, meridian, and are involved in wide arrange of diseases, treatment is difficult. Accordingly, the creation of Zhou acupuncture "eliminate phlegm prescription", is widely used in stroke, dizziness, epilepsy, globus hysteriocus, mental disorder, ADHD, Tourette and other rare illness treatments.2.3 Treatment of painDr. Zhou specializes in the treatment of pain, mainly based on the location of pain and differential diagnosis of deficiency and excess. Treatment to nearby acupoints, acupoints along meridians, and in combination of acupoints based from experience. For neck pain, back pain and other common pains, he created the "four-needle neck prescription" " five-needle waist prescription" and other similar treatments based on experience; Dr. Zhou believes that pain is mainly caused by the stagnation of liver-Qi, promoting the flow of Qi and blood circulation to achieve pain relief, thus the creation of the Zhou "regulating Qi to relieve pain prescription", is widely used in a variety of pain treatment. For the choice of needles, based on differential diagnosis of deficiency and excess, moderation or urgency, the use of acupuncture needle, fire needle, moxibustion, bleeding and cupping, each has its own advantages.2.4 Treatment of windTreatment of wind including treatment of facial paralysis due to wind-pathogen, but more importantly refers to the treatment of diseases caused by endogenous wind, such as stroke, dizziness, epilepsy, hysteria and other diseases. Acupuncture for stroke has some special prescription. Dr. Zhou has a deep understanding for the "kaisiguan" method, for stroke Harbinger caused by syndrome of hyperactivity of liver yang, syndrome of up stirring of liver-wind, syndrome of flaring up of the liver fire, dizziness and migraine, epilepsy, etc. often use the "kaisiguan " method to calming liver to stop endogenous wind, eliminating heat and purging fire, tranquilizing and allaying excitement, and achieved good results.2.5 Treatment of abnormal movementADHD and tic are common children diseases and difficult to cure. Dr. Zhou named both diseases " syndrome of abnormal movement" and believes that these diseases are related to the traditional Chinese medicine theory of heart, liver, spleen, lung and kidney, there are deficiency and excess syndrome in clinical practice. Excess syndrome is syndrome of up stirring of liver-wind and phlegm-fire attacking the heart. Therapeutic principle is removing heat-phlegm, calming liver wind, tranquilizing and allaying excitement. Deficiency syndrome is syndrome of deficiency of blood and Qi. Therapeutic principle is strengthening the spleen and replenishing qi, nourishing the blood and enhancing the sinews, supporting vital Qi and relieving uneasiness of body and mind. Due to the fact children with ADHD are lax attention, often accompanied by varying degrees of learning difficulties, on the basis of the above treatment Dr. Zhou have often acupunctured points of awakening consciousness combined with Chinese medicine that benifiting intelligence and soothe the nerves. Acupuncture combined with Chinese medicine treatment has shown impressive results, hereby proposing to make acupuncture, traditional Chinese medicine to be the primary treatment for children with ADHD and Tourette’s.2.6 Treatment of deafnessNeural hearing loss and tinnitus are common and frequently-occurring diseases. Dr. Zhou specializes in treatment of these diseases by use of acupuncture and Chinese medicine; 70% of patients have seen improvement in various degrees,20%-30% saw significant improvement. According to the Acuteness and chronicity of cases, patients are treated by stages. Syndrome differentiation mainly divided into two types deficiency and excess. Sudden deafness is excess syndrome, mainly hyperactivity of liver and bladder fire. Therapeutic principle is eliminating liver and bladder fire, opening ear orifice. Chronic hearing loss and tinnitus is deficiency syndrome, mainly Deficiency of Kidney. Therapeutic principle is nourishing yin of liver and kidney, calming the nerves.3 The academic opinion of "Zhou’s major prescription of acupuncture"After deeply researching Dr. Zhou’s methods of diagnosis diseases and the characteristics of prescriptions, "Zhou’s major prescription of acupuncture" academic standpoint is put forward academically in this paper. During the training these years with Dr. Zhou, I have gradually learned that Dr. Zhou often use several but more commonly used acupuncture prescriptions for different diseases in practicing the effectiveness of calming the nerves, nourishing vital Qi, eliminating phlegm and regulating Qi broadly in treatments of diseases of Internal Medicine, Surgical, gynecology, Pediatrics and etc, including acupuncture "four shen prescription"、"regulating Qi to relieve pain prescription"、"nourishing vital Qi prescription"、"eliminating phlegm prescription" and etc. used as basis acupuncture prescriptions for many type of diseases. Mastering these basic acupuncture prescriptions in practice of different diseases will improve acupuncture effectiveness. Academic opinion is put forward based on these prescriptions in this paper, and are described in concept principle, range and rule of application. In this paper, some acupuncture prescriptions are summarized and listed also, which are very effective and frequently used by Dr. Zhou in clinical practice.4 Effect of ginger-salt-partitioned moxibustion on urinary disorders after strokeThis study based on the clinical experiences carried forward from teacher ZhouDeAn’s moxibustion in treatment of poststroke patients, applying the innovations of ginger-salt-partitioned moxibustion on poststroke urinary incontinence, urinary frequency and urgency of urination disorders, expanding the scope of its clinical applications. By utilizing randomized control study, affirms this treatment’s effectiveness on improving urinary incontinence, urgency, frequent urination symptoms and the bladder functional capacity of poststroke patients with syndrome of qi-deficiency or syndrome of kidney-yang deficiency, reduce the burden on caregivers.Subject Words:Zhou De An, the theory of " six cure of acupuncture", "Zhou’s major prescription of acupuncture", ginger-salt-partitioned moxibustion, urinary disorders after stroke, urge urinary incontinence after stroke, Inheritance of academic experience. Objective:1 To evaluate the ginger-salt-partitioned moxibustion on its clinical efficacy and safety for poststroke voiding disorders.2 To explore the ginger-salt-partitioned moxibustion’s impacts on urodynamic for patients with poststroke voiding disorders.Method:1 Utilize a multi-centre, controlled and single-blind study methods to find hospitalized patients who met the inclusion criteria of poststroke urinary incontinence, urinary frequency and urgency of urination disorders, then randomly divided into treatment and control groups according to the ratio of 2:1. The treatment group uses the ginger-salt-partitioned moxibustion, with treatment 5 times a week for 4 weeks. Control group uses blank control. Follow a voiding diary for 72 hours before and after treatment, for urinary incontinence patients, observe and record the frequency of urination during daytime, the frequency of caregiver request at night, the average volume of urine output and other criteria for efficacy and safety, evaluate the clinical efficacy and safety of the ginger-salt-partitioned moxibustion for treating poststroke voiding dysfunction.2 Patients participating in the ginger-salt-partitioned moxibustion treatment, after informed consent, underwent urodynamic examination at the beginning of treatment and once again after 4 weeks in treatment, to explore the ginger-salt-partitioned moxibustion’s impacts on the criteria of urodynamic for patients with poststroke voiding disorders.Result:145 patients from treatment group and 22 patients from the control group underwent observation. The number of incontinence during nighttimes in a 72 hours period, the treatment group decreased from 1.09 times to 0.29 times, the control group decreased from 0.91 times to 0.86 times; the frequency of daytime urination, the treatment group reduced 1.78 times, the control group reduced 0.68 times; the frequency of caregiver request at night, the treatment group reduced 1.95 times, the control group reduced 0.55 times; the average volume of urine for treatment group increased 58.68 ml, the control group increased 13.87 ml. The above differences in every criterion between the two groups were statistically s ignificant.2 Proportion of incontinence in the treatment group reduced from 57.8% to 22.2%, while control group reduced from 54,5% to 40.9%; The number of incontinence during daytime in 72 hours, the treatment group decreased from 2.44 times to 0.53 times, the control group decreased from 1.68 times to 1.14 times. From the above data, the treatment group was superior to the control group, but the difference between two groups is not statistically significant.324 patients in the treatment group underwent urodynamic examination before treatment,22 of them had involuntary detrusor contraction during the bladder filling phase, correspond with neurogenic bladder urodynamic diagnostic criteria. After 4 weeks of treatment,9 patients underwent urodynamic examination, all 9 patients showed involuntary contraction of bladder detrusor during the bladder filling phase, still correspond with neurogenic bladder urodynamic diagnostic criteria.7 cases of bladder instability reduction,4 of which reduced involuntary detrusor contractions to 1.75 times from 3.25 times before treatment; the other 3 patients’ maximum cystometric capacity increased an average of 23ml.Conclusion:1 This study based on the clinical experiences carried forward from teacher ZhouDeAn’s moxibustion in treatment of poststroke patients, applying the innovations of ginger-salt-partitioned moxibustion on poststroke urinary incontinence, urinary frequency and urgency of urination disorders, expanding the scope of its clinical applications. By utilizing randomized control study, scientific evaluation of its clinical efficacy, affirms this treatment’s effectiveness on improving urinary incontinence, urgency and frequent urination symptoms of poststroke patients with syndrome of qi-deficiency or syndrome of kidney-yang deficiency, reduce the burden on caregivers. This treatment is easier, safer and more suitable for general application.2 This study demonstrated that,4 weeks of ginger-salt-partitioned moxibustion treatment, can increase on average 58.68ml of urine each time, improves the bladder functional capacity in patients with poststroke voiding dysfunction. The improvement of the bladder capacity is the objective reflection of increased detrusor stability during urine storage period. Increased detrusor stability during urinary bladder filling stage, increases volume of urine each time and extend the time between urination which is the root cause of reducing the symptoms of urinary incontinence, urgency and frequent urination.3 The urodynamic examination of 9 patients in this study’s treatment group before and after treatment showes:the ginger-salt-partitioned moxibustion may improve the stability of the detrusor during bladder filling stage. Clinical studies have confirmed the ginger-salt-partitioned moxibustion can increase the average volume of urine each time, proposing for the first time:that the average volume of urine each time should be a key criterion in evaluating the urine storage function of the bladder, it should also be a key criterion in clinical assessment of poststroke neurogenic bladder.4 This was a 4 week treatment study, the efficacy of a longer course of treatment and the influence of this on urodynamic is to be studied further and clarify.