| Purpose:To review Professor Tian Delu’s academic thoughts and clinic practices, on FD in particular; to explore the laws and distinguishing features of his treating principles and prescription; and to comprehensively undertake his clinical experience.Methods:1. Following up with my tutor to collect first-hand information on his treating for three years; learning and reviewing the teacher’s books, papers, and the medicine classics signed by him to comprehensively understand his academic thoughts and clinical practices.2. Collected the clinical cases, all together 105 on FD treated by professor Tian in special outpatient service. All cases are inputted in excel databases. The data collected should be analyzed by Spss 18.0 statistics:enumeration data with Chi-square test; measurement data with T-test, Rank tests, and Logistic. By doing so, the law of Professor Tian’s prescription on FD can be summarized and the more can be discussed, including symptoms, syndromes, formulae, and herb medicine etc.The summary:1. The teacher’s academic origins can be summed up in:Beijing University of Chinese Medicine for his formal education and the foundation of his ancient Chinese medicine classics; in Beijing Dong Zhimeng Hospital he got benefits from many eminent doctors and Professor Dong Jianhua guided him as his supervisor.Professor Tian’s thought comes from:(1) Dr. Zhang Zhongjing.Based on Five-organs, all eight-methods could be adopted; For the severe cases, treatment should start from dietary pathogen. (2)Dr. Li Dongyuan. It’s better to elevate stomach-qi; Against the herb medicine with fragrant property alone. (3) (1) Dr. Zhu Danxi’s. Ascending clear Qi accompanies descending evil Qi; Eliminating evil Qi from both upper and lower parts. (4) Zhang Jingyue’s. Identifying deficiency or excess type and treating them separately; (5) The theory of his supervisor, academician Dong Jianhua. In dealing with Stuffy and Full Sensation, treatment centers on the stomach.Adopted Dr.Zhu Danxi’theory, Professor Tian emphasized on flaming of fire from yin deficiency in deal with kidney deficiency of miscellaneous diseases, wisely used Da Bu Yi Pill (Tonifying Yin Pill).In treating chronic liver diseases, Professor adopts Dr. Gao Gufeng’s theory to attache importance to regulating kidney, accompanying patent medicine Zi Shui Qing Gan Yin (Cold Herbal Decoction to Replenish Water to Clear Liver)Professor Tian carries forwards the academic thoughts and clinic practice of the distinguished doctors above, and furthers them on.2. Professor Tian’s academic theory includes:2.1 In deal with Five-organs, he emphasizes on liver and stomache;In regulating Qi activities of stomach, he pays more attention to clearing and descending on the condition of eliminating the tangible evils in stomach; In treating deficient syndrome, promoting blood circulation and replenishing are employed. Besides, Professor Tian tends to apply modern medicine results to Chinese medicine prescription base on syndrome differentiation.2.2 The clinical experience on treating kinds of FD:Based on FD, professor emphasizes on "regulating stomach to eliminate Dietetic Evil" in treating refractoriness distention and fullness. On gastro esophageal reflux disease (GRD), he centers on treating upward perversion of stomach-qi due to gallbladder-heat, and prescribes Zhi Suan San He Tang (Herbal Decoction to Combat Gastric Acid), as well as Wei Dong Si Zhu Yao.2.3 The academics thoughts and clinic practices on miscellaneous diseases:In treating miscellaneous diseases, he adopts Dr. Zhu Danxi’s theory "Commonly yang is excessive while yin deficient" and "Ministerial Fire" theory. In Zhu Danxi’s theory, kidney deficiency meant kidney yin worn out, always mixed with phlegm retention due to damp-heat. In treating, attention should be paid to diet, emotion, activities of daily living and health preserving. The principles are to replenish yin to reduce fire, remove heat and dampness, and reduce phlegm and remove blood stasis. Based on these principles, this paper summarized the Professor Tian’s treating on metabolic syndrome,climacteric syndrome etc.3. Both Chinese medicine’s and west medicine’s researches on FD3.1 West medicine researches on FDIn west medicine, studies indicated:1) Related to gastric dyskinesis and hypersensitity, FD has no inevitable relation to them.2) In cause and mechanism of the disease, environment, diet, and digestion play a relatively important role; Helicobacter pylori, chronic gastritis, gastric acid secretion and duodenitis in a certain role; No clear connection with interdigestive myoelectrical complex (IMC), disorder of autonomic nervous system, and Hormone Changes; FD is relevant with psychological and pathogenic factors and co-exists with mental diseases, such as, anxiety, in particular. In clinic, the differential diagnosis has been employed usually.3) The treating principle focuses on altering patients’life style, drugs on promoting gastric dynamics, antacid, Helicobacter pylori eradication etc. and the efficacy can hardly be perfect.(2) Chinese medicine researches on FDOn reviewing the recent 10 years literatures, we can see FD locates in stomach, has close relationship with liver, spleen etc. Its primary pathogenesis is relevant to disharmony between liver and stomach, deficiency of spleen and stomach. The treating method falls into dispersing the stagnated Liver-qi to regulate the qi circulation, invigorating Spleen and benefit qi, and specific treatment and formulae of the schools have hardly been found.In regulating Qi activities of stomach, he pays more attention to clearing the tangible evils like indigestion, retention of phlegm, damp-heat etc. and has established Shi Pin Fang (prescription to remove the fullness syndrome) for this type, which represents his theory and practice.Conclusion:By analyzing the clinical data, we arrive at:(1)In identifying the pattern, Professor Tian holds the FD is caused by stomach-qi stagnation, if there are bitter in the mouth, pain in the hypochondrium, they are disharmony between liver and stomach. (2) In regulating Qi activities of stomach, although Professor Tian pays more attention to "clearing and descending", he centers on regulating functional activities of qi on stomach, lung and liver, which indicates the theory that treating stomach diseases start with Five-organs. (3) In treating disharmony between liver and stomach, attention should be paid first, to depression and stagnation of qi, then depressing-heat in Liver Meridian. Perillaseed, pericarpium citri reticulatae or the root of three-nerved spicebush etc. are prescribed to warm and promote the qi activities of spleen and stomach. Meanwhile, in smoothing the liver to regulate qi, herbs with cold property like radix bupleuri, Chinese herbaceous peony, fructus aurantii immaturus, scutellaria baicalensis etc. are conversely added to achieve balance. (4) By study the usual FD’s syndromes and signs, we draw the conclusion that in deal with FD, the diagnosis is directed to "stuff and full sensation"; it locates primary on stomach, then liver, rare on spleen. Its differentiation relates to qi -stagnation, which is frequently combined with damp, stagnation and heat. Deficiency in spleen is less frequently seen. (5) By studying his commonly used herbs medicine, we can see that Professor Tian primary focuses on indigestion, then production of pathogen due to dampness stagnation, and pathogen due to stagnant heat in aspects of dampness, stagnation and heat.Significance:This study proves that Professor Tian primary theory on treating FD--- FD is caused mostly by stomach and majorly manifests as excess and heat. As FD’s core pathogenesis is stagnation of stomach, treating liver and stomach should be carried out. The theory includes (1) In regulating Qi activities of stomach, he centers on regulating functional activities of qi on stomach, lung and liver, which indicates the theory that treating stomach diseases start with Five-organs. (2) Professor Tian pays more attention to "clearing and descending". In the tangible pathogens the most common are indigestion and stagnant dampness, and pathogen due to stagnant heat is less frequent. The herbs prescribed function to regulate the descending and ascending of the qi-activities. In clearing heat, herbs to warm spleen and stomach are companied in order to achieve balance. The two points above throw a new light on Professor Tian’s "clearing and descending", which bears significance in the theory. Purpose:To review Professor Tian Delu’s academic thoughts and clinic practices on FD; to explore the laws and distinguishing features of his treating principles.Methods:1. Reviewed the past 10 years Chinese and west medicine literatures on FD, having a good hand of the present study on FD.2. Collected the clinical cases, all together 105 on FD treated by Professor Tian in special outpatient service. All cases are inputted in excel databases and should be analyzed by Spss 18.0 statistics:enumeration data with Chi-square test; measurement data with T-test, Rank tests, and Logistic. By doing so, the law of Professor’s prescription in FD can be summarized and the more can be discussed.3. Analyzing the results obtained to find the law of Professor Tian’s application on syndrome differentiation and treatment.The summary:1. In treating with FD, the review on Chinese medicine and west medicine1.1 West medicine researches on FD1.1.1 Diagnostic criteriaThe internationally accepted standards for FD is RomeⅢstandards and its definition: It means FD derives from the stomach and duodenum of indigestion, and can cause these organs a group of physical, systematic or metabolic syndromes[3]. Of indigestion symptoms includes:epigastric pain, after-dinner blown out, early enough, epigastric flatulence and the epigastrium burning sensation, nausea, vomiting, etc.1.1.2 Cause, pathological and physiological mechanismIt has not been clearly defined. The most accepted theory is that it relates with DGE, visceral hypersensitivity, abnormal gastric acid secretion, helicobacter pylori infection, mental factors, emergency factors, gastrointestinal hormones etc.1.1.3 Treatment The treating principle focuses on altering patients’life style, drugs on promoting gastric dynamics, antacid, helicobacter pylori eradication etc. however, the efficacy is hardly perfect.1.2 Chinese medicine research on FDOn reviewing the recent 10 years literatures, we can see FD locates in stomach, has close relationship with liver, spleen etc. Its primary pathogenesis is relevant to disharmony between liver and stomach, deficiency of spleen and stomach. The treating method falls into dispersing the stagnated Liver-qi to regulate the qi circulation, invigorating Spleen and benefit qi, and specific treatment and formulae of the schools have hardly been found.In regulating Qi activities of stomach, he pays more attention to clearing the tangible evils like indigestion, retention of phlegm, damp-heat etc. and has established Shi Pin Fang (prescription to remove the fullness syndrome) for this type, which represents his theory and practice.2. Clinic research:On Analysizing the 105 cases that treated by Professor Tian Delu, we draw the conclusion:(1) Patterns:Most frequently seen are disharmony of liver and stomach, stomach-qi stagnationg.(2)Main patterns and their corresponding symptoms:After-dinner blown out, early enough etc.(3) The main patterns and their corresponding herb medicine: Radices Paeoniae Alba, Lily, Radix Bupleuri, Fructus Aurantii, Fructus Aurantii Immaturus, Pericarpium Citri Reticulatae, Radix Paeoniae Rubrathe (unpeeled) Root of Common Peony, Scutellaria Baicalensis, Radices Saussureae, Perillae, and the Root of Three-nerved Spicebush etc. The usual medicine for syndrome of stomach-Qi stagnation includes Caulis Perillae Acutae, Cyperus Rotundus, Pericarpium Citri Reticulatae, Perillae, Semen Coicis, Radix Bupleuri, Poria Cocos, Scutellaria Baicalensis, Radices Paeoniae Alba, Radix Paeoniae Rubrathe (unpeeled) Root of Common Peony, Fructus Forsythiae, Fructus Amomi, Pericarpium Citri Reticulatae Viride;(4)For constipation, Polygonum cuspidatum, Semen Pharbitidis,for blown out after that heavy meal, charred semen aremen,and perillaseed are suggested.Conclusion:By analysizing the clinical data, we arrive at:(1)In identifying the pattern, Professor Tian holds the FD is caused by stomach-qi stagnation, if there are bitter in the mouth, pain in the hypochondrium, they are disharmony between liver and stomach. (2) In regulating Qi activities of stomach, although Professor Tian pays more attention to "clearing and descending", he centers on regulating functional activities of qi on stomach, lung and liver, which indicates the theory that treating stomach diseases start with Five-organs. (3) In treating disharmony between liver and stomach, attention should be paid first, to depression and stagnation of qi, then depressing-heat in Liver Meridian. Perillaseed, pericarpium citri reticulatae or the root of three-nerved spicebush etc. are prescribed to warm and promote the qi activities of spleen and stomach. Meanwhile, in smoothing the liver to regulate qi, herbs with cold property like radix bupleuri, Chinese herbaceous peony, fructus aurantii immaturus, scutellaria baicalensis etc. are conversely added to achieve balance. (4) By study the usual FD’s syndromes and signs, we draw the conclusion that in deal with FD, the diagnosis is directed to "stuff and full sensation"; it locates primary on stomach, then liver, rare on spleen. Its differentiation relates to qi -stagnation, which is frequently combined with damp, stagnation and heat. Deficiency in spleen is less frequently seen. (5) By studying his commonly used herbs medicine, we can see that Professor Tian primary focuses on indigestion, then production of pathogen due to dampness stagnation, and pathogen due to stagnant heat in aspects of dampness, stagnation and heat.Significance:This study proves that Professor Tian primary theory on treating FD--- FD is caused mostly by stomach and majorly manifests as excess and heat. As FD’s core pathogenesis is stagnation of stomach, treating liver and stomach should be carried out. The theory includes:(1) In regulating Qi activities of stomach, he centers on regulating functional activities of qi on stomach, lung and liver, which indicates the theory that treating stomach diseases start with Five-organs. (2) Professor Tian pays more attention to "clearing and descending". In the tangible pathogens the most common are indigestion and stagnant dampness, and pathogen due to stagnant heat is less frequent. The herbs prescribed function to regulate the descending and ascending of the qi-activities. In clearing heat, herbs to warm spleen and stomach are companied in order to achieve balance. The two points above throw a new light on Professor Tian’s "clearing and descending", which bears significance in the theory. |
PDF Full Text Request