| ObjectiveArranging Liu Donghan teacher’s academic experience of treating spleen and stomach diseases by systematic data analysis and studying ulcerative colitis sequential clinical therapy’s method, which is arising Yang and sweeping intestines. In order to sublimate and inherit the academic thoughts of Liu Donghan teacher in treating spleen and stomach diseases, providing some precedents academic experiences of TCM clinical therapy in the field of spleen and stomach diseases.MethodsThis study base on the records of learning with the teacher’clinical and teaching combining with the teacher public published works and published papers, referring views of TCM related genres and the physicians, which including five aspects:the TCM clinical study progress of ulcerative colitis, the origin academic and character academic of teacher the adjustment of therapy of Liu Donghan teacher in spleen and stomach diseases, the study of ulcerative colitis sequential therapy’s methods,which is arising Yang and sweeping intestines. In the first part, from TCM clinical study progress of ulcerative colitis, adopting the researching methods of literature review to comprehensive and analysis, which include the etiology and the pathogenesis, the regular of syndrome, the therapy rules and drugs, the outside therapy methods and so on; in the second study part of academic origin and academic characteristic,arranging mainly the inheritance veins of Liu Donghan as a traditional Chinese medicine family of eighth generation successor,collecting and introducing the main literary work which play an important role in the process of family inheritance and also summarizing the main academic characteristic of Liu teacher in the TCM clinical therapy;In the third academic experiment study part of treating spleen and stomach diseases by Liu Donghan, adopting the study method of literature analysis combining with the traditional classic theory of TCM,from the teacher’s understanding of physiology pathology of spleen and stomach,the diagnosis methods of tongue and pulse syndrome, the main treatment methods of spleen and stomach.etc to systematic arranging and summarizing the academic experiment of treating spleen and stomach diseases by Liu teacher;In the fourth study part of Liu teacher’s using drugs regular of therapy, collecting and screening the Liu teacher’s 199 treating prescriptions of spleen and stomach disease inputting the data to the adoption of auxiliary platform(TCMISS V2.5) and then using the function of’prescription analysis’and’statistics’in the software of data analysis module, adopting the association rules,the complex system entropy clustering and the unsupervised data analysis methods to reveal the frequency of using drugs, the regular of formula design and analysis of new prescription displaying the results of analysis for network visualization;In the fifth clinical study part of ulcerative colitis by the method of arising Yang and sweeping intestines, adopting randomized controlled clinical study methods according to the estimation method of two independent sample design mean comparison determining 64 clinical cases, dividing into TCM treatment group and Western medicine control group, removing off lost cases, selecting 30 case of TCM treatment group and 28 cases of Western medicine control group. From the two group of the age, sex, course of disease, clinical types and so on to analysis the material of baseline data and then to determine the comparable. Among them, TCM treatment group be divided into two phases of active stage and remission stage, adopting Liu teacher’s methods of arising Yang and sweeping intestines to sequential treat, Western medicine control group adopting the western medicine of meishalaqin to treat. The clinical effects of two groups were evaluated in terms of clinical symptom scores, TCM syndrome scores, induced remission rate, quality of life scores, and so on, using enzyme linked immunosorbent assay (ELISA) to measure the changes of serum IL-8 and TNF-levels in two groups of patients before and after treatment,ResultsThrough the study of Liu Donghan’s academic origin and academic characteristics clearing the academic origin of the eight generation of the Liu Donghan, Condensing out of the teacher’s overall academic characteristics, such as according to the treatment based on syndrome differentiation to recognize syndrome of prescription, the using and reforming of prescription is accurate and pure,the different methods to cure difficult and complicated disease, using expectorant to cure acute critically ill and regulating spleen as well as stomach in miscellaneous diseases.In third part, through study of Liu Donghan’s academic experience of Spleen and stomach disease in dialectical theory of traditional Chinese Medicine, Liu Donghan pays attention to the gasification theory of spleen and stomach, advocating the physiological concept of the Yang theory of spleen and stomach, believing that Yang theory is the key to the gasification of spleen and stomach, which playing a decisive role in the function of the spleen and stomach; meanwhile, thinking that the key pathological mechanism of spleen and stomach disease are "soil barrier’of the indicates lag impassability of the spleen as well as stomach and’wood depression’mainly in liver depression of the abnormal liver catharsis,emphasizing that’wood depression’and’soil barrier’are essence and standard, which can transmit to each other’s pathology; Proposing that Yin Syndrome tongue and Yang Syndrome tongue of the tongue differentiation of symptoms and signs in the spleen and stomach disease, emphasizing that through the tongue differentiation to know cold and heat and according to the sink of the position of’guan’in pulse diagnose to identify the actual symptom of spleen and stomach disease, it forms the experience that according to the tongue to distinguish differentiation syndrome of cold and heat, the actual symptom pulse to identify differentiation disease; In the treatment of spleen and stomach diseases,the teacher suggest that’regulating spleen and stomach’,which based on the guide of Confucianism thoughts,’pursuing harmony in the progress of using’, in pre Qin and two Han Dynasty and traditional TCM academic of spleen and stomach disease, the foundation of the spleen and stomach Yang physiology and the pathological view of soil accumulation and wood stagnation. In the treatment of spleen and stomach disease, the teacher suggest that we should focus on the two words of’through and regulating’, when the function of spleen and stomach is’through’, the stasis and turbid food in the stomach can smooth downward, while the key of’regulating’method is to take into account the spleen and stomach’s character of ascending and descending, shrink and transport, dry and wet, yin and yang balance, establishing the corresponding treatment. In the specific rule treatment and therapeutic method aspects, the teacher think that’yang weakness yin flourishing’is the physical characteristics of the residents of northwest, the Northwest resident’s pathological features of spleen and stomach disease is the weakness of Spleen Yang weakness, which lead to the Qi of spleen and stomach can’t transmit in the body, furthermore,establishing the therapeutic method of warm transport middle Jiao and regulating the spleen and stomach, the teacher is good at use drugs,which tastes are Pungent, sweet and warm, in actual prescription, through these drugs taste compose as one taste that regulating the direction of drug’s effective can achieve the purpose of warm transport spleen and stomach and keep middle Jiao smoothing, meanwhile, the teacher thinking that no matter liver disease transfer to spleen, spleen diseases transfer to liver or spleen and liver are co-morbidity in spleen and stomach, the spleen and stomach disease all related with the irregular function of liver, which must have an influence on Qi and blood’s running and middle Jiao’s smooth, while the key of irregular function of liver lies in’less than’and’"too much’, accordingly, the teacher often treat the disease’s syndrome of irregular function of liver that result in the Qi movement of spleen and stomach does not rise or does not rise but decline by the method of regulating the Qi of liver inhabiting liver Qi to treat the syndrome of the over rise of liver Qi,which lead to irregular of Qi movement and affect the function of spleen and stomach,the teacher’s another method of regulating liver Qi.which can keep spleen and stomach smoothing,is soothing the liver or depression the liver that achieve the purpose of the balance of Qi movement.Furthermore, the teacher mainly emphasizes the thought that eat and drink regularly, the food as prescription and the drug relay on food to play function in the treatment process of spleen and stomach.In the fourth part, the study of rely on data analysis the regular of using drugs in the treatment of spleen and stomach indicates that the mean of prescription ingredients is 11.5,the maximum of the whole part dose is 178.45g, the minimum is 96g, which have the characteristic of fewer but better medicine’in prescription;According to the frequency of drugs using, above the proportion of 30% have Banxia, Danggui, Huangqi, Gancao, Xiangfu, Chaihu, Fuling, Maiya, Baishao, Guizhi, Baizhu, Sharen,.etc. some have a distinct dose level in these high-frequency medicines, such as Banxia, Danggui, Huangqi, Gancao, Chaihu, Fuling, Maiya, Baishao, Guizhi, Baizhu, the highest frequency dose level in different dose level should be the core of the drug dose usage in the teacher’s therapy of spleen and stomach disease. According to analysis of the frequency of using drug in the teacher’s therapy of spleen and stomach and basing the relation rule to analysis the compose regular of prescription indicate that the teacher usually using these medicines, which have the function of making spleen healthy, clearing damp and phlegm, adjust liver and Qi,making the blood flow smoothly,the application of the two kinds of medicines are focus on the two words of ’through and adjustment’which indicates the teacher’s therapy thought of pathological view that’soil barrier and wood depression’and treatment view that’through and adjustment of spleen and stomach’. The relation rule also indicates that the high-frequency composition of pairs of medicines compose mainly by ’warm and heat’and’pungent, and sweet and bitter’ the pairs of medicines apply’pungent and warm drugs’ and’sweet and warm’to compatibility, the pungent has the function of driving out of pathogens, the sweet has the function of making spleen healthy and moderating hastiness, taking pungent and sweet together can transform into Yang that can nourish spleen,warm spleen,which combined with the function of’through and smooth’and’rising and diffusing’is the exemplification of warming the middle Jiao of our teacher’s thought. Through the analysis of complex system entropy clustering, digging the new candidate prescription of the treatment of spleen and stomach disease, which mostly reflect the drug using characteristics of’warm transport the middle Jiao, through and adjust spleen and stomach’At the same time, this study of prescriptions for the data digging also suggests that in the prescription of the teacher’s therapy of spleen and stomach, the frequency of the drug belong to liver meridians up to 789, compared with the frequency of the drug belong to spleen and stomach meridians, owning the position of third, which mainly reflect the recognize of the pathological mechanism of ’wood depression’in teacher’s treatment of spleen and stomach diseases.In the fifth part, the teacher thinks that the core pathogenesis of ulcerative colitis are the spleen Yang do not raise, the hot and damp as a damper in the phase of active and remission, which have the regularity of relation, the variable of primary and secondary syndromes, therefore, the teacher puts forward the academic experience that the method of arising Yang and sweeping intestines to sequential treat ulcerative colitis. By the clinical research shows that after the treatment of TCM and western medicine group, in different phase time, the main symptom scores of diarrhea, purulent blood excrement and belly ache and the secondary symptom scores of anal heat, tenesmus, stay and the lack of power are decline, which have distinctive statistical significance (p<0.05). After two months of the TCM treatment, especially on third month, the improvement of main and secondary symptom of TCM group is previous compared with western group, which have distinctive statistical significance (p<0.05). The integral of result evaluation of TCM syndrome shows that the total effective rate of TCM treatment on January, February and March and so different period is higher than the same phase time of western treatment, which have statistical significance (p<0.05). The inductive remission rate of TCM treatment on January, February and March and so different period is higher than the group of western on the same time, which have statistical significance (p<0.05). Compared with the pretreatment, the quality life scores of systemic symptom, gastrointestinal symptoms, social and emotional ability on January, February and March and so different period of TCM and western treatment has obvious improvement, which have statistical significance (p<0.05); The quality life scores on January, February and March and so different period of TCM treatment group is higher than the group of western treatment, which have statistical significance (p<0.05). Compared with the pretreatment, the content of serum IL-8 and TNF-a are significantly decline after the treatment of TCM and western treatment, which have statistical significance (p<0.05). The content of serum IL-8 and TNF-a of the TCM treatment is obviously better than the western medicine group, which have statistical significance (p<0.05).Conclusion:The teacher’s academic inheritance is clear, the family original is long, the academic characteristic is distinctively different; in the therapy of spleen and stomach disease, the teacher advocate that the physiological view of’the characteristic of spleen and stomach is Yang’.the pathology view of "wood depression and soil barrier’, the dialectical view of ’combining tongue with pulse to dialectics’, the treatment opinion of’through and adjustment of spleen and stomach’.the food therapy view of’combining medicine with food’, forming Liu Donghan’s academic system of the therapy of spleen and stomach; in the compose of prescription of the treatment of spleen and stomach, the teacher advocate that the dosage is less but the compose of the prescription is harmony, emphasizing the medicine taste of sweet and pungent, the taste of warm and hot, the application of drugs that belong to the meridian of spleen, stomach and liver, which have the distinctive features of the Northwest; the teacher put forward the method, arising Yang and sweeping intestines, the sequential treatment of ulcerative colitis in the in the treatment process, grasping TCM ulcerative colitis pathogenesis key of the regularity of dynamic change, primary and secondary syndrome evolution in the phase of activity and the remission, clinical studies confirmed that method of sequential treatment of ulcerative colitis, arising Yang and sweeping intestines having efficient effect of improving the patients’clinical symptoms, TCM syndromes, the induction of relief, especially in improving patient quality of life and preventing relapse of curative effect, the mechanism may be related to reducing the level of IL-8 and TNF-a in serum, providing preliminary clinical basis in the exploration aspect of using the method, arising Yang and sweeping intestines, to sequential treat ulcerative colitis. |
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