An Overview Of Pro.zhang Tiezhong's Academic Thought In Geriatrics And The Study On Insomnia With Depression Syndrome With The Theory Of "Six Yu"

This research systematically sorts out Pro.Zhang Tiezhong's road to success through interview,literature review and clinical study.And it also cards his academic context,digs out,sorts out and condenses his academic thought and clinical experience on treatment of geriatrics.This research includes three parts:Part 1 Academic OriginIt cards Pro.Zhang Tiezhong's academic origin through literature research.Pro.Zhang Tiezhong,was born at a traditional Chinese medicine family in Tianjin city.He graduated from Tianjin University of Traditional Chinese Medicine at 1970.And then he passed the examination to be a master of China Academy of Chinese Medical Sciences,under the tutelage of Chen Keji academician.Afterwards he works for a long time at China-Japan Friendship Hospital and engages in the clinical work of cardio-cerebrovascular disease and kidney disease by traditional Chinese medicine method.He was former director of China-Japan Friendship Hospital's Geriatrics department.Pro.Zhang's academic thought derives from the classical theory of four great Classics of TCM and the four eminent physicians in Jin and Yuan period.It merges the essence from Yishui School and Danxi School and he studied more on Li Dongheng and Zhu Danxi's books.As for Ming and Qing dynasties era,he values Chen Shiduo and Cheng Zhongling's academic essence.He is heavily influenced by Dongheng's thought of "Many illness come from the internal injuries of spleen and stomach" and hence emphasizes the importance of spleen and stomach.His prescription usually takes into account of spleen and stomach while not limited by Dongheng's thought,e.g.pay more attention to tune up spleen and kidney in geriatrics.Pro.Zhang is heavily influenced by Zhu Danxi's academic thought.That is,the aged person should benefit his body based on protecting Yin(concept from Tao),and choose tonic but not oily supplements.He further developed"Qi-Blood-Phlegm-Static" which is called the four-injury theory.He achieved remarkable curative effect of persistent ailment,abnormal disease and incurable disease from the perspective of Phlegm Theory.He considers that the aged person mostly might be Static and is good at curing geriatrics from the perspective of Static Theory.Pro.Zhang values Chen Shiduo's creative spirit quite a lot.And he is inspired by it deeply.He believes that geriatrics should be more related with Phlegm Evil,which is influenced by Chen's corresponding thought.He emphasizes the effect of the "intercourse between heart and kidney" theory in curing geriatrics.He studies deeply of Cheng Zhongling's "Medicine Comprehended",exerts its prescription and has a good curative effect.Above all,Pro.Zhang Tiezhong TCM family background,from the medical school,pay attention to the traditional Chinese medicine combined with modern medicine,he absorbed various strengths and eventually formed the treatment of geriatric attaches great importance to the Tan,Yu,Xu's academic thoughts.Part 2 Academic thought and sorting and summary of clinical experiencePro.Zhang concentrates on studying how to cure geriatrics for decades of years,and forms his own special academic thought and clinical experience.He believes that the aged person would have aging viscera and hypofunction,and this physiological characteristic will cause corresponding special performance and change law in pathology;the aged persons mostly might be weak,so he pays more attention to tuning up,especially for spleen and kidney;body and mind simultaneously get ill is an important feature of geriatrics,that is because the aged person mostly might be Static,so the treatment should not forget to "break Static";combination of both identifying symptoms and identifying disease must be done on treatment,traditional medicine oriented while referring to western medicine,keep macro and microcosmic combined,keep the whole and the part combined;he is good at grasping primary symptom;he thinks that the aged person's five internal organs are weak and impaired,especially kidney and spleen;Phlegm Evil is scourge and be everywhere,eliminating evil should depend more on reducing phlegm;on prescribing,he is good at existing prescriptions and is careful to use self-prescription;he thinks that the aged person's five internal organs are weak and impaired,and their spleen and stomach's functionalities drop already,so more attention should be paid to these two organs.He also proposed the viewpoints of "the large intestine is indigested accumulatly","water stasis","the aged person might be Static","wind might cause phlegm","etc.And he gets good results by applying these viewpoints on Clinical practice.Pro.Zhang Tiezhong is good at dialectical treatment on geriatrics by applying traditional Chinese medicine.He has unique experience on treatment on aged high blood pressure disease,stroke,obstruction of qi in the chest,insomnia,epigastric pain,constipation,etc.This paper summarize his distinctive experience on above disease in detail,and the typical treatment cases are attached.Part 3 the Study on Insomnia with Depression Syndrome with the Theory of "Six Yu"Disease incidence of insomnia is very high,and psychological factors might be the important reason.Many patients with insomnia could be diagnosed as depression.Sleep disorders is one of the most popular symptom of depression.Insomnia and depression usually occur simultaneously and influenced by each other.Currently western medicine is limited to cure insomnia.Mainly it has side effect,addiction and drug withdrawal reaction.Due to long term medicine taking,the patient compliance will decrease a lot.On the contrary,the basic features of traditional Chinese medicine are the overall concept and dialectical treatment.It has the effect of adjusting the whole human body,especially has sure curative effect on functional disorders.So it has broad value and social significance to seek secure and effective traditional Chinese medicine and treatment for curing insomnia which is caused by depression.Insomnia usually occur simultaneously with anxiety,depression and somatic symptoms,and influences the quality of life of the patients seriously.According to the theory of "unity of body and soul",it is considered that the essence of the psychosomatic problems is the disharmonious relationship of body and soul in traditional Chinese medicine.Pro.Zhang was inspired by the theory "Zu Ming Ze Xia An",and then he applied ZuDanxi's "Six Yu" to cure insomnia,establish a treatment thinking start from "Six Yu".He recuperates and cures the insomnia which is caused by depression by considering both body and soul of the patient.To adjust one's mood and stabilize one's emotion are his fundamental method.He create"Yuejuanshen decoction",which could be the basic prescription for curing insomnia which is caused by depression according to clinical experience.Objective To observe the effect and safety of the "Six Yu" theory in the treatment of depression with insomnia.Methods 120 cases were randomized into two groups.The experimental group was treated with Yueju Anshen Decoction,while the control group was given zolpidem,treatment for 4 weeks,The scores of PSQI,the TCM symptom and HAMD-17 was compared before and after treatment.The clinical efficacy was evaluated by the reduction rate of PSQI.Results There were no significant clinical differences(P>0.05)between these two groups before treatment.PSQI score comparison.Group comparison:after 2 weeks of treatment,the sleep efficiency factors were not statistically significant in two groups.After 4 weeks of treatment,the sleeping factors in the treatment group were significantly different,P<0.01.In the Control group sleep efficiency factor were significantly different,P=0.026<0.05,and other factors were significant differences,P=0.000<0.01.Comparison between groups:After treatment,the PSQI and total scores of two groups were decreased.After 2nd,the treatment group was better than the control group in the improvement of sleep quality,P=0.030<0.05,the differences were statistically significant.and the other two groups had no difference(P>0.05).In the 4th week,two groups of PSQI item and total scores were decreased.There was no difference between the two groups(P>0.05).Comparison of the scores of TCM syndrome scores.Group comparison:after 2 weeks of treatment,the major TCM syndromes of the treatment were significantly different in the treatment group,P<0.01.The syndrome of emotional depression in control group had no significant changes,P>0.05;insomnia,dreaminess,dizziness and irritable lassitude had significant difference,P=0.000<0.01.After 4 weeks of treatment,the main TCM syndromes in the treatment group were significantly different between the two groups,P=0.000<0.01.The diet syndromes in the control group had no significant changes,P=0.410>0.05;insomnia,dreaminess,dizziness,irritable emotional depression were significantly different,P=0.000<0.01.Comparison between groups:After treatment,the scores of TCM syndrome scores of the two groups were reduced.After 2 weeks of treatment,the control group was better than the treatment group in insomnia,more dreams,with statistical difference(P<0.05).about item of no desire to eat the treatment group were better.There was no difference between the two groups in the other items(P>0.05).In the 4th week,the treatment group and the control group,the main TCM syndrome was further improved,emotional depression and do not want to eat the treatment group was better than the control group,the difference was statistically significant(P<0.05).There was no difference between the two groups in the other items(P?O.05).HAMD-17 score comparison.Group comparison:after 2 weeks of treatment and 4 weeks after treatment,the total score of HAMD-17 in two groups decreased,there were significant differences between the two groups,P<0.01.Comparison between groups:After treatment,the total scores of HAMD-17 in two groups were decreased.After 2 weeks of treatment,the total score difference between the two groups was significantly different,P=0.003<0.01.After 4 weeks,the total score of HAMD-17 in the two groups was further reduced,and the difference between the total scores of the two groups was significant,P=0.000<0.01.The total effective rate of the treatment group was 74%,while that of the control group was 57.69%.No significant difference was found in the total clinical efficacy between the 2 groups(P>0.05).There were no obvious adverse reactions in the two groups.Conclusion The use of "Six Yu" theory in the treatment of depression with insomnia is safely and effective,is helpful in improving the quality of life of the patients.Original ideas the theory of "Six Yu" enriched the treatment of insomnia.In this study,a randomized controlled clinical trial was used to observe the effect of this prescription on insomnia and depression in patients with depression related insomnia.Inspired by the teacher,I will use "six Yu" in the treatment of depression related diseases.