| Purpose Ever since “Shang Han Za Bing Lun”(Treatise on Febrile and Miscellaneous Diseases),attempts to discuss and understand the use of Pinellia never peter out among physicians of different ages,and so is in the contemporary scientific research.Records of the use of Pinellia in clinical practice were found since ancient times and Pinellia was prescribed for a wide range of illnesses.This study will first outline and summarize the findings of ancient classics,including Ben cao gang mu(Compendium of materia medica),and the contemporary medical research about Pinellia.Then the study will proceed to present the examples of using Pinellia in “Linzheng Zhinan Yi’an”(A Guide to Clinical Practice with Medical Record),process the data with statistical software,thus examine and summarize the thought of Ye Tianshi about how to use Pinellia.The study will then scrutinize “Shang Han Za Bing Lun”,medical classics of different ages,as well as other books written by Ye Tianshi,in the hope that their findings will help explain the analyzed results and shed light on the clinical use of Pinellia for physicians in modern times.Research Methodology This study will process the data with the assistance of Microsoft Excel,categorize the data in accordance with twelve items,including the names of the medical record,titles,disease names,types of etiology and pathogenesis,tongue quality,tongue coatings,pulses,symptoms,medications,treatments,remarks and doctors’ comments.In the first part of the statistical research,the term “Pinellia” will be used as the keyword in the search.The study intends to look into the medical records about the etiology and pathogenesis,tongue quality and symptoms of cases with prescription of Pinellia,then further on to have a closer look at the related pathogenesis,tongue pulse and symptoms that involve Pinellia and its products.SPSS 16.0 will be used to conduct the following analysis:Frequency statistics: Frequency analysis examines the frequencies of different numerical values in a group of data.This helps understand the distribution of the data.The study will centre on the six frequencies,including disease names,types of etiology and pathogenesis,tongue signs,pulses,symptoms and medications,thus unveil the interrelationship among diseases,symptoms distribution and the use of Pinellia.Correlation analysis: Correlation analysis,which is a statistical method to study the relationships among random variables,delves into not only the dependency relationships among research objects,but also the possible development and the degree of correlation.This study will explore the interrelationships among etiology and pathogenesis,tongue,pulse,syndrome and Pinellia,as well as probe into the potency of Pinellia on the involved illnesses,in order to gain insight of the thought of Ye Tianshi on using Pinellia in clinical practice.In the second part of the statistical research,the study will examine the compatibility of medicines.With the help of the database in Chinese Medicine Inheritance Platform 2.5,all prescriptions with Pinellia will be included for analysis.Result 1.Common illnesses prescribed with Pinellia There are in total 86 illnesses transcribed in ““Linzheng Zhinan Yi’an”,59 of them are prescribed with Pinellia,accounting for 67.4% of the total number.Malaria holds the highest proportion among the Pinellia-related illnesses,which is 13.9%.8.5% of the Pinellia-related illnesses transcribed is phlegm retention,while another 65% is for 12 illnesses including vomiting,abscess,epigastric pain,choking and belching,stomach distension,swelling,heat,phlegm,stroke and dampness.Spleen and stomach diseases and arthralgia account for 2.2% respectively.Chest obstruction and diarrhea account for 2.2% each.Depression,hypochondriac pain,ascaris,menstrual adjustment and convulsion account for 1.46% respectively.Hiccup and cough account for 1.22% each,while dizziness,diarrhea,abdominal pain and insomnia respectively account for 0.98%.Abdominal lumps,warm heat,pre-foetal period,liver wind,pox,jaundice and sores account for 0.73% each.The remaining illnesses are blood vomiting,headache,accumulation,asthma and postpartum,pediatrics,diarrhea,cholera,scrofula,malaria,heartache,wheezing,impotence,head wind,eye illness,dysentery,sweat syndrome,chancre,liver-fire,lung impotence,epilepsy,intestinal obstruction,poor appetite and bloody stool,accounting for 7.3% of the total number.2.“Linzheng Zhinan Yi’an” Distribution of etiology and pathogenesis with Pinellia prescribed A total of 42 types of etiology and pathogenesis were sorted out,of which 16 types were found by more than 10 times.including 90 cases of liver and stomach disharmony,73 cases of stomach yang deficiency,44 cases of obstruction of phlegm-dampness,38 cases of spleen yang deficiency;23 cases of phlegm qi obstruction of vessels,22 cases of dampness and stagnation of qi,17 cases of syndrome of liver qi depression transforming into fire,16 cases of dampness and heat of spleen and stomach,15 cases of heat accumulation,14 cases of liver and spleen disharmony,12 cases of stagnation of qi and blood and 11 cases of spleen and stomach qi deficiency,11 cases of Yin turbidity and drink coagulation,and 10 cases of stomach qi inversion.3.“Linzheng Zhinan Yi’an” Distribution of tongue signs with Pinellia prescribed A total of 410 cases are prescribed with Pinellia in “Linzheng Zhinan Yi’an”,47 of which are recorded with the tongue signs,accounting for 11.33%.White tongue is found the most common among the tongue signs recorded,which is 32,while the number of cases with yellow coating is 5;red tongue is 4;gray and black tongue is 2;Crimson tongue,dry tongue,white coating and grey and yellow coating account for 1 respectively.4.“Linzheng Zhinan Yi’an” Distribution of pulses with Pinellia prescribed In the medical records with Pinellia recorded,there are 8 types of pulse appeared more than 10 times.Wiry pulse appears by 43 times,followed by sluggish pulse,which appears by 23 times.Thready pulse appears by 21 times,while sunken pulse appears by 15 times.Soggy pulse and large pulse respectively appear by 14 times,weak pulse comes next with 12 times,then rapid pulse with 11 times.Moderate pulse and feeble pulse appear by 9 times and 8 times respectively.5.“Linzheng Zhinan Yi’an” Distribution of symptoms with Pinellia prescribed The 38 symptoms involved by more than 10 times include: vomiting,gastric acid reflux;abdominal distension and discomfort;epigastric abdominal pain;loss of appetite and less intake of food;fever and chills;vomiting;loose stools;abdominal distension;nausea and retching;constipation;cold limbs;hypochondriac pain;hypochondriac distension;spitting;chest distension and discomfort;cough;retrogression of the air,inversion of the air;putrid belching with regurgitation of stomach acid;dizziness;phlegm;vexation and thirst;easily irritable;perspiration;limb numbness and stiff paralysis;physical muscle swelling and pain;coma;choking pain;dysphagia discomfort;elimination discomfort;chest pain;yellowish eyes;dyspnea;headache and head distension;insomnia;weight loss;belching;borborygmus;bright complexion and reddish face.6.“Linzheng Zhinan Yi’an” Distribution of symptoms with Pinellia prescribed Among 410 cases of using Pinellia,Pinellia accounts for more than 70%,of which 290 cases that are involved.It is then followed by fried Pinellia and fermented Pinellia,prescribed in 71 and 29 cases respectively.Cooked Pinellia is prescribed in 10 cases,while Pinellia mixed-fried with vinegar and burnt Pinellia are prescribed in 7 cases and 3 cases respectively.7.“Linzheng Zhinan Yi’an” The use of other medicines with Pinellia In Linzheng Zhinan Yi’an there are 154 kinds of herbal medicines being prescribed together with Pinellia.The 10 most common kinds of medicines are poria cocos,ginger juice,ginseng,tangerine peel,red tangerine,fructus aurantii,coptis chinensis,almond,magnolia officinalis and dried ginger.Amongst the ten medicines poria cocos are most frequently used with Pinellia,which is by 232 times,followed by ginger juice,used by 141 times,ginseng by 128 times and tangerine peel by 102 times.8.The relationship between Pinellia/its product and etiology and pathogenesis Pinellia is related to the obstruction of phlegm-dampness and liver and spleen disharmony(P < 0.05),while burnt Pinellia is related to the weakness of spleen and stomach and spleen and stomach qi deficiency(P < 0.05 and P<0.01).Fried Pinellia is related to phlegm qi obstruction of vessels(P<0.05).Fermented Pinellia is related to the spleen yang deficiency,the syndrome of liver qi depression transforming into fire and the spleen and stomach qi deficiency.Cooked Pinellia is related to liverstomach disharmony and qi and blood stagnation(P < 0.05 and P < 0.01).Pinellia mixed-fried with vinegar is related to dampness obstruction of qi(P < 0.01).9.The relationship between Pinellia/its products and tongue signs.Burnt Pinellia and fried Pinellia are related to white tongues.10.The relationship between Pinellia/its products and pulses.Wiry pulse is related to the use of fried Pinellia(P<0.05).Large pulse is related to the use of burnt Pinellia(P<0.01).Rapid pulse is related to the use of burnt Pinellia and fermented Pinellia(P<0.01).11.The relationship between Pinellia/its products and symptoms Pinellia is prescribed for 6 symptoms(P < 0.05 or P < 0.01),including gastric acid reflux,salivation,abdominal distension,abdominal discomfort,nausea and retching.Fried Pinellia is related to fever and cold,cough,wheezing,nausea and retching(P<0.05).Fermented Pinellia is related to vertigo and epigastric distension(P<0.05).Cooked Pinellia is prescribed for cold limbs,limb paralysis,distending pain and constipation(P < 0.01).Burnt Pinellia is related to phlegm,elimination discomfort,abdominal distension,perspiration and easily irritable(P < 0.05 or P < 0.01).12.“Linzheng Zhinan Yi’an” The use of other medicines with Pinellia Pinellia is most commonly used with poria cocos,ginseng and ginger juice.(Support:50;Confidence: 0.6)13.“Linzheng Zhinan Yi’an” The organ meridians which Pinellia is prescribed for In “Linzheng Zhinan Yi’an”,prescriptions with Pinellia are mostly used for the four organ meridians which are spleen,lung,stomach and heart.More than 1000 cases are found.Among them spleen meridian is mostly prescribed with Pinellia,which is by 2143 times.14.The four qi of prescriptions with Pinellia in “Linzheng Zhinan Yi’an” In Linzheng Zhinan Yi’an”,prescriptions with Pinellia are mostly warm in nature,accounting for more than 50%.15.The five tastes of prescriptions with Pinellia in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,prescriptions with Pinellia taste mostly hot and bitter,accounting for 36% and 32% respectively.16.Medicines prescribed with Pinellia for malaria in “Linzheng Zhinan Yi’an” Pinellia are most commonly used with ginseng,Baicalin and Magnolia officinalis,which are recorded by 26,24 and 21 times respectively.(Support:15;Confidence: 0.6)17.Organ meridians that prescriptions with Pinellia subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,prescriptions with Pinellia mostly belong to the meridian of spleen,lung,stomach and heart,with frequency of more than 150 times,among which the highest was subsumed into spleen meridian,which is 349 times.18.The four qi of medicines used with Pinellia for Malaria in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for Malaria are mostly warm in nature,accounting for 50%.19.The five tastes of medicines used with Pinellia for Malaria in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for Malaria mostly taste spicy and hot,respectively accounting for 34% and 35%.20.Medicines used with Pinellia for cases related to phlegm retention in “Linzheng Zhinan Yi’an” Pinellia is most commonly used with poria cocos and cinnamon twigs,each recorded by 29 and 21 times.(Support 15;Confidence 0.6)21.Organ meridians that medicines used with Pinellia for phlegm retention subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia are mostly subsumed into the meridian of spleen and lung,with frequency of more than 100 times,followed by stomach and heart,among which the highest was subsumed into spleen meridian,which is 149 times.22.The four qi of medicines used with Pinellia for phlegm retention in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for phlegm retention are mostly warm in nature,accounting for 67%.23.The five tastes of medicines used with Pinellia for phlegm retention in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for malaria mostly taste spicy and sweet,accounting for 37% and 32% respectively.24.Medicines used with Pinellia for vomiting in “Linzheng Zhinan Yi’an” Pinellia is most commonly used with Poria cocos and ginger juice.(Support 15;Confidence 0.6)25.Organ meridians that medicines used with Pinellia for vomiting subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia are mostly subsumed into the meridian of spleen,with frequency of more than 139 times,followed by lung,stomach and heart,which are 91,89 and 61 times respectively.26.The four qi of medicines used with Pinellia for vomiting in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for vomiting are mostly warm in nature,accounting for 55%.27.The five tastes of medicines used with Pinellia for vomiting in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for vomiting mostly taste spicy and bitter,accounting for 35% and 34% respectively.28.Medicines used with Pinellia for “wood overacting on earth” in “Linzheng Zhinan Yi’an” Pinellia is most commonly used with ginseng,which is by 14 times,while with Poria cocos by 12 times,and with ginseng and Poria cocos by 11 times.(Support 10;Confidence 0.6)29.Organ meridians that medicines used with Pinellia for “wood overacting on earth” subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for “wood overacting on earth” are mostly subsumed into the meridian of spleen,with frequency of m124 times,followed by stomach,lung and heart,which are 82,81 and 62 times respectively.30.The four qi of medicines used with Pinellia for “wood overacting on earth” “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for “wood overacting on earth” are mostly warm in nature,accounting for 55%.31.The five tastes of medicines used with Pinellia for “wood overacting on earth” in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for “wood overacting on earth” mostly taste bitter and spicy,accounting for 35% and 32% respectively.32.Medicines used with Pinellia for epigastric pain in “Linzheng Zhinan Yi’an” Pinella is used with poria cocos,corydalis corydalis,galangal,dried ginger and cinnamon twigs for 5 times or more.(Support: 5;confidence: 0.6)33.Organ meridians that medicines used with Pinellia for epigastric pain subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for epigastric pain are mostly subsumed into the meridian of spleen,with frequency of 105 times,followed by lung,stomach and heart,which are 67,64 and 61 times respectively.34.The four qi of medicines used with Pinellia for epigastric pain in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for epigastric pain are mostly warm in nature,accounting for 51%.35.The five tastes of medicines used with Pinellia for epigastric pain in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for epigastric pain mostly taste spicy,accounting for 46%,while those that taste bitter account for 34%.36.Medicines used with Pinellia for hiccup and nausea in “Linzheng Zhinan Yi’an” Pinella is used with ginger juice,coptis chinensis and for 10 times or more.(Support: 10;confidence: 0.6)37.Organ meridians that medicines used with Pinellia for hiccup and nausea subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for hiccup and nausea are mostly subsumed into the meridian of spleen,with frequency of 91 times,followed by stomach,lung and heart,which are 62,61 and 54 times respectively.38.The four qi of medicines used with Pinellia for hiccup and nausea in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for hiccup and nausea are mostly warm in nature,accounting for 52%.39.The five tastes of medicines used with Pinellia for hiccup and nausea in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for hiccup and nausea mostly taste spicy and bitter,accounting for 38% and 37% respectively.40.Medicines used with Pinellia for abdominal bloating in “Linzheng Zhinan Yi’an” Pinella is used with fructus aurantii for 5 times,together with coptis chinensis,radix scutellariae and dried ginger for abdominal bloating.(Support: 5;confidence: 0.6)41.Organ meridians that medicines used with Pinellia for abdominal bloating subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for abdominal bloating are mostly subsumed into the meridian of spleen,with frequency of 77 times,followed by stomach,lung and heart,which are 60,52 and 34 times respectively.42.The four qi of medicines used with Pinellia for hiccup and nausea in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for abdominal bloating are mostly warm in nature,accounting for 50%.43.The five tastes of medicines used with Pinellia for abdominal bloating in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for abdominal bloating mostly taste spicy and bitter,accounting for 39% and 37% respectively.44.Medicines used with Pinellia for swelling in “Linzheng Zhinan Yi’an” Cooked pinella is used with poria cocos for 5 times,together with coptis chinensis and dried tangerine peel.It is also used with coptis chinensis and poria cocos only for another 10 times.(Support: 10;confidence: 0.6)45.Organ meridians that medicines used with Pinellia for swelling subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for swelling are mostly subsumed into the meridian of spleen,with frequency of 117 times,followed by stomach,heart and lung,which are 88,63 and 59 times respectively.46.The four qi of medicines used with Pinellia for swelling in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for swelling are mostly warm in nature,accounting for around 45%.47.The five tastes of medicines used with Pinellia for swelling in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for swelling mostly taste bitter and spicy,accounting for 36% and 32% respectively.48.Medicines used with Pinellia for summer-heat illnesses in “Linzheng Zhinan Yi’an” Pinellia is used talc,radix scutellariae,magnolia officinalis and almond for summer-heat illnesses.(Support: 5;confidence: 0.6)49.Organ meridians that medicines used with Pinellia for summer-heat illnesses subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for summer-heat illnesses are mostly subsumed into the meridian of lung,with frequency of 68 times,followed by stomach,spleen and large intestine,which are 57,52 and 32 times respectively.50.The four qi of medicines used with Pinellia for summer-heat illnesses in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for summer-heat illnesses are mostly warm in nature,accounting for around 54%.51.The five tastes of medicines used with Pinellia for summer-heat illnesses in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for summer-heat illnesses mostly taste bitter and spicy,accounting for 41% and 34% respectively.52.Medicines used with Pinellia for phlegm-related illnesses in “Linzheng Zhinan Yi’an” Pinellia together with poria cocos,ginger juice and cinnamon twigs are often prescribed for phlegm-related illnesses.(Support: 10;confidence: 0.6)53.Organ meridians that medicines used with Pinellia for phlegm-related illnesses subsumed to in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for phlegmrelated illnesses are mostly subsumed into the meridian of spleen,with frequency of 195 times,followed by lung,stomach and heart,which are 175,122 and 120 times respectively.54.The four qi of medicines used with Pinellia for phlegm-related illnesses in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for phlegmrelated illnesses are mostly warm in nature,accounting for around 61%.55.The five tastes of medicines used with Pinellia for phlegm-related illnesses in “Linzheng Zhinan Yi’an” In “Linzheng Zhinan Yi’an”,medicines used with Pinellia for summer-heat illnesses mostly taste spicy,sweet and bitter,accounting for 37%,29% and 27% respectively.ConclusionCombining the comprehensive analysis of the medical cases of using Pinellia in “Linzheng Zhinan Yi’an” and the findings in “Ben cao gang mu” and medical books of different ages,one comes to understand that Pinellia,instead of being just prescribed for nourishing yin and yang,external and internal and cold and heat,can also be of the use for a wide range of illnesses.Indeed the acridness and bitterness of Pinellia serve the purpose of opening and descending respectively.In addition,its nature is able to connect yang to yin.Thus Pinellia can be prescribed for illnesses related to intermingled cold and heat. |
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