Research On Professor Duan Junguo’s Academic Thoughts Of Xuanfu Theory And Its Clinical Application

Objective:(1)To summarize the Origin and Progress of Xuanfu theory and Xuanfu theory of TCM ophthalmology:The origin,development,perfection and research progress of xuanfu theory and Xuanfu theory of TCM ophthalmology are summarized.(2)To study Professor Duan Junguo’s academic thoughts of Xuanfu theory and Xuanfu Theory in TCM ophthalmology:Systematically sorted out the series of innovative understandings and viewpoints of Xuanfu Theory and Xuanfu Theory in TCM ophthalmology proposed by Professor Duan Junguo,and analyzed the clinical value of guiding the diagnosis and treatment of microvascular diseases and retinal vascular diseases.(3)Clinical Application of Professor Duan Junguo’s Xuanfu Academic Thoughts:The clinical guiding value of the tutor’s academic thoughts of Xuanfu theory on treating microvascular diseases and retinal vascular diseases is discussed.and the scientific connotation of the innovative viewpoints of Xuanfu theory and the theory of Xuanfu in TCM ophthalmology is analyzed also,Based on the results of multi-center,randomized,double-blind and placebo-controlled of the treatment of diabetic retinopathy by taking Qi Ming granules oral(treatment of the method of opening Xuanfu--communicating collaterals).Methods:(1)The Origin and Progress of Xuanfu theory and Xuanfu theory of TCM ophthalmology:the origin,development,perfection and research progress of Xuanfu theory and Xuanfu theory of TCM ophthalmology are summarized by literature review.(2)To study Professor Duan Junguo’s academic thoughts of Xuanfu theory and Xuanfu Theory in TCM ophthalmology:(1)To summarize the tutor’s innovative viewpoints about the core role and value of Xuanfu in the structural system of Qi,blood and body fluid,and about the biomedicine essence of Xuanfu.and analyze Duan Junguo’s academic thoughts on the treatment of microvascular diseases based on the innovative viewpoints.(2)To systematically summarize the innovative viewpoints of professor Duan Junguo on the connotation,etiology and pathogenesis,treatment method and clinical application of Xuanfu Theory in TCM ophthalmology,and discuss the academic thought of the tutor’s treatment of retinal vascular diseases based on the innovative(3)Clinical Application of Professor Duan Junguo’s Xuanfu Academic Thoughts:Multicenter,randomized,double-blind,placebo-controlled study on nonproliferative diabetic retinopathy by treatment of the method of opening Xuanfu--communicating collaterals: 15 hospital were carried out at the same time nationwide,and 312 moderate and severe of nonproliferative diabetic retinopathy subjects meeting the inclusion and exclusion criteria were divided into the trial group and the control group according to the central randomized method,with 162 cases in the trial group and 150 cases in the control group.The trial group received basic treatment and Qiming granules,the control group received basic treatment and placebo,and both groups were treated continuously and followed up for 24 weeks.Observe the changes of following indicators and compare the efficacy of the two groups at the end of follow-up,including:(1)primary end events: proliferative diabetic retinopathy(PDR)or total retinal photocoagulation(PRP);(2)secondary end events: incidence of moderate visual loss(MVL)and persistent visual loss(SMVL);(3)vision(ETDRS characters);(4)retinal thickness(OCT in different retinal areas);(5)TCM symptom scores.And compare the efficacy of the two groups and analyze the scientific value of academic thoughts on the treatment of microvascular diseases based on the innovative view of Xuanfu theory.Results:(1)The Origin and Progress of Xuanfu theory and Xuanfu theory of TCM ophthalmology:(1)Liu Wansu founded the Xuanfu theory which is originated from the “Huangdi Neijing”,Modern and contemporary doctors have enriched and developed the Xuanfu theory,and fruitful results in the concept,physiological function,etiology,prescription,clinical application and modern biology of Xuanfu were achieved.(2)Xuanfu theory of TCM ophthalmology originated from the Xuanwu theory founded by Liu Wansu;Ming and Qing doctors promoted the development of Xuanfu theory of TCM ophthalmology;modern doctors gradually improved the Xuanfu theory system of TCM ophthalmology;contemporary doctors expanded the clinical application scope of Xuanfu theory in TCM ophthalmology.(2)To study Professor Duan Junguo’s academic thoughts of Xuanfu theory and Xuanfu Theory in TCM ophthalmology:(1)“Sanjiao-striae-Xuanfu”is the structure and function unit of Qi and body fluid flow;“collateralsSunluo-Xuanfu” is the structure and function unit of Qi and blood flow;and Xuanfu is the common terminal structure between Qi and body fluid and Qi and blood flow,Xuanfu of collaterals(Sunluo)is the place of Qi,blood and body fluid exchange,more importantly,gasification is the motive force for mutual exchange of qi blood and body fluid.Which the structure system for operation and exchange of qi,blood and body fluid can be established.(2)The structural characteristics of Xuanfu which is small to micro,distribution to wide,number to most,full function and unity of hole and channel determine that Xuanfu is the structural unit of cell level.The functional characteristics of circulation spirit,blood,qi and body fluid of Xuanfu are similar to the circulation and exchange of materials,energy and information in modern biomedical,namely metabolism.Therefore,Xuanfu is the structural and functional unit of the circulation and exchange of material,energy and information in cell level.so Xuanfu is the structure and functional unit of material,energy,information circulation and exchange in cellular level.(3)The profound understanding of the circulation structure network of qi,blood and body fluid has realized the theoretical integration of Xuanfu theory and collaterals theory,and enriched the theoretical connotation of promoting blood circulation and removing blood stasis.The in-depth discussion of the essence of the modern biology of Xuanfu has clarified the theoretical basis that Xuanfu can be classified.(4)Based on the innovative understanding of Xuanfu theory and collaterals theory,the tutor believed that microvascular disease takes "Xuanfu disorder--collaterals stasis" as the core pathogenesis,and communicating collaterals--opening Xuanfu is the basic treatment method,and put forward the academic view that "promoting blood circulation is communicating collaterals,and communicating collaterals is opening Xuanfu" in microvascular disease.(5)Professor Duan Junguo put forward many innovative ideas of Xuanfu theory in TCM ophthalmology based on the profound understanding of Xuanfu theory: proposed the new definition of the ocular Xuanfu;expounded the theoretical basis for its classify of the ocular Xuanfu,and proposed the view that Xuanfu disorder is the basic pathogenesis of ocular diseases,and opening Xuanfu is the basic principle of treating ocular diseases,and analyzed the new theoretical evidence.(6)Retinal vascular diseases belong to the category of microvascular diseases.Professor Duan Junguo believes that retinal vascular diseases take "Xuanfu disorder of eye--Collateral stasis of eye " as the core pathogenesis and take the basic treatment,which should go through the diagnosis and treatment of RVO and DR.(3)Clinical Application of Professor Duan Junguo’s Xuanfu Academic Thoughts:(1)primary endpoint events: 18(11.1%)in the trial group,28(18.7%)in the control group,down by 7.6%;(2)Secondary endpoint events: the trial group was lower than the placebo control group,reducing moderate vision loss rate by 13.13% and moderate sustained vision loss rate by 10.47%.The difference was statistically significant(P <0.01).(3)Visual acuity(ETDRS characters): At the end of treatment,the number of ETDRS characters was(41.235 ±14.243)in the trial group,up(4.867 ± 16.765)than before treatment;in the control group,(34.927± 12.336),down(3.350 ± 16.565)than before treatment.the difference was statistically significant between the two groups(P <0.05).(4)Retinal thickness measured by OCT: The differences between regions 1,2 and 3 of Retinal thickness measured by OCT were significant(P <0.05),while the other region were no significant differences between the two groups.In the contralateral eye,Statistical differences between the two groups were in regions 1,2,3,6,and 8(P <0.05),while the other regions were not significant differences.(5)TCM syndrome: The difference of total score of TCM symptom between pre-treatment and post-treatment score between the two groups was statistically significant(P <0.05),the score of the trial group decreased,and the score of the control group increased.Conclusion:(1)The Origin and Progress of Xuanfu theory and Xuanfu theory of TCM ophthalmology:(1)Xuanfu theory has formed a relatively perfect academic system,and Xuanfu has become one of the important concepts of TCM theory.(2)Xuanfu Theory of TCM ophthalmology has formed a relatively perfect academic system.(2)To study Professor Duan Junguo’s academic thoughts of Xuanfu theory and Xuanfu Theory in TCM ophthalmology:Xuanfu is the core and link of the operation and exchange of qi,blood and body fluid,and is the bridge between Xuanfu and collaterals theory,So it should found the structural network of the operation and distribution of qi,blood and body fluid taking Xuanfu as the core.(2)Xuanfu is the structure and function unit for material,energy,information circulation and exchange in cell level,which is a relatively comprehensive,objective and accurate generalization,and can lead or correct the current all kinds of Xuanfu substance hypothesis.(3)It is of great theoretical significance to have a deep understanding of the operation structure ntework of qi,blood and body fluid and a indepth discussion of the essence of modern biology about Xuanfu.(4)Professor Duan Junguo’s academic thought of treating microvascular disease reflects the value of Xuanfu theory in guiding the diagnosis and treatment of microvascular disease,and also reflects the connotation consistency of promoting blood circulation--communicating collaterals--opening Xuanfu.(5)Professor Duan Junguo’s series of innovative viewpoints of Xuanfu theory in TCM ophthalmology is consistent with the connotation of the viewpoints of Xuanfu theory.(6)The homogeneity of retinal vascular disease and microvascular disease determines the consistency of its etiology and treatment,and also reflects the connotation consistency of the innovative viewpoints between Xuanfu theory and Xuanfu theory in TCM ophthalmology.(3)Clinical Application of Professor Duan Junguo’s Xuanfu Academic Thoughts:opening Xuanfu--communicating collaterals method(Qiming granules)treatment of moderate and severe nonproliferative diabetic retinopathy tends to reduce the risk of blindness,and protects the visual function of nonproliferative DR patients.Qiming granule can also improve the body constitution of DR patients by improving the symptoms and the TCM syndrome score,which reflect the advantages of comprehensive prevention and treatment of TCM.The results confirm the clinical application value of opening Xuanfu--communicating collaterals method on treatment of microangiopathy guided by the innovative view of Xuanfu theory.Combined with the previous research results of the efficacy mechanism of Qiming granule in the treatment of DR rat,which can make a deeper understanding of the scientific connotation of Professor Duan Junguo’s innovative viewpoints about Xuanfu theory.