Professor Feng Xinghua Academic Experience Inheritance Research For The Treatment Of Rheumatism

Objective:To inheriting the academic thoughts and clinical experiences of Fengxinghua treating rheumatism diseases, and with ankylosing spondylitis(AS) as the research focus, based on ankylosing spondylitis (AS)"deficiency of kidney as the principal aspect, damp-heat, damp-cold, blood-stasis all as labeled aspects, blood stasis syndrome throughout the disease procession always" academic thought of my advisor, I have sorted literature, analysised clinical medical records to find out Professor Fengxinghua thoughts of syndrome differentiation and regularity of herbs using of treatment of ankylosing spondylitis. This subject also carried out clinical trial to inspection academic thoughts clinical curative effect and safety.Methods:1. Following the advisor study three years, through my advisor vocal education, watching he treat patients and thinking, analysis of his clinical treating cases, I have analyzed my adviser published professional articles, based on the Chinese medicine classic literature, comb and summarizes the advisor academic thoughts and clinical experiences of the rheumatism diseases treatment.2. Syndrome research:210patients with ankylosing spondylitis patients’database was established, and taken symptoms, syndromes type, therapies and formulae for data mining, use frequency analysis and correlation rules analysis.3. Clinic research:A6-month, randomized, positive controlled clinic study was carried out, to evaluate the efficacy and safety of traditional Chinese medicine treatment, in patients with AS, by using the international working group of ASAS formulated ASAS20, BASDAI50standards and TCM syndrome curative effect.Results:1. Summarize my advisor’s academic thoughts and clinical experience of treatment of rheumatism diseases:Put forward " eliminating pathogenic factors is the basic therapy of rheumatoid arthritis "; Put forward ankylosing spondylitis "deficiency of kidney as the principal aspect, damp-heat, damp-cold, blood-stasis all as labeled aspects, blood stasis syndrome throughout the disease procession always"; Put forward primary Sjogren syndrome "supplementing qi and nourishing yin, removing drynes.s-toxin and dispersing stagnation and dredging the collaterals is the basic therapy ", etc.2. Analysis of pathogenesis syndrome factor and syndrome type:Among210patients AS, five of the main syndrome factors are blood-stasis, deficiency of kidney Yang, damp-heat, deficiency of spleen Yang and qi stagnation in order. And deficiency of kidney Yang and blood-stasis> damp-heat and blood-stasis> deficiency of kidney Yang and damp-heat and blood-stasis> blood-stasis> deficiency of spleen and kidney Yang and blood-stasis are the most common type of AS. Put forward the pathogenesis of ankylosing spondylitis "deficiency of kidney as the principal aspect, damp-heat, damp-cold, blood-stasis all as labeled aspects, blood stasis syndrome throughout the disease procession always".Characteristic of using prescriptions and drugs:characteristics of prescriptions:the main prescriptions analysis shows:Characteristic of using prescriptions:Five of the common used recipes are Bushenqiangji Decoction, Simiao decoction, Shentongzhyu decoction, Qingreqiangji decoction, Qianghuoshengshi decocotion. The most common recipes are Bushenqiangji Decoction with nourishing liver and kidney and activating blood and dredging collaterals, Simiao decoction with clearing heat and removing dampness and activating blood and dredging collaterals. Characteristic of using drugs:The first five classes of herbs were reinforcing drugs, promoting-circulation drug, clearing-heat drugs, inhibiting-damp drugs, dispel-wind drugs. The frequently used drugs were Salvia, achyranthes root, red peony root, japanese teasel, angelica sinensis.Analysis of relationship of syndrome factor and drugs and between the drugs:Correlation analysis of syndrome factor and drugs of210cases of patients with AS:Reinforcing kidney related to Japanese teasel, Japanese teasel, achyranthes root, barrenwort, rhizomadrynariae, salvia. The spleen deficiency and atractylodes related. Damp-heat and coix lacryma-jobi, achyranthes root, Bixie, salvia, cortex phellodendri related. Blood-stasis and salvia, achyranthes root, red peony root were related. According to the drug efficacy distribution, reflects AS deficiency of the kidney, damp-heat, blood-stasis and characteristics of each case. Among them salvia was related with deficiency of the kidney, damp-heat, blood-stasis, from the other side suggested blood-stasis in the important role of ankylosing spondylitis, treatment should be for activating blood circulation and eliminating stasis through disease always. Professor Feng is good at using herbs to benefit kidney Yang and kidney Yin. The high correlation of two league drug is more in compatibility, to enhance the curative effect. Drug related and drugs (quad correlation) analysis, the right medicine always was reinforcing kidney drugs no matter whether the left medicine was reinforcing kidney or promoting blood circulation. It reveals the kidney deficient is the basic pathogenesis of ankylosing spondylitis, reinforcing kidney and promoting blood circulation is the basic law of AS treatment, also from a certain degree, reflects the dialectical thought professor Feng individual therapy. Also, in part reflects my adviser thinking of syndrome differentiation of AS treatment.Therefore, through mining database of my adviser medical records of AS treatment, summed up AS "deficiency of kidney as the principal aspect, damp-heat, damp-cold, blood-stasis all as labeled aspects, blood stasis syndrome throughout the disease procession always" pathogenesis characteristics; Method follow syndrome, formed the two fundamental treatment rules that are nourishing kidney and activating blood, clearing heat and activating blood.3. Through a6-month, randomized, positive controlled clinic study, by using the international working group of ASAS formulated ASAS20, BASDAI50standards and TCM syndrome curative effect. The results are as follows:The curative effect of traditional Chinese medicine treatment of ankylosing spondylitis is exactly, and rapid onset, curative effect lasting stability. After treating6months, the ASAS20is84.85%, BASDAI50is65.15%, and the total effective rate of traditional Chinese medical syndrome is95.45%.Traditional Chinese medicine are obviously improved BASDAI score, BASFI score, overall evaluation of pateints, spine inflammation score, and morning stiffness, the pain at night, spinal pain and restricted movement. It can very good reduce the disease activity of AS, and can significantly improve patients with function condition; Traditional Chinese medicine also can improve the BASMI score of AS patients, cervical vertebra, lumbar lateral bending rotation, lumbar proneness to wall, ankle from directed anatomical-space; It can reduce ESR, CRP of AS patients.Traditional Chinese medicine has good curative effect of peripheral joint and axis joints of AS patients, with no obvious difference when comparing with Sulfasalazine. But Traditional Chinese medicine has better curative effect of axis joints.The efficiency of Traditional Chinese medicine treatment AS is timeliness, that is to say when the time goes by, the curative effect gradually strengthened. Bushenqiangji Decoction and Qingreqiangji Decoction with clinical efficacy, safety are relatively good, has the broad application prospect and the development value.This study combined international ASAS disease evaluation factors and the effect assessment of TCM syndrome, and evaluated curative effect and safety of traditional Chinese medicine treatment AS. The results provide a powerful evidence of a comprehensive assessment for herbal treatment AS, also confirmed professor Feng’s reasonable and effective traditional Chinese medicine treatment AS. ConclusionsPrefessor Feng engaged in rheumatism for many years, rich experience and medical skill is exquisite. This research objectively reflects "deficiency of kidney as the principal aspect, damp-heat, damp-cold, blood-stasis all as labeled aspects, blood stasis syndrome throughout the disease procession always" which my advisor puts forward, which is the characteristics of pathogenesis. Through to the symptoms associated with drugs, syndrome types and the main prescriptions, reflects "benefiting liver and kidney, clearing heat removing dampness and activating blood and dredging collaterals" my advisor puts forward, which is the principle law of treatment. At the same time, through analysis of using herbs and prescriptions, established "deficiency of kidney as the principal aspect, reinforcing kidney and promoting blood circulation are basic therapeutic principle". Also from a certain degree, reflects the dialectical thought individual therapy of professor Fengxinghua. Also, in part reflects my adviser thinking of syndrome differentiation of AS treatment.And through a6-month, randomized, positive controlled clinic study, by using the international working group of ASAS formulated ASAS20, BASDAI50standards and TCM syndrome curative effect, confirmed the exact curative effect of traditional Chinese medicine treatment of ankylosing spondylitis, and rapid onset, curative effect lasting stability, to provide evidence-based medicine evidence to my adviser traditional Chinese medicine treatment of AS theory.