From Zhongjing’s Dialectical Treatment Of "appetite Loss" To The Study Of Professor Li Jiageng’s "harmonizing Stomach Qi" Academic Thought And The Law Of Drug Use

objective This study screened 1162 cases of Professor Li Jiageng’s clinical records in the treatment of appetite loss,and carried out data mining,experience analysis and pharmacological research on the basis of syndrome medicine,in order to summarize Professor Li’s academic thought of "harmonizing stomach qi" and lay a foundation for better learning and carrying forward Professor Li’s academic experience.After that,we discussed Professor Li’s inheritance and development of Zhongjing’s spleen and stomach academic thought in the treatment of appetite loss.Based on the research of network pharmacology,we supplemented and explained it and observed the action pathway of the selected prescription,in order to open up ideas for the follow-up research.Method(1)From October 2014 to October 2019,Professor Li Jiageng’s outpatient medical records in Fenghuang clinic of Hubei Hospital of traditional Chinese medicine and Guoyi Hall of Hubei University of traditional Chinese medicine were screened.We sort out and classify the selected outpatient medical records,and then import them into excel,and carry out various standardized processing,so as to build the database needed for this study.We complete the frequency analysis by Excel,then import the medical record data into Weka 3.6.11 software,and use the methods of association analysis and cluster analysis to mine the data.After that,we used the software of Cytoscape 3.7.2 to draw the image,and constructed the core drug network diagram of Professor Li’s treatment of appetite loss.(2)We selected Professor Li’s top 14 traditional Chinese medicines which are most frequently used in spleen-stomach damp-heat syndrome as a research object,named SRZ decoction.Then select Banxia Xiexin Decoction in Shang Han Lun as the research object,named BXXX decoction.Through the online bioinformatics analysis website BATMAN-TCM,we analyzed the network pharmacology of the two prescriptions,and collected the chemical components and corresponding targets of traditional Chinese medicine.Then we do gene function analysis,pathway enrichment analysis based on KEGG database and disease enrichment analysis based on TTD database.After that,we screened the target,used the software Cytoscape 3.7.2 to generate the network diagram of traditional Chinese medicine-target-disease,so as to comprehensively and intuitively discuss the pharmacological mechanism of the two prescriptions in the treatment of diseases.Result(1)Data mining Professor Li Jiageng’s experience in the treatment of appetite loss We screened 1162 cases of Professor Li Jiageng’s treatment of appetite loss,335 of which were male,accounting for 29% of the total,827 of which were female,accounting for 71%;the minimum age of the patients was 5 months old,the maximum age was 93 years old,and the average age was 53.4 years old.The patients aged 51-60 accounted for the largest proportion.The common symptoms of appetite loss are not only stomach distention,belching,stomachache,acid regurgitation,abnormal stool and other digestive system diseases,but also insomnia,dry mouth,fatigue,dizziness,backache,frequent urination and cold fear.1162 cases were divided into 7 types: Damp heat syndrome of spleen and stomach,liver depression and spleen deficiency syndrome,yin deficiency and fire hyperactivity syndrome,lung deficiency and pathogenic retention syndrome,spleen and kidney deficiency syndrome,liver depression and kidney deficiency syndrome and dampness obstruction and qi stagnation syndrome.According to the frequency of Western medicine diagnosis and laboratory examination,the most frequent diagnosis is hypertension,and digestive system diseases included erosive gastritis,superficial gastritis,atrophic gastritis,intestinal metaplasia,etc.The prescriptions include Erchen decoction,Banxia Xiexin Decoction,Huoxiang Zhengqi powder and Sini Powder.According to the classification of efficacy,the top ten efficacy of the frequency of use are heat clearing medicine,deficiency tonic medicine,surface resolving medicine,food eliminating medicine,Qi regulating medicine,blood activating and stasis removing medicine,water and moisture removing medicine,dampness removing medicine,phlegm resolving and cough relieving and asthma relieving medicine.The top ten traditional Chinese medicines used in this study were Glycyrrhiza,fried hawthorn,red peony,Salvia miltiorrhiza,Poria cocos,faban pinellia,tangerine peel,chuanxiong,Fushen and patchouli.Dampness and heat of the spleen and stomach are the most common syndrome types of appetite loss diseases.The basic formula is Banxia Xiexin Decoction Combined with Huoxiang Zhengqi powder.The basic prescriptions of liver depression and spleen deficiency syndrome are Chaihu Shugan powder,Sini Powder,Siwu Decoction and Yupingfeng powder.The basic prescriptions of yin deficiency and Huowang syndrome are yinqiao powder,Wuwei Xiaoxiao drink and Sini Powder.The basic prescriptions of lung deficiency syndrome were Huoxiang Zhengqi powder,Sanao Decoction and Yupingfeng powder.In spleen and kidney deficiency syndrome,the basic prescriptions of the patients with more yang deficiency are Huoxiang Zhengqi powder,Erchen decoction and Siwu Decoction;the basic prescriptions of the patients with more yin deficiency are Liuwei Dihuang pill and Zengyi decoction.In the syndrome of liver stagnation and kidney deficiency,the basic formula of the patients with liver qi stagnation is Chaihu Shugan powder and Siwu Decoction;the basic formula of the patients with liver and kidney yin deficiency is Liuwei Dihuang pill and Erzhi Pill.The basic prescriptions of damp blocking qi stagnation syndrome are Chaihu Shugan powder and Anshen Dingzhi pill.(2)Study on the molecular mechanism of drugs based on network pharmacology We searched the TCM resource database batmam-tcm,and got 316 active ingredients and 13103 predicted targets of SRZ decoction,325 active ingredients and 12972 predicted targets of BXXX decoction.After the enrichment analysis of the website,we got the enrichment results of two prescriptions: 57 core channels of SRZ decoction and 60 core channels of BXXX decoction.There are 49 core pathways in the two prescriptions are the same,mainly in metabolism,tissue system,signal transduction,especially in amino acid,lipid metabolism,nervous system and endocrine system.After the analysis of disease phenotype enrichment,the disease enrichment results of two prescriptions were obtained.There are 26 kinds of diseases that can be treated by SRZ decoction and 23 kinds of diseases by BXXX decoction.There are 21 kinds of potential diseases that can be treated by two prescriptions are the same,which mainly related to the treatment of pain,as well as nervous system,cardiovascular disease,mental illness,etc.conclusion Professor Li inherits and develops Zhongjing’s Thoughts on spleen and stomach.Professor Li paid attention to protecting the spleen and stomach,making Qi and blood unobstructed,so as to make the stomach qi harmonious.On the basis of syndrome differentiation and treatment,Professor Li paid more attention to the application of Qi regulating,blood stasis removing and food eliminating drugs.This paper summarizes Professor Li’s academic thought of harmonizing stomach qi,including(1)attaching importance to the spleen and stomach,regulating qi and blood;(2)the diagnosis and treatment mode is "combining four diagnosis with reference",and attaching importance to the overall concept;(3)referring to the views of many doctors,flexibly using the treatment methods;(4)using small dosage and combining the thoughts of traditional Chinese and Western medicine;(5)attaching importance to psychological guidance,and advocating the comprehensive treatment of drugs and food.