| Objective:Collecting and soring the data which was from Professor Ren’s clinic of the patients with chronic atrophic gastritis(CAG)during my period of clinical learning.To summarize his medication rules and clinical experience of this disease,"Traditional Chinese Medicine Inheritance Platform(V2.5)" was used to analyze data for the screened information(symptoms,syndrome types,herbal prescriptions,etc.).Methods:Reference to both inclusion and exclusion criteria,we choose valid patients with CAG whose diagnosis and treatment were from Professor Ren between July2018 to June 2020.Professor Ren’s clinical experience will be discussed from the statistics,including every patient’s gender,age,symptoms(tongue image and pulse condition),syndrome types and the frequency,also the flavor,the channel tropism of herbal medicines,etc.Data analysis methods are frequency statistics,rule of prescription combination and new prescription combination.Results:In this study,medical records of 205 patients with CAG treated by Professor Ren were screened out,the results are as follows:1.General Statistics: There were 99 male patients(48.3%)and 106 female patients(51.7%),with a gender ratio of 1:1.07.The patients were concentrated in 40-69 years old for 85.86%.The age group of 50 to 59 years old has the highest incidence of CAG,accounting for 44.88%.2.Symptom statistics: According to symptom frequency statistics,including traditional Chinese tongue image and pulse condition,the total frequency of all 70 symptoms was 2025 times.The symptoms of gastrointestinal tract and mood were the main symptoms,among them(except tongue image and pulse condition),there were 23 kinds of symptoms with frequency more than 10 times,arrange them from high to low is as follows:gastric distension,stomach pain,belching,heartburn,dyspepsia,bitter taste,inappetence,acid reflux,dry mouth,abdominal distension,sleeplessness,dry stool,rib-side pain,lassitude and asthenia,thermophilic,loose stool,constipation,chest tightness,sick,foreign body sensation in throat,over-anxiety,sticky stool,bad breath,sigh.The result of tongue and pulse symptoms occurrence frequency(more than 10)ranked from high to low is: pale tongue,sunken pulse,thin white coating on the tongue,thin yellow coating on the tongue,stringy pulse,white coating on the tongue,slippery pulse,yellow greasy coating on the tongue,thin stringy pulse,red tongue,fat big tongue,slow pulse,heavy stringy pulse,thick white coating on the tongue.The total number of tongue and pulse symptoms was 14.3.Syndrome type statistics: The frequency of the 6 TCM syndrome types from high to low: syndrome of spleen-stomach weakness or cold(34.63%),syndrome of liver and stomach stagnation(26.83%),syndrome of heat stagnation of liver and stomach(25.37%),syndrome of dampness-heat in spleen-stomach(11.22%),syndrome of deficiency of stomach Yin(1.95%),and syndrome of blood-stasis in stomach(0%).4.Medication rules: One hundred and twenty kinds of herbs in 205 prescriptions were calculated.There were 46 kinds of medicine with occurrence frequency ≥15 times,and the top 15 herbal medicine was(the statistical results of common doses are listed after each herbal medicine): Codonopsis,Ginger-processed Rhizoma pinelliae(10g,12 g,15g),Tangerine Peel(6g,9g),Salvia miltiorrhiza(15g,20g),Inula flower(12g,15 g,20g),Atractylodes(raw:20g,30 g,40g;baked:10g),Magnolia officinalis(9g,10g),Radix Bupleuri(6g,9g),Scutellaria(6g,9g),Coloured malt(15g,20 g,30g),Fried rice sprout(the same as the former),Medicated leaven(the same as the former),Zedoary(6g,9g),Ginger(3g,6g),Cuttlebone(20g,30g).Qi-regulating herbal medicine,tonifying deficiency herbal medicine,dampness-resolving herbal medicine and blood-activating and stasis-eliminating herbal medicine are the most classification.The commonly used herbs are mostly warm(55.2%),and the taste of the medicine is mainly bitter,spicy and sweet,accounting for 89.11%.Most of the medicine goes to the Spleen Meridian,the Stomach Meridian,the Lung Meridian and the Liver Meridian,71.22% in total.The commonly used medicine combinations obtained by association rules include: Bupleuri Radix,Scutellaria,Ginger-processed Rhizoma pinelliae,Tangerine Peel,Medicated leaven,Salvia miltiorrhiza,Zedoary.7 groups of core prescriptions were obtained by cluster analysis,which were synthesized into 7 new prescriptions: Oyster Concha,Fructus Tritici Levis,Ligustrum lucidum Ait,Cornus officinalis;Semen Arecae Prepareta,Aurantii Fructus Immaturus,Arecae Pericarpium,Atractylodis Macrocephalae Rhizoma,Ziziphi Semen Spinosae,Polygalae Radix,Longan Arillus,Polygoni Caulis Multiflori,Paeoniae Radix Alba,Corydalis Rhizoma,Toosendan Fructus,Curcumae Radix,Akebia Fruit;Pogostmonis Herba,Atractylodis Macrocephalae Rhizoma,Perillae Caulis,Herba Eupatorii,Zingiberis Rhizoma Praeparatum,Dioscorea Rhizoma,Lablab Semen Album,Amomi Fructus Rotundus,Prepared Liquorice Root,Ramulus Cinnamomi,Radix Astragali preparata,Cyperi Rhizoma,Paeoniae Radix Alba.5.Formulation rules: Through data analysis,it is concluded that Chaiping decoction is the basic formulation of Professor Ren in the treatment of CAG.Different syndrome types are treated with Liujunzi Decoction,Xiaochaihu Decoction,Banxiahoupu Decoction,Chengqi Decoction,Banxiaxiexin Decoction,Sanren Decoction etc.which was based on syndrome differentiation.Conclusion:Through all objective and subjective analysis,we know that Professor Ren has a distinctive view on treatment of CAG.From his point of view,the deficiency of spleen-stomach is the basic of CAG,the stagnation of the stomach is the pathogenesis,the phlegm-dampness and blood stasis are the pathological products.Symptoms of tongue is the vital evidence of syndrome differentiation.Stomach-downward transporting and blood-stasis activating is the therapeutic principle throughout whole treatment process.With the significant therapeutic effect,Professor Ren attaches importance to bitter and pungent flavored herbal medicine in order to balance both cold-hot and symptoms-root causes,this contributes different methods in traditional Chinese ways. |
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