Director Ma Wenhui’s Experience In Treating Rheumatoid Arthritis With Guizhi Shaoyao Zhimu Decoction

Objective:In this study,by summarizing the medical records of patients with rheumatoid arthritis treated with Guizhi Shaoyao Zhimu Decoction by Director Ma Wenhui,combining with daily clinical study with teachers and in-depth communication with tutors,we can further explore the TCM pathogenesis of rheumatoid arthritis and the compatibility significance of Guizhi Shaoyao Zhimu Decoction,and further popularize its treatment experience,providing new ideas and methods for expanding the clinical treatment of rheumatoid arthritisMethods:Specific methods:35 patients with rheumatoid arthritis admitted from December 2019 to January 2021 were taken as the research objects,and the general conditions such as gender,age,course of disease,main symptoms,related tests,tongue pulse,prescription usage,etc.were recorded,and the case data sorted out after each visit were recorded into Word document and Excel database,which was convenient for case management and preservation.And use SPSS26.0 to make descriptive analysis and cluster analysis of the collected data to study the application of prescription drugs(frequency of drug use,use of flavored drugs,classification of traditional Chinese medicines,etc.)after Guizhi Shaoyao Zhimu Decoction was modified and treated for rheumatoid arthritis,and draw corresponding charts to summarize and analyze the medication rules of Director Ma Wenhui.Secondly,through clinical interviews with teachers,we can understand their understanding of the pathogenesis of rheumatoid arthritis and summarize their clinical experience.Results:1.Among the 35 patients who met the inclusion criteria,according to the evaluation criteria of curative effect,20 cases were markedly effective and 15 cases were effective.There are 63 prescriptions and 83 kinds of traditional Chinese medicines.The data of their sex,age,years of onset,tongue pulse and prescription drugs are sorted out and analyzed.The results are as follows:①Gender:There are 8 men and 27 women,accounting for 23%and 77%respectively,and the ratio of male to female is 1:3.3②Age:Among the 35 patients,the oldest is 70 years old,the youngest is 19 years old,the patients aged 41-50 are the most,accounting for 37%,and the patients aged 51-60 and 61-70 are both 23%.③Length of illness:The length of illness was 7.86 2 years,of which the longest course was 30 years and the shortest was 1 year.④Main symptoms:The patients with rheumatoid arthritis treated by Guizhi Shaoyao Zhimu Decoction mainly have joint pain,joint tenderness,j oint swelling,morning stiffness,joint fever,fear of wind and cold,j oint coldness,thirst and other symptoms⑤Tongue pulse:The statistics of tongue picture show that the tongue quality of rheumatoid arthritis treated by Guizhi Shaoyao Zhimu Decoction is light,red and dark,and the tongue coating is mainly yellow and white.Combined with the diagnosis of pulse condition in three parts and six diseases,it is found that the single pulse condition and the compound pulse overflow are common in rheumatoid arthritis patients⑥Drug analysis:In terms of prescription and drug frequency,63 prescriptions and 83 traditional Chinese medicines were collected,with a total frequency of 918 times According to the order of drug use frequency,50 kinds of drugs with use frequency≥5%were obtained,with a total frequency of 880 times,accounting for 95.8%of the total drug use frequency.Ramulus Cinnamomi(63 times),Radix Paeoniae Alba(60 times),Radix Aconiti Lateralis(57 times),Herba Ephedrae(56 times),Radix Puerariae(55 times),Caulis Sinomenii(55 times),Rhizoma Anemarrhenae(50 times),Atractylodes macrocephala(49 times),Herba speranskiae tuberculatae(48 times)and Radix Saposhnikoviae Ramulus Cinnamomi,Radix Paeoniae Alba,Radix Aconiti Lateralis Preparata,Herba Ephedrae,Radix Puerariae,Caulis Sinomenii,Rhizoma Anemarrhenae,Atractylodis Macrocephalae,Herba speranskiae tuberculatae,Radix Saposhnikoviae,Caulis Spatholobi,Herba Erodii,Caulis Lonicerae,Radix Angelicae Pubescentis,Radix Glycyrrhizae,Radix Angelicae Sinensis,Semen Plantaginis,Pericarpium Citri Tangerinae,Loofah,Achyranthis Radix,Rhizoma Smilacis Glabrae,etc.According to the efficacy categories of the drugs used,they can be divided into 15 categories.Among them,the cumulative frequency of exterior syndrome relieving drugs reached 242 times,followed by rheumatism eliminating drugs,deficiency tonifying drugs and heat clearing drugs,which were 212 times,164 times and 115 times respectively.The most frequent drugs are Ramulus Cinnamomi,Herba Ephedrae,Radix Puerariae and Radix Saposhnikoviae.The other drugs are arranged as follows:warming the internal organs(64 times),promoting blood circulation and removing blood stasis(64 times),promoting diuresis and eliminating dampness(22 times),regulating qi(11 times),tranquilizing mind(5 times),calming liver and calming wind(6 times),eliminating phlegm,relieving cough and asthma(4 times),promoting digestion(4 times),eliminating dampness(3 times),Medicine for purging(twice)and medicine for inducing resuscitation(once).Through the cluster analysis of high-frequency drugs,two groups of angular drugs and two pairs of drugs were obtained,which were Plantago asiatica,loofah and Lonicera japonica Thunb.Caulis Sinomenii,Herba speranskiae tuberculatae,and Radix Saposhnikoviae;Pericarpium Citri Tangerinae and Glycyrrhrizae Radix;Radix Angelicae Pubescentis and Radix Achyranthis Bidentatae.2.According to the collation results of prescription data,through a careful interview with Director Ma Wenhui around the etiology,pathogenesis and medication rules of the disease,it was found that the tutor believed that rheumatoid arthritis should be treated from Ying Wei,with the main pathogenesis being "Ying Wei tilting",and the deeper pathogenesis being "Ying Wei tilting",in which wind evil is the starting factor,so the general principle of treating the disease should be "harmonizing Ying Wei",and the treatment methods should be dispelling wind and removing dampness and supporting Ying Wei.Conclusion:Director Ma Wenhui’s experience in treating rheumatoid arthritis with Guizhi Shaoyao Zhimu Decoction is summarized as follows:(1)Etiology and pathogenesis "Ying-Wei tilting" is the main pathogenesis of rheumatoid arthritis,with pathogenic wind as its starting factor,and hyperactivity of Wei-Qi occupies a dominant position in the whole pathogenesis.(2)The key to treatment experience is to coordinate the whole.The general principle should be to harmonize the camp and health,and the main treatment methods should be to dispel wind and remove dampness,support the camp and restrain the health.By harmonizing,the natural healing energy of human body can be restored,qi and blood can be adjusted smoothly,and the five internal organs can be reconciled.