Study On Clinical Experience Of Professor Liu Gui-rong In The Application Of Buzhong Yiqi Decoction

ObjectiveBuzhong Yiqi decoction is a classic prescription for nourishing spleen and stomach,which is one of the commonly used clinical prescriptions of Professor Liu Guirong.This study systematically collates the relevant outpatient medical records of Professor Liu Guirong’s application of Buzhong Yiqi decoction,deduces and analyzes the pathogenesis of the main treatment syndrome of Buzhong Yiqi decoction,in order to summarize the application indication of Buzhong Yiqi decoction.Expand the scope of treatment of Buzhong Yiqi decoction,expect to achieve the purpose of improving the clinical effect.MethodsThis thesis adopts the methods of philology and data mining.First of all,sort out the literature on the origin of Buzhong Yiqi decoction,consult the clinical experience of doctors of previous dynasties in the application of Buzhong Yiqi decoction,Professor Liu Guirong studied related papers and published works of Buzhong Yiqi decoction,and collect Professor Liu’s outpatient medical records.on the basis of fully mastering the original data,the outpatient medical records are classified in detail.Secondly,the data mining method is used to analyze and explain the medication law of Professor Liu’s application of Buzhong Yiqi decoction.Finally,it makes an academic exploration of Professor Liu’s clinical experience in the application of Buzhong Yiqi decoction,summarizes the changing rules of Professor Liu’s application of Buzhong Yiqi decoction,and forms a syndrome differentiation and treatment system in which reason,method,prescription and medicine are interlinked.Results1.Basic situation: among the 102 outpatient medical records included in this subject,male accounts for 26.47%,female accounts for 73.53%,and the ratio of male to female is about 1:3.Most of the patients were 40-59 years old,accounting for 48.04% of the total.2.Statistics of the four diagnosis information: a total of 117 clinical symptoms were counted.The high-frequency clinical symptoms were fatigue(7.41%),dry mouth(3.93%),light sleep and easy to wake up(3.85%),dizziness(3.74%),anorexia(3.74%),palpitation(3.67%),irritability(3.63%),irritability(3.26%),thin stool(2.96%),constipation knot(2.70%)and so on.A total of 11 kinds of tongue were counted,most of which were dark,accounting for 52.95%,followed by red tongue(12.04%)and tongue with tooth marks(10.07%).There are a total of 9 kinds of tongue coating,most of which are white,accounting for 38.22%,followed by thick(23.01%).There are 12 kinds of pulse,most of which are pulse string,accounting for 31.88%,pulse sinking(15.04%)and pulse fineness(14.27%).3.Statistics on the types of treatment diseases: there are 30 kinds of TCM diseases,and the top 5 TCM diseases are: palpitation,chest arthralgia,vertigo,cough,stomach ruffian.There are 38 kinds of western medicine diseases,and the top 5 western medicine diseases are coronary atherosclerotic heart disease,hypertension,chronic gastritis,chronic fatigue syndrome and cough.4.Prescription statistics: there are a total of 44 kinds of Buzhong Yiqi decoction,of which the top 3 are Juyuan decoction,Ginseng Yangrong decoction and Sheng Depression decoction.A total of 247 traditional Chinese medicines are involved,and the most frequently used traditional Chinese medicines are Bupleurum(5.44%),cohosh(4.88%),Angelica sinensis(4.68%),tangerine peel(3.70%),Astragalus membranaceus(3.57%),Atractylodes macrocephala Koidz(3.04%),ginseng(2.77%)and so on.A total of 9 kinds of medicinal properties are involved,which are warm,slightly cold,flat,mild warm,cold,cool,big heat,hot,and Greater Cold,among which warm traditional Chinese medicine is the most,accounting for 32.25%,followed by mild cold traditional Chinese medicine(21.13%)and flat traditional Chinese medicine(20.24%).A total of 10 kinds of medicinal flavors are involved,which are sweet,pungent,bitter,sour,slightly bitter,slightly sweet,astringent,salty,light and slightly pungent,among which the commonly used ones are sweet(32.12%),spicy(27.70%)and bitter(20.19%).In terms of meridian tropism,12 meridians are involved,of which the spleen meridian is the most,accounting for 19.93%,followed by the lung meridian(18.10%)and the liver meridian(15.17%).5.Cluster analysis results: according to the cluster analysis of high frequency symptoms with frequency ≥ 50,11 combinations were obtained: A1: fatigue;A2: dizziness,irritability;A3: frequent urination and blurred vision;A4: light sleep,easy to wake up,but difficult to fall asleep;A5: palpitations,chest tightness and shortness of breath;A6:irritability;A7: cold,abdominal pain;A8: spontaneous sweating;A9: easy to be frightened,thin stool;A10: constipation,stuffy;A11: dry mouth,sweating.According to the cluster analysis of high frequency traditional Chinese medicine with frequency ≥ 50,two combinations were obtained.They are B1: Astragalus,ginseng,tangerine peel,Angelica,Bupleurum,Cimicifuga;B2: Atractylodes macrocephala,Poria,Radix Astragali,Codonopsis,licorice,Salvia miltiorrhiza,Guizhi,licorice,Chuanxiong,Radix Paeoniae Alba,Radix Scutellariae,Radix Puerariae,Cornus officinalis,Platycodon grandiflorum,Fructus Schisandrae,Radix Ophiopogonis,oyster,keel.6.The results of association analysis: the correlation analysis of the high-frequency symptoms showed that in the combination of the two symptoms,there were 6 with a confidence level of more than 0.6,of which the combination with the highest confidence was palpitation-fatigue,with a confidence level of 0.81.The correlation analysis of high-frequency traditional Chinese medicine showed that there were 9 combinations with confidence greater than 0.9,of which the combination with the highest confidence was Pueraria and Bupleurum,with a confidence level of 0.98.ConclusionProfessor Liu Guirong’s application of Buzhong Yiqi decoction is deeply influenced by the Yi water school and attaches importance to the ascending function of spleen and stomach.Although Buzhong Yiqi decoction is widely used in clinical application,the related pathogenesis of its main treatment syndrome is evolved from the basic pathogenesis of weakness of spleen and stomach and no rise of Qingyang,and does not deviate from the original intention of Li Gao Cube.The achievement of Li Gao’s theory is mainly sweet and warm,replenishing qi and rising yang,but Professor Liu is not limited to this.In the change of clinical addition and subtraction,less sweet,bitter and cold products are added to purge yin and fire,which is of guiding significance to modern clinic.