Real World Study On The Inheritance And Application Of Invigorating Spleen And Colluding And Detoxifying Method In Treating Chronic Atrophic Gastritis

This paper is divided into two parts:literature review and clinical research.The literature review first introduces the modern research progress of chronic atrophic gastritis,including epidemiology,risk factors,diagnosis and treatment.Secondly,it introduces the current research status of TCM treatment of chronic atrophic gastritis,including TCM disease name,etiology and pathogenesis,treatment methods,prescriptions and external treatment methods.Finally,it introduces the real world research progress of TCM.It includes six aspects of real world research concepts,research design,data specification,statistical analysis,quality evaluation and application scope.Clinical research can be divided into retrospective study and prospective study.Studyl:Based on the real world,the medication law of Yao Naili’s treatment of chronic atrophic gastritis with the method of invigorating spleen and regulating collages and detoxifying toxins was studiedObjective:Using the real world research method,the real world data of Professor Yao Naili’s treatment of chronic atrophic gastritis were mined and analyzed,in order to summarize the medication law of Professor Yao Naili’s treatment of chronic atrophic gastritis.Methods:The real world data of Professor Yao Naili’s treatment of chronic atrophic gastritis were retrospectively collected according to the Nanpai standard.The time period was from January 2010 to December 2022.The data were processed by SQL software and ETL technology,and the data were mining by OLAP and TCM complex relationship analysis system.Results:(1)General information:A total of 535 cases were included in this study,with a total of 6598 visits.Among them,there were 354 male patients,accounting for 66.17%,and 181 female patients,accounting for 33.83%.(2)Disease diagnosis:The most common disease diagnosis in TCM is gastric puffiness,followed by stomach pain,spleen diseases,puffiness,constipation and so on.Chronic atrophic gastritis and intestinal metaplasia are the main diseases diagnosed in Western medicine.In the diagnosis of secondary Western medicine diseases,the frequent ones are reflux esophagitis,chronic gastritis,insomnia,erosive gastritis,Helicobacter pylori infection,etc.(3)Syndrome characteristics:the frequency of liver depression and spleen deficiency syndrome is the highest,followed by spleen deficiency no transport,liver and spleen disharmony,dampness qi stagnation syndrome,liver qi stagnation syndrome,liver collateral stasis syndrome,etc.(4)Characteristics of the treatment method:the frequency of regulating the liver and spleen and soothing the liver and strengthening the spleen is the highest,followed by stomach dampness,softening the liver and softening the strong,regulating the liver and stomach,strengthening the spleen and water,strengthening the spleen and stomach,strengthening the spleen and reducing phlegm,and stomach removing blood stasis,etc.(5)Medication pattern:A total of 382 drugs were commonly used,and the most frequently used drugs were poria cocos,followed by Radix pseudostellariae,pinellia japonica,stir-fried white rhizome with bran,Coptis coptidis,honey roasted licorice,magnolia officinalis,Perilla stem,licorice,salvia miltiorrhiza,vinegar curcuma curcuma,Thunbergamme fritillaria,xylosa sinensis,etc.In the category of TCM,deficiency supplementing drugs were the most,followed by heat-clearing drugs.The drug properties are mainly warm,bitter and sweet,and liver meridian is the most common drug channel.The number of toxic drugs used was 18.The core prescriptions were Radix pseudostellariae,poria cocos,stir-fried atractylodes with bran,roasted licorice,Tangerine peel,Pinellia officinalis,Magnolia officinalis,Radix coptidis,salvia miltiorrhiza,Rhizoma curcuma in vinegar,Angelica sinensis,Rhizoma coptidis,Radix vulgaris rhizome,Thunberg Fritillaria,Radix rhizome in vinegar,Radix bupleuri,Radix paeoniae paeoniae.The most frequent drug combination was white rhizoma atractylodes and poria cocos.Common combinations are raw oyster and keel,Perilla stem and licorice.Conclusion:Invigorating spleen,dredging collaterals and detoxifying are the fundamental methods of Professor Yao Naili’s treatment of chronic atrophic gastritis,and this core prescription is the basic formula of invigorating spleen and dredging collaterals and detoxifying.Study2:Real world clinical research on the treatment of chronic atrophic gastritis by invigorating spleen and dredging collaterals and detoxificationObjective:To verify the efficacy and safety of the treatment of chronic atrophic gastritis by invigorating spleen and Tongluo and detoxifying,and to obtain real-world evidence of human experience.Methods:According to the sodium standard and the diagnostic standard of traditional Chinese and Western medicine,the real world clinical data of chronic atrophic gastritis patients treated by Zhang Runshun,chief physician of spleen and stomach Department in Guang ’anmen Hospital were collected from June 2022 to February 2023.All enrolled patients had been clinically treated with traditional Chinese medicine by Yao Naili method of invigorating spleen and dredging collaterals and detoxification,and there was no other related treatment.The data were input into the management and service platform of famous doctors’ experience inheritance knowledge,processed by SQL software and ETL technology,and mined by OLAP and TCM complex relationship analysis system.The efficacy of the treatment was evaluated by observing the clinical symptoms and gastroscopy results,and the safety of the treatment was evaluated by the results of relevant laboratory tests.Results:A total of 42 cases were included,of which 4 cases were abscission,the abscission rate was 9.5%.A total of 38 cases were treated.(1)General information:There were 20 male patients,accounting for 52.63%,and 18 female patients,accounting for 47.37%.The youngest patient was 33 years old and the oldest was 69 years old,with an average age of 54.03 years.The education level of the patients is mainly undergraduate or junior college.The patients’ BMI ranged from 18.52 to 26.84kg/m2.(2)Family history:A total of 20 patients had relevant family history,accounting for 52.63%.(3)Disease diagnosis:Gastric puffiness is the most common disease diagnosis in traditional Chinese medicine,chronic atrophic gastritis and intestinal metaplasia in Western medicine,followed by reflux esophagitis,sleep disorders,gastric polyps and chronic cholecystitis.(4)Symptom characteristics:poor sleep,stomach pain,easy to wake up,dry mouth,fear of cold,stomach distension,unformed stool,irritability,heartburn,bitter mouth and other symptoms are the most common.(5)Four diagnostic features:The tongue quality with high frequency showed light dark tongue quality,fat tongue body,cyanosis of sublingual choroid,tooth mark on tongue edge,crack in tongue and light tongue quality.The most frequent tongue coating is manifested as yellow and white greasy,thin and yellow and white greasy,yellow and white greasy.The most common pulse patterns are pulse sinking,pulse sinking and pulse sinking.(6)Syndrome characteristics:the most common TCM syndrome is spleen deficiency dampness-heat syndrome,followed by spleen and stomach deficiency syndrome,liver and stomach disharmony syndrome,stomach qi upside-down syndrome,liver and spleen imbalance syndrome,etc.(7)Medication rules:A total of 211 TCM flavors were used,among which the most commonly used herbs were vinegar curcuma,followed by white rhizoma curcuma stir-fried with bran,codonopsis codonopsis,Hedyoglossia officinalis,tangerine peel,tuckaia,red peony root,bran stir-fried Fructus aurantii,salvia miltiorrhiza,white peony root and xylosa officinalis.The deficiency tonic drugs were the most in the Chinese medicine category,and the qi tonic drugs were the most in the Chinese medicine subcategory.The medicinal properties of drugs are mainly warm drugs,and the medicinal flavor is mainly sweet.Seven toxic drugs were used.The drug combination with the highest frequency was Hedyotis white and zedoary vinegar.The core prescriptions were Codonopsis codonopsis,poria codonopsis,Radix angelica,Ligusticum Chuanxiong,Tangerine peel,Radix xylosa,Fructus aurantii fructus with bran,Rhizoma coptidis,Rhizoma curcuma vinegar,salvia miltiorrhiza,red Peony root,Bupleurum bupleurum,Radix panax notoginseng powder.The common drug additions and subtractions were convolvulus and calcined ochre,pinellia pinellia and Magnolia officinalis,fritillaria thunbergii and calcined varnishes,Xu Changqing and calcined pear root.(8)Efficacy evaluation:The difference of symptom score before and after treatment was statistically significant,the total effective rate of comprehensive efficacy evaluation was 63.16%,and the total effective rate of symptom score evaluation was 100%.The difference of atrophy degree before and after treatment was not statistically significant,while the difference of intestinal metaplasia degree before and after treatment was statistically significant.Conclusion:Chief physician Zhang Runshun inherited Professor Yao Naili’s academic thought of treating chronic atrophic gastritis with the method of invigorating spleen and colluding and detoxifying,which can effectively improve patients’ clinical symptoms.