Professor Wei Qiping 's Academic Thought And Clinical Experience And Clinical Study On Treatment Of Macular Edema By Phlegm And Blood Stasis

Professor Wei Qiping, the chief physician, doctoral supervisor of Dongfang Hospital of BUCM, the national famous veteran teran doctors of TCM, is the fourth generation academic inheritor of Wei-chiari-ophthalmology which is the aristocratic family of traditional Chinese ophthalmology. Professor Wei has been engaged in clinical ophthalmology for more than forty years. Professor Wei, erudite through family academic context and influence, and coupled with years of hard work, now has made a great contribution in ophthalmology of traditional Chinese medicine industry.1. Objective1.1 To systemically summarize Prof. Wei’s academic origin, academic thoughts and clinical experience.1.2 With the help of data mining technology, to analyze the medication rule and the compatibility characteristic of Prof. Wei in treating maculae edema, and discuss his clinical treatment thoughts.1.3 To explore treatment protocol with higher performance-cost ratio by a clinical controlled observation on anti-VEGF and TCM in the treatment of macular edema in central retinal vein occlusion.2. Method2.1 This paper analyzes the forming origin of Prof. Wei’s academic thoughts, by studying his family academic background, experience of learning, working and clinical practicing, as well as the ancient books of TCM which have deeply affected the academic thoughts of Wei-chiari-ophthalmology.2.2 We organize systemically Prof. Wei’s academic thoughts, such as intergration of Chinese and western medicine, combination of disease and syndrome, diagnostic and therapeutic pattern of "Local—Binocular——Systemic--Psychological--Social", the pulse is not the only focus on diagnosing ophthalmic diseases, and so on.2.3 This paper summarizes Prof. Wei’s experience in diagnosis and treatment and medication characteristic of many ophthalmic common diseases, obstinate diseases, and diseases of other departments.2.4 With the help of the "data mining system for medication rules of famous veteran teran doctors of traditional Chinese ophthalmology" developed by "academic inheriting studio of Wei-chiari-ophthalmology in Yanjing", we mine the incidence relation among different medications, and between medications and primary diseases, medications and clinical signs in Prof. Wei treating ME, and hence analyze and discuss his medication rules and clinical thoughts in treatment of this disease.2.5 50 cases of ME in CRVO patients were brought into a prospective controlled research,25 cases were treated by Chinese medicine, and the other 25 cases were treated by anti-VEGF for 2 courses (56 days). Then visual acuity and data of optical coherence tomography for ME of the two groups, before and after treatment, were analyzed statistically to evaluate the clinical effect.3. Results3.1 Prof. Wei Qiping’s academic thoughtsWith the complementary advantages of traditional Chinese medicine and western medicine, Prof. Wei combines disease differentiation based on pathophysiology and syndrome differentiation centred upon pathogenesis. He analyses pathological and physiological mechanism as the clue of syndrome differentiation; takes western medical examinations as the extensions of the four diagnosis methods of Chinese medicine; composes prescriptions basis on syndrome differentiation of fundus fluorescein; takes into account the influence of western medical treatment on syndrome typies, and reduces its toxicity and side-effect with Chinese medicine. Prof. Wei focuses on "people" in the diagnostic and treatment process, pays close attention to the influence on the diseases of multiple factors, such as system, psychology, society, etc. He follows the diagnostic and therapeutic pattern of "Local—Binocular— Systemic--Psychological--Social".3.2 Prof. Wei Qiping’s clinical experienceTreat optic neuritis which had received hormonotherapy with nourishing yin and clearing heat, using Zengyedihuang Tang.Treat retinal vein occlusion according to syndrome differentiation by stages:with cooling blood for hemostasis, promoting blood circulation for removing blood stasis, tonifying deficiency and activating and nourishing blood, depleting phlegm and stagnant blood.Treat Ophthalmic Graves’disease according to local syndrome differentiation, with eliminating pathogenic heat from the blood and softening hardness to dissipate stagnation.Treat retinitis pigmentosa with experienced prescription benefiting qi and elevating yang, nourishing blood, replenishing essence and improving eyesight.Treat glaucoma and Glaucomatous optic nerve atrophy individually by integrated traditional Chinese and Western Medicine.Treat asthenopia at its pathogenesis, with nourishing the blood to expel wind, using Mushu bolus.Treat children recidivity chalazia with strengthening spleen, dissipating phlegm and resolving masses, using Huajianerchen Tang.Treat herpes simplex keratitis with protecting spleen qi, strengthening body resistance to eliminate pathogenic factors.Treat repeated cold which occurred after prolonged disease or long-term medication, with strengthening body resistance and firning exterior. Treat insomnia with dispelling melancholy, regulating blood and calming the mind. Treat Weipi with smoothing liver, regulating stomach and qi. Treat constipation due to deficiency of vital energy with replenishing qi to invigorate spleen, relieving dryness and promoting purgation.3.3 Correlation analysis of characteristics of the formulas in treating macular edema by Prof. WeiBased on the data mined from 147 prescriptions, we identify the usage frequency of every herbal medicine, the association rules among these medicines, and the association rules between medicine and different factors. The top twenty medicines with the highest usage frequency are:Chaobaizhu, Fuling, Chenpi, Sanqifen, Shenghuangqi, Zhiqiao, Baimaogen, Zhebeimu, chaoyiren, Chaopuhuang, Hanliancao, Lianqiao, Wuweizi, Zhigancao, Cheqianzi, Chishao, Danshen, Honghua, Niuxi. They are mostly used for replenishing qi to invigorate spleen, regulating qi to disperse dampness (remove dampness by diuresis), cooling blood for hemostasis and removing blood stasis, as well as softening hardness to dissipate stagnation.The central pair drug is "Chaobaizhu—Fuling", the drug groups with the highest usage frenquency are mainly for cooling blood for hemostasis and removing blood stasis, replenishing qi and invigorate spleen to disperse dampness (remove dampness by diuresis), resolving phlegm and softening hardness to dissipate stagnation. The medication rule is closely related to local syndrome differentiation of fundus fluorescein. Prof. Wei treats the patients of macular edema those who meanwhile have haemorrhage with cooling blood for hemostasis and removing blood stasis, those who have exudation with replenishing qi and invigorate spleen to disperse dampness (remove dampness by diuresis), and those who have organization with resolving phlegm and softening hardness to dissipate stagnation. These give expression to his therapeutic thoughts of treating macular edema in theory of spleen, with depleting phlegm and stagnant blood, and eliminating pathogen to support healthy qi.3.4 Clinical observation on the therapeutic effect of Synchronic Treating Phlegm and Blood Stasis in ME in CRVO by Prof. WeiThe clinical observation has been made on 48 patients (48eyes) in 2 groupswith 24 patients (24eyes) of western medicine (anti VEGF) in one group and 24 patients (24eyes) of Chinese medicine (Prof. Wei’s treatment) in the other group. Visual acuity:visual acuity of patients in both groups is increased after treatment, but there are no statistical differences between the two groups (P=0.34). Macular edema:the maximum of the macular retina thickness and the average of the macular central retina thickness of patients in both groups is reduced after treatment, but there are no statistical differences between the two groups (P=0.25, P=0.07). Prof. Wei’s clinical experienced prescription provides similar efficacy to anti-VEGF in the treatment of macular edema in retinal vein occlusion.4. ConclusionsProfessor Wei, who is cultivated by prominent doctorsand erudite through family academic context and influence, with arigorous, systematic and formal education, coupled with years of hard work, now has made a great contribution in ophthalmology of traditional Chinese medicine industry. His academic thoughts are adhering to the ancient precept. Prof. Wei studies intensively clinical skills of TCM, and pay close attention to the newest developments of modern medicine. With the complementary advantages of traditional Chinense medicine and western medicine, he diagnoses and treats common or stubborn diseases in ophthalmology, forms his special characteristic, and gains significant clinical effect. Prof. Wei’s medication is fine and ingenious; he has an agile mind and keeps pace with the times. To summarize his academic thoughts and clinical experience is of great importance to the academic and clinical development of ophthalmology of TCM.Innovations:1. In the past years, the students of Prof. Wei did literature review, animal experience, clinical experiment, and clinical effect observation of some single disease to study his clinical experience; but they have not already summarized his academic thoughts systematacially. By analyzing the historical origin of Prof. Wei’s academic thoughts, and summarizing his special medication characteristic and experience in diagnosis and treatment of various common or stubborn diseases in ophthalmology, I hope I can do my best to systematacially summarized his academic thoughts and clinical experience, and promote those to certain theoretical altitude.2. In the clinical study, with the help of data mining technology, I analyzed the medication rule and the compatibility characteristic of Prof. Wei in treating maculae edema, discussed his clinical treatment thoughts, and meanwhile gained a clinical experienced prescription. Then the clinical effects of this prescription and anti-VEGF in the treatment of macular edema in retinal vein occlusion were observated and compared.With the help of the "data mining system for medication rules of famous veteran teran doctors of traditional Chinese ophthalmology" developed by "academic inheriting studio of Wei-chiari-ophthalmology in Yanjing", we hope we can further study Prof. Wei’s characteristic of syndrome differentiation in treating macular edema and other diseases. And then we could make the clinical experiences of famous veteran teran doctors of TCM explicit,systematic, and convenient for clinical application.