Professor Qian Ying 's Academic Thought And Clinical Experience: A Theoretical And Clinical Study On The Decompensated Period Of Hepatitis B And Cirrhosis

Professor Qian Ying is a famous veteran doctor of Traditional Chinese Medicine (TCM) who was born in TianJin City in 1937. Now, he is the professor and the chief physician at Capital Medical University, Beijing, China. Also he is the 3rd,4th and 5th advisor in national TCM academic experience inheritance. Professor Qian Ying has been working for more than 50 years. He has broad research interests especially in TCM diagnosis and treatments of liver diseases, who is good at the kidney diseases and miscellaneous diseases too. Professor Qian Ying is well experienced in clinical skills and western medicine theories. He deeply focuses on TCM treatments for liver diseases. It’s effective and creative for many types of liver diseases that he proposed these theories in treatments of such as "Adjusting both internal organs and function of the liver", "reinforcing the kidney in liver diseases" and "nourishing blood harmoniously".There are three parts in this paper. They include a TCM theoretical research on the formation of Professor Qian Ying’s academic thought and further generalizations of his original content. Then we mined his academic thought and clinical experiences. Besides,We did theoretical and clinical research on compensatory period patients of chronic hepatitis B cirrhosis with TCM methods of "nourishing blood harmoniously".The first part, we looked back Professor Qian Ying’s special learning, growing, and working experience so that we could explore his academic origin. We found his thorough knowledge of both Western Medicine and TCM. We also found that he learned widely from others’ strong points and swallowed anything and everything. He was not limited in ancient methods and went for innovation. All these characteristics are rich and valuable.In the second part, we summarized the TCM characteristics and clinical experiences of him that included two significant theoretical summary of "Adjusting both internal organs and function of the liver" and "reinforcing the kidney in liver diseases"."TI" and "YONG" were all Chinese transliteration which were categories in ancient Chinese philosophy. TI and YONG were used to describe the relationship between physiological basis and functional activity in TCM theory. We thought that Ti meant internal organs and YONG meant the function. All of the five internal organs could contain "TI" and "YONG". TI of the liver is made of blood and Yin, YONG of the liver is made of Yang and Qi combined with the TCM theory of Yin-Yang and Qi-blood and body fluid.Professor Qian Ying think that the course of chronic liver disease is the process of the liver’s physiological basis is damaged and the liver’s functional activity is disorderd. So, professor Qian Ying put forward that the treatment of liver disease must adjust TI and YONG togather. Adjust TI and YONG together firstly means we nourish the liver blood and liver yin filling liver feminine body, provide material conditions for liver with; At the same time regulating liver, liver gas filling liver Yang and liver, the normal physiological function of liver. Secondly Adjust TI and YONG together firstly also refers to the adjustment by the liver involved with other organ’ disorder.Professor Qian Ying according to the theory of "liver and kidney homologous", put forward the academic thought that the treatmeat of liver disease must strengthen renal" He thinks that chronic hepatitis, liver fibrosis and liver cirrhosis, and even the occurrence of HCC process is the process of virtual love evil, evil is not up to. Deficiency of vital qi basically is, first and foremost, ferrite congenital kidney essence deficiency; Liver disease after many days, in disorder, is bound to stolen child mother gas, involving the kidneys, leading to kidney Yin and kidney Yang deficiency. Professor Qian Ying put forward that treat liver disease should be early solid renal, nourishing kidney Yin, warming kidney Yang to Yin Yang, Yin and Yang. Tonify liver or tonify kidney, or focus on Yin or Yang, flexible use of liver and kidney with treatment, can deal with complex syndrome. Qian Ying professor emphasis solid renal not exclude tonify spleen. He argued that the treatment of liver disease has day pay equal attention to, pay attention to regulate the liver spleen and kidney.Secondly this part also summarizes the clinical experience of Professor Qian Ying, including treatment clinical experience of liver disease and other diseases were summarized. In liver disease treatment, summed up the "fast truncation, counter-current holding boat" the treatment of chronic severe hepatitis. The centralizer, detoxification, blood to treat liver cancer. Thesanjiao (triple energizer) gasification theoretical treatment of cirrhosis ascites, Clearing damp, phlegm, detoxification, blood treatment of jaundice, Body with homology, and liver detoxification treatment of chronic hepatitis b, Liver stagnation, Yin and Yang double fill in treatment of hepatic myelopathy, Fatty liver spleen and clearing damp, eliminating phlegm to t2dm treatment, Clearing damp phlegm blood detoxification treatment of alcoholic liver disease, Tonify Qi and nourishing Yin and regulating immune treatment of autoimmune hepatitis and so on. In terms of other disease treatment, summarizes the urinary tract infection, hepatitis b associated nephritis, Ig A kidney disease, the treatment of peptic ulcer, mei nuclear gas.The third part is about that professor Qian Ying and blood treatment for hepatitis b cirrhosis compensatory stage theory summarizes and conducted the clinical study.1. The study of the theory of the treatment of liver disease and blood methodProfessor Qian Ying influenced by the theory of generations of doctor of traditional Chinese medicine about the blood. Especially the teacher Qin Bo Wei "upward the basis of blood and blood, blood stasis, on the basis of this a principle ". Again TCM gynecology famous doctor Liu Fengwu "if you would pass, shall first be". GuanYoubo "treating disease, blood to follow", "making necessarily cure blood, blood line creation is". Such as academic point of view, the effect of combining the physiological and pathological characteristics of liver, and their profound clinical comprehension, thought of liver blood feud is the basis of liver disease occurs, put forward a method for the treatment of chronic liver disease and blood academic thoughts.Eliminate pathogenic treatment; The treatment of chronic liver disease don’t use drug, is what medicine does not reach, like the tap; "Blood stasis resistance collaterals" is one of the core syndrome of chronic liver disease, to reconcile blood as the outline, but treatment for body with homology message, based on the "and" word, including blood and nourishing blood and promoting blood circulation to remove blood stasis and blood method, rather than to simply promoting blood circulation to remove blood stasis. Professor Qian Ying "and blood" blood method of "rationality" and "and" meaning, contains all the features, principle method of blood and the essence of the and law.2. Hexue method of clinical research for the treatment of hepatitis b cirrhosis compensatory periodCirrhosis of the liver in human leading causes of death in a 4 or 6, in our country, caused by chronic hepatitis b cirrhosis of the liver are the biggest cause of cirrhosis of the liver. How to prevent and treat of hepatitis b cirrhosis of the liver, delay the development of cirrhosis of the liver process, reduce the incidence of cirrhosis of the liver compensatory period, reduce the adverse outcome, prolong patient life, improve the quality of life of patients, effective medical intervention for patients with economy, has been a popular domestic clinical research of traditional Chinese medicine. Qian Ying professor put forward Hexue method for the treatment of chronic liver disease. And according to many years of clinical experience, he carried out in-depth research on the patients with hepatitis b cirrhosis compensatory period who were treated by Hexuetiaogan decoction for a long time. Objective:This study observed the clinical efficacy and safety of the new decoction treating the compensatory period of hepatitis B cirrhosis of the liver. Method:Following the Principle of random, collation and single blinding,60 patients who got the Compensatory period of hepatitis B cirrhosis of the liver blocked by blood stasis were divided into two groups which were Therapeutic group(30 cases, ETV 0.5mg Qd and Hexuetiaogan decoction Qd)and Control group (30cases,ETV 0.5mg Qd)。 Period of treatment is 12 weeks. Observing TCM symdromes and changes of symptom score to determine the clinical efficacy before and after treatment. Liver function, HBV DNA, serological indexes (HA, LN, P-Ⅲ,IV-C),AFP indicator before and after the treatment were determined and B ultrasound examination of DPV, VPV, DSV and VSV were measured before and after the treatment.Liver stiffness value of LSM changes before and after treatment were measured too. Detecting the changes of Blood Routine, Urine Routine, Stool Routine, ECG, renal function to determine the safety.Result:1.The condition of clinical symptoms and symptom score:Two groups both had the effect of improving the clinical symptoms and physical signs, and Therapeutic group were better than Control group. Two groups had the statistical differences(P<0.05).2.Curative effect of the illness:The total effieiency of the Therapeutic group and Control group were 71.6% and 30%.Therapeutic group were better than Control group. Two groups had the statistical differences(P<0.05).3.Comparision of Liver function before and after treatment:liver function index of ALT, AST in the Treatment group and Control group after treatment all showed a trend of decline, the degree of Treatment group decreased more significantly, but compared with the Control group has no statistical differences (p>0.05).TBIL in the Treatment group and Control group b after treatment all showed a trend of decline, the degree of Treatment group decreased more significantly, two groups had the statistical differences(P<0.01).PALB in the Treatment group after treatment showed a trend of rise, on the contray, PALB in the Control group after treatment showed a trend of decline, two groups had the statistical differences(P<0.05).4.Comparison of serological indexes for liver fibrosis before and after treatment:Comparison of the variation of serum HA、 IV-C、 P-ⅢP、 LN of the two groups before and after treatment:The degrees of HA、 IV-C、P-ⅢP、LN in the two groups after treatment for 12 weeks all decreased, the decline of treatment group was significantly than the control group. But two groups had no statistical differences (P>0.05).5.Comparison of AFP before and after treatment:two groups before and after the treatment of AFP change is not obvious, but there was no statistically significant difference (p>0.05).6.Comparison of hepatitis b virus DNA capacity before and after treatment:two groups before and after the treatment of HBV-DNA change is not obvious, but there was no statistically significant difference (p>0.05).7. Comparison of ultrasound indexes before and after treatment of the two groups:After therapy, Dpv and Dsv of treatment group were shrank than those of the control group(P<0.01).Compared with baseline, Dpv and Dsv of Treatment group after therapy was statistically significant difference (p<0.05).Vpv and Vsv of treatment group after therapy slower than those of the control group.Two groups had the statistical differences(P<0.05).8.Changes of LSM before and after treatment of the two groups:There were 26 cases of treatment group and 30 cases of control group did Fibroscan examination before and after treatment. After treatmen two groups of LSM were lower than the baseline.Compared with baseline, the LSM of Treatment group after therapy was statistically significant difference (p<0.01).The comparison of the decline of LSM of the two groups has statistically significant difference (p<0.05).9.No changes of significant difference between pre-and post-treatment in routine tests for blood and urine and stool, renal function and ECG, etc.There was no statistically significant difference changes between the two groups (P>0.05), no adverse events. Conclusion:(1) with the Hexuetiaogan decoction can improve clinical symptoms in patients with hepatitis b cirrhosis of the liver, improve the quality of life of the patients. (2) with the Hexuetiaogan decoction can reduce the hepatitis b patients with cirrhosis liver function damage, reduce portal vein pressure, improve liver fibrosis indicators have significant clinical implications, in reducing the hepatitis b virus DNA loads and AFP curative effect is not significant. (3) with the Hexuetiaogan decoction can improve the hardness value is hepatitis b patients with cirrhosis of the liver. Hexuetiaogan decoction is a safe and effective medicine for the treatment of compensatory period of hepatitis B cirrhosis of the liver.