| ObjectiveThe study aims to analyze and summarize the laws of herbal formula applications and the differences of the representatives of medical masters of Yishui School at each era in the treatment of spleen and stomach disorders and to reveal the academic thought characteristics and the laws of evolution of the treatment of spleen and stomach disorders in Yishui School at each era.MethodsThe relevant clauses and items were screened in 7 disorders of spleen and stomach systems (gastric pain, gastric fullness, vomiting, diarrhea, dysentery, constipation and abdominal pain) in 18 works of 9 representatives of medical masters (Yang Yuansu, Li Gao, Wang Haogu, Luo Tianyi, Xue Ji, Zhang Jiebin, Li Zhongzi, Zhao Xianke, Zhang Lu) at 4 eras, the Jin, Yuan, Ming and Qing Dynasties of Yishui School. The name of disease, etiology, pathogenesis, herbal formula and herbal composition were collected. On the basis of the preliminary database set up in Microsoft Excel 2010, the herbal medicine was taken as the subject, the category, four natures, five flavors and meridian tropism of herbal medicine were extracted to build up the herbal database in reference to the data information of authoritative national and industrial standards and specifications. Microsoft Excel 2010 was used to analyze statistically the frequency and distribution of formulas, herbal medicines, herbal category, natures, flavors, tropism, etiology, pathogenesis and herbal composition in the entity of Yishui School, different medical masters and disorders. The comparative method was applied to analyze the differences in the etiology, pathogenesis and formula and herbal medicine application among different medical masters. Using SQL Server 2008+MicroSoft Excel 2010 and based on Apriori algorithm, the herbal medicine association rules were analyzed and the distribution of the high-frequently used herbal composition was calculated. The vector included angle cosine method was adopted, on the basis of the use frequency of herbal medicines and compositions of each medical master, to measure the similarity of the representatives of Yishui School in the characteristics of herbal medicine application and academic thoughts.Results1. Totally 833 formulas of 1440 times of use frequency,272 herbal medicines of 9701 times of use frequency were collected. There were 25 kinds of herbal medicines using over 100 times. The herbs of over 300 times of use frequency included Licorice, Atractylodes, Ginseng, Tangerine Peel, Poria Cocos, Rhizoma Zingiberis, and Pinellia Ternata.2. The top 6 categories of herbal medicines in the treatment of spleen and stomach disorders in Yishui School were the herbs for tonification (2836 times of use frequency, 29.23%), the herbs for regulating qi (1327 times of use frequency,13.68%), the herbs for warming the interior (701 times of use frequency,11.25%), the herbs for benefiting water metabolism and removing damp (624 times of use frequency,7.23%), the herbs for eliminating the exterior (624 times of use frequency,6.43%) and the herbs for resolving damp (622 times of using frequency,6.41%). The herbs for tonification occupied 1/3 of the total use frequency, which was increased more apparently in the Ming and Qing Dynasties compared with the Jin and Yuan Dynasties.3. Regarding the rules of nature, flavors and meridian tropism of the herbs in the treatment of spleen and stomach disorders in Yishui School, the sequence of herbal medicines were the herbs of warm nature (3973 times of use frequency,40.95%), the herbs of neutral nature (1848 times of use frequency,19.05%), the herbs of mild warm nature (1172 times of use frequency,12.08%); the herbs of pungent flavor (5173 times of use frequency,53.32%), those of sweet flavor (4637 times of use frequency,47.90%) and those of bitter flavor (4313 times of use frequency,44.46%); those going to stomach meridian (5115 times of use frequency,52.73%) and those going to lung meridian (4176 times of use frequency,43.05%).4. Regarding the disorders, Tangerine Peel, Costustoot, Rhizoma Zingiberis and Ginseng were commonly used for the treatment of gastric pain and abdominal pain. Atractylodes, Tangerine Peel, Ginseng and Pinellia Tuber were commonly for gastric fullness. Ginseng, Tangerine Peel, Poria Cocos, Pinellia Tuber were commonly for vomiting. Atractylodes, Ginseng, Poria Cocos, Rhizoma Zingiberis, Aconite and Cinnamon were commonly for diarrhea. Angelica Sinensis, Radix Paeoniae Alba, Atractylodes, Rhizoma Coptidis and Rhizoma Zingiberis were commonly for dysentery. Rhubarb, Angelica Sinensis, Costustoot, Fructus Aurantii Immaturus, Fructus Cannabis and Ginseng were commonly for constipation.5. Regarding the characteristics of each medical representative in the treatment of spleen and stomach disorders, Zhang Yuansu preferred to Atractylodes, Poria Cocos and Rhizoma Alismatis; Li Gao preferred to Atractylodes, Tangerine Peel, Angelica Sinensis, Rhizoma Cimicifugae and Astragalus. Wang Haogu preferred to Rhizoma Zingiberis, Tangerine Peel and Pinellia Tuber. Luo Tianyi preferred to Atractylodes, Tangerine Peel, Rhizoma Zingiberis and Costustoot. Xue Ji preferred to Ginseng, Atractylodes, Poria Cocos, Tangerine Peel and Angelica Sinensis. Zhang Jiebin preferred to Ginseng, Atractylodes, Poria Cocos and Rhizoma Zingiberis. Zhao Xianke preferred to Ginseng, Atractylodes, Poria Cocos, Angelica Sinensis and Rhizoma Alismatis. Li Zhongzi preferred to Ginseng, Atractylodes and Poria Cocos. Zhang Lu preferred to Ginseng, Poria Cocos, Rhizoma Zingiberis and Atractylodes.6. Regarding to the frequency of herb combination in the treatment of spleen and stomach disorders of Yishui School, the herbal pairs were Ginseng and Atractylodes, Poria Cocos and Atractylodes, Tangerine Peel and Atractylodes, Ginseng and Poria Cocos, Ginseng and Tangerine Peel, Ginseng and Rhizoma Zingiberis, Rhizoma Zingiberis and Atractylodes. The herbal combinations were Ginseng, Poria Cocos and Atractylodes; Ginseng, Tangerine Peel and Atractylodes; Ginseng, Rhizoma Zingiberis and Atractylodes.7. Regarding the similarity of the single herbal use in the treatment of spleen and stomach disorder, it was 0.74 between Zhang Yuansu and Li Gao, was 0.81 between Zhang Yuansu and Wang Haogu, was 0.84 between Li Gao and Luo Tianyi, was 0.86,0.81 and 0.83 in comparison of Li Gao with Xue Ji, Zhang Jiebin and Li Zhongzi separately, was 0.79 between Xue Jiand Zhao Xianke and was 0.86 and 0.89 in comparison of Zhang Lu with Xue Ji and Zhang Jiebin separately. The means was 0.8.8. Regarding the similarity of the couplet medicines use in the treatment of individual spleen and stomach disorder, it was 0.33 between Zhang Yuansu and Li Gao, was 0.4 between Zhang Yuansu and Wang Haogu, was 0.32 between Li Gao and Wang Haogu, was 0.6 between Li Gao and Luo Tsianyi, was 0.46,0.44 and 0.53 in comparison of Li Gao with Xue Ji, Zhang Jiebin and Li Zhongzi separately, was 0.53 between Xue Yi and Zhao Xianke and was 0.5 and 0.65 in comparison of Zhang Lu with Xue Ji and Zhang Jiebin separately. The means was 0.47.9. Yishui School believed that the common etiology and pathogenesis of spleen and stomach disorders were injury by food and seven emotional factors, phlegm, cold invasion, overstrains; qi stagnation, spleen and stomach deficiency and cold, food retention, spleen and stomach qi deficiency, and spleen and kidney yang deficiency.Conclusion1.The general laws of formulas and herbal medicine application in the treatment of spleen and stomach disorders of Yishui school reflects:taking the theory of zhangfu differentiation as the core, especially emphasizing the overall academic thought of spleen and stomach theory.2.Regarding the recognition of spleen and stomach disorders, Yishui School takes spleen and stomach as the center, associating with relevant organs in physio logy and pathology, such as lung, heart, liver, kidney and large intestine. Improper diet, overstrain, external pathogens and emotional factors cause spleen and stomach qi deficiency or coldness. Dysfunction of spleen and stomach in pivot activity is the essence of pathogenesis.3. Yishui School prefers to tonification formula, warming interior formula, resolving damp formula and regulating qi formula in the treatment of spleen and stomach disorders. The herbal medicines are commonly for tonification, regulating qi, warming interior, benefiting water metabolism and resolving damp and eliminating exterior. They are generally pungent, sweet, bitter, warm or neutral, seldom sour, astringent, salty and cold. They mostly act on spleen, stomach, lung and heart meridians, as well as liver and large intestine meridians.4. Yishui School treats the disorders individually on the basis of the overall laws. Benefiting qi and warming the middle Jiao are for gastric pain and abdominal pain; strengthening spleen and stomach, regulating qi and resolving damp are for gastric fullness; tonifying qi and benefiting spleen function to resolve damp and harmonizing stomache are for vomiting; warming and tonifying spleen and kidney to remove damp are for diarrhea; nourishing and activating blood circulation, regulating qi and clearing heat are for dysentery; purgation, nourishing blood and yin and promoting qi circulation are for constipation.5. The medical master representatives of Yishui School have their own features in the differentiation and treatment of spleen and stomach disorders on the basis of the general laws of formula and herbal medicine application.6. The clear inherent relationship displays by the recognition of spleen and stomach disorders and the similarity of formula and herbal medicine applications among the master representatives of Yishui School, which is consistent with the acceptable one. But, among the masters of high similarity of general application, the low similarity is still present for some disorders. It shows the innovation and development of the academic thoughts.7. The angle cosine method is used to calculate the similarity of two categories in the inherent relationship of medical school. It is worth to have a further study and promotion.
|
PDF Full Text Request