Summary Of Zhang Jie 's Chief Physician' S Academic Thought And Clinical Experience And Clinical Study On Treatment Of Hyperlipidemia With Bushen Jiangzhuo Method

Objective Chief Physician Zhang Jie,one of academic experience inheritance instructor of the third and fifth batches of Chinese traditional medicine(TCM),has been engaged in the clinical medical work more than 50 years,and has rich experience and unique skills in the treatment of difficult miscellaneous diseases.He reads classics and is diligent in clinical practice; He absorbs the new knowledge and is good at summarizing.He continuously explores and summarizes in clinical practice,and thus forms a unique academic ideological system.To summarize Jie Zhang’s methods of scholarly research and to conclude his academic thoughts as well as clinical experience are important constituent parts of inheritance of TCM.The method of Bu Shen Jiang Zhuo was used to treat hyperlipidemia and the curative effect was observed,in order to explore the treatment of hyperlipidemia.Methods Teacher Zhang’s personal materials and growth experiences are collected,and his experiences of learning TCM is summarized.Through retrieving literature of TCM and doctors praised highly by teacher Zhang,and summarizing the academic thoughts that having great influence on the tutor,thus the academic origin overview of Jie Zhang was completed.The arrangement and summary of academic thoughts and clinical experience were conducted mainly through copying the prescriptions of Jie Zhang,arranging clinical medical records,carefully reading his published academic works,feelings and experiences accumulated by students,and summarizing his academic thoughts and clinical experience.Sixty hyperlipidemia patients were collected,and randomly divided into 30 cases in control group and 30 cases in treatment group,and treated with the method of Bu Shen Jiang Zhuo and simvastatin for continuous 4 weeks,respectively.The improvement of clinical symptoms and change of blood lipid level were observed and compared between the two groups.Results Jie Zhang is good at reading classical works,and diligent in clinical practice and good at absorbing new knowledge.Based on "restraining excessiveness to acquire harmony" and the relationship theory of evil and positive in "Huangdi Neijing",he proposed "Turbidity toxin pathogenesis",and considered that endogenous turbid toxin easily occurred in excessive refined nutritious substances,and spleen and kidney deficiency is the main pathogenesis of turbidity toxin.He emphasized the use of method of warming spleen-yang and dissolving turbidity,Bu Shen Jiang Zhuo,and also applied them in treatments of diseases,such as asthma,ulcerative colitis,heart failure,chronic atrophic gastritis,hypertension,cerebral circulation insufficiency,chronic renal failure,lung cancer,hyperlipidemia,and so forth,and achieved good curative effect."Turbidity toxin pathogenesis":The theory of "turbidity toxin",one of the special concept of TCM, which has been appeared and constantly improved with social development in recent years. He believed that turbidity toxin easily occurred in generalized dyspepsia caused by excessive eating or improper diet,in refined nutritious substances,in spleen and kidney deficiency,and in other internal medical diseases.He emphasized on the theory of "spleen Yang-focused". The survival and death of all things depends on Yang. The generation and operation of human essence, Qi, blood and body fluid depend on Yang.The spleen is the root of after-birth and source of qi-blood.The transformation function for water and food essence mainly lies in the strength of spleen Yang.In nature, the growth of all things on earth cannot do without soil or sunlight.Only with fertile soil and enough sunlight,the livings can grow vigorously,but not vice versa. Teacher Zhang pays attention to the academic thought of "spleen Yang-focused" in the treatment of the difficult and complicated miscellaneous diseases.He often chooses the drugs which can warm yang and invigorate spleen,such as rhizoma zingiberis,fructus amomi,Amomum tsao-ko,cassia twig,Fructus evodiae,ginseng and so on,particularly tends to use rhizoma zingiberis in large dose (15-30g) which is warm but not dry,and can warm middle and relieve exterior syndrome.If the main location of disease is in heart,ginseng and cassia twig should be added; If in lung, fresh ginger and cassia twig should be added; If in spleen and stomach, Amomum tsao-ko and fructus amomi should be added; If in kidney, Aconitum carmichaelii,cortex cinnamomi and herba epimedii should be added; If in liver,fruuctus evodiae should be added. Kidney governs storing essential substances and is the root of storing.The kidney essential qi is the root of body’s life activities.If the kidney qi is deficient and cannot restore essential substances, which is extensive resulting in turbidity;The kidney governs water liquid. If the renal gasification function is abnormal, the excessive essential substances cannot be metabolized,which is gathered resulting in turbidity.Treatment should resolve the current problems and eliminate the root causes,and reinforce kidney and replenish essence,so as to enhance body’s function and promote the metabolism in vivo. The difference between yang deficiency,yin deficiency and qi deficiency in kidney should be identified.Descending the turbid and dissolving turbidity can promote the excretion of turbidity and elimination of the pathological products.The nature of evil should be distinguished, maybe belongs to damp turbidity,or turbid phlegm,or stasis turbid,or a turbid toxin.The choice of drugs also should be different.As for the treatment of chronic atrophic gastritis,teacher Zhang thoughts that "deficiency", "toxin","stagnation" and "stasis" were the primary pathologies of the disease.The symptom and root cause could interact as both cause and effect.The root cause were "deficiency",and the symptom were "toxin", "stagnation" and "stasis".Long duration would transform into the pathological state of intermingled deficiency and excess,and primarily deficiency. As for the syndromes of intermingled deficiency and excess,and intermingled cold and heat, "warm", "tonify", "eliminate" and "clear" should be combined and flexible used according to deficiency and excess,chills and fever.The occurrence of lung cancer was considered to be the accumulation of "phlegm", "heat" and "stasis" and "toxin" pathogens in lung, spleen and kidney. The treatment should be tonification and purgation in combination,drugs should be chose taking both disease and syndrome into consideration.He also considered that lung cancer metastasis in upper-jiao was because of "phlegm", "heat", "toxin" aggravation and deficiency of lung-spleen qi. Lung cancer metastasis in lower-jiao was because of the "stasis", "toxin" aggravation and deficiency of liver and kidney. He has accumulated rich clinical experience in the treatment of liver cirrhosis.He considered that when having a syndrome differentiation treatment,the differentiation of syndrome and disease,supplement of vital energy and elimination of unhealthy influences should be considered,and qi and blood should be regulated and diuresis should be induced.The prescription selection should combine syndrome differentiation and treatment with modern pharmacological research,and give full play to multi-level,multi-link,multi-target and multi-approach advantage of TCM in human body. Only this can obtain better curative effect.Case-control study showed that the method of Bu Shen Jiang Zhuo could significantly reduce the contents of total cholesterol,triglyceride,low density lipoprotein cholesterol in hyperlipidemia patients,and elevate the content of blood high density lipoprotein cholesterol.The effect was equivalent to that of simvastatin;The method of Bu Shen Jiang Zhuo was significantly superior than simvastatin in improving vertigo,head heavy as if swathed,chest tightness,vomiting phlegm,limb numbness,intoleranceofcold,coldlimbs,fatigue,loosestool,tinnitus,soreness and weakn ess of waist and knees,palpitation,insomnia and upset.The method of Bu Shen Jiang Zhuo could improve the syndromes of spleen-deficiency and phlegm-stagnation, yin deficiency of liver and kidney in hyperlipidemia patients.Conclusion "Turbidity toxin pathogenesis" of Jie Zhang was derived from the classical theory of TCM and long-term clinical practice.The method of warming spleen-yang Yang eliminating turbidity and Bu Shen Jiang Zhuo were specific treatments of "Turbidity toxin pathogenesis".The method of Bu Shen Jiang Zhuo had the similar lipid-lowering effect with simvastatin.It was superior to simvastatin in improving patient’s clinical symptoms,sputum stasis syndrome, syndrome of yang deficiency of spleen and kidney,and syndrome of yin deficiency of liver and kidney.(1)Jie Zhang’s academic achievements were derived from diligently studying the classics of TCM and long-term clinical practice,suggesting that "classics reading and clinical practice" and learning widely from others’ strong points were the only way to becoming excellent in TCM.(2)"Turbidity toxin pathogenesis" was the application of "restraining excessiveness to acquire harmony"and the relationship theory of evil and positive in "Huangdi Neijing".The method of warming spleen-yang Yang eliminating turbidity and Bu Shen Jiang Zhuo were specific treatments of "Turbidity toxin pathogenesis".(3) "Turbidity toxin pathogenesis" could be used to guide the treatment of diseases with the syndrome of deficiency of vital qi and turbidity toxin resistance,such as hyperlipidemia,hypertension,chronic atrophic gastritis,lung cancer,chronic renal failure.(4)Bu Shen Jiang Zhuo,Jie Zhang’s empirical formula,had the similar lipid-lowering effect with simvastatin. It could significantly improve clinical symptoms caused by hyperlipidemia,such as dizziness,head heavy as if swathed,chest tightness, vomiting phlegm,limb numbness,intolerance of cold,cold,limbs,fatigue,loose stool,tinnitus,soreness and weakness of waist and knees, palpitation,insomnia,restlessness,etc.