Ka Lai, Joseph Old Chinese Academic Thought And Clinical Experience

Chen Jiali, Shanxi provincial expert of traditional Chinese medicine(TCM) is from Xuzhou city, Jiangsu province. Graduated from Nanjing College of TCM, he learned from Mr Zhu Liangchun and had been chosen as one of the third and the fourth group of the famous Chinese medical experts on inheritance of academic experience. He has been engaged in teaching, clinical working, scientific research for more than 40 years and achieved a lot. Focusing on classical theories, he concentrates on research. With a wide reading, he doesn't adhere to the ancient theory rigidly and instead, he keeps pace with the times. He contributes a lot to the TCM cause. He is diligent in reading and clinical activity all year round 40 years. He is a good example for us to follow during treating because he is strictly with his work but nice with patients.During the three years of practising and learning, I can not only see doctor Chen's diligence in TCM cause, but also know his sound basis on TCM and unique diagnostic and therapeutic technique,which is described in three main aspects.The First aspect is the overview of the academic origins of doctor Chen. Doctor Chen has not only assimilated the theory of physiology and pathology of spleen and stomach and their relation with other viscera, which was described in Hangdi Neijing, but also summarized Zhang Zhongjing, Li Dongyuan, Ye Tianshi and other physicians'theories about spleen and stomach. In accordance with the characteristics of physicians'theories, he points out that we should have a profound understanding of the academic thought of spleen and stomach theory, and treat with syndrome differentiation under the guidance of spleen and stomach theory.The second aspect is a summary of the clinical experience and the academic thought of doctor Chen. After three years'learning and case arranging, I conclude five aspects of doctor Chen's academic thought:the first one is the spleen governing four zang-organs and reinforced spleen preventing invasion of pathogenic factors. The second is the emphasis on spleen and stomach when inquiring. The third is the focus on tongue when comprehensively analysing with the four diagnostic methods. The fourth is to treat other disease through treating the spleen and stomach. The fifth is to regulate qi and middle energizer. Clinically, spleen and stomach is everywhere from inquisition to treatment.For example, "spleen governing four zang-organs" and "treating other diseasethrough treating spleen and stomach". Doctor Chen praise highly of Li Dong Yuan"stomach deficiency causing diseases'theory. He holds that spleen and stomachdamage is the immanent cause of the disease, clinical differentiation of symptomsand signs is from the overall view, visceral syndrome differentiation is as the core.Emphasizing the fundamental of spleen and stomach, spleen governing viscera, heprefers to treat diseases with the worship of spleen treatment and he also paysattention to the spleen and stomach, and tries to regulate and nourish spleen andstomach, nourish and protect both.He emphasizes on spleen and stomach in diagnosis and syndromedifferentiation. Dong Yuan,s spleen and stomach academic thought "all diseasesare derived from spleen and stomach damage" gave some clue to doctor Chen informing "the spleen and stomach as the core" diagnosis and treatment system inthe viscera syndrome differentiation.Focus on the tongue when comprehensively analysing with the four diagnosticmethods. Doctor Chen pointed out that the tongue is a more sensitive signs ofdisease" the tongue is the external manifestation of spleen and stomach"? spleenconnects with the tongue through meridian, and the spleen opens into the tongue,tehrefore diagnosis of spleen and stomach can be identified from tongue.In the administration, doctor Chen think where the deficiency of the spleen andstomach is due to improper diet, overstrain, excess of seven emotions, or improperliving conditions and they will lead to the dysfunction of transformation of middleenergizer, so that cold, heat, dampness, phlegm, blood stasis, food and otherpathological products will form, and they often result in a variety of complexclinical syndromes such as cold-heat jumble, coexistence of deficiency and excess,Qi deficiency and Qi stagnation, Yin deficiency mixing with dampness and so on.Drugs can cope with it clinically; Correct administration of drugs can be effectiveadn guide the drugs to the right locations and enhance the curative effect. Thefunction of treatment is to reduce toxicity and protect vital qi. In the preparationof modified cimicifuga, bupleurum root, rhizome angelica, ginseng, promotingSpleen Yang, and body Qi.Even in the treatment, according to the "spleen governing four zang-organs"theory, doctor Chen believes that spleen and stomach are the source of qi, bloodand essence and the subtle essence of the five zang-organs and six fu-organs and all the limbs and bones are derived from spleen and stomach. Spleen and stomachare the source of the essence of human body and body Qi with lifting and entry, thespleen and stomach influence the functions of all other viscera through regulatingthe body Qi. So damage to spleen and stomach leads to disorders. The relationsbetween disorders of other organs might result from the disorders of spleen andstomach damaged, body qi disorders. Treasting disorders of the spleen can beeffective clinically.Lung disease can be treated through spleen and stomach: Doctor Chenbelieves that the disorders of the lung and the spleen are deficiency generation ofbody qi and fluid metabolic disorders. The generation of the body qi mainly comesfrom lung qi, lung respiratory function, and the spleen and the stomach digestivefunction. When the spleen is damaged, "earth don't give birth to metal, causeinsufficiency of lung-qi, and lower function the lung respiration and lead tocough, asthma, which should be treated with "reinforce the earth to promote themetal" method.Liver disease can be cured via spleen and stomach: Doctor Chen alsoconsiders the spleen and stomachin the treatment of liver disease. Because thespleen and stomach is key for qi to lift and descend. The liver is responsible forpromote qi flow, and complete the rise and fall of the body qi with the spleentogether. Spleen's function of digestion depend on the liver. If the liver fails topromote qi flow, the spleen and stomach will consequently fail to lift and descendcausing "wood failing to promote the function of the earth". Disharmony betweenliver and spleen or stomach will appear and clinical manifestations are depression,chest full, abdominal distension, loose stools, belch and so on. As Zhong Jing said:"see the liver disease, know liver transmit to the spleen, then first reinforce thespleen".Heart disease can be treated through spleen and stomach:Doctor Chen pointsout that there is a close relationship between the heart and the spleen and stomach.Kidney disease can be cured via spleen: Doctor Chen thinks there is closerelationship between viscera in the Yin and Yang and five elements. The spleenand stomach are in middle-earth, connecting the upper and lower. They are thesource of qi blood, key of qi lifting and descending, and irrigation of all nearbyorgans, and promote visceral functions. Spleen is to lift while stomach is descend,dominated the liver dredging excretion, pulmonary dispersing and descending, thekidney storing qi, and the heart on fire reducing, the kidney water rising. In the specific clinical process, this paper summarizes the moisture resistancedisease, constipation, diabetes, wheezing illness, pregnancy disorders arediscussed in detail and an example of applications.The third aspect is the clinical research. According to "reinforced spleenpreventing the body from invasion of pathogenic factors" and teacher' s "takingspleen as a treament gap" academic thought, 60 patients of type II diabetes inprediabetic stage were treated by strengthening spleen, eliminating dampness anddredging collaterals and were observed in the fasting plasma glucose (FPG),glycosylated hemoglobin (HbAlC), oral glucose tolerance test (OGTT) and insulinrelease test (INS), insulin resistance index (HOMA-IR) and other index. Theinfluence of the method of strengthening spleen and eliminating dampness anddredging collaterals on pre diabetes insulin resistance (IR) and phlegm dampnessconstitution will be discussed.Based on the subject of insulin resistance (insulin esistance, IR) is type 2diabetes mellitus (T2DM) pathological basis, obesity is the important clinicalfeaturesof type 2diabetes prophase, they are a common pathologic basis-insulinresistance, insulin resistance cause B cell apoptosis and throughout the diabetesoccurrence, development of the entire process. Obesity is a risk factor for diabetescontrollable, TCM believes that "fat people much phlegm"", "fat people more wet,"the spleen is the source of phlegm", phlegmy wet the formation of the mainresponsibility is to the spleen , insufficiency of the spleen cause transportdisorders and the water metabolism disorders, therefore form phlegmy wetphysical clinical research. Research shows that the control group (metformingroup) and the experimental group of 60 patients with clinical observations, twogroups in control blood sugar, glycated hemoglobin, insulin resistance indexhave no statistical difference (P > 0.05), in the control lipid aspects compared withcontrols ,there were statistically significant (P < 0.05); In treatment group, therewere significant differences (P < 0.05, P < 0.01)in glycosylated hemoglobin ,bloodglucose, insulin resistance index, blood fat in patients before and after treatment,the therapy of "strengthening spleen and eliminating dampness and dredgingcollaterals" and metformin have the same effect in blood sugar, glycatedhemoglobin, lipid control and improvement of insulin resistance, lower highinsulin hematic disease, etc. In improvement of symptoms, there was a significantdifference between the two groups (P < 0.01)5the compound preparation oftraditional Chinese Medicine in the treatment group can relieve the clinical symptoms of the patients in different degrees, improve the clinical symptoms,such as abdominal distension, mouth greasy, stay stuck languid, thirsty to drink,head frowsty, palpitations insomnia and tongue and pulse condition, the therapy of"strengthening spleen and eliminating dampness and dredging collaterals" inimproving the symptoms have good advantage, in addition, observed thatstrengthening spleen and eliminating dampness and dredging collaterals methodon glycemic control has certain stability.Therefore, research thinks, the deficiencyof spleen is the fundamental cause of diabetes,the abnormal water metabolism isthe pathological basis of diabetes mellitus, phlegm and dampness is the internalenvironment of IR and dehumidification validates the method of treatment for type2 diabetes were confirmed by IR, through the invigorating spleen essence,desiccant taken change chaotic, promoting blood circulation, dredging, canincrease the islet cell surface receptors number, improve the sensitivity of insulinreceptor, adjust phlegmy wet body constitution. Through the clinical observationinference is concluded that the therapy of "Strengthening spleen and eliminatingdampness and dredging collaterals" have effective intervention therapy role onobese type 2 diabetes prophase with insulin resistance in patients.