| Stroke refers to a disease which is due to the reversed flow of Qi and blood to cause the cerebral thrombosis or hemorrhage, and on the basis of deficiency of Qi and blood, the common pathogenesis are over fatigue and internal injury, over eating greasy food and over drinking; the main clinical symptoms are sudden fainting, hemiplegia, wry eyes and mouth, dysphasia or aphasia, hemianesthesia. It marked by acute onset and quick change and is a common senile disease, the same as acute cerebral accident in modern medicine. According to2010China guideline of the secondary prevention of ischemic stroke and transient ischemic attack, stoke has become to the first reason of disability and death, and the morbidity is increasing rapidly. Some epidemic studies show that there are1500000to2000000new strokes per year, and the yearly mortality is58to142death per one hundred thousand people. The prevention of stoke is one of the major task of national public health. Traditional Chinese medicine(TCM) has2000years development and a large of clinical practice and therapies on stroke and systematical theories on Zhiweibing (preventive treatment of disease), so it is meaningful on how to use these values for the help of stroke prevention today.TCM doctors have taken profound studies on prevention and treatment of stroke in more than2000years of Chinese medicine history. Unfortunately most doctors have been focusing on treating but not preventing stroke throughout history. Traditional Chinese Medicine has systematical theories on Zhiweibing, but for stroke, they are some words scattering in a large number of ancient or present documents. These words are valuable today for the prevention of stroke, so we make a work on collecting and reorganizing these volumes, and take passages on the prevention of stroke occurrence or recrudescence from them. Further more, we contrast these ideas old and new, under the help of some data centers, such as CNKI, and conmbine the west medicine guideline with TCM methods, and design a software system, which all are in order to find a better way for stroke prevention today.Objective:To explore TCM documents on stroke prevention and treatment, and to discuss how to bring Zhiweibing theory into play at present health care system; and finally to develop a software of stroke prevention, which can provide patients a comprehensive prevention scheme on the base of best evidence.Methods:1. TCM documents collection and reorganizationIt is referred to Zhongfenbing Zhuanji (Stroke album), Guji Mingyi Linzheng Jinjian etc. which makes a good collection of the stroke literature old and new, i n add i t ion with Tang Song Jin Yuan Mingyi Quanshu Dacheng, Ming Qin Mingyi Quanshu Dacheng, the volumes on acupuncture, internal medicine, life cultivation of Zhongyi Linchuang Bidu Congshu, Minguo Mingyi Zhuzuo Jinghua, in which limits we make comparison and contrast, and finally makes out nearly30famous books or doctors who made a large contribution on strokes. They are Huangdi Neijing(Huangdi's canon of internal medicine), Zhang Zongjing, Zhongzangjing, Chao Yuanfang, Sun simiao, Wang Tao, Liu Wansu, Li Dongyuan, Zhu Danxi, Wang Zhizhong, Luo Tianyi, Xue Ji, Zhang Jingyue, Zhao Xianke, Li Zhongzi, Gong Tingxian, Yu Jiayan, Jiang Tianxu, Li Yongcui, Shen Jin'ao, Chen Xiuyuan, Ye Tianshi, Wang Qingren, Zhang Shixiang, Zhang Shanlei, Zhang Xichun, Ren Ji xue, Zhang Xuewen. First, we collect every book of these doctors and read the passages on stroke in, and take out the words on stroke prevention, recognize their ideas from pathogenesis, mechanism, and treatment principle and prevention theory. And then a discussion about these ideas would take by the way of historical comparison and CNKI data which may tell us the acceptance and confirm by the following doctors. For the present doctors'study, we take use of the database of CNKI, Weipu, China biological literature, studied from five points, life cultivation, risk intervention, stokes sign treatment, truncation course and recurrence prevention, especially the studies from state level task or famous doctors, such as Wang Yongyan, Shi Xuemin, etc.2. The discussion on preventive process At the same time, we rethink the present situation of stroke prevention. Compared with western medicine, Chinese medicine's Zhiweibing theory has five advantages:earlier intervention, dynamic intervention, more therapies, lower-priced effect and close to daily life. But it has disadvantage either. First, almost all therapies are doctors' personal experiences but not evidenced base medicine and no standard for the application result into no guaranteed effect for every patient. Secondly, though we know Chinese medicine has effect on prevention of stroke, but we do not know how much effect it has, and whether the effect exist or not at the base of western medicine treatment. Thirdly, for the same prescription or the same problem, different doctors may have different opinions and always have conflict results. So we get a conclusion that Chinese and Western medicine have complementary advantages. We should take a combination for stroke prevention. So the question is how to take advantage of TCM Zhiweibing theory at the base of standard treatment by western medicine, which is the main focus of us.According to the study of TCM documents, we conclude Zhiweibing theory for stroke into five stages:life cultivation, risk intervention, stokes sign treatment, truncation course and recurrence prevention. We explored the five stages'definitions and ways of diagnosis. And further the newly achievement of western medicine, such as Framingham study, high blood pressure layered grading diagnosis and dyslipidemia risk stratification are taken into use of stroke risk assessment, and the result described into four levels:low-risk, intermediate-risk, high-risk and very high-risk. Five stages and four levels are united into one and it could be applied to stroke-risk-assessment for most of people. We believe that the best way to prevent stroke is good risk assessment and personal treatment. Next, Five stages and four levels are taken as an outline, and the special treatments are discussed. Among the treatments, the western medicine part is according to the Chinese guideline such as2010Chinese guideline on prevention and treatment of high blood pressure, some from the guideline of oversea countries such as Guidelines for the primary prevention of stroke:a guideline for healthcare professionals from the American Heart Association, the Chinese medicine part is from the conclusion we collected and reorganized out from the ancient and present TCM documents, among which we choose the widely accepted and used in history or which are the results from Chinese state level research. The present situation of stroke prevention is not good in china. Most patients get such medical service from clinics or community healthcare center; the revised guideline can not be applied into patients quickly as doctor's low profession or busy work. Some patients may not be given enough time to get such knowledge; some may be treated by specialists who have little relative to stroke or known little about these guidelines. Considering stroke prevention is related to many kind of diseases and too much information, a doctor can not manage all, we propose to make an invention of software, called stroke prevention software system. It is software that can provide every people stroke-risk assessment and personal preventing therapies. The therapies are combinations of both TCM methods and western interventions, both daily life guiding and medical suggestions. It takes as much as advantage from both Chinese and western medicines, and characterized by six aspects, which are easy use, wide indication, open and developing, comprehensive interventions, personal intervention and medical education function. It is used specially for clinical or community patients. So at last, we introduce the process of stroke risk assessment and prevention under the help of this software for clinic patients.Result and Achievements:1. Literature resultsAs far as I know, it is the first TCM documentary reorganization on stroke prevention but not stroke treatment. After the study, we get all of the passages from the famous doctors in Chinese history. Peoples later can easily reach their viewpoints, herbal prescriptions, acupuncture or moxibustion methods and case reports on stroke prevention.2. A new stroke prevention methodTCM Zhiweibing theory has five advantages of earlier intervention, dynamic intervention, more therapies, lower-priced effect and close to daily life. Stroke prevention should be treated according life cultivation, risk intervention, stokes sign treatment, truncation course and recurrence prevention, five stages and low-risk, intermediate-risk, high-risk and very high-risk, four levels. A new risk assessment way is initiated including Framingham scores, high blood pressure layered grading diagnosis and dyslipidemia risk stratification. Both the risk diagnosis and treatments are according to Chinese guideline and in a integrated medicine framework, which aim to provide patients a personal and best-evidence based treatment. At last, we propose a software to help doctors achieve this new stroke prevention means, and we draw out the blueprint of it.Conclusion:Under the help of modern computer software technology, it can make a better result to take good use of2000years TCM documents and Zhiweibing theory at base of national guideline of stroke prevention and prevention of some relative diseases.
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