| PHD Supervisor:Zhou Yaoting, male, born in Daishan, Zhejiang province in 1930.He is a chief physician in Capital Medical University, nationwide famous old traditional Chinese physician. Professor Zhou Yaoting has 50 years of clinical experience. He is the expert on " Internal Medicine ", "Pediatrics,", Also good at external diseases, gynecology, dermatology.30 years teaching experience on febrile diseases, have extensive clinical experience and higher theoretical foundation in Western medicine, and especially has deep attainments in the seasonal febrile diseases. Making use of theories of traditional Chinese medicine to treat Febrile diseases, efficacy is outstanding. This thesis will involve two aspects, one is for mining professor Zhou’s experiences and academic thinkings and the other is to summarize Professor Zhou’s clinical treatment of long term febrile diseases due to bloking MOYUAN (membrane prototype) by dampness.1. Professor Zhou Yaoting’s academic thinking on treating long-term fever and clinical experience.Long-term fever is a fever lasting for more than 2 weeks. Professor Zhou regards long-term fever as a symptom. This is caused by various diseases and factors. The patient’s condition may be simple or complex and shorter duration as 2-3 weeks, sustainable course for the several years. According to the different level of long-term temperature, there may be divided in long-term high-grade fever (temperature above 38℃) and long-term low-grade fever (body temperature below 38℃) two categories. Long-term high heat may be mainly divided into 4 types:Heat stagnant in lung and stomach with exterior evil; MOYUAN blocked by dampness; dampness heat in QIFEN; phlegm stagnated in the lung。Long term low degree fever may be mainly divided into 7 types。there are:Residue of toxic heat and the evil conceal in YINFEN; food stagnant in spleen and stomach; MOYUAN blocked by dampness; dampness heat in QIFEN; interior heat due to YIN-deficiency; blood stagnation and deficiency of QI and Xue。Clinically Professor Zhou strongly emphasizes on careful observation, careful analysis, stress analysis of history, from the tiny spare change, as much as possible to capture the dialectical clues. When the syndrome is not comprehensive, not typical, Professor Zhou will seize the main points of differentiation; to identify for the suspected evidence, and then eliminated. Clinical evidence and therefore the corresponding side have a significant effect.2. Professor Zhou Yaoting’s theory of academic thought and clinical experience of treatment on respiratory infections by using the theories on instant affected febrile diseases.TCM treatment on infectious diseases has tremendous potential. Professor Zhou Yaoting making theories and methods of TCM for treat febrile diseases with a good combination with clinical infectious diseases, and have accumulated a lot of good experience. This paper concluded complex diseases he proposed, for example, there are always coexisted both by heat and cold evil and this is more commonly happened in cough and asthmatic diseases。in such conditions, the pathogenesis were more often affected in lung and stomach; these changeable conditions all together with the complications of pediatrics can not be ignored. Concluding the point whether the superficial syndrome was existed; identified in the interior heat levels, the insufficiency or excess of QI distinguish the condition whether is benign or deteriorated, and distinguish the presence or absence of complications. Professor Zhou raised his theories on the treatment methods and principles:such as dispelling the evils and to keep YIN and fluid, and the methods of to stop cough and asthmatic syndrome. Professor Zhou’s treatment on common cold, purulent tonsillitis, acute bronchitis and pneumonia and commonly used therapies, prescription and drugs were systematically summarized.3. Professor Zhou Yaoting’s academic thought and clinical experience on treating rashes.Watching rash can identify the cause, location and depth of evil, yin or yang in property, the severity and prognosis. Spotted color red is hot, the purple color is with toxic evil, black color denoting severe heat, Purple and black are blood stasis; rash out and dissipated quickly, itching skin lesions due to the wind; local skin blisters, subsidized by water leakage due to dampness. Rash observation is a Methodist camp with the disease, skin rash is related with WEI and YING levels, and the purpla is related with QI and XUE。If there are co-existence of rash and purpla, so it is involved all levels of the disease: it involving almost Wei Qi, Ying and xue levels. Purpla may divided in YIN and YANG in property, but the rash is only has YANG and no YIN property. Spots with Exopathogen heat mostly were YANG property; if occur in miscellaneous internal diseases, both YIN and YANG properties can be seen. Appearing of rash and purpla are indicating expelling of toxic-heat evils from inside of the body, and was in good prognosis. but in the measles, if the rash spread all over the body smoothly; spotted with red and bright color, it is a favorable sign; if it spotted black and dull as the inverse; shaped loose and float smooth is benign, tight-binding for the reverse. the eruption in mostly "FUXIE" febrile disease that indicate the evil exposing to superficial from inside of the body. otherwise, the eruption accompany with progressive symptoms, it indicating that is instant infectious diseases. the exposing of the rash and purpla, indicate the evil is deep in YING and XUE, treating with clearing the heats of YING and xue; spotted out was often accompanied with toxic heat, in treatment, methods of clearing toxic heat was always used; spotted out is the chance of toxic heat go out from inside, the treatment must be guide properly the trend in the development in the disease. spotted out always related with PI and WEI, so the treatments must be connected with FEI AND WEI.4. To summarize Professor Zhou Yaoting treatment on digestive diseases and clinical experienceProfessor Zhou Yaoting specializes in the treatment of digestive diseases, in particular epigastric pain, diarrhea and dysentery. For patients with epigastric pain, Zhou Professor thinks yang Deficiency and Liver Qi stagnation is the main cause, normally to warm stomach and to dispersing the stagnated liver QI are always used. He is against the blindly using the warm recuperating methods, such as Lizhong Wan (理中丸), Bu Zhong Yi Qi Tang (补中益气汤) which will resulting in stomach pain lingering. Although diarrhea and dysentery are all stomach and intestinal disorders, diarrhea is due to spleen dampness, and disease in the spleen, the treatment should be dispelling the dampness by diuresis; dysentery due to damp heat and was going to transforming into dryness in property, and the evil was deep into Blood, the pathogenesis is in large intestine and prohibition of using diuretics. Professor Zhou’s treatment on stomach-ache, diarrhea, dysentery, common therapies, prescription and drugs were systematically summarized.5. Professor Zhou Yaoting’s academic thought and clinical experience on treatment of skin diseases.Acne, urticaria, eczema and allergic rashes Although these four diseases are skin diseases, belong to different diseases. However, Professor Zhou believes these four diseases are closely linked with interior viscera. the Etiology were include of wind-dampness and toxic heat and pathogenesis were always related with the lungs, spleen and stomach. Treatment has to be enhanced in dispelling the wind heat and dampness detoxification. However, there are differences between with the four kinds of the diseases. On treatment have to focused on the pathogenesis, and the treatment should be targeted for drug selection. Professor Zhou’s treatment on urticaria, acne, eczema, allergic skin rash commonly used therapies, prescription and drugs were systematically summarized.6. Professor Zhou Yaoting’s academic thought and clinical experience on treatment of blood diseasesProfessor Zhou Differential Treatment of blood diseases with special emphasis on the following points. (1) What organs are closely related with blood diseases. "Yellow Emperor"says:"absorpiong juice from the middle energizer and change to red in color, that is blood," The stomach is the root of postnatal, kidney is the root of innate, and closely related In producing blood. Kidney is the origine of the essence, the spleen and stomach as the source of qi and blood. (2) Modern medical diagnosis of anemia, definitely not the same as Chinese medicine blood deficiency. (3) Blood stasis is a pathological product, but also are risk factors, clinical evidence to fully understand the dangers of blood stasis. "if the blood stasis do not be removed, the new blood will not be prodused. " "if blood stasis was not removed, the blood does not go through." Professor Zhou’s treatment on nutritional anemia, polycythemia vera common therapies, prescription and drugs were systematically summarized.7. Professor Zhou Yaoting’s academic thought and clinical experience on treatment MelancholiaProfessor Zhou Yaoting considering that today’s society, the international and domestic competition is getting fierce, rapid economic development, working, living, learning are in faster pace, increasing pressure from various quarters, and it even affect children, so both men and women, adults, children, and regardless of foreign countries, domestic, urban, rural, as the emotional disorders can not resolve by themselves, the situation led to increasing depression syndrome, liver QI stagnation, liver fire and other evidence are very common, affecting a wide range, this area is modulating the advantages of Chinese medicine. But the performance of a variety of such evidence, the treatment also varies by difference of symptoms. Professor Zhou’s treatment on QI stagnation, stagnation of the fire cause headache, palpitations, pharyngitis, gastritis, epilepsy, hyperactivity, irregular menstruation in women, commonly used therapies, prescription and drugs were systematically summarized.The third part is a study on the new huashidayuantang treating the syndrome of MOYUAN blocked by dampnessLong-term fever in Internal Medicine and pediatric, is recognized as problem. Professor Zhou Yaoting uses traditional Chinese medicine theory of the MOYUAN (menbrane prototype), and have had a long period of time penetratingly study on the long-term heat caused by dampness blocking the MOYUAN, and achieved encouraging results. Based on years of clinical experience, he created a new decoction of XINDINGHUASHIDAYUANTANG. Objective:This study observed the clinical efficacy and safety of the new decoction treating the original syndrome of MOYUAN blocked by dampness. Method:Following the principle of random, collation and single blinding,66 patients who got the syndrome of MOYUAN blocked by dampness were divided into two groups which were Therapeutic group (33 cases, new huashidayuantang) and Control group (33cases, dayuanyin). Observing the temperature before and after treatment, TCM symdromes and changes of symptom score to determine the clinical efficacy. Detecting the recurrence si tuat ion after the course of the treatment finished 1 month and the of recurrence rate was calculated. Detecting the changes of Blood Routine, Urine Routine, Stool Routine, ECG, GPT and renal function to determine the safety. Result:1. body temperature examination:Two groups decoctions used both had the Antifebrile action. They had the statistical differences before and after treatment (P<0.001). Compared with Control group, Therapeutic group were better than Control group on the antifebrile action at the 7th,14th,21th and 28th days, They had the statistical differences before and after treatment(P<0.01, P<0.001, P<0.05).2. 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<0.001) 3. Curative effect of the illness:The total efficiency of the Therapeutic group and Control group were 90.91% and 66.7%. Therapeutic group were better than Control group. Two groups had the statistical differences (P<0.05).4. Syndromes curative effect:The total efficiency of the Therapeutic group and Control group were 93.94% and 69.70%, Therapeutic group were better than Control group. Two groups had the statistical differences (P<0.05).5. Fol lowup:The recurrence rates of the Therapeutic group and Control group were 0% and 12.12%, Therapeutic group was fewer than Control group. Two groups had the statistical differences (P<0.05).6. Safety index:Two groups had no significantly changes on Blood Routine, Urine Routine, Stool Routine, ECG, GPT (ALT、AST), renal function (Scr、BUN). Conlusion:new decoction treating the original syndrome of MOYUAN blocked by dampness. Xindinghuashidayuantang can significantly decrease the temperatures of the patients who got the syndrome of MOYUAN blocked by dampness, and its antifebrile action is better than dayuanyin. Xindinghuashidayuantang can also improve the symptoms and physical sign such as pyrexia, rigor, nausea, the color of face, rash, lymph node enlargement, arthralgia, greasy fur and so on, and it is better than the dayuanyin on improving the symptom score and TCM syndromes. Its Antifebrile effect remains stable, and it’s seldom to recurrence. Xindinghuashidayuantang has its safety property. Objective:This study observed the clinical efficacy and safety of the new decoction treating the original syndrome of MOYUAN blocked by dampness. Method: Following the principle of random, collation and single blinding,66 patients who got the syndrome of MOYUAN blocked by dampness were divided into two groups which were Therapeutic group (33 cases, new huashidayuantang) and Control group (33cases, dayuanyin). Observing the temperature before and after treatment, TCM symptoms and changes of symptom score to determine the clinical efficacy. Detecting the recurrence situation after the course of the treatment finished 1 month and calculating the rate of recurrence. Detecting the changes of Blood Routine, Urine Routine, Stool Routine, ECG, GPT and renal function to determine the safety. Result:1. body temperature examination:Two groups decoctions used both had the Antifebrile action. They had the statistical differences before and after treatment (P<0.001). Compared with Control group, Therapeutic group were better than Control group on the antifebrile action at the 7th,14th,21th and 28th days, They had the statistical differences before and after treatment (P<0.01, P<0.001, P<0.05).2. 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<0.001) 3. Curative effect of the illness:The total efficiency of the Therapeutic group and Control group were 90.91% and 66.7% Therapeutic group were better than Control group. Two groups had the statistical differences (P<0.05).4. Syndromes curative effect:The total efficiency of the Therapeutic group and Control group were 93.94% and 69.70%, Therapeutic group were better than Control group. Two groups had the statistical differences (P<0.05).5. Followup:The recurrence rates of the Therapeutic group and Control group were 0% and 12.12%, Therapeutic group was fewer than Control group. Two groups had the statistical differences (P<0.05).6. Safety index:Two groups had no significantly changes on Blood Routine, Urine Routine, Stool Routine, ECG, GPT (ALT. AST), renal function (Scr、BUN). Conlusion:new decoction treating the original syndrome of MOYUAN blocked by dampness. Xindinghuashidayuantang can significantly decrease the temperatures of the patients who got the syndrome of MOYUAN blocked by dampness, and its antifebrile action is better than dayuanyin. Xindinghuashidayuantang can also improve the symptoms and physical sign such as pyrexia, rigor, nausea, the color of face, rash, lymph node enlargement, arthralgia, greasy fur and so on, and it is better than the dayuanyin on improving the symptom score and TCM synpdromes. Its Antifebrile effect remains stable, and it’s seldom to recurrence. Xindinghuashidayuantang has its safety property. |
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