Wei Holds True Academic Thoughts And Clinical Experience And The Treatment Of Fast Arrhythmia Syndrome Cure Law Research

My mentor Professor Wei Zhizhen is a senior expert in traditional Chinese medicine well known nationaly. I am lucky enough to persue my doctor degree under her guidance for three years and have benefited a lot.Professor Wei, graduated from Beijing Medical College of TCM (now Beijing University of Chinese Medicine) in 1962, is one of the first doctors who specialize in traditional Chinese medicine got their medical degree through formal high education system. While at medical school, she was taught by contemporary Chinese medicine masters such as Qin Bowei, Ren YingQiu, Shi Jinmo, etc. She is devoted to medicine learning in perseverance, seeking knowledge without slack, and she is well-known among peers at the academy for her diligence and persistence in learning. As top in her class, she was selected to be apprentice to Dr. Qin Bowei, a famous modern Chinese medicine scientist, educator and scholar. She learned a lot from Dr. Qin, and even published a book "Guidelines in TCM Clinical Practice" as a co-author with Dr. Qin in 1963. The book is all about Dr. Qin’s clinical experience and academic theories in Chinese medicine. Professor Wei began her career in Beijing Chinese Medicine Hospital after graduation. As a cardiologist, she’s not only specializing in clinical practice, but also involve in teaching and research. Professor Wei studies the medical classics and follows the ancient motto, inheriting her teacher Dr. Qin’s academic ideology, she is also familiar with medicine progress, studies hard constantly,so she had accumulated rich experience of treating medical diseases,especially in cardiovascular disease and diabetes,such as arrhythmia, diabetic cardiopathy, cerebral atherosclerosis and cerebral circulation insufficiency. Professor Wei had obtained 11 adwards, including Ministry of Health, State Administration of Traditional Chinese Medicine, Beijing Municipal Science and Technology Commission, etc, she is famous at home and abroad because of treating arrhythmia. After practicing for nearly fifty years, Professor Wei has published a lot of books to share her experience from clinical practice instead of keeping secret to herself. Her syndrome differentiation and treatment comes from traditional method but is not limited to that, which is accurate and pure, brisk and significant.This study aims to summarize Professor Wei’s academic ideology and clinical experience, to focus on her unique differentiation and treatment ideology in arrhythmia, to seek the origin of the teacher’s academic ideology through ancient classics and experience from teachers. And I collected cases of tachyarrhythmia treated by Professor Wei, analyzed the common syndrome elements of tachyarrhythmia and Professor Wei’s medication characteristics,through SPSS16.0 statistical software, by using frequency, fatctors analysis, hierarchical cluster analysis and logistic regression methods. In this way, to further discover Professor Wei’s principle of syndrome-treatment of tachyarrhythmia.This thesis mainly divided into three major contents.The first part is about the origins of Professor Wei’s academic ideology.In this part, I Reviewed ancient literature, and researched how the physicians at that time thought about "heart palpitations" in pathogenesis and how they treated it, to find the basic theory Professor Wei is based in syndrome differentiation of arrhythmia. Professor Wei creats her unique ideology in differentiation and treatment of arrhythmia which is "combination of four diagnosis with emphasis of pulsing, dividing into two classifications, ten kinds and three syndromes", following the ancient motto, absorbing the quintessence of other physicians by well-reading, and is especially influenced by the book "Pulse Diagnosis" which was written by Li Shizhen.I also read the writings of Dr. Qin Bowei to further discover origins of Professor Wei’s academic ideology in treating cardiovascular diseases. Professor Wei inherits Dr. Qin’s academic ideology, she advocates that syndrome differentiation and disease differentiation should be combined, and a physician should put syndrome differentiation first, diagnosis and treatment should be closely connected. In the treatment of cardiovascular diseases, Professor Wei advocates "regulating Qi and harmonizing Blood", be careful with taking removing stasis drug.Professor Wei thinks that it is very important to combine theory with practice, she works hard and summarizes her experience in cilinal practice, in this way, Professor Wei creats her unique ideology in dirrerentiation and treatment of arrhythmia and series of prescriptions of "pulse regulating soup". Especially in treatment of tachyarrhythmia, her "cooling blood and clearing heat" treatment is a national initiative.The second section of the thesis is to summarize the academic thoughts and clinical experiences of Professor Wei.Through clinical work, learn and summarize Professor Wei’s thoughts and experience in diagnosis and treatment of cardiovascular and cerebrovascular diseases.Professor Wei specializes in the treatment of arrhythmia, coronary angina, diabetes heart disease, congestive heart failure, cardiomyopathy, cerebral atherosclerosis and hypertension and other diseases. She believes that the basic pathogenesis of most cardiovascular diseases is heart deficiency, blood stasis or poor circulation. She advocates nourishing qi and heart, regulating qi and activating blood circulation. Based on this, depending on different diseases, add appropriate treatment such as:cooling blood and clearing heat for tachyarrhythmia; congestive heart failure is treated with clearing lung for diruesis, nourishing yin and liver, promoting spleen and diuresis in accordance with the condition how the lung, liver, spleen and stomach and kidney is affected respectively. Diabetes heart diseases are differentiated as Diabetes chest stuffiness, Diabetes heart palpitations and Diabetes heart failure. Come to the treatment, in addition to the regular treatment of chest stuffiness, heart palpitations and heart failure Diabetes, it should be emphasis in clearing heat and nourishing heat. For cardiomyopathy, the treatment will be different depends on heart failure or arrhythmia.Professor Wei emphasizes the use of qi drug as "qi is the commander of blood, smooth flow of qi results in good blood circulation". However, note that it’s necessary to regulating qi instead of forcing qi. Professor Wei also advocates "harmonizing blood", namely, choose medicine which can harmonize blood without hurting vital qi. Never choose removing stasis drug. In clinical practice, Professor Wei advocates accuracy in differentiation, treatment principle, formula formation and selection of medication, so that diagnosis and treatment are closely connected. Professor Wei is cautious not only in the choice of drugs, but also in dosage as well as formula adjustment. Her prescription is light and accurate, looks plain, but bears profound meanings in them.And in this part I summarize Professor Wei’s experiences of treating arrhythmia, congestive heart failure, coronary angina, cerebral atherosclerosis, etc. Now I would like to take arrhythmia for an example.Professor Wei combs courses of generations of ancient physicians about heart palpitations, and thoroughly studies "Pulse Diagnosis". Combining the wisdom of sages and her long-term clinical practice, she creates her unique ideology in differentiation and treatment of arrhythmia which is "combination of four diagnosis with emphasis of pulsing, dividing into two classifications, ten kinds and three syndromes".Professor Wei stresses that pulse condition plays an important role in diagnosis of cardiac arrhythmia. Each arrhythmia has corresponding main pulse which also has its corresponding main disease. During syndrome differentiation, first thing needs to do is to understand the pulse so as to get the fundamental pathogenesis of cardiac arrhythmias. Then, refer to other 3 diagnostic methods and finally analyzing the causes, dividing into two classifications and ten kinds.Two classifications are yang-heat and yin-cold. The former is similar to tachyarrhythmia in modern medicine and the latter is similar to arrhythmias. Each classification is divided into five different kinds respectively. The pathogenesis of yang-heat arrhythmia is heart deficiency, blood stasis with heat. Professor Wei believes that "heat" is the main cause of disease, the "heat" here refers to heat in blood, so "cooling blood and clearing heat" is the key treatment. The pathogenesis of yin-cold arrhythmia is yang deficiency of heart, spleen and kidney, or with deficiency of yin blood, combined with cold-dampness, phlegm stagnation, systolic stasis and poor circulation. Aimed at the syndromes of the ten kinds, Professor Wei prepares series of prescriptions of "pulse regulating soup". Three syndromes are stagnation of qi and vital energy, restless spirit and poison from wind heat in arrhythmia, which deserve special attention. At these stage, apply the principle "treat evident symptom in urgent condition" to achieve effective results. Among the three syndromes, poison from wind heat is the most dangerous one.In the third part of this thesis is to study Professor Wei’s principle of syndrome-treatment of tachyarrhythmia.I collected cases of tachyarrhythmia treated by Professor Wei from Oct.2008 to Sep.2011, there are 325 cases altogether. I analyzed the common syndrome elements of tachyarrhythmia and Professor Wei’s medication characteristics, through SPSS16.0 statistical software, by using frequency, fatctors analysis, hierarchical cluster analysis and logistic regression methods. The results show that:1. In 325 cases, Professor Wei uses 88 kinds of herbs, the highest frequency of usage is 99.4%, while the lowest is 0.3%. The top 10 are: Cyperus, Cortex Moutan Radicis, Radix Paeoniae Rubra, Rhizoma Coptidis, Radix Linderae, Radix Ophiopogonis, Fructus Schisandrae, Citron, Fingered Citron and Radix Glehniae.2. In the 88 cases of atrial fibrillation, Professor Wei uses 74 kinds of herbs. The frequency greater than 50%:Radix Pseudostellariae, Radix Glehniae, Radix Ophiopogonis, Fructus Schisandrae, Radix Paeoniae Alba, Cyperus, Citron, Fingered Citron, Radix Linderae, Cortex Moutan Radicis, Radix Paeoniae Rubra and Rhizoma Coptidis. The results of logistic regression analysis show that:the regression coefficients of Poria Cocos, Radix Paeoniae Alba, Radix Linderae, Radix Rehmanniae, Radix Pseudostellariae and Citron were greater than 1, the "OR" are greater than 5, with statistical significance (P<0.001 or P<0.05).3. The results of using drugs frequency analysis in the treatment of premature beats, sinus tachycardia and paroxysmal supraventricular tachycardia show that:The frequency greater than 50%:Radix Glehniae, Radix Ophiopogonis, Fructus Schisandrae, Cyperus, Citron, Fingered Citron, Radix Linderae, Cortex Moutan Radicis, Radix Paeoniae Rubra and Rhizoma Coptidis.4. Professor Wei uses Rhizoma Atractylodis Macrocephalae in 47 cases, among the 47 patients, there are 14 cases using dose of 10g and the patients have white and yellow and thick fur; there are 4 cases using dose of 15g and the patients have yellow and thick fur; there are 29 cases using dose of 30g and the patients have thin white fur and loose stool.5. in the 325 cases, frequencies of symptoms greater than 30%: palpitations, dry mouth with desire for drink, fatigue, shortness of breath and tightness in the chest, from 10% to 30%:stool pond or dry stool, difficulty in falling asleep, abdominal distension and wake up early.6. To analyze the symptoms whose frequencies are greater than 10% by factor analysis, the results show that:the main components of tachyarrhythmia are palpitations, shortness of breath, fatigue and chest tightness. Dry mouth with desire for drink, dry stool and difficulty in falling asleep are closely related to palpitations; fatigue, loose stools and wake up early are closely related to shortness of breath.7. To analyze the symptoms whose frequencies are greater than 10% by cluster analysis, I get 3 groups of symptoms. The first groups of symptoms are palpitations, dry mouth with desire for drink; the second groups of symptoms are shortness of breath, fatigue; the third groups of symptoms are chest tightness, abdominal distension, dry stool, difficulty in falling asleep, waking up early and loose stools.So I may safely draw the conclusions as follows:1. Professor Wei usually uses herbs such as Radix Pseudostellariae, Radix Glehniae, Radix Ophiopogonis, Fructus Schisandrae, Cyperus, Citron, Fingered Citron, Radix Linderae, Cortex Moutan Radicis, Radix Paeoniae Rubra and Rhizoma Coptidis while treating tachyarrhythmia, and these herbs make up the basic prescription in the treatment of tachyarrhythmia.2. Radix Paeoniae Alba and Radix Rehmanniae have higher specificity in the treatment of atrial fibrillation.3. The common symptoms of tachyarrhythmia are:palpitations, dry mouth with desire for drink, fatigue, shortness of breath and tightness in the chest, usually with abdominal distention, difficulty in falling asleep and wake up early. 4. The most common characteristic-syndrome elements of tachyarrhythmia are Yin deficiency, Qi deficiency, Qi stagnation and heat; while bit-syndrome elements are heart and spleen.innovation:After three years of study with Professor Wei, also by my own clinical practice, I have some thougts as my innovation.1. Some patients have deficient and cold syndrome in middle-Jiao, so I think that we might add a small dose of Rhizoma Zingiberis, it might keep stomach from injuries and prevent the discomfort symptoms by the herbs.2. I think that patients with menopausal syndrome have syndrome of endogenous heat due to Yin deficiency, fire syndrome due to stagnation of liver-Qi, syndrome of hyperactivity of the liver-Yang, so we could use the "cooling and nourishing soup regulating pulse" and the "Rou Gan Qing Xuan Tang" in these patients.3. Some hypertensive patients’diastolic function improved after taking the "Rou Gan Qing Xuan Tang", so I think that the soup could be used in patients with diastolic dysfunction, and it might be a new way to treat diastolic dysfunction.4. Professor Wei treats diabetes patient who has strong appetite with polygonatum, so I think that the herb could be used in hyperthyreosis patients.5. According to an antient Chinese book, Atractylodes macrocephala koidz has the effect of "huan pi sheng jin", so I think that we could take Atractylodes macrocephala koidz and polygonatum in the treatment of diabetes.