Research Experience Of Prof. Zengyuan Zhuang In Fundus Degenerative Disorders By"Combination Of Disease And Syndrome"

This article discussed and summarized Prof. Zengyuan Zhuang’s idea and experience in Chinese ophthalmology degenerative disorders by "combination of disease and syndrome" academic thought. Taking high myopia macular hemorrhage as an example, we explored the specific application of " combination of disease and syndrome " diagnosis and treatment system.The combination of disease and syndrome is the traditional Chinese ophthalmology major clinical pattern; the purpose of the research is to improve the clinical effect of traditional Chinese medicine. The diagnosis and treatment model of combination of disease and syndrome combine the Western and traditional Chinese medicine theory, through the communication and clinical validation, with single disease clinical research as the foundation, and gradually form Integral view and syndrome differentiation principle, the new medical mode about specific diseases. It is usually clinical pattern that disease differentiation of Western medicineâ†'syndrome differentiation of traditional Chinese medicineâ†'TCM treatment based on syndrome differentiation. For difficult and critical diseases, the treatment base on the dual diagnosis in western medicine and Chinese medicine, combine the routine treatment of Western medicine with the treatment based on syndrome differentiation of Chinese medicine. This model is better than the traditional Chinese medicine syndrome or separate treatment of Western medicine.Prof. Zhuang thought that Chinese ophthalmology "combination of disease and syndrome" research should pay attention to the following:1. Clinical practice is the basis of the combination of disease and syndrome:both Western medicine and Chinese medicine are application medicine. For the same person, with the same disease, we could use different perspective strategies and different treatments. Chinese medicine pays attention to "people", that is, through the smell, ask, cut, collected from patients, and under the guidance of Chinese medicine theory, a comprehensive analysis of the etiology, disease, illness and disease, and treatment based on syndrome differentiation of prescription. Western medicine pays attention to " disease", that is, through contact, listen and biochemical, imaging, pathology and other means of detection, analysis of etiology, pathophysiology and anatomy. The treatment of traditional Chinese and Western medicine for the same disease could achieve same clinical efficacy. Therefore, only clinical practice is the combination of disease and syndrome research platform.2. Primary syndrome is the clinical research bridge of the combination of disease and syndrome:finding the main syndrome could catch the point of the combination of disease and syndrome differentiation. Clinical study on combination of disease and syndrome, with main symptoms as the core, combined with other associated symptoms and history, after a comprehensive analysis, then give a clear differentiation of syndromes and treatment. The main syndrome is the bridge between disease and syndrome and the clinical syndrome differentiation key factors.3. According to pathological changes of syndrome differentiation of traditional Chinese Ophthalmology to study the common symptoms of ocular fundus.We summaried Prof. Zhuang’s clinical thought in the study of a certain disease by combination of disease and syndrome. It is divided into the following six steps.1. A clear diagnosis of Western medicine:in some difficult and complicated disease, one should first determine the disease diagnosis and clinical stage, grasp the basic pathological changes and disease incidence in different stage.2. Complete differentiation of traditional Chinese medicine:based on the definitive diagnosis, it is premise to grasp its basic pathogenesis syndrome. According to specific clinical manifestations (main syndrome) of different disease, applicant Chinese medicine related dialectical method, analysis disease pathogenesis.3. Differentiation of disease and syndrome:in difficult eye diseases, we could find many diseases at the same time, which increase the difficulty and complexity of syndrome differentiation. When multiple etiologies in some diseases occur at the same time, we should differentiate of diseases and syndrome according to the incidence, primary and secondary successively and mutual relations. At the same time, we should pay attention to the problem that the same disease has different syndromes.4. Treatment according to different syndromes:each kind of disease has its specific clinical manifestations and pathological development. At one stage, the corresponding symptom is a diagnosis basis of syndrome of traditional Chinese medicine, and each syndrome has a certain internal relation and evolution. Therefore, we should according to clinical features (main symptom) in different stages analysis the main pathogenesis; accurately grasp the staging treatment of syndrome differentiation.5. The special medicine for special disease:special medicine research of the combination of disease and syndrome diagnosis and treatment system is the future direction and goal.6. The combination of traditional Chinese and Western medicine diagnosis and treatment:we take the advantage of Western medicine and traditional Chinese medicine.Prof. Zhuang put forward that the construction of Chinese ophthalmology "combination of disease and syndrome diagnosis and treatment mode" has to meet and reflect the ophthalmological syndrome-differentiation characteristics, especially in dgenerative eye diseases study, in order to adapt to the needs of the development of traditional Chinese ophthalmology. As in "the combination of disease and syndrome" mode of high myopia macular hemorrhage etiology, from "disease" analysis the development of "syndrome". Early lacquer crack without neovascular macular hemorrhage, with liver and kidney yin deficiency, blood deficiency failed to foster; as the illness progresses, choroidal neovascularization can cause bleeding, with hyperactivity of fire due to yin deficiency, and mainly stagnated heat injury. Yin deficiency, and fire, and the stasis, deficiency of clamp. From the analysis of disease development, pathogenesis evolution from Qi positive imaginary evil.Prof. Zhuang thought that" the combination of disease and syndrome" diagnosis and treatment system also contributes to the research of special disease. Special patient with special medicine, treatment based on syndrome differentiation and according to the main disease pathogenesis and syndromes. For example, in traditional Chinese medicine in the treatment of high myopia macular hemorrhage clinical studies, we used prospective study and observed the treatment efficacy of SIWEIWUZI and SHENGPUHUANG on high myopia macular hemorrhage by fluorescein angiography, objective evaluate the traditional Chinese medicine in the treatment of macular hemorrhage and inhibition of retinal neovascularization membrane recurrence.Inspired by prof. Zhuang’s experience in the treatment of neovascular age-related macular degeneration using "Artemisia" and with reference to the modern pharmacological studies, we formed the clinical thinking of application Artemisia or Artemisia extract in the treatment of choroidal neovascularization. Initially we developed intervention study of artesunate on laser induced choroidal neovascularization rat, try to explore prof. Zhuang’s clinical experience.However, Chinese and Western medicine are two different medical systems, the combination of disease and syndrome research still has a lot of difficulties need thoroughly practice and exploration, but the combination of disease and syndrome patterns will be developed and perfected.