Li Yan Democracy As A Physician Academic Ideas

As a common clinical disease, the osteoarthritis of knee joint is the most common degenerative joint disease. With the development of our national economy and the improvement of living level, the people’s average life expectancy extends obviously. Therefore, the aging of the population will be very apparent in the foreseeable future. Osteoarthritis, forming a huge threat for the specific population of elder people, not only affect the quality of patients’life, but also bring a huge even a fatal blow on the patients’family. The disease, being both a medical problem and a social problem, has aroused the attention of many clinical workers. In modern West Medicine, the etiology and pathogenesis of osteoarthritis of knee joint is still not completely clear. Although a lot of treatments are available, there is no effective therapy currently. This article discusses Professor Li Yanmin’s analgesic method for treating osteoarthritis of knee joint from two aspects of summarizing the academic thought and researching the clinical experience, hoping to find better solutions in treating the osteoarthritis of knee joint.Theoretical research:Professor Li Yanmin made the deep research on the TCM theory in his process from clinic to theory then back to the guidance of clinic. And combined with modern medical research, he formed his unique theory on pathogenesis, diagnosis and treatment of arthralgia syndrome. The present study makes a summary on osteoarthritis of knee joint from two aspects of TCM theory and West Medicine theory based on the cognition of pathogenesis, clinical manifestation, treatment principles about the osteoarthritis of knee joint in the TCM and the cognition of epidemiology, etiology and pathology, diagnosis and treatment methods about the osteoarthritis of knee joint in the modern medicine. Professor Li Yanmin points out that in the most cases of the disease, the root is defficiency while the surface is excess, which causes that the treatment should be dispelling the excess pathogen on the basis of protecting the root and essence. In addition, Professor Li also points out that the osteoarthritis of knee joint’s main symptom is joint pain by reviewing and analyzing some literatures on traditional Chinese medicine and modern medicine. At the same time, he deeply studied the TCM theory on "pain caused by blockage". On the above basis, and according to some TCM theories such as "syndrome differentiation","internal and external therapy" and "treating disease from the root", Professor Li Yanmin put forward the analgesic method to treat the osteoarthritis of knee joint. He also classifies the disease into four kinds as "cold-dampness blocking","phlegm and blood stasis","syndrome of deficiency of liver and kidney" and "deficiency of Qi and blood" based on his clinical experience and the osteoarthritis of knee joint’s pathogenesis and symptoms, In addition, he established their respective treatment formulas according to the corresponding typical clinical symptoms. In his over30years’clinical work, Professor Li summarized the analgesic method for treating arthralgia syndrome, taking hold of the main symptoms of the osteoarthritis of knee joint in a variety of complicated symptoms, and then using different treatment for different symptoms with the point of Tongluo and stoping pain. As to the medication, Professor Li advocated cutting out the superfluous, putting fumigationl, washing and hot compress into one party, which is convenient for patients to use and helping accumulate the effect time to improve efficacy. In clinical practice, he has developed clinical programs combining internal and external treatment to treat the osteoarthritis of knee joint, providing theoretical basis for clinical research.Clinical research:Objective:We hope to understand Professor Li Yanmin’s cognition on the osteoarthritis of knee joint by reviewing the knowledge about the osteoarthritis of knee joint from the angle of TCM and West Medicine, interpreting the comprehension and treatment experience on the disease from the TCM aspect, and learning epidemiology investigation, etiology and pathology analysis and diagnosis method of treatment for the osteoarthritis of knee joint. Through clarifying the definition of Pro Li’s analgesic method and combining the method in clinical research, we hope to summarize Professor Li Yanmin’s clinical experience, in order to provide theoretical and practical basis for spreading his syndrome differentiation method and improving clinical efficacy in treating the osteoarthritis of knee join. Method:Based on his clinical experience, with the mechanism and main symptomatic features of the osteoarthritis of knee joint in consideration, Professor Li had divided the disease into four types including "cold-dampness blocking","phlegm and blood stasis","syndrome of deficiency of liver and kidney" and "deficiency of Qi and blood". By proposing the therapy of "activating the meridians to relieve the pain", Li had made prescriptions for the four types above accordingly. Xianlong Granules has been applied for the treatment of "cold-dampness blocking" type; modified Pain-relieving and Stasis-removing Decoction for the "phlegm and blood stasis" type; Xiwu Decoction for the "syndrome of deficiency of liver and kidney" type; and Danggui Blood Nourishing Decoction in combination with Huangqi Guizhi Wuwu Decoction for the "deficiency of Qi and blood" type. Patients who meet the established standard have been equally divided into two groups based on the preset technology roadmap for clinical research. Meanwhile, patients’symptom score has been evaluated. Results have been analyzed as to whether remarkable difference between the two groups existed. Group A were administered solely herbal medicine after proper syndrome differentiation; while Group B were given both herbal medicine and Lotions for Activating Meridians. Symptoms scores and TCM symptoms scores, which are the main observational index, have been collected after treatment to assess the therapeutic effects. Percentage change of Lysholm-Ⅱ score has been applied to aid the assessment. The calculation formula of the percentage change is as follows:therapeutic effect index (n)=(pre-treatment score—post-treatment score)÷pre-treatment score X100%. And assessment standard of the therapeutic effects includes:clinical control if the percentage>95%; outstanding effect if the percentage ranges between70%and95%; effective if the percentage>30%. Conclusion has been made after statistical processing of the observational results.Result:Firstly, we carry out the statistics calculation of the gender, age, course of the disease and TCM symptoms distribution of the patiens in group A and B and conferm that there were no significant differences between group A and B in these aspects, with comparability. According to the symptom scores of the patients before and after treatment, the total effective rate of the patients in group A and B is respectively80%and97%. There exists significant differences in scores (the Lysholm—Ⅱscore) before and after treatment, that is to say, therapeutic methods of the two groups are effective. The results of the group comparision is P<0.05, showing that there exists significant differences between the two groups, that is to say, the efffect of the group B is better than that of group A. It proved that the overall effect of the comprehensive treatment is better than oral administration of TCM. Secondly, according to the comparison of the clinical effects and the analysis of TCM symptome scores before and after treatment of the two groups, it turned out that the effectiveness of the dredging collaterals to eliminate pain during the treatment and once again verifies that the effect of the comprehensive treatment (oral administration of TCM and external lotion of relaxing tendons and activating collaterals) is significant than the oral administration of TCM.Conclusion:The mature theory of dredging collaterals to eliminate pain fits well with the traditional concept that " Not General Pain"(It is the obstruction that causes the pain) and "General Pain’’(the pain barrier) from the theory of Traditional Chinese Medicine. The theraputic effect of the osteoarthritis of knee joint with dredging collaterals to eliminate pain is effective. He receives a satisfying theraputic effect in the improvement of knee function, the reduction of clinical symptoms, and the alleviation of TCM symptoms. Also, the effect of comprehensive treatment based on the combination of the internal and external is more satisfying than that of oral administration of TCM. The comprehensive treatment is worth applying in clinic.