| Hyperemesis gravidarum as a name of disease of traditonal Chinese medicine, is a familiar and multiple disease of gynaecology. Hyperemesis gravidarum is common in older or younger primipara. The fast pace of life, the severe stress and environmental contamination all may induce or aggravate the disease. The characteristics of hyperemesis gravidarum is that it happens when early pregnancy (about6weeks) and recovers when12weeks of gestation. The clinical manifestation is nausea, vomitingand dizziness. Traditional Chinese medicine has been having an understanding about the disease for a long time, and the past dynasties Chinese medical literature contains a lot of valuable experience of treatment with this disease, which remains to be excavated.ObjectiveThe objective of this article is to find out the historical distribution of the treatment based on syndrome differentiation of hyperemesis gravidarum in past dynasties literature. Because of the precious literature and statistical method, we can reflect the characteristics of past dynasties Chinese medicine in the treatment of this disease. For the purpose to lay the literature basis for clinical work and scientific research.Methods1. Literature comment.The books used in this research are mainly from the library of our school(Guangzhou University of Tradtional Chinese Medicine), or secondly bought by funds. If there is no printed version, Chinese Medical Code will be used to search the electronic versions. This article collected the past dynasties literature, and systematically sums up with define of this disease, clinical features, areas of disease, pathogenesis, differentiation of treatment and prescription. So as to generalize their knowledge and comment the rules of development.2. Research on the principle of syndrome differentiation and treatment.This article chose the recipes by using the Chinese Medical Code as the main search target, and using the resources of library and internet as the secondary methods. Because the first prescription treated hyperemesis gravidarum was in Synopsis of Golden Chamber in the Han dynasty, so the range of collection of prescriptions was from the Eastern Han dynasty (about ad200) to1911. This research collects and selectes the prescriptions to establishes the database and carries out the frequency analysis with Excel, and carries out the cluster analysis with world recognized authority software "Spss19.0"1. Literature comment.(1)Name of disease.Synopsis of the Golden Clamber which had been written in the Eastern Han dynasty named it "Renshen Outubuzhi"."E Zhu" was first found in General Treatise on the Causes and Symptoms of Diseases in the Sui dynasty. The disease was named by "Zi Bing","E Shi" in the Tang dynasty. When the Song dynasty, it was called by "Tai Ni","Bing Er","Xuan Fan","Renshen Bu Xiashi". In the Ming dynasty and Qing Dynasty, treatment according to syndrome differentiation of the disease had been taken more and more seriously.(2)Etiology and pathogenesis.The common etiology and pathogenesis of hyperemesis gravidarum were as follows:deficiency of the spleen and stomach, phlegm blocking in the middle warmer, liver-stomach disharmony, liver and kidney Yin deficiency. Different dynasty had different views.(3)The therapeutical principle and therapeutic methods.The therapeutical principle of the hyperemesis gravidarum can be summarized as: I Taking care of the patients to take the place of treatment.II Treatment according to syndrome differentiation in order to treat the cause of the disease.III Giving up the pregnancy in order to protect the pregnancy woman.The therapeutic methods of treatment according to syndrome differentiation were as follows:tonifying spleen and regulating stomach, guiding qi downward and eliminating phlegm, invigorating the spleen and regulating the liver, nourishing the kidney and the liver. The therapeutic methods were according to the pathogenesis.2. Research on the principle of syndrome differentiation and treatment.(1)Before Song dynasty.Before Song dynasty, involving a total of29kinds of drug use. Relatively high frequency of drugs were as follows:replenishing drug, eliminating phlegm and relieving cough, diaphoretic drug. Pungent, bitter and sweet are the mail medicinal odour. Channel tropisms were mainly spleen and stomach.(2)Song dynasty.Song dynasty, involving a total of58kinds of drug use. Relatively high frequency of drugs were as follows:replenishing drug, eliminating phlegm and relieving cough, qi-regulating drug. Pungent, sweet and bitter were the mail medicinal odour. Channel tropisms were mainly stomach and spleen.(3)Jin and Yuan dynasties.Jin and Yuan dynasties, involving a total of21kinds of drug use. Relatively high frequency of drugs were as follows:qi-regulating drug, replenishing drug, eliminating phlegm and relieving cough. Pungent, sweet and bitter were the mail medicinal odour. Channel tropisms were mainly spleen and stomachy.(4)Ming dynasty.Ming dynasty, involving a total of68kinds of drug use. Relatively high frequency of drugs were as follows:replenishing drug, qi-regulating drug, eliminating phlegm and relieving cough. Pungent, sweet and bitter were the mail medicinal odour. Channel tropisms were mainly stomach and spleen.(5)Qing dynasty.Qing dynasty, involving a total of65kinds of drug use. Relatively high frequency of drugs were as follows:replenishing drug, qi-regulating drug, eliminating phlegm and relieving cough. Pungent, sweet and bitter were the mail medicinal odour. Channel tropisms were mainly stomach and spleen.Conclusion1. Synopsis of the Golden Clamber had an initial recognition of hyperemesis gravidarum. It was for the first time to propose pathogenesis of this disease that was deficiency-cold, and listed the prescription and drugs. With the development of the dynasty, the comment of the disease had been enriched. 2."E Zhu" was first found in General Treatise on the Causes and Symptoms of Diseases. It proposed pathogenesis of this disease that were deficiency of the spleen and stomach, phlegm blocking in the middle warmer, which made the influence for the later ages.3. The common etiology and pathogenesis of hyperemesis gravidarum were as follows:deficiency of the spleen and stomach, phlegm blocking in the middle warmer, liver-stomach disharmony, liver and kidney Yin deficiency. Different dynasty had different views. The therapeutic methods of treatment according to syndrome differentiation were as follows:tonifying spleen and regulating stomach, guiding qi downward and eliminating phlegm, invigorating the spleen and regulating the liver, nourishing the kidney and the liver.4. The main drugs for hyperemesis gravidarum were replenishing drug. Pungent, sweet and bitter were the mail medicinal odour. Channel tropisms were mainly spleen and stomachy.5. In the medicine combination of statistical clustering, Erchen decoction and Sijunzi decoction were the most representative prescription. This charactristic reflects that the spleen and stomach dysfunction are the basic pathogenesis of this disease, and classical prescription occupied an important position to cure this disease. The relatively high frequency of drugs were as follows:replenishing drug, qi-regulating drug, eliminating phlegm and relieving cough. |
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