Professor Cai Bingqin Academic Thought And Experience In The Treatment Of Peripheral Vascular Disease And Clinical Research

Professor Cai Bingqin has engaged in clinical practice, teaching and research work in surgery of TCM for more than40years, and gained a lot in clinical experience, especially in the treatment of peripheral vascular diseases. Under the supervision of Prof. Cai for three years, Ii-ve summarized the academic thoughts and experience in the treatment of peripheral vascular diseases, and carried out clinical researches on his experience, and summarized as below:1. Main academic thoughts of Prof. Cai1.1Professor Cai Bingqin emphasis that external treatment is the key characteristic of TCM surgery. Based on the characteristics of ischemic wounds, he summarized a series of nibbled debridement therapy, improved preparation process of saprophytic muscle removing cream. According to the fact that tendon infection and necrosis of diabetic foot is the leading cause to amputation, he proposed management principles for local "cured rot myogenic series" as early "deep cut, smooth drainage, continuous irrigation, and remove rot myogenic"1.2Professor Cai Bingqini-s surgical concept in Chinese medicineProf. Cai proposed that "cut" in Chinese medicine is different from that of Western medicine operations, the operation should be directed under the principles of TCM, such as surgery are mainly means of "eliminating the pathogenic factors", we can not hurt the human vitals while "dispelling the evil", and should pay more emphasis on the relationship between local and global. TCM also focuses on adapting and further fostering human vitals after the surgery. These are the unique of TCM operations. The correct opinions of TCM surgery should be established, TCM surgery is one of external treatment representative for "treatment human first but not disorders." He opposed to be just "a knife" as a surgical doctor, and emphasized that "Kung Fu of a surgeon is outside the scalpel", focusing on perioperative surgical treatment of TCM.1.3Prof. Cai put forward that the subject construction is the breakthrough of TCM surgery development, and the biggest confusion is the insufficient of external treatment of TCM. Specialized department establishment according to TCM treatment advantages, combining advanced technology and the Chinese traditional culture and the treatment concept, and the combination of the development of traditional Chinese medicine surgery will be infinite vitality.1.4Academic origins of Prof. Caii-s treatment of peripheral vascular disease. Prof. Caii s achievement was first gained from the treatment of vasculitis, and then he established peripheral vascular department, and formed their own characteristics. He turned to research on the surgical treatment of diabetic foot after the change of disease spectrum.He put forward the series therapy of saprophytic muscle removing starting from using saprophytic muscle removing cream in the treatment of diabetes foot ulcer, and for diabetes foot muscle to jaundice type, anti-infection drugsi-difficulties in local wound, and founded the Traditional Chinese Medicine "Ke-ju washing formula". He kept correcting treatment in the long period of clinical practice, and simplified saprophytic muscle removing series therapy recently. He treated diabetic foot according to clinical characteristics of three different period, and achieved significant clinical effect.2. Research and arrangement of Prof. Caii-s academic thoughts and clinical experience of treatments of peripheral vascular disease2.1Prof. Caij s theory of applications of blood-activating and stasis-dissolving drugs in Peripheral vascular surgeryProf. Cai thinks, with the change of the disease patterns, secondary vascular impairment, fibrosis lesions increases gradually, for activating blood circulation and eliminating stasis drugs broad prospect of application. According to common of the formation of the blood stasis syndrome in the vascular disease, classified them into three types:2.1.1therapy of supplementing qi and activating blood circulation: combined drugs of activating blood circulation and supplementing qi, stands for the principle that activating must be used along with tonifying.2.1.2Promoting blood change chaotic:Cai thinks blood disease is the beginning of turbidity, blood is ill and end, and the only force sex flat and promoting blood circulation to remove blood stasis drugs discharge turbidity medicine share, prevention and cure high sticky hematic disease, lower cholesterol, prevent arteriosclerosis plaque occurrence and development.2.1.3Warm the meridians:Cai will be using warm drugs that expelling blood stasis and scatter cold medicine, and to treat diseases of later phase, stubborn unhealed, or other vascular disease involving difficult cases.2.2Prof. Caii s opinion on difficulties and countermeasures of the treatment of diabetic foot. Cai believes that the difficulties and treatment strategies lie in how to deal with the following four relations:2.2.1Medical and surgical:diabetes foot is systemic disease-s local expression, and not an independent surgical disease, which should be treated with internal medical treatment firstly before gangrene, while serious infection of foot gangrene should be treated surgically. One should enhance the concept of overall consciousness, the correct understanding of local and systemic causality, master hypoglycemic, anti-inflammatory, support therapy all over the body such as the foundation treatment.2.2.2Diabetes foot and diabetic arterial occlusion disease:Cai thinks, only familiar with the different pathological and clinical characteristics of diabetes foot and occlusive atherosclerosis, can different treatment measures be taken on a diabetes foot gangrene patients, especially diabetic occlusive artery sclerosis patients.2.2.3Glucose-lowering and antimicrobiology:Cai thinks that high blood glucose is initiating linkfor diabetes foot, the infection is the key link of throughout the disease history, gangrene, ulcer is terminal link, three links are cause and effect mutually.2.2.4"Nibbled debridement" and "debridement and drainage":Cai thinks that only when infection of diabetic foot is basically controlled, or diabetic atherosclerosis block disease is in chronic ischemic phase, latively stable condition, and gangrene is in relatively limited circumstances, should the former treatment be applied.2.3Caio-s experience on staging differentiation for allergic vasculitis. Prof. Caii-s treatment experience of allergic vasculitis’s has the originality, according to the pathogenesis of this disease he characteristics, disease and syndrome union, staging treatment, and got significant clinical effect. The acute phase:Cai thinks that disease of this period is mingled with excess and deficiency syndromes, and should be treated wi th consideration of the root cause and symptoms of the disease, by both internal and external treatment, managing qi and blood, and clear humid using self-made "five grass decoction". In chronic remission period, Cai thinks skin surface damage and long course hurt vital qi, pathogenesis is deficiency complicated with excess, asthenia complicated with sthenia. Treatment should be tonify deficiency and body surface, combined with heat and dampness expelling, using Yupinfeng Powder with "five grass decoction ".2.4Caii s experience of tonifying principle for peripheralvascular disease. Cai believes that the treatment of peripheral vascular disease is mainly to seize the basic pathogenesis of the disease; use tonifying method for the treatment of anthrax, boils and other peripheral vascular disease; use Supplementing Qi and Activating Yang method for anthrax treatment, thus formed his own unique treatment characteristics.2.5Cai; s experience of staging treatment for diabetic foot gangrene tendons. Prof. Cai analyzed tendons of diabetic foot gangrene according to the clinical characteristics of different periods, based on the comprehensive medical treatment, he adapted a serie external treatment in three different periods, including deep incision and adequate drainage in acute phase of infection, nibbled debridement and continuous infusion in resolving stage, remove saprophytic muscle in recovery stage, and improved the clinical effect significantly.3. Clinical effects observation of TCM external treatment by stage for diabetic foot muscle gangreneClinical observations to prove the clinical effects of TCM external treatment by stage for diabetic foot muscle gangrene were performed, based on the experience summary of Prof. Cai, and literature review. Results showed23cases cured,13improved, and4ineffective in treatment group, with total effective rate of90.0%; while9cured,7improved and4ineffective in control group, with total effective rate of80.0%. Comparison of two groups showed significant difference (P<0.05). Conclusion:TCM external treatment by stage for diabetic foot muscle gangrene is a good TCM treatment plan, and should be generalized for its exact clinical effectiveness, good maneuverability, and relative standard operation techniques.