On The Basis Of Lung Distension Study Laws Of Wind Temperature Lung Fever Syndrome

Wind-warm disease with lung heat is one of the most common sicknesses in breath branch, along with the coming of Chinese aging society, the patients often have several basic sicknesses simultaneously, as for breathing system, lung inflation is one of such common basic illnesses. Due to the old age and long-term sickness, the patient suffering from lung inflation is lack of the positive air, and is susceptible to wind-warm disease with lung heat, meanwhile the clinic performance is complex and with its unique syndrome characteristics. The essence of Traditional Chinese Medicine(TCM) lies on treatment based on syndrome differentiation, the accurate control of syndrome characteristics is the premise of clinic effect; therefore, this paper studies the symptom, syndrome distribution and medication characteristics of wind-warm disease with lung heat through modern literature research, clinic reviewing study and perspective clinic research, and on the basis of the tutor’s early stage output, the effective herbal medicine has been worked out, and it is primarily proven to be effective to the clinic intervention of the most common syndrome of phlegm-heat obstructing lung.[Objective]1. By means of the reviewing research of modern literatures, from the view of literatures, the symptom, TCM syndrome and syndrome elements distribution of lung inflation based wind-warm disease with lung heat, as well as the medication characteristics of phlegm-heat obstructing lung have been analyzed.2. By means of the reviewing research on clinic cases, from the view of clinic, the basic data, TCM syndrome and syndrome elements distribution, and the evolution rules of patients suffering from lung inflation based wind-warm disease with lung heat have been analyzed and researched.3. By way of investigating the cross-section of the patients suffering from lung inflation based wind-warm disease with lung heat, as well as using the method of multi-element statistics, the further research on the TCM syndrome characteristics of this sickness has been carried out.4. The effective herbal medicine has been summarized, and the clinic intervention and effect observation on phlegm-heat obstructing lung, which is the most common syndrome of lung inflation based wind-warm disease with lung heat have been conducted. [Methods]1. Part of reviewing research on modern literaturesThrough the searching and sorting on modern literatures relevant to lung inflation based wind-warm disease with lung heat of recent10years, with the application of Excel2010, the symptom database, syndrome database and medicine database have been established separately, and the frequency number and frequency statistics analysis has been conducted with SPSS20.0software.2. Part of reviewing research on clinic casesThe clinic data collection of patients suffering from lung inflation based wind-warm disease with lung heat in breath branch of Dongzhimen Hospital of Beijing Chinese Medicine University in recent3years (2010-2012) has been performed, database has been established with EXCELL2010, and the statistics analysis has been conducted with SPSS20.0software.3. Part of perspective research on clinic casesOn the basis of cross-section investigating on clinic epidemiology, the four diagnostic information on the patients up to lung inflation based wind-warm disease with lung heat standards in breath branch of Dongzhimen Hospital of Beijing Chinese Medicine University has been collected, the database has been built up with Epidata3.0software, and statistics analysis has been conducted with SPSS20.0software. The ordinary clinic data are analyzed with descriptive statistics, and are shown on frequency number and percent; the TCM four diagnostic information is mainly used for basic components analysis in combination with cluster analysis.4. Clinic intervention partThis part has divided60patients suffering from lung inflation based wind-warm disease with lung heat into two groups:treatment group and control group, and both the groups have taken regular basic treatment; the treatment group has taken additional TCM clearing heat and expectoration/detoxification and dissipation blood stasis dosage once per day. The basic compositions are as follows: Trichosanthes (pericarp)15g, Scutellaria12g, Echinps latifolius15g, Forsythia suspense15g, Dahurian Patrinia Herb30g, raw CoixSeed30g, Pinellia ternate10g, Caladium10g, Roast Herba Ephedrae6g, almond10g, Balloon Flower10g, Citrus aurantium10g, peachseed10g, angelica10g, Radix Pseudostellariae30g, zhigancao6g. The treatment course is12days. The clinic intervention has been performed to collect the clinic data of the sixth and twelfth days, database has been established with Epidata3.0, and the statistics analysis has been conducted with SPSS20.0software.[Results]1. Part of reviewing research on modern literatures1.1. Symptom distribution1.1.1. Symptoms of lung systemThe top ten symptoms of lung system are ranked as:asthma, cough, chest obstruction, cough with sputum, viscous sputum, large sputum volume, sputum yellow and thick, breath hard, asthma too hard to prostrate and wheezing due to retention of phlegm in throat.1.1.2. Constitutional symptomsThe top ten constitutional symptoms are ranked as:fever, lack of force, fear of cold, excessive sweat, spirit fatigue, aversion to cold, spontaneous sweating, aversion to wind, timid low voice and edema.1.1.3. Head and face symptomsThe top ten head and face symptoms are ranked as:paro xymally cyanosis, puffy swelling of the face, dizziness, running nose, angina, tinnitus, deaf, headache, eyes swelling, itchy pharynx and snuffle.1.1.4. ComplexionThe top five abnormal complexion symptoms are ranked as:somber facial complexion, green-blue or purple facial complexion, white facial complexion, red facial complexion, yellow facial complexion.1.1.5. Symptoms of chest and rib partThere are totally seven types of chest and rib part symptoms, and they are ranked as follows:heart-throb, shortness of breath, fearful throbbing, rib side lump glomus, hypochondriac pain, rib-side distention and rib-side distending pain.1.1.6. Symptoms of stomach ductThere are totally nine types of stomach duct symptoms, and they are ranked as follows:abdominal distention, stomach-duct full, nausea, vomit, melanemesis, hydrogaster, eructation, bellyache and pantothenic acid.1.1.7. Symptoms of waist, back and limbThe top five symptoms of waist, back and limb are ranked as follows:nails cyanotic, limb edema, limb reversal cold, limp aching lumbus and knees and twitch.1.1.8. Symptoms of skinThere are two types of skin symptoms:skin ecchymosis and skin encrustation, which represent the possibilities of active blood and static blood.1.1.9. Symptoms of consciousnessThe top five consciousness symptoms are ranked as follows:irritation, dizziness, clouded spirit and dilirious speech, lethargy and upset.1.1.10. Symptoms of diet and tasteThe top five diet and taste symptoms are ranked as follows:xerostomia, anepithymia, bitterness in the mouth, dry mouth but no desire for drink and mouth viscidity.1.1.11. Symptoms of sleepingThe relevant sleeping symptoms are as follows:sleepless and excessive dream.1.1.12. Symptoms of stool and urineThe top five stool and urine symptoms are ranked as follows:astriction, stool dry, urine fewness, yellow urine and grimy sloppy stool.1.1.13. Symptoms of andriatrics and gynedologyThe Symptoms of andriatrics and gynedology are as follows:libido recession, mankind gonacratia, impotence, woman scant menses or amenorrhea.1.2. The distribution of syndromeAfter the syndromes criteria are extracted from the literatures, the top ten syndromes are ranked as follows:pattern of phlegm-heat congesting the lung, pattern of phlegm turbidity obstructing the lung, pattern of phlegm-stasis obstructing the lung, yang2vacuity water flood pattern, pattern of phlegm confounding the orifices of the heart, pattern of lung-kidney qi4vacuity, phlegm-heat obstructing lung, concurrent blood stasis pattern, exterior cold and interior drink, lung and spleen qi4vacuity pattern and blood stasis pattern.1.3. The distribution of syndrome elementsThe syndrome is further decomposed into syndrome elements, and the top five syndrome elements are ranked as:lung, Phlegm, heat, blood stasis and qi4vacuity, and they account for66.15%of the total frequencies.1.3.1. The distribution of sickness location type syndrome elements11sickness location type syndrome elements are ranked as per their occurred frequencies from the highest to the lowest:lung, kidney, spleen, mind, appearance, heart, liver, channels, large intestine, stomach and gallbladder.1.3.2. The distribution of sickness property type syndrome elementsThere are totally24sickness property type syndrome elements, the top ten of them are phlegm, heat, blood stasis, qi4vacuity, yang2vacuity, water stop, yinl vacuity, cold, drink and wind.1.4. The distribution of medicine for pattern of phlegm-heat congesting the lung By means of analyzing377TCM modern literatures which have the records of medicine applications, and totally21categories236types of Chinese medicines relevant to pattern of phlegm-heat congesting the lung have been extracted. If the usage frequency of medicines is higher than10times, such medicines shall be sorted according to their purpose, and they are also ranked as per the usage of medicines types。Clear heat and transform phlegm medicines. totally16types:trichosanthes, platycodon root, Thunberg Fritillary Bulb, Rhizoma Arisaematis Cum bile, Chinese Waxgourd Semen, Unibract Fritillary Bulb, raw coix seed, Pericarpium Trichosanthis, reed stem, Radix Peucedani, clamshell powder, trichosanthes seed, Bamboo Shavings, Semen Plantaginis, Tabasheer and pumex.heat-clearing medicines, totally12types:Baical Skullcap Root, houttuynia cordata Thunb, raw gypsum, Honeysuckle Flower, Blackberrykiky Rhizome, golden bell, reed root, Common Anemarrhena Rhizome, dandelion, Wild Buckwheat Rhizome, burnt gardenia and Golden Thread. Qi4-supplementing medicinal, totally12types:mix-fried licorice, mix-fried astragalus, Atractylis ovata, Radix Codonopsis, raw licorice, pseudostellaria, Panax, date and raw astragalus.cough-suppressing pant ing-calming medicines, totally9types:almond, Cortex Mori, descurainiae, perilla, mix-fried ephedra, Flos Farfarae, aster, Radix Stemonae and Ginkgo.Blood-quickening stasis-transforming medicines, totally6types:Danshen Root, peach seed, Rhizoma Ligustici, Chinese Angelica, red peony and safflower.2. Part of reviewing research on clinic casesBy means of reviewing researches on the clinic data of524patients, it has been found that the ages of patients suffering from lung inflation based wind-warm disease with lung heat are generally old, and99.24%of the patients are over50years old; the number of male patients is more than that of the female patients,60.31%of the patients are male and39.69%of them are female; through the analysis on366COPD patients who have lung function records, usually, their sickness severity degrees are Ⅱ grade, III grade and IV grade, and the percents are30.05%,33.33%and31.97%separately, whereas the I grade patients are scarce, and only4.64%of patients are Ⅰ grade; most of the patients have onset of illness in spring, which accounts for38.36%, and the sickness rate in autumn is the lowest, and which accounts for16.60%; the vernal equinox is the summit of sickness rate, and the end of heat is the trough of sickness rate. From the view of sickness unset days prior to going to hospital, the periods of within3days,4-7days and over7days account for35.50%,31.87%and32.63%separately, and their distribution is relatively average. From the view of pathogenesis diagnosis, this research shows that the sputum cultures negative rate is49.81%, and among the positive patients of sputum cultures, most of them are mixed-infected by more than two types of germs, which account for13.74%, and the common sickness induced germs are microzyme, Pseudomonas aeruginosa, K. pneumoniae, mildew and acinetobacter baumanii.Among the general distribution of syndromes, the most common one is complex syndrome, which accounts for89.19%of the syndromes types, among them, the co-existence of two syndromes are75types, and which make up67.57%of the total syndromes types; the co-existence of three syndromes are12types, and which make up10.81%of the total syndromes types. The top5most frequently occurred syndromes are ranked as:pattern of phlegm-heat congesting the lung (75times,14.34%), phlegm-heat obstructing lung, pattern of lung-kidney qi4vacuity (36times,6.88%), phlegm-stasis obstructing the lung, pattern of lung-kidney qi4vacuity (34times6.50%), phlegm-stasis obstructing the lung, pattern of dual vacuity of heart qi4and yinl (32times6.12%), phlegm-heat obstructing lung, pattern qi4vacuity with blood stasis (31times5.93%), among the five syndromes, only pattern of phlegm-heat congesting the lung is simple syndrome, the rest four are complex syndromes, therefore, the pathogenesis of post-wind-warm disease with lung heat patients is complicated, and easy to show the syndrome of vacuity-repletion complex.From the sickness unset days prior to going to hospital, the patients have been analyzed as per the periods of0.5-3days,4-7days and over7days, and it is known that all the three periods are susceptible to pattern of phlegm-heat congesting the lung, pattern of phlegm-stasis obstructing the lung and pattern of lung-kidney qi4vacuity; during0.5-3days, the sickness rate of dual vacuity of heart qi4and yinl is higher than the late two periods; whereas, during the late two periods, the sickness rate of blood stasis pattern is higher than that of the first period.The repletion patterns proportions of the three periods are separately66.36%, 61.78%and60.44%, and the vacuity patterns proportions are separately33.64%,38.22%and39.56%; it is obvious that as time goes on, the repletion patterns proportions drop stepwisely and the vacuity patterns proportions increase step by step.3. Part of perspective research on clinic casesThis part divides the four diagnostic information combination of196patients into19main constituents firstly, then the19main constituents are considered to be new variables and are analyzed with Hierarchical clustering method; totally6symptom groups have been obtained, and they are analyzed with professional knowledge. Among the6symptom groups, two of them are hard to identify their syndrome types, and the rest four are categorized as:similar yin deficiency, similar qi4vacuity with blood stasis, yang2vacuity water stop, similar dual vacuity of the spleen and kidney, and similar pattern of phlegm-heat congesting the lung; the conclusion is basically identical to the results of subjective pattern identification.4. Clinic intervention partThis part shows that at the end of treatment, the symptom recovery rate presents no obvious different between treatment group and control group, but at the sixth clay, the main symptoms like cough, phlegm rale in the throat, phlegm productive difficult, thrist, bitter taste, green-blue or purple lips and nails, abdominal distent ion and dry stool of treatment group are better than the control group; at the twelfth day, the symptoms like thrist, bitter taste, green-blue or purple lips and nails, abdominal distent ion and dry stool of treatment group are still better than the control group, which shows the advantages of TCM on rapid and consistent improving the patients’symptoms. This research shows the treatment group and control group have no obvious difference on remission laboratory indices, and the remission of symptoms keeps no step with the assisted check indices, therefore, the method of measuring the treatment effect of TCM which is good at macro-think.ing with the micro index of modern medicine is still in question, the only doable way to establish reasonable TCM treatment effect appraisal system is aiming at clinic practices and realizing the combination of macro and micro perspectives.