Study On The Law Of Diagnosis And Treatment Of Meteorism (Ascites Due To Cirrhosis) Based On The Analysis And Comparison Of Medical Literature In Wan Qing Min Guo And After 1978 Times

ObjectiveBased on the medical literature of meteorism (ascites due to cirrhosis) in Wan qing Min guo and after 1978 times, this research is approached the law of diagnosis and treatment of meterism after western medicine’s intervention. On the one hand, by studying the law of diagnosis and treatment of meteorism hided in Chinese medicine case reports to reveal the main syndrome, dialectical patterns and core drug groups. Further, to analysis the correlations between patterns (syndrome) and Chinese drugs, eg. highly frequent patterns and drugs, ascites classification and drug dose. On the other hand, summarize the treatments of meteorism in the two periods. At last, by analyzing and comparing the commonness and difference of the law and the treatments in the two periods to retrieve better treatment of meteorism.Methods1. To collect meteorism medical records which were in Wan qing Min guo and after 1978 times. By regulating the symptoms, location of the disease, nature of the disease, disease’s pattern and drugs, to set up databases of the two periods. And analysis with statistical methods including frequency analysis, factor analysis, cluster analysis, logistic regression analysis and pearson correlation analysis. With Chinese Medicine’s theory to summarize the law of differentiation and medications of Wan qing Min guo and after 1978 times. Analyze the commonness and difference of the law in the two periods and to discuss the reasons in order to retrieve newly ideal treatment in meteorism.2. Firstly, summarize the treatment peculiarity in the two periods with frequency analysis based on the method 1’s meteorism medical records. Secondly, summarize other treatments in the two periods by collecting the other meteorism medical literature. Lastly, analyze the commonness and difference on treatments of the two periods to find better therapeutic program.Result1. The results of the law of patterns and treatments of meteorism in Wan qing Min guo and after 1978 periodsThis study had referred to 97 medical authoring and 94 kinds of medical journals, including 798 cases. And 207 cases in Wan qing Min guo period and 591 cases in modern times.Law of patterns and treatments of meteorism in Wan qing Min guo period(1) To conclude that main pathogenic factors were disease after secondary, diet, emotion, fatigue, and etc.(2) High frequency symptoms were:abdominal distent ion, hypourocrinia, stool disorder, anorexia, edema, venous engorgement on abdomen, umbilical hernia and etc.(3) Disease locations were mainly distributed in spleen, liver, stomach, kidney and lung.(4) Deficiency-excess complex patterns were main kinds. Pathogenic changes were mainly stagnations of qi and fluid-dampness internally, also, with qi, blood, water coexisting. Yang deficiency pattern in Wan qing Min guo was more than that in modern times. The difference was statistically significant (P<0.05).(5) High-frequency patterns might be syndromes of stagnation of liver qi and spleen deficiency, internal stagnation of fluid-dampness, accumulated dampness-heat, Liver qi stagnation and etc.(6) Medication①Analysis on sorts of drugs:Chinese medicine of regulating vital energy, diuretics for eliminating dampness and curing deficiency were main drugs.②The most common tastes of high-frequency medicines were acrid, sweet and bitter. The main natures were warm and neutral property. The chief channel entries were spleen meridian, stomach meridian and lung meridian. The drugs of Poisonous and mild toxicity only accounted for 8.43%.③ With factor analysis, the F1 group were found containing Yueju wan, F2 containing Wuling san, and F12 containing Ganjiang huanglian wan. And the third one mainly acted on the damage of spleen and stomach by eating raw or cold food and so on.④ With cluster analysis, the core group medicines were areca peel, green tangerine peel, tangerine peel, white peony root, tuckahoe, largehead atractylodes rhizome, alisma orientalis, agaric, costusroot, villous amonmum fruit and endothelium corneum gigeriae galli.Law of patterns and treatments of meteorism after 1978 times(1) To conclude that main pathogenic factors were disease after secondary, diet, fatigue, emotion, and etc. Also, there were more reports about worm infection, medication history, familial history, postpartum and etc.(2) High frequency symptoms were:abdominal distention, hypourocrinia, anorexia, lassitude, abnormal facial, edema and etc.(3) Disease locations were mainly distributed in spleen, liver, stomach, kidney and gallbladder, also connected with lung, triple energizer, heart and eight extra-channel.(4) Deficiency-excess complex patterns were main kinds. Pathogenic changes were mainly asthenia of healthy energy, and water-dampness, blood stasis, qi stagnation were important pathogenic factors. Yin deficiency pattern and blood stasis pattern were more than those in Wan qing Min guo period. The differences were statistically significant (P<0.05).(5) High-frequency patterns might be syndromes of internal stagnation of fluid-dampness, liver and spleen and blood stasis, accumulated dampness-heat, stagnation of liver qi and spleen deficiency and etc.(6)Medication① Sorts of drugs:Chinese medicine of curing deficiency, diuretics for eliminating dampness and activating blood circulation were main drugs.②The most common tastes of high-frequency medicines were sweet, bitter and acrid. The main natures were warm and neutral property, but cold and mild cold property of drugs accounted for 34.56% comparing with Wanqing Minguo period’s 18.84%. The chief channel entries were spleen meridian, liver meridian and lung meridian. The drugs of Poisonous and mild toxicity only accounted for 3.34%.③ With factor analysis, several groups were found, such as activating qi and eliminating phlegm, dispersing stagnated liver qi, helping digestion, curing deficiency, promoting qi circulation and etc.④ With cluster analysis, the core group medicines were Tuckahoe, agaric, alisma orientalis, largehead atractylodes rhizome, areca peel, asiatic plantain seed, mongolian milkvetch root, chinese thorowax root, chinese angelica, white peony root, licorice, salvia miltiorrhiza, turtle carapace and red peony root.⑤ The correlation between high frequency patterns and medicines as following:common jujube, bottle gourd peel, cassiabarktree twig, mongolian milkvetch root, lobedleaf pharbitis seed, asiatic plantain seed and alisma orientalis were relevant with syndrome of internal stagnation of fluid-dampness and etc.⑥ With Spearman Correlation analysis based on the ascites classification and drug dose:asiatic plantain herb, safflower, oysters and szechwan lovage rhizome showed a low level of relevance to ascites classification; mongolian milkvetch root, red peony root and tuckahoe were weakly revelant to ascites classification.2. The results of treatments of meteor ism in Wan qing Min guo and after 1978 periodsThe situation of treatments of meteorism in Wan qing Min guo period(1) Treatment peculiarity of 207 medical records of meteorism:Referred to 49 medical literatures, and 1 kind of Periodicals.Self-prescription(188), set-prescription (18)、experiential effective recipe(6)、folk formula(0). And 19 medical records with formula name, the main set-prescriptions were liujunzi tang, shenqi wan, li zhong tang, fangji huangqi tang and etc. Some features:pills boiled in decoction; idiomatical processing of drugs; attention to the time and mode of drug administration; combination with Chinese patent drug or the other Decoction drug; matching with external application or medicated diet; attention to life adjustment and contraindications.(2) Summary of the other treatments in Wanqing Minguo periodIn this period there were roughly three kinds of treatments, endotherapy, external treatment and therapeutic alliance. Endotherapy, also, simple recipe. External treatments, sunch as umbilical compress therapy, hot application of medicine, soft extract, acupuncture and moxibustion and etc. Therapeutic alliance still contained acupuncture and moxibustion added Chinese drugs. In addition, doctors at this time also laid stress on prognosis and contraindications.The situation of treatments of meteorism after 1978 times(1) Treatment peculiarity of 591 medical records of meteorism:Referred to 48 medical literatures, and 93 kind of Periodicals.self-prescription(444), set-prescription(175)、experiential effective recipe(21)、folk formula(2). And 223 with formula name, the main set-prescriptions were wuling san, sipi yin, weiling tang and etc. Some features: combination of≥2 set-prescriptions; pills boiled in decoction; drastic water expelling drugs usually matched with other decoction; attention to the time and mode of drug administration; combination with Chinese patent drug; matching with external application or medicated diet or dietary therapy; attention to life adjustment and contraindications.(2) Summary of the other treatments after 1978 timesIn this period there were roughly four kinds of treatments, endotherapy, external treatment, Psychotherapy and therapeutic alliance. Psychotherapies were music intracavitary, family nursing intervention, dialectical nursing of Chinese medicine and etc. Therapeutic alliances were mainly the combinations of method and method of TCM, and western medicine and TCM. Conclusion1. Summary of the law of differenciation and medication in two periodsIn the period of late Qing Dynasty, although Western medicine intervened, there was no real combination of the two medicines. The treatment still followed the "lifting theory", and centering on "spleen and stomach", which played an important role in the later treatment. But after 1978, the rapid development of information and technology, traditional Chinese medicine and Western medicine intervened in all branches of medicine, and the combination was comprehensive, so the treatment abide not only by the traditional Chinese medicine "theory of spleen and stomach" and Zhang Xichun’s spleen and stomach thought, but also the real combination of traditional Chinese medicine and Western medicine appeared, which embodied on the "development of five viscera correlation theory". And this has a certain guiding significance for future clinical treatment. For patterns, the results of high frequency patterns after 1978 times were in line with the syndrome classification standards of TCM syndrome diagnosis and treatment about fluid tympanites. And these results also replenished the syndromes of stagnation of liver qi and spleen deficiency, deficiency of spleen qi and combination of water and static blood. So the appearance of western medicine in the period of late Qing Dynasty motivated the development of the real combination of the two medicines.2. Summary of the features of treatments in two periodsOn the one hand, after 1978 the traditional Chinese medicine due to changes in the specific historical environment for application generated some changes with the cultural characteristics of the times, such as pay attention to the psychological and emotional mood, health maintenance and etc; on the other hand, the appearance of western medicine in the period of late Qing Dynasty largely motivated the development of the Chinese treatments after 1978 times.3、Some special medicine laws were found.Several drugs were found having close relationship with some specific patterns. common jujube, bottle gourd peel, cassiabarktree twig, mongolian milkvetch root, lobedleaf pharbitis seed, asiatic plantain seed and alisma orientalis were relevant with syndrome of internal stagnation of fluid-dampness; and radix pseudostellariae, chinese quince, cyperus rotundus, rheum, salvia miltiorrhiza and hirsute bugleweed herb with syndrome of liver and spleen and blood stasis; mongolian milkvetch root With syndrome of accumulated dampness-heat; Indian Bread Exodermis, largehead atractylodes rhizome, white peony root and chinese thorowax root With syndrome of stagnation of liver qi and spleen deficiency; prepared common monkshood daughter root, barbury wolfberry fruit and mongolian milkvetch root With syndrome of yang deficiency of spleen and kidney; barbury wolfberry fruit, lilyturf root tuber, common yam rhizome, fructus broussonetiae, coix seed and subshrubby peony root-bark With syndrome of yin deficiency of liver and kidney; chinese thorowax root With syndrome of stagnation of liver qi; common burreed tuber, salvia miltiorrhiza With syndrome of Water and blood stasis; swordlike atractylodes rhizome and largehead atractylodes rhizome With syndrome of dampness stagnancy due to spleen deficiency.