Research On Clinic Prescription Disciplinary Of School Of Integrative Medicine By Prescription Metrology

Objectives:1) To analyze the principles of prescription in clinical practice ofrepresentative physicians of the School of Integrative Medicine including Zhang Xichun,Tang Rongchuan, Yun Tieqiao, LuYuanlei, Ran Xuefeng, etc. through metrology study offormulas.2) To compare the similarities and differences of prescriptions in clinicalpractice between the School of Integrative Medicine and non the School of IntegrativeMedicine the school of pestilence.3) Clearly analysis the inheritance and change of theprescribing habits between the School of Integrative Medicine and non the School ofIntegrative. Methods: This study used formula metrology with traditional literatureresearch.1) Selected historic documents through traditional literature researchmethodology.2) Set up the study group (the School of Integrative Medicine) and the fivecomparison groups (physicians of Early Qing、Modern Beijing four big famous doctor,Famous contemporary Chinese Medicine, Contemporary Integrative doctors). Chose andconfirmed physicians of all groups and the relevant literature. Using the chi-square test toall the doctor’s clinical cases of disease composition, the results are comparTable.3)Selected3991clinical prescriptions from18clinic records of18selected physicians. Outof the total,3056are prescriptions with dosage. The prescriptions were labeled withmetrology indexes. The data and materials were standardized. Systematic analysis wasdone through index including the range of formula prescriptions, dosage combination,and the variety of medicine selected.4) The research has:①used prescription metrologyto analyze the basic instance on prescriptions in clinical practice of the five physicians ofthe school of Integrative Medicine epidemic febrile using Frequency Analysis, VarianceAnalysis, Relation Analysis and Cluster Analysis;②discussed the similarities anddifferences of the prescription formula habits in clinical practice between the School ofIntegrative Medicine and non the School of Integrative.③used index of prescription metrology of15physicians as basic statistic unit to study the origins of clinical practices of the fivephysicians of the school of Integrative Medicine and other physicians of different times.Results:1) The main features of prescriptions in clinical practice of the School ofIntegrative Medcine physicians are:①The20most frequently use herbs for clinicalprescription include fuling, zhigancao, danggui, baishao, shengdihuang, fuling, huangqinetc. They are the core composition of sijunzi decoction, Siwu soup, The white tiger soup,Four inverse soup, Two Chen Shang, sun Microsystems soup, Principle of pills etc. Tangrongchuan、LuYuanlei and Liuduzhou’s prescriptions had the highest relevance，YunTieqiao, Ran Xuefeng and Heren’s prescriptions had the highest relevance，while ZhangXichun had the lowest relevance，with the other physicians.②In the clinical use ofmonarch herbal prescription drugs in the top10include shengdihaung, chaihu, danggui,shengshigao, shanyao etc. Zhang Xichun and Kongbohua’s prescriptions had the highestrelevance， And negatively correlated with other doctors, Tang rongchuan andFangheqian’s prescriptions had the highest relevance, Yun Tieqiao and Fangheqian’sprescriptions had the highest relevance， LuYuanlei and Liuduzhou’s prescriptions hadthe highest relevance， Ran Xuefeng and zhushenyu’s prescriptions had the highestrelevance，③Clinical commonly used prescription Compatibility of medicines in the top20are: dangui with baishao, danggui with shengdihuang, baizhu with fuling,shengdihaung with baishao, haunglian with huangqin, baishao with baizhu etc. Tangrongchuan、LuYuanlei and Renjixue’s prescriptions had the highest relevance, RanXuefeng and Heren’s prescriptions had the highest relevance④For the four features, han,wen, ping were the most frequently applied. Warm medicine frequency average of2.991,cold medicine frequency average of4.225, Flat sexual medicine frequency average of1.428, The contrast of application of han with wen is1.545. Clinical medicine layparticular stress on cold, and ranxuefng is the highest (2.085). For the five tastes, gan, ku,xin and suan were the most frequently applied. Meridian attribution ranked top four is:spleen, lung, stomach, liver. Tang Rongchuan heart kidney meridian is the first,Yuntieqiao liver、The small intestine meridian is the first and LuYuanlei The spleen,stomach meridian is the first, Ran Xuefeng arge intestine channel is the first; the Specialmeridian average ranking of the School of Integrative Medicine is the spleen、stomach、liver and kidney. Liver and kidney ratio is1.606＞1, The spleen and stomach ratio is1.185＞1, The sum of liver and kidney combined with spleen and stomach, ratio of0.739＜1. Liu Yuanlei ratio of spleen and stomach, Yuntieqiao ratio of liver and kidney is thefirst;⑤Total efficacy of averageranking in the top five is clear heat, tonifying qi, eliminating phlegm, nourish the blood tonic. The six kind of method to Removepathogens ranked in the top three is: clear heat (1.758), Remove moisture (0.847),eliminating phlegm (0.825), Zhang Xichun tonifying qi, Tang Rongchuan nourish theblood tonic, Yuntieqiao eliminating phlegm, Ran Xuefeng clear heat is thefirst.Tonic/eliminate pathogenic ratio less than1(0.478); Tonic/non tonic ratio (0.349＜1), Qi Yang/Yin blood tonic (1.539＞1), Zhang Xichun Qi Yang/Yin blood tonic, Qi/blood tonic ratio in the first, Tang Rongchuan blood tonic is The highest. Qi/Yang ratio(22.22) in the lead, Liu Yuanlei nourish blood/filling Yin ratio (2.983＞1) first. TangRongchuan tonifying qi/filling Yin ratio is the lowest (0.139), Ran Xuefeng yin medicinefrequency is highest, tonifying qi yang/filling blood Yin ratio is the lowest (0.515＜1),⑥384herbal medicine were used by the School of Integrative Medicine Comparing themean number of ingredients analysis of variance was statistically difference. The Schoolof Integrative Medicine’s The number of drug use four indicators，mean less than othercontrast the acknowledgement. Zhang Xichun is minimum value of, Value is larger.Druguse accurate and medicine for less, Change slightly larger. Five dose index varianceanalysis have statistical difference. the School of Integrative Medicine except thataverage below other physicians, other indicators are high. Five indicators of ZhangXichun ranks first, the School of Integrative Medicine the average of below otherphysicians, within the Prescription medicine relative variation and largest variability,dosage is relatively balanced. Three indicators of RanXuefeng are among the best.⑦doseven metrics to compare of the11kinds of drugs used by the15doctors, Huitong fivephysicians in the use value, unilateral mean dose, dose relative standard deviation andvariation coefficient of four index is higher than other contrast the acknowledgement,Including Zhang Xichun using plaster stone, yam, dogwood, red ochre highlightparticularly, high every index. Later generations of doctors, Zhu shenYu, Kong Bohuasimilarities with him. Liu Yuanlei in use of huangqi, danggui, baizhu, fuling, banxia, eachindex ranks first, Later generations of doctors Kong Baihua, Xiao Longyou, Ren Jixuevariation coefficient and the prominent index on the high side, bold use drugs.RanXueFeng when using baishao, shengdihuang each index ranks first. Any futuregenerations, Shi Jinmo, He ren, Ren Jixue in variation coefficient index on the high side,similar to Ran Xuefeng, flexible. Clinical use of baizhu, fuling, banxia, daizheshi, thelater doctor is higher than that huitong five Chinese and western medicine physicians,especially in the Wang Fengchun, Liu Du boat, Zhu shenYu, Ren Jixue is significant,comparing with statistical significance.。2) The similarities and differences of prescription in clinical practice between the School of Integrative Medicine and non theSchool of Integrative Medicine. The School Of Integrative Medicine (TSOIM) andFCCM common utilization rate is the highest (0.609), and MBFBFD that the lowest(0.580). TSOIM and CID, FCCM Total efficacy sort average frequency of the first andthe third is clear heat, phlegm. The heat in CID frequency highest (2.636), efficacysecond TSOIM and CID is given priority to with tonifying qi in TCM. Eliminatepathogenic six method to compare subject benefit/eliminate pathogenic ratio five groupwere less than1, give priority to in order to eliminate pathogenic. TSOIM eliminatepathogenic six method are the three heat, qushi, phlegm, and in MBFBFD and CID groupsort is consistent, In the five groups of physicians effect clear heat, expelling dampnessand phlegm, invigorate the circulation of the most significant for MBFBFD. Five groupsof physicians benefit and non benefit ratio less than1, With TSOIM、CID and FCCM fillgas frequency ishigher, especially in CID is significant. Six doctor fill Yin and bloodtonic frequency close to, TSOIM tonifying qi Yang/filling Yin blood ratio (1.308) for thefirst of five groups.②Five groups of physicians use The traditional Chinese medicinefour warm, flat, cold as the leading, Five groups of physicians cold/warm medicine ratiogreater than1, especially in the contemporary western as the highest (2.063). The rankingresults of TSOIM for the sweet, bitter, bitter, for six group first, six group, all subject toXinGan as the first.③TSOIM and CID medicine meridian attribution to sort results andMBFBFD group of former three are the same, all is the lung (4.281,4.281), stomach(3.611,6.422), liver (3.559,3.559), but the average MBFBFD is greater than TSOIM。Sixgroup of the sum of liver/the sum of kidney ratio less than1, liver/kidney ratio greaterthan1, the spleen/stomach except by MBFBFD, were greater than1, TSOIM the sum ofliver/the sum of kidney ratio than the minimum value in each subject that (0.739),liver/kidney ratio (1.606).④TSOIM prescription with the mean number of ingredients(9.05) is less than the other five groups of physicians, analysis of variance wasstatistically significant，TSOIM prescription with the minimum number of ingredientsmean minimum in five groups, formula is the most helpful ingredients, with a smallnumber of ingredients mean all, and POEQ have similarities, but POEQ that theindicators in the last of five groups. Five measures of measuring absolute TSOIM dosemean in the first six biggest (29.312), In the standard coefficient of variationCin thecomparison, the traditional Chinese and western huitong, coefficient of variation of meanhigh acknowledgement standards change of dosage. In index of prominent index,MBFBFD average slants big, TSOIM doctor in the middle. Characteristics of gypsum etc. Eight kinds of drugs, the minimum quantity to TSOIM average minimum.The mosthelpful value in CID is on the high side.sheng dihuang, baizhu, fuling etc indicators forTSOIM and FCCM is higher.Compared with statistical significance，The relationshipbetween TSOIM and non-TSOIM in clinical practice:①TSOIM and non-TSOIM inproperties, tastes and the meridian entries、the six method, total efficacy, eliminatepathogenic, with a number of ingredients and so on eight aspects showed a strongcorrelation, with statistical significance.Prescription to measure the average correlationcoefficient R value in addition to the compatibility of high frequency, high frequency0.391、0.352、0.254, high-frequency of principal drugs is low, the correlation is not strong,the other aspects of strong correlation. TSOIM and non-TSOIM clinical characteristics of11kinds of medical measuring indicators are correlation relationship, and contrast theacknowledgement of daizheshi (0.963) shanyao (0.963), huangqi (0.899), baishao (0.884),shengshigao (0.842), difference is bigger..②Cluster analysis showed that TSOIM andPOEQ and CID in properties, cold temperature indicators and return by7aspects, such aspoly into category; TSOIM and CID in the high frequency20drugs, high-frequency ofprincipal drugs, total efficacy, shanyao8aspects can be gathered into a class; TSOIM andFCCM in the high frequency20drugs, pecific meridians belong, he total number ofefficacy, eliminate pathogenic six method, measuring, shan zhuyu, ban xia10nine aspectscan be gathered into a class; With MBFBFD on the compatibility of high frequency,shengshigao, shan zhuyu, baizhu, shengdihuang, banxia9aspects can be gathered into aclass. Conclusion: The physicians of TSOIM in clinical prescription drug to both thecommon features, and show individual character characteristic: have the habits ofapplying cold and cool medicine while at the same time balance the warmth and nutrition,achieving a balance of nourishment and xie, At the same time solution qi and blood heatevil, Common use multi-purpose method, such as clear heat, diuresis, aromatic drugsremove wet, etc. Pay attention to benefit spleen and stomach, nourish the subtlesubstances and blood. paying attention to qi and yang, tonifying qi is more important thanYang, while not ignoring the yin and blood. Dosage, drug compatibility, the amount is notexactly the same, their characteristic. Zhang Xichun clinical medicine more cold, oftenuse GanXin herb.Attaches great importance to supplement the lung and spleen qi,attaches great importance to use moist drugs to regulate the function of qi activity fallingof lung and stomach, especially good at nourishing stomach Yin, used to use acid to softsmooth liver. The amount less medicine, flexible, large dose effect is strong. TangRongchuan doctor prescription medicine lay particular stress on the use of cold LiangYao, using both gas drugs and blood drug, emphasizes the use of blood drug.Accustomed tousing bitter bitterness, especially good at using the bitter drugs, clear hot heart, clear thestomach heat, drop the stomach gas, stop the bleeding.Attaches great importance to thebenefit spleen and lung, clear heat and relatively common use, and at the same timeregulate water, air, fire and blood, formula is balanced, moderate stability also havechange. YunTieqiao doctor prescription medication, cold and warm drugs are used, andthe e cosin, use tonic and eliminate pathogenic methods at the same time, at the sametime benefit spleen and kidney, at the same time arrange essence and blood, attachesgreat importance to the liver blood supplement.Formula designed dexterity, change. LiuYuanlei doctors prescription medication, heavy use of cold drugs, commonly used hardgan light drugs; Used at the same time to eliminate pathogenic benefit method, and at thesame time supplement qi and blood, tonifying qi greater than Yang, and blood thannourishing Yin fluid, the number of medicines in prescription is moderate, dosageequilibrium. RanXueFeng doctor prescription medicine especially attaches greatimportance to the use of cold drugs, the use of more acid salt drugs, eliminate pathogenicmost aggressive, at the same time adjust qi and blood, eliminate pathogenic when usingmultiple channels to pathogens, small number of prescription of drugs, medicine,precision and complex and simple changes.2.TSOIM and NON-TSOIM whenprescribing rule is: same in different, each has its own characteristics。TSOIM physiciansprescription drugs tonifying qi Yin simultaneously, common use Xin Gan sour drugs,using shanyao, huangqi tonifying qi spleen, shan zhuyu, bai shao, sheng di huang,daizheshi Quality is heavy, can suppress the decline of qi activity, Prescription drugs usedin the small, bluff accurate and distinctive traits when using individual drugs. POEQ andTSOIM in four proptrities, five flavous, channel tropism, qi and blood tonic.While in thedrug screening, compatibility, efficiency on different. POEQ use more cold and Xin Gandrugs, lay particular stress on regulating spleen、lung and stomach, liver, and accustomedto using shengdihuang shudihuang, danggui, shaoyao, renshen, baizhu to fill qi and blooddouble, kuxingren, houpo descending lung qi, shihu, maidong nourishing the stomachYin, always give priority to with Gan Xin Gentle and soft. give consideration to bitterand cold drugs, Medication at eliminate pathogenic, phlegm heat lishi to two ormorethings, prescription drug use simple, refined, smooth and constant. MBFBFD withTSOIM common features are: combination of Chinese and western, have lay particularstress on XinGan drug use, drug also used cold temperature, the use of lay particularstress on cold LiangYao, also used to two methods to remove pathogens and tonic, remove pathogens is given priority to, more clear heat phlegm drug use, make good useof sheng shigao, zhi mu oneself clear heat, recuperation lung and stomach at the sametime, and regulate the liver. MBFBFD prescription drug use at the same time, often usingfloating medicine, depressing qi durg, damp-clearing drug and tonic, especially toremove pathogens, hot wet phlegm eliminating, along with all the qi and Yin andnourishing blood.Is good at using renshen to fill double to qi and yin, using shengdishaoyao danggui to nourished blood of liver.Attaches great importance to strengthen thespleen and stomch.Nourishing the stomach through the zhuru, lugen, etc., prescriptiondrugs with a high number of multifarious but flexible. FCCM and TSOIM clinicalprescription medicine common features are: combination of Chinese and western, areusing XinGan drug, is given priority to use cold and warm drug, cold drug of layparticular stress on, tonic and drive out evil ways at the same time, in order to removepathogens as the key point, more use of heat phlegm drugs, regulate lung, spleen andstomach three at the same time, more to regulate the liver. FCCM is the dominant idea ofTCM clinical practice for use of traditional Chinese medicine, western medicine is body;Prescription in bitter GanXin salty use, especially pay attention to eliminate pathogenic,supporting, hot wet table, along with all the attention and qi and blood, balancing Yin,make good use of qi shen、zhu、gui, heshouwu fulling qi, use of dihaung baishaonourishing Yin blood, use of shashen, maidong, shihu, nourishing the stomach, use of jixueteng, chuan shanjia and insects drugs dredging collaterals number of prescriptiondrugs in the moderate, change.TSOIM and CID physicians clinical medication incommon cold and warm, cold of lay particular stress on, contemporary Chinese andwestern medicine is more significant, pleased with shengdi chishao baishao clearingqi-blood; All XinGan oriented, CID is all the more, Prescription in the use of acid sweet,light most drugs, qi, blood, Yin and Yang balance; tonification and purgation incombination, emphdsis is getting rid of evil, and ZhuShi for most, clear heat first,especially are best in lung and liver and spleen deficiency and pay attention to supplemetand descend lung qi, CID heavier regulation liver blood, and has the distinctcharacteristics of The Times; Small and focused TSOIM that CID ingredients, largeamount of CID Prescription miscellaneous, flexible.3.With TSOIM and non-TSOIMphysicians clinical sent medicine formula of the thinking mode of inheritance and itsinfluence on offspring physicians, TSOIM physicians clinical medicine both inherited the"Canon""typhoid fever""the warm disease", and unique, TSOIM physicians areadvocated "based on TCM and in modern medicine to use". Zhang Liushi especially promotingdiagnose diseaseby modern medicine, and Chinese medicine treatment. Yun,tang, jean valjean physicians tend to use western medicine anatomy physiologyknowledge explanation of traditional Chinese medicine on qi-blood and so on physiologyand pathology of zang-fu organs and meridians, inspired by the posterity, TSOIMphysicians and POEQ is most similar in the custom of Prescription. In high frequencymedication, gentleman medicine selection and CID nearest to, and with zhu shenYu,fangheqian most relevan. In the compatibility of high frequency and characteristics ofdrug use and MBFBFD most close, especially with Kong Baihua, shijinmo is mostrelevant.