The Study Of Academic Thought And Clinical Experience On Chronic Hepatic Diseases By Sheng Guoguang

Objective: China is a high incidence area of chronic hepatitis B, a total of more than 30 millions of patients of incidence. It is difficult to cure, it is easy to develop into liver cirrhosis and liver cancer, and the death toll is 400,000 every year. Liver cancer ranked in second regarding patients with malignant tumor, a total of up to 150,000.The epidemiological data showed that above 80% liver cancer patients having positive HBs Ag and most of them having fatty liver. Fatty liver is kind of liver steatosis with a variety of causes, further development can lead to the occurrence of fatty hepatitis, liver fibrosis and cirrhosis. The majority of patients with decompensated hepatic cirrhosis within 10 years will develop into ascites.The occurrence of ascites symbolizes an important phase in the development of liver disease and is a major complication of cirrhosis, which often leads to a decline in the quality of life of patients and is prone to cause abdominal infection and renal failure. Mortality rate of patients with ascites increases significantly, and the prognosis is poor. Professor Sheng Guoguang, who was granted as the fifth batch of the national traditional Chinese medicine expert academic experience in succession, has been committed to clinical diagnosis and treatment and research of chronic liver disease for thirty years, with a wealth of theoretical knowledge and clinical experience. I have great honor to serve him and has benefitted a lot. Through studying Professor Sheng’s academic thought, syndrome differentiation and clinical experience of the treatment of chronic liver diseases, I intend furthering the clinical effect of TCM treatment of liver diseases, in the hope of enhancing the treatment of liver diseases in TCM and academic level in TCM.Methods: adhering to the idea of "following the teacher, reading the classics, doing clinical research", I would adopt regular clinical study with the teacher, learn classical Chinese medicine,have a comprehensive collection of old traditional Chinese medicine Professor Guo Guang Sheng’s papers, books, lecture notes, medical record data, experience and other information.Besides,I would analyze and summarize Professor Sheng Guo Guang’s academic origin, the rules of syndrome differentiation and treatment, the clinical experience and academic thought of chronic liver disease. Using retrospective study and information mining technology, medical record data of 76 cases of patients with cirrhosis ascites were set up to carry out a descriptive analysis analyzed by SPSS13.0.in studying Professor Sheng’s clinical diagnosis and treatment of liver cirrhosis ascites and experience of drug use. By a randomized controlled design method, I try to verify the efficacy of the treatment of chronic hepatitis B using Haizhu Yigan Jiawei decoction.46 cases fitted in the diagnostic criteria of chronic hepatitis B patients are divided into 2 groups, the treatment group were given oral entecavir 0.5 mg /(fasting), once a day, while given Haizhu Yigan Jiawei decoction 300 ml, twice a day, in the morning and in the evening.Meantime, the control group were given oral entecavir 0.5 mg /(fasting), once a day. The treatment of both groups lasts 3 months for 1 course, after 1 course of treatment the efficacy was evaluated. By testing the relevant index before and after the treatment, the efficacy and safety were evaluated.Results: Professor Sheng holding ground for old and being learned in books, his academic thought has originated from ancient Chinese classic theory and ancient physicians. His academic thoughts are as follows:(1) the combination of all, pay attention to examine the pathogenesis. "Examining pathogenesis” is the key aspect of the dialectical theory of governance, the pathogenesis has a direct role in guiding the clinical prescription method. The TCM treatments of certain syndrome adopted by medicine healers can work only by adjusting to the pathogenesis;(2) to distinguish disease and dialectical combination, emphasizing the overall. In terms of choosing medicine, Medicine healers should not only pay attention to the local, but also must pay attention to the whole. They should promote the recovery of the lesion by the overall regulation in order to reach the relative balance between Yin and Yang;(3) to notice the clinical significant infuence of the treatment of the spleen and stomach upon the treatment of the syndrome of the liver;(4) to guide the clinical treatment of liver diseases in TCM with the idea of “harmony”. TCM treatment should grasp the whole, starting from “examining”, adjusting its state of imbalance and grasping the dynamic change;( 5) to treat chronic liver disease from toxin,phlegm and blood stasis. In treating chronic liver disease, it was advocated to such methods as detoxification and removing blood stasis, strengthening body resistance and removing blood stasis, resolving phlegm and removing blood stasis, righting and detoxification, resolving dampness and removing stasis, softening firm knots and removing blood stasis;(6)pay attention to nurse the liver disease back to health. From the point of view of TCM theory, diet and emotional health are stressed. Complied with the traditional ideas from such TCM classics as “Nei Jing” and “Golden Chamber”, It should be emphasized the balanced and moderate diet of diversification.Chronic liver disease clinical experiences include :( 1) the deficiency is the cause of liver disease. “The body will keep healthy with the existence of favorable Qi”, “As the malicious Qi congregates, the body will be sick.” The invasion of the malicious Qi and weakening of the favorable Qi, as well as the conflict between the two kinds of Qi, will run across in the whole process of the pathogenesis of chronic hepatitis B. The etiology and pathogenesis of chronic hepatitis B virus is toxin, phlegm, blood stasis and deficiency, based on which the methods of treatment of detoxification, resolving phlegm, removing stasis, strengthening spleen and supplementing Qi deficiency were established,(2)hepatic fibrosis, stages of treatment. It was treated in three different stages according to the Qi differentiation, in the beginning, in the middle and in the end;( 3) the pathogenesis of liver cirrhosis ascites disease is typical of the weak virtual reality, Qi deficiency blood stasis and water stop. Attacking and supplementation is the general guideline of treating buldging.Pay attention to the spleen deficiency, under the guideline of supplementing Qi and strengthening spleen, and resolving dampness and replenishing water.(4) for hepatocellular carcinoma(HCC), the interaction and mutual transformation of phlegm, toxin and blood stasis jointly promote the occurrence and development of HCC. Rules of treatment is to stand the favorable Qi and to remove malicious Qi, and to pay attention to reinforce spleen regarding the problem of spleen deficiency and to revitalize Qi and stand the favorable Qi;(5) fatty liver, It should be treated by eliminating dampness and phlegm, promoting blood circulation to remove blood stasis, emphasizing comprehensive recuperation under medical treatment; and(6)the treatment of chronic liver disease emphasizes diet section, dialectical nursing, and pays attention to nurse spleen and stomach.Research on Information Mining: liver cirrhosis ascites disease is complex, with a variety of symptoms, from this study; the common symptoms are bloating, fatigue, anorexia, liver discomfort, hypochondriac rib pain, jaundice, dry mouth, mouth pain. Cirrhotic patients with ascites can be classified into four categories of syndrome. Professor Shen’s ideas of diagnosis and treatment liver cirrhosis ascites are based on the damp heat, Qi stagnation, blood stasis, water stop, adding and subtracting according to the actual degree of the disease. The rules of treatment are invigorating spleen and regulating Qi, promoting blood and diuresis, being in line with common symptoms of the liver cirrhosis ascites disease, which also coincide with such common categories of syndrome as tongue and pulse, Qi stagnation wet resistance, water wet trapped spleen, accumulation of damp heat, Qi stagnation, blood stasis, water stop.Clinical research: research shows that Haizhu Yigan Jiawei decoction can obviously improve the symptoms and liver function of patients with chronic hepatitis B, especially the noticeable improvement of the fatigue, anorexia, abdominal distension, and can reduce the damage to the liver, and can inhibit viral replication. As for the comparison of clinical comprehensive efficacy, treatment group’s effective rate was significantly better than that of the control group, which demonstrated the safeness and effectiveness of using Haizhu Yigan Jiawei decoction in the treatment of chronic hepatitis B,and again verified the etiology and pathogenesis theory, thatis,toxin,phlegm,blood stasis and deficiency,and treatment principle, of the chronic hepatitis B virus, embodying the advantages of Chinese medicine.Conclusion: there is a source of academic thought in the Professor’s Sheng division, and has rich clinical experience, Professor’s Sheng division having accumulated unique insights and experience, and having received the good clinical curative effect, in terms of the etiology and pathogenesis of chronic liver disease(chronic hepatitis B, liver fibrosis, liver cirrhosis, ascites, fatty liver, hepatocellular carcinoma(HCC), as well as pathogenesis, syndrome differentiation and herbal prescription medication. Considering this, we should actively explore and inherit Sheng division in diagnosis and treatment of chronic liver disease academic thoughts and clinical experience. Detoxification, phlegm, blood stasis and deficiency is the basic law for the treatment of chronic hepatitis B, Haizhu Yigan dicoction treatment for chronic hepatitis B is secured and effective.