Summary Of Chief Physician Wei Fuliang’s Academic Thinking And A Collation Of Clinical Experience And Research On Knee Osteoarthritis Treated By Acupuncture

Chief physician, doctor tutor Wei Fuliang is the adviser of the third group, fourth group, and the fifth group of the national work of study the clinical experience of famous TCM doctor, the state-level doctor of traditional Chinese medicine, and Chinese medicine master of Anhui Province. He had been involved in the field of acupuncture clinical work of TCM for more than 40 years. He had studied western medicine and traditional Chinese medicine, always practises personally what one preaches, had accumulated rich clinical experiences. This research is divided into three parts.Part 1:Chief physician Wei Fuliang’s academic origin.We summed it by forms of interviews and analysis. He had been studying in Shanghai university of TCM, accumulating clinical experience, and studying TCM classics, combined with understanding of the ancient physicians, thus forming his own clinical thought of treating diseases related orthopedics and traumatology by using the Syndrome differentiation of meridians and collaterals. He believes that the pathogenesis of diseases related orthopedics and traumatology is kidney deficiency, blood stasis and obstructing collaterals. The core method of main pathogenesis treatment is Nourishing kidney and activating blood circulation and dredging the channel.Part 2:conclusion of Chief physician Wei Fuliang’s academic thoughts and clinical experience.Chief physician Wei has been researched TCM for more than 40 years, has a broad vision, creative thinking, clear thinking and profound knowledge of traditional Chinese medicine, thus forms a unique academic style and thoughts. When he treatments orthopedic diseases by acupuncture and moxibustion, he suggests to takes into account the bones and muscles, to pay attention to the internal organs of the body, both qi and blood, but sometimes be focused on Qi or blood, to identify the actual situation and impose reinforcing and reducing, to defense pericardium, to pay attention to the phlegm and blood stasis, to dredge the meridians and regulate both Zang and Fu. Deficiency of liver, spleen and kidney is the underlying cause of the orthopedics-related diseases, the cold and dampness invasion, or Injury or strain is the main cause of the disease. The characteristics of the pathogenesis is to originate in the internal organs, involve the Qi and blood, attack to bones and muscles; among Zang and Fu, the kidney is the fundamental, supplemented by liver and spleen; between Qi and blood, there is dysfunction of Qi, blood stasis; in external factor, there are the outside invasion, sprain and contusion injuries, pathogenesis of orthopedic related diseases is deficiency of kidney and blood stasis and obstructing collaterals and excesses asthenia in origin and asthenia in superficiality, thus puts forward the basic principle of nourishing kidney and activating blood circulation and dredging the channel, and the treatments of orthopedics and traumatology related diseases. The treatment of acupuncture emphasizes the view of the whole, pay attention to difference of the Yin and Yang, the exterior and interior, deficiency and excess, cold and heat, combined with theory of syndrome differentiation of Qi and blood, main and collateral channels, bones and muscles, and the law of disease occurrence and development. It is important to nourish liver and kidney, to promote blood circulation and remove blood stasis, to scatter cold and dampness in treatment, therefore acupoints selection should be identified disease and syndrome differentiation, meridian, and be refered to each other; at the same time pay attention to acupuncture action specification, mend and reducing manipulation. The performer should be spirit, maintain a good mental state.Chief physician wei has the clinical experience of diagnosis and treatment of diseases related orthopedic.(1) The experience of diagnosis and treatment for knee osteoarthritis:Wei believes that the disease is related to aging, chronic fatigue, exogenous evils. Deficiency of liver and kidney, Yang deficiency of spleen and kidney, deficiency of Qi and blood, bones and tendons dystrophy is the main pathological basis of the disease, pathogenic factors invading, fatigue damage is a pathogenic factor. Appropriate treatment of Tonifying the liver and kidney, promoting blood circulation and dredging collaterals. In acupuncture point selection he pay more attention to the partial pulse feeling and palpation, focus on disease differentiation positioning, emphasizes the resolution which spaces belongs to, pay attention to syndrome differentiation of Zang and Fu. In clinic he often selects acupoints by combining meridian, syndrome with disease differentiation.(2) The experience of diagnosis and treatment of the cervical spondylosis, cervical spondylosis is due to the effects of the age, insufficiency of liver and kidney, deficiency of essence and blood, dysfunctional Qi and blood, fatigue damage, Incorrect posture, the wind cold dampness evil miscellaneous to meridians, leading to cervical muscle strain, meridian stasis caused, obstruction of channels,context impassability. Because of different damaged tissue, parts of the incidence or acupoint selection is different in the same disease. We often selected Clip ridge cave in middle and lower cervical spine on treatment of cervical spondylotic radiculopathy, in upper cervical spine on treatment of vertebral artery type of cervical spondylosis, clip ridge cave in middle cervical spine, the Du meridian on treatment of cervical spondylotic myelopathy, obvious parts of transverse process of cervical vertebra tenderness on treatment of sympathetic type of cervical spondylosis. We often selected acupoints by both syndrome differentiation and differentiation of syndromes of meridian.(3) The experience of diagnosis and treatment of lumbar intervertebral disc herniation:The etiology of this disease is deficiency of viscera, trauma, exogenous wind cold dampness etc.. Deficiency of Zang and Fu is closely related to the disease. The main pathogenesis is unconsolidation of the kidney-qi, the not adjustable liver, abdominal gas barrier, dys-splenism, undesending of gastric Qi. Qi-stagnancy and blood stasis of the waist due to various reasons is the basic pathogenesis. The disease is in the waist and leg, and is closely related to the liver meridian, kidney meridian, bladder meridian, gallbladder meridian, Ren channel, governor meridian etc.. In early stage the disease is positive,due to Qi stagnation and blood stasis caused by trauma, or blockage of the meridians due to the wind, cold, wet, heat evil; In middle and later stage asthenia syndrome is becoming more common because of deficiency of kidney essence and liver blood, or dys-splenism. We often selected acupoints by both differentiation of syndromes of meridian and syndrome differentiation.Part 3:Clinical study treating knee osteoarthritis using acupuncture of Wei’s acupointsBy randomized and compared research design,70 cases with knee osteoarthritis patients were chosen, and divided by ratio of 1:1 into two groups.3 cases had lost, the treatment group of 34 patients would adopt the treatment of acupuncture of Wei’s acupoints, and 33 cases would use traditional acupuncture and moxibustion. The treatments lasted for 4 weeks,5 times a week. Then we observed the changes of the indexes of WOMAC, and the overall evaluation (scores)of the knee osteoarthritis from both patients and doctors, and the overall evaluation (scores)of levels of pain, Joint tenderness in knees from patients, and the appraisal scores of joint function to evaluate the therapeutic effect of acupuncture of Wei’s acupoints before the treatment and after several times of treatments(i.e.,5 times,10 times and 20 times). The results show that: after treatment, the indexes of WOMAC and, the overall evaluation (scores)of the knee osteoarthritis from both patients and doctors, the overall evaluation (scores)of levels of pain, Joint tenderness in knees from patients, and the appraisal scores of joint function from both of the two groups have all been improved(P<0.01). In aspects of the degree of decline in the indexes of WOMAC, the overall evaluation (scores)of the knee osteoarthritis from the doctors, the overall evaluation (scores) of levels of pain, Joint tenderness in knees from patients, and the appraisal scores of joint function, there is a Significant difference between the treatment group and the control group(P<0.05). Based on the general curative effects, two groups showed no obvious difference, but the treatment group was better than control group in terms of Significant efficiency rate (P<0.05). The study confirms:When adopting the treatment of acupuncture of Wei’s acupoints in treatment of knee osteoarthritis, the symptoms could be improved, and the therapeutic effect is better than regular treatment using acupuncture. The therapeutic effect of adopting the principle of nourishing kidney and activating blood circulation and dredging the channel in treatment of knee osteoarthritis has been concerned.