| Objectives1. To explore the academic origin of professor Wangxinzhi, through the educational practice following professor Wang in clinic and the research achievements of literature in the present and past. Meanwhile, to analyse the academic thoughts of professor wang, and selectively gather professor Wang’s clinical experience on stroke disease treatment and some classical prescriptions using.2. Based on the professor Wang’s academic thoughts and clinical experience, to access the impact on intra-abdominal pressure in phlegm heat and bowel repletion pattern coma patients with mechanical ventilation using xuanbaichengqitang decoction enema plus conventional therapy, and eventually to explore the scientificity and universality of professor Wang’s academic thoughts and clinical experience.Methods1. To explore professor Wang’academic origin through his background, learning experience, personal examples set up by word and deed, past medical books and theory, academic report, and past research achievements from his students. On the basis of the forementioned results, to summarize the professor Wang’academic thoughts, and trace back to the background of professor Wang’s specific academic arguments. Then, to summarize and excavate the internal logic and the core idea according to basic TCM theories. In addition, through 3-year clincal learning experinces following professor Wang combined with his medical cases, to analyse professor Wang’s academic thoughts, and selectively gather professor Wang’s clinical experience on stroke disease treatment and some classical prescriptions using.2. A total of 50 phlegm heat and bowel repletion pattern coma participants with mechanical ventilation were randomized to treatment group and control group in a ratio of 1:1 using random number table. In treatment group,400ml xuanbaichengqitang decoction (36℃～38℃ in temprature) enema (for a 20～30cm in depth), combined with conventional treatment (anti-infection therapy, organ function support, shock recovery, acid-base balance maintenance, etc.) were used.In control group, saline or glycerol enema (depth into the rectum, and the mantenance time of enema were all the same as the treatment group), along with conventional treatment (same as the treatment group) were applied. Treatment took place 1 time every 12 hours for 3-6 d in two groups. At the end of the treatment, the degree of coma(the Glasgow score), parenteral nutrition support time, the incidence of complications such as abdominal distension, pneumonia associated with ventilator, and the mortality at the 28th day were evluated.Results1. Professor Wang’s academic thoughts were as follows:(1)He attached importance to the basis of TCM basic knowledge, and learned from the TCM classics.He emphasized the combination of overall concept with dynamic differentiation, the combination with syndrome differentiation and disease differentiation in disease diagnosis and treatment. He holds the opinion that the doctor should differentiate flexiblely so as to search the basic pathogenesis of disease. In the basis of syndrome differentiation, he considered that the classical prescriptions should be used before the compatibility of medicines.(2)He thought that TCM doctor should learn from clinic, and learn from other doctors. According to this theory, he emphasized that stroke should be divided into four phases(the presymptom phase, the acute phase, the recovery phase, the sequelae phase) while treated.In the presymptom phase, prevention measures should be taken. In the acute phase, in addition to distinguishing whether the location of the disease was in the meridian or in viscera, relaxing the bowels and relieving phlegm should be done at first. In the recovery phase, he considered that the patients should accept both the medicine and acupuncture therapy, and conduct rehabilitation training at early. In the sequelae phase, he thought that TCM medicine decoction could take effect when invigorating qi and activating blood. (3) He hold the opoion that the past experince of TCM can be used nowadays, and the doctor should apply it flexiblely. The 10 frequently-used methods in stroke treatment were as follows:the method of calming liver wind, the method of relieving the bowels and expelling the toxin, the method of clearing heat and dissipating phlegm, the method of promoting blood circulation to remove blood stasis, the method of replenishing essence and marrow, the method of supplementing qi and activating blood circulation, the method of invigorate the spleen to damp elimination, the method of tranquilize mind by nourishing the heart, the method of consciousness restoring resuscitation, the method of recuperating depleted yang to treat collapse.when treating the syndrome containing blockage and collapse symptoms, he thought that symptomatic treatment in acute condition and radical treatment in chronic case.2. Professor Wang’s clinical experience was as follows:(1) He thought that the doctor should induce resuscitation and relieve phlegm heat, supplement qi and promote blood so as to activating meridians, nourish yin and kidney fire so as to make it return, dispelling wind so as to adjust ying and wei, invigorate kidney and birth marrow so as to add spirit. (2) He had the specific experience on relaxing bowels for patients with stoke disease. The common methods as follow:relaxing bowels and transforming phlegm so as to regulaing qi activity, relaxing bowels and discharging heat so as to suppressing hyperactive liver, relaxing bowels and transforming stasis so as to calming liver wind, relaxing bowels and nourish yin so as to settle the liver and extinguish wind and relaxing bowels and dispersing lung so as to regulating qi activity. (3) In addition, professor Wang clear always clear mind and purge fire so as to relaxing muscles and tendons using gegen huangqin huanglian decoction, warm the middle-burner and harmonize stomach so as to descending inverse gas using wuzhuyu decoction, relaxing the bowels so as to moistening intestines using dachengqi decocting, settle fright, quiet the spirit and scattere stagnation using chaihu jia longgu muli decoction, and warm meridians and expell wind using mahuang xixin fuzi decoction.3.The results of the randomized controlled trial was as follows:the Glasgow score in treatment group was significantly higher than that in control group(P<0.05). The parenteral nutrition support time, the incidence of complications such as abdominal distension, pneumonia associated with ventilator, and the mortality at the 28th day were all significantly lower than that in control group, respectively(all P<0.05).Conclusions1. The academic thoughts of professor Wang have a specific trait. Professor Wang attached importance to the basis of TCM basic knowledge, and learned from the TCM classics.He emphasized the combination of overall concept with dynamic differentiation, the combination with syndrome differentiation and disease differentiation in disease diagnosis and treatment. He holds the opinion that the basic rule of syndrome differentiation was to differentiate the location, cause and nature of disease, and discriminate the primary syndrome and secondary syndrome, the trends and the degree of urgency of syndrome.He is good at treating stoke, and emphasized that stoke should be divided into 4 phases when treated. Meanwhile, he developed 10 methods for stoke treatment, and accumulated wealthy clinical experience on some classical prescriptions using.2. The xuanbaichengqi decoction enema combined with the conventional treatment could improve the degree of coma, reduce parenteral nutrition support time, decrease the incidence of complications such as abdominal distension, pneumonia associated with ventilator and the mortality at the 28th day in phlegm heat and bowel repletion pattern coma patient... |
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