| Objective:To trace back to the academic origin of Professor Luo Ling, who is one of the 5th batches of national famous senior TCM doctor. To arrange and study the academic thought and clinical experience of Professor Luo Ling about chronic cough and internal medicine diseases. Focus on Luo Ling's clinical experience of pulmonary disease by wind, phlegm and blood stasis, and reconcile the lung qi to treat the cough and gasp.Study the accuracy of TCM differentiation types about chronic obstructive pulmonary diseases.Study the relationship on the different TCM syndrome type of COPD and lung function such as FEV1,FEV1%pred and oxygen saturation, CRP and PARC/CCL18 which belongs to modern medicine inflammatory markers for providing the objective basis for the study of COPD, and promote the objectification and standardization and scientization of TCM of COPD.Methods:In the aspect of theories and clinical experience summary: the academic thought and t clinical experience about pulmonary disease and internal medicine diseases of Professor Luo Ling was summarized and arranged and refined by reviewing from learning, and by studying classical books and arranging medical literatures.In the aspect of clinical study:using the methods of random, tradicional medicine in control,96 COPD patients were arranged in two groups:the treatment group was divided into three different TCM syndrome type syndrome of turbid phlegm obstructing lung, syndrome of phlegm and blood stasis obstructing lung, Qi and Yin deficiency syndrome. and were given suzijiangqi decoction,added to sanziyangqin decoction, or erchen decoction matured xuefuzhuyu decoction,or raw pulse dispersion.The control group was treated with western medicine treatment:oxygen uptake, appropriate antibiotic according to individual condition, doxofyllin 0.2 ivgtt qd, ambroxol injection 45mg add to 0.9% normal saline 100ml ivgtt. Analysis pulmonary function TCM symptoms score of two groups before and after treatment and statistic the efficiency so as to verify the accuracy of TCM differentiation types and the mean of the direction of medication usage.At the same time, we record FEV1, FEV1%pred. and oxygen saturation, CRP and PARC/CCL18, and obtain the correlation with them in different syndromes of COPD by statistics.Results:1. the academic origin of professor Luo Ling:It is origined from traditional Chinese medicine classics such as Inner Canon of Huangdi;, Treatise on Cold Pathogenic and Miscellaneous Diseases, Wen Bing Tiao Bian,learning the methods of zhang zhong jing, and monographs such as Blood SyndromeTheory of Tang Rongchuan, and the basis professional essay, the academic journals and so on. She learns the modern clinical experience from them. She eclectic and integrate the various.she keeps its essence and discards its dross,at last she formed her academic thought.2. The academic thought of professor Luo Ling:(1)the lung diseases are causeded by lung, but not merely by lung.It could be seen not only through the classic, but also through the etiology,and through the symptoms and the therapy; (2) Treating the cough and gasp with idea of Qihua; First, she adjusts the activity of Qi. Second, she adjusts the activity of Qi,the blood,ferry and liquid.Third, she regulates zang-fu organs gasification,especially invigorates the lung,nourishes spleen, notifies kidney,or strengthenes the spleen and tonifies the lung, or notifies the spleen and kidney,or nourishes lung and kidney,or strengthenes them together. (3)Treating the cough from wind, phlegm and blood stasis, and deficiency:she thinks the etiology of the cough lies in wind, phlegm and blood stasis, and deficiency which leads to the lung qi xuan and su loss and lifting disorder,we should treat the lung diseases from wind, phlegm and blood stasis, and deficiency. (4) Nourishing the spleen and stomach while treating the cough and gasp. (5)She adopt the theory of TCM while consulting western medicine, and knows about differentiation of zheng combined with disease. She combines medicinal with pharmacology,then she can get a better curative effect while treating disease.3. The clinical experience of Luo Ling: (1)the experience ot treating cough ang gasp: ?diagnostic experience: comprehensive analysis by the four examination methods,and paying attention to listening and smelling; ? dialectical experience:she pays attention to zang-fu syndrome differentiation and Qi-blood-liquid-fluid pattern identification;?therapeutic principle:she keeps pathogenesis, and uses different treatments for same disease and same treatment for different diseases;?the treating experiences for the cough and gasp of professor Luo Ling's:she treats the cough and gasp by neijing"hefa" she treats the cough and gasp by the theory of "five kinds of taste"of neijing; she treats the cough and gasp by the theory of "shanjiao" coming from wenbing;she treats the cough and gasp by the theory both opposite and complementary to each other;she treats the cough and gasp on the method of "hexuehuayu"; she treats the cough and gasp on the method of "xinkaikujiang"; she treats the cough and gasp on the method of "lianfeizhike";she treats the cough and gasp on the method of "peitushengjing"; ? the characteristics of priscription:she likes to use classical prescription such as sangjuyin, xiaoqinglong docation,erchen docation, sanziyangqin decoction,weijing docation,tinglidazao docation,suzijiangqi docation.xiebai powder; ? the characteristics of using drugs:she likes to use ephedra, agilawood, silkworm larva, earthworm, ? treating experience of special disease:she treats the COPD from Qi and stasis; she treats the pulmonary fibrosis by intermingled phlegm and blood stasis; she treats GERC by curing both lung and stomach; she treats the lung cancer by deficiency and phlegm and stasis; she treats the injured Yin syndrome Chronic Pulmonary Heart Disease from blood stasis; she treats the bronchial asthma by wind and phlegm and blood stasis; she treats chronic pharyngiti with sanjieliyan pill; (2)The experience of treating other internal medical diseases: ? she cures thrombocytopenia from blood heat and stasis; ? she treats chronic gastritis by chaihusugan san. ?she protects spleen and stomach while treating tumour and incurable deseases.4.Clinical research:(1)the TCM symptom score of the treatment group was significantly decreased compared with the control group(P<0.05). (2)the effective rate of the treatment group was 89.6%,and the control's was 72.9%,the treatment group's was significantly higher than the control group (P<0.05); (3)From syndrome of turbid phlegm obstructing lung, to syndrome of phlegm blood stasis obstructing lung, to Qi and Yin deficiency syndrome. the patient'S level of FEV1 and FEV1% Pred was significantly decreased (P<0.05); From syndrome of turbid phlegm obstructing lung, to syndrome of phlegm blood stasis obstructing lung, to Qi and Yin deficiency syndrome, the patient'S level of CRP and PARC/CCL18 was significantly increased(P<0.05); the lung function was correlated with the CRP and PARC/CCL18. and among other groups,their diference was significantly(P<0.05).(5) The analyzation of the correlation:The FEV1% Pred in corresponding with oxyhemoglobin saturation was positively correlated, r=0.925; The FEV1%Pred in corresponding with CRP was negaitively correlated, r=-0.659; The FEV1%Pred in corresponding with PARC/CCL18 was negatively correlated, r=-0.594.Conclusion:1. The academic thought of professor Luo Ling:it is formed by studying the classic,especially by studying neijing, jingguiyaolue and wenbingtiaobian.also by studying xuezhenglun and medical magazines.2. The academic thought of professor Luo Ling:(1)the lung disease are causeded by lung, but not merely by lung; (2)she treats the cough and gasp with idea of Qihua;(3)she treats the lung deseases from wind, phlegm and blood stasis, and deficiency;(4)She adopts the theory of TCM while consulting western medicine, and knows about differentiation of zheng combined with disease. She combines medicinal with pharmacology.3.the summary of Luo Ling's clinical experience:(1)the experience of treating cough ang gasp: ? diagnostic experience:comprehensive analysis by the four examination methods,and she pays attention to listening and smelling; ? dialectical experience:she pays attention to zang-fu syndrome differentiation and Qi-blood-liquid-fluid pattern identification; ?therapeutic principle:she keeps pathogenesis, and uses different treatments for same disease and same treatment for different diseases; ?the clinical experience for the cough and gasp of professor Luo Ling's:The methods are rich, the application is flexible, reconciling the lung qi is very important; ?the characteristics of priscription:she likes to use classical prescription; ? medication Experience:she likes to use ephedra, agilawood, silkworm larva, earthworm; ?reating experience of special disease:Her experience is rich, she is good at treating the lung disease.(2)The experience of treating other internal medical diseases:She is good at curing thrombocytopenia from blood heat and stasis and treating chronic gastritis by chaihusugan san. she is also good at protecting spleen and stomach while treating tumour and incurable deseases.4. Clilical research:(1)the TCM symptom score of the treatment group was significantly decreased compared with the control group, and the effective rate was higher than the control's. It was confirmed that the syndrome differentiation of traditional Chinese medicine of the chronic obstructive desease was accurate. (2)the lung function was significantly decreased; the patient'S level of CRP and PARC/CCL18 was significantly increased from syndrome of turbid phlegm obstructing lung to syndrome of phlegm blood stasis obstructing lung, to Qi and Yin deficiency syndrome,It showed that patient's condition was more serious,and the inflammation was more obvious. (3)all kinds of TCM of COPD were correlate with the lung function, and the lung function was positive correlated with oxyhemoglobin saturation,and negative correlated with the CRP and PARC/CCL18.They could provide the objective modern medical basis for COPD, and promote the TCM standard and objective and scientific. |
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