| Basic information:Prof.Dong Zhenhua,chief physician,famous integrated traditional Chinese medicine(TCM)and western medicine expert of Department of Traditional Chinese Medicine,Peking Union Medical College Hospital,Beijing,China,is one of the first nationally selected inheritors of famous veteran doctors of TCM academic experience.Prof.Dong Zhenhua learned after famous TCM expert Prof.Zhu Chenyu(1914—1999)and is the favorite pupil of Mr.Zhu.As a famous integrated TCM and western medicine expert and social activist,Prof.Zhu Chenyu was identified as one of the first national-level famous veteran doctors of TCM by the Ministry of Health and State Administration of Traditional Chinese Medicine(SATCM)of PRC,who enjoyed government subsidies granted by the State Council.In his early years,Mr.Zhu studied TCM with Mr.Shi Jinmo,one of the Four Famous Doctors in Beijng,then he crossed over to Japan to learn western medicine.Mr.Zhu was the first academic dean and research section of Beijing University of Chinese Medicine.In 1975,he was transferred to be director of Department of TCM,Peking Union Medical College Hospital.In his whole life,Prof.Zhu Chenyu was noted for his meticulous scholarship,with a thorough knowledge of both western and TCM.He strictly followed Mr.Shi Jinmo’s instructions and persistently insisted the principle of integrated traditional Chinese medicine(TCM)and western medicine.Mr.Zhu emphasized syndrome-differentiation of qi and blood,and proposed "promoting blood circulation to remove blood stasis".He was especially good at the treatment of diabetes,gastroenteropathy,gynopathy and rheumatoid nodule,with rich experience.He also created the method of "promoting blood circulation to remove blood stasis"to cure diabetes in China.After years of study from Mr.Zhu,Prof.Dong Zhenhua has learnt the essential part of Mr.Zhu;after years of clinical practices,the treatment of Prof.Dong Zhenhua has marked remarkable effects in internal miscellaneous diseases,rheumatism,gynopathy and hepatopathy,etc.Since 2003,Prof.Dong Zhenhua took the lead and established a TCM professional group of rheumatic autoimmune disease in the Department of Traditional Chinese Medicine,Peking Union Medical College Hospital,engaged in medicals,education,scientific researches and talents cultivation,and made great achievements in using TCM to cure rheumatic autoimmune diseases such as sicca syndrome and rheumatoid arthritis,etc.[Research objective]:With forty years of clinical experience,Prof.Dong Zhenhua is dedicated to the research into clinic with noble medical ethics and remarkable curative effects.Hence,it is of great theoretical and practical significance to summarize and inherit his academic theory and clinical experience.Based on the experience of seniors,the inheritors shall upgrade the theories,innovate and put into practice,and improve their own TCM basic theoretical level and clinical syndrome differentiation level.Meanwhile,they need to learn the experience in curing rheumatoid immune diseases,internal miscellaneous diseases and gynopathy,especially the clinical diagnosis and treatment idea,experience and medication characteristics of curing pSS(primary Sjogren’s syndrome),and raise new ideas and proofs to deal with hard and complicated diseases.[Research methods]:Through methods of home visit with the teacher,recording teacher’s notes,listening to their lectures,writing monthly report,writing typical medical record experience,reading classic TCM books,writing feelings and experiences,consulting literatures,collecting cases,sorting medical records,and establishing data base to archive patient files,the inheritors shall inherit and study teacher’s academic idea origin,comb and summarize teachers academic idea and clinical experience in curing rheumatism and other common diseases.The clinical research method is to explore the experience of Prof.Dong Zhenhua in curing complicated diseases with TCM,take patients with pSS Yin deficiency and dampness syndrome as the research objects,use the treatment of "nourishing Yin,clearing damp and detoxifying",choose the "dew drink Chai Qin lift scattered flavor"prescription for treatment,accomplish the clinical research,analyze and summarize the clinical effect,and provide new idea for dealing with difficult clinical problems.Through random grouping method,the pSS patients were divided into(TCM)treatment group and(western medicine)control group,who took TCM decoction of"dew drink Chai Qin lift scattered flavor" and hydroxychloroquine sulfate tablets respectively.The treatment courses were three months and six months.Then the overall response rates(ORR),disease activity index scores,and TCM syndrome scores of the two groups of patients were observed.The inheritor adopted statistical method to analyze the data,and to evaluate the clinical efficacy of the two groups and the improvement of the patient’s condition,then to summarize the academic experience characteristics of Prof.Dong Zhenhua in curing the disease,upgrade the clinical idea and medication experience,deepen the knowledge of the characteristics of the disease,innovate and develop the treatment experience to provide new idea to treat new clinical difficulties.[Research results]:I:The first part mainly introduced the forming of the academic idea of Prof.Dong Zhenhua,including his development to success and succession experience,and studied different schools of theories of the past and the present.The part summarized the influences of the academic theories of ancient and modern scholars and studying from seniors on the forming of his academic idea,especially the effect on the establishment of rheumatism research direction.Ⅱ:The second part comprehensively sorted and summarized the academic idea and clinical experience of Prof.Dong Zhenhua,which includes the following three parts:1.Academic idea:(1)attaching great importance to the Qi and blood,Qi and blood depend on each other and CQi is in the blood,Qi is more important.(2)nourishing spleen and kidney.(3)Arthromyodynia very weak is also very complicated,deficient and complicated pain or numbness.It specifically introduced the importance of syndrome-differentiation of Qi and blood,close relationship between Qi and blood,nature and nurture,as well as the characteristics of deficient and complicated pain or numbness.2.Clinical experience:combination of disease and syndrome,combined prescription,embarked prescription,strengthen the basis.It also introduced teacher’s double mode of syndrome-differentiation,curable effect of integrated TCM and western medicine,identification of principle syndrome,proper use of prescription and medication,and listed some clinical experience and application of proper medication in curing common internal miscellaneous diseases,gynecopathy and rheumatism,etc.The patients were also treated for severe acne and ovarian dysfunction.3.Teacher’s clinical experience of curing rheumatism1)Brief introduction of diagnosis and treatment idea on rheumatism:introduce how to seize the point-cut and give full play of TCM characteristics;introduce teacher’s experience of effect-enhancing,toxicity-reducing and alleviate the disease during the treatment on rheumatismsymptom of Bi.2)Clinical experience of curing pSS:including teacher’s knowledge on the etiology and pathogenesis from the perspective of TCM,and the main curing experience.The clinical experience mainly includes two parts:A.Symptomatic treatment on non-system damages by the disease:including the treatment on Sjogren’s syndrome,enlargement of parotid gland,arthralgia,skin mucous membrane lesions.B.Comprehensive treatment on multi-system involvement of disease:including the treatment of pSS interstitial lung disease,renal tubular acidosis(RTA),blood system damage and nervous system damage;some typical cases were listed to testify the curative effect.In addition,this part also supplemented teacher’s experience in identifying and curing pSS.At last,the inheritor sublimated and developed the experience,and described the in-depth understanding and clinical experience in dealing with pSS Yin deficiency and dampness syndrome during the study with teacher.4.Clinical research results:1)Analysis of comprehensive curative effect:The ORR of three-month treatment course by "dew drink Chai Qin lift scattered flavor" TCM prescription is 51.1%,while the six-month course is 75.6%;the ORR of three-month treatment course by hydroxychloroquine sulfate tablets(western medicine)is 35.6%,while the six-month course is 82.2%;the difference of the two groups has no statistical significance(P>0.05).2)The variation trend of the ESSDAI and TCM syndrome scores of two groups at different courses:The scores of the two groups decrease gradually with the increasing of treatment course,showing a remarkable change(P<0.05).Between the two groups,the course of treatment for 3 months,ESSDAI score decreased,there was no difference in the change between the two groups(P>0.05);the scores of TCM symptoms in the treatment group decreased more than that in the control group(P<0.05).The course of 6 months,ESSDAI score and TCM symptom scores decreased,there was no difference(P>0.05).3)Improvement of western medicine illness state and clinical symptoms:For both three-month course and six-month course,the ESSDAI of the two groups decreased notably,which has statistical significance(P<0.05)with the difference before treatment.After three-month and six-month treatment,the scores of lymphadenectasis,parotid gland swelling and high IgG of treatment group patients are notably lower than that before treatment;the difference has statistical significance(P<0.05).The comparison between the two groups has no statistical difference(P>0.05).4)Improvement of TCM symptom scores and specific symptoms:At the three-month course and six-month course,the TCM symptom scores of the treatment group decreased remarkably,which has statistical significance with the difference before treatment(P<0.05).The difference between the decrease of the TCM symptom scores of the three-month course treatment group with the control group has statistical significance(P<0.05).For the intra-group comparison of the treatment group,after three months of treatment,the TCM symptom scores of oropharyngeal drying,dry eyes,dry skin,month and eyes sticky,parotid gland swelling,arthralgia and thick greasy tongue of the patients are notably decreased compared with that before treatment;when the treatment continued to six months,the above scores will be furrther decreased and the illness state cores of dysphoria in chestpalms-soles will be reduced;the score difference before and after treatment has statistical significance(P<0.05).Comparing between the groups,for three-month treatment,the difference between the scores decrease of month and eyes sticky,arthralgia and thick greasy tongue and that of the control group has statistical significance(P<0.05).For six-month course,the difference between the symptom scores of dry skin and arthralgia and thick greasy tongue of the treatment group and the control group has statistical significance(P<0.05).5)Improvement of laboratory serum inflammatory biomarkers:during the intra-group comparison in the treatment group at three-month course,the IgG level decreased notably(P<0.05);for the six-month course,the erythrocyte sedimentation rate(ESR)and IgG all decreased remarkably(P<0.05),which has no statistical difference compared with the control group(P>0.05).[Research conclusions]:1 Dedicated to clinic,Prof.Dong Zhenhua advocates classic and combination of TCM and western medicine,hoping to take full advantage of TCM in clinical practices.He has rich experience in curing internal miscellaneous diseases,gynopathy and rheumatoid immune diseases with remarkable curative effects.Hence,his experience is worthy for inheritors to study and develop.2 The treatment of Prof.Dong Zhenhua on rheumatoid immune diseases especially pSS is distinctive and unique.He seized the point-cut of curing rheumatism with TCM,trying to give full play of effect-enhancing and toxicity-reducing of TCM.His treatment on pSS has a clear hierarchical structure with accurate medication.The curative effect on complicated and difficult clinical diseases is great.3 Based on the exploring and summarizing of the experience of former teachers,the inheritor took the patients with pSS Yin deficiency and dampness syndrome as its research objects for the first time,use TCM "dew drink Chai Qin lift scattered flavor"prescription for the treatment.The results showed that the prescription can significantly relieve the state and symptoms of lymphadenectasis,parotid gland swelling and high IgG with continuous effect.The ORR is equivalent to that of hydroxychloroquine sulfate(western medicine).This prescription can alleviate the TCM symptoms of pSS oropharyngeal drying,dry eyes,dry skin,month and eyes sticky,parotid gland swelling,arthralgia,dysphoria in chestpalms-soles,dry and cleft tongue,and thick greasy tongue with continuous effect.The six-month treatment course has the best curative effect with medicinal safety;in the aspect of improving pSS TCM month and eyes sticky,thick greasy tongue and chapped skin,the TCM method has faster effect,which is better than western medicine of hydroxychloroquine sulfate tablets.4 The inheritance of the experience of famous veteran doctors of TCM has great significance in improving the academic level of the inheritor.The inheritors innovated the experience and put into practice,who first analyzed the clinical effect of using TCM prescription to treat pSS Yin deficiency and dampness syndrome,and provided strong clinical evidence for using TCM to treat hard and complicated diseases. |
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