| Professor WangYongyan is the famous expert in internal medicine and neurology of traditional Chinese medicine(TCM).He has taken the clinical and basic research of Cardiocerebrovascular disease as the main research direction,and undertaken a number of major national issues.As the academic leader of TCM,he conducted an in-depth and systematic study in clinical and basic research of stroke and dementia,and improved the level of prevention and treatment of encephalopathy with TCM.I have the honor as Professor Wang academic heir,and summarize his academic thoughts and experiences especially in the prevention and treatment of cardiovascular disease.This paper mainly summarizes Professor WangYongyan's academic thoughts and clinical experiences from four aspects:1.Professor WangYongyan's academic origin in TCM;2.Professor WangYongyan's academic thought in TCM;3.The finishing and summary of Professor WangYongyan's experience in the diagnosis and treatment of cardiovascular diseases with TCM;4.Clinical study of Yangyinxifengfumai decoction in treating premature ventricualr contraction with the syndrome of heart-YIN deficiency and wind-driven heart collaterals.1 The first part:Summarizing the academic origin of Professor WangYongyan.Professor WangYongyan is from the family of TCM.As the apprentice of the famous TCM expert Tung Chee-hwa,his academic thoughts are well received by Tung Chee-hwa,and he inherited many valuable experiences,and was good at development and innovation,read the classics of TCM,diligent in clinical practice.As a doctor for decades,he has accumulated a wealth of academic experiences,not only in stroke-based TCM theory and clinical encephalopathy he has formed his own main academic direction,and cultivated a large number of talents in the standardization of TCM,prescription ingredients compatibility,Clinical evaluation,TCM resources,clinical medicine and other aspects.2 The second part:Summarizing the academic thoughts of Professor WangYongyan.Professor Wang creatively established and improved the system of TCM diagnosis and treatment of stroke,the biggest achievement and the most widely used of it is "syndrome standardization"research.He chaired the formulation TCM diagnosis and curative effect evaluation standard of stroke,and put forward the disease name,disease class and syndrome diagnostic criteria and efficacy criteria,unified disease called stroke,the disease is divided into acute,recovery and sequelae phas,and put forward the corresponding treatment.He made the clinical study of stroke to the standardized,systematic,scientific step forward through research,this played a leading role and exemplary role for the study on standardization of diagnosis and treatment of common diseases and syndromes in clinical departments.Professor Wang made a clear interpretation of the concept of abnormal collaterals for the first time,that:the abnormal collaterals is the collateral disease of the pathological process,pathogenesis,the source of disease and syndrome.It is of great significance to deepen the analysis of pathogenesis of abnormal collaterals,to seek common pathogenesis of syndromes,to determine the treatment and treatment of prescription and to determine the prognosis.On this basis,developing and innovating,he combined theory and practice for the treatment of cardiovascular disease,put forward the heart-YIN deficiency and wind-driven heart collaterals is one of the pathogenesis of premature ventricular contraction,according to the basic pathogenesis of this disease,he formed the experienced prescription:Yangyinxifengfumai Decoction.3 The third part:Mainly sorting out and summarizing the experience of Professor WangYongyan in treatment of cardiovascular disease in diagnosis.This part focuses on selecting cardiovascular disease,including hypertension,coronary heart disease,atrial fibrillation,and premature ventricular contraction,systematically analyzes the clinical experience and academic thought of Professor WangYongyan in prevention and treatment of such cardiovascular disease,to provide valuable academic heritage experience of prevention and treatment of cardiovascular disease.Hypertension:Professor Wang believed that we should pay attention to think of the five internal organs as a whole,both organs in the treatment of hypertension,The main causes of hypertension include emotional disorders,eating disorders,internal injuries wasting,the main pathogenesis is that early signs for the more syndromes are real mark,such as Liver Yang hyperactivity,congestion resistance,exopathic wind,etc.in the medium-term,especially the elderly and refined,it often into the kidney essence deficiency or lack of Qi and blood,which pathogenesis is complex,serious,changeful.Its dialectical points are:Western medicine and TCM combined use,disease identification is the premise,syndrome differentiation is the core.The principle of clinical syndrome differentiation is adhering the advantages of TCM,emphasizing syndrome differentiation.Coronary heart disease:Professor Wang believes that the total pathogenesis of coronary heart disease is "weak pulse at YANG and stringy pulse at YIN",its location is in the heart and heart of the context,involving the liver and spleen and kidney.The pathogenesis takes the deficiency of Qi,Blood,Yin and Yang as a fundamental,the phlegm,blood stasis,air cooling,toxic heat and other evil as the mark,the general principles of TCM treatment is:urgent is the treatment of its mark,slow the rule of this..he emphasis the need to follow the "internal organs of the overall regulation" on the diagnosis and treatment of coronary heart disease,distinguish the priorities of diseases,treat with syndrome differentiation,take care of both tip and root.Professor Wang pointed out that the prevention of coronary heart disease should be placed first and foremost,TCM should play its due edge,focusing on acupuncture and medicine together.Atrial fibrillation:In the treatment of atrial fibrillation,Professor Wang explored the attending rule of common recipes of this disease based on syndrome differentiation.He founded that Guizhi plus keel oyster decoction,Wendan decoction as the main recipes.Professor WangYongyan considered that deficiency of kidney is an important cause of the disease pathogenesis,and attach importance to nourish Kidney-essence in the clinical.Premature ventricular contraction:Professor Wang believed that " heart-YIN deficiency and wind-driven heart collaterals " is the basic pathogenesis of premature ventricular contraction with Yin-difficiency syndrome,put forward that wind-cause-disease is with rapid onset and rapid changes in the characteristics,and the palpitations of the "throbbing","the heart suddenly uneasy","sometimes it happens sometimes stops"," sometimes severe and sometimes light”and other symptoms are similar to wind evil for disease performance.In the treatment,he embodied the idea of the "wind to rule the wind," the wind type of medicine is with light weight and odor clear,with the role of clarification and transparent,and its characteristics are mostly pungent,scattered,channeling,through,moving,etc.,on the one hand,it can spread through evil and removing dampness to reduce phlegm;on the other hand,it has a role of divergent opening depression,warming,nourishing blood,eliminating blood stasis.Yangyinxifengfumai decoction:In clinical practice for many years,Professor Wang emphasis on the role of wind disease in the pathogenesis,believe that the effect of wind medicine's on improving Premature ventricular contraction is particularly important.He put forward the heart-YIN deficiency and wind-driven heart collaterals is one of the pathogenesis of premature ventricular contraction,according to the basic pathogenesis of this disease,he formed the experienced prescription:Yangyinxifengfumai decoction.It consists of the following drugs:North Adenophora,radix scrophulariae,Salvia miltiorrhiza,Rhizoma Coptidis,bombyx batryticatus,Cicada slough,scorpio,Raw keel,Raw oyster,Suanzaoren,spikenard and so on.As the Monarch drugs,North Adenophora and radix scrophulariae have combined effect of Nourishing Yin and moistening dryness,nourishing Yin to reduce pathogenic fire,nourishing pneuma;Bombyx batryticatus which can dispell wind and relieve convulsion,reduce phlegm and resolve masses,Cicada slough which can dispell wind and heat,Scorpio which can dispell wind and dredging collaterals,conteract toxic substances and eliminate stagnation,these three drugs have combined effect of dispelling wind and dredging collaterals as the adjuvant drugs;Salvia miltiorrhiza which can promote blood circulation to remove blood and remove blood stasis for promoting tissue regeneration,Rhizoma Coptidis which can clear away heat and toxic material,Raw keel and Raw oyster which can make the mind convergence,tranquilize and sedate the mind,Suanzaoren which can make the mind convergence,these five drugs have combined effect of nourishing heart and quieting spirit as the adjuvant;Spikenard is aromatic and can relieve stagnation to activate spleen and guide the drug until the disease as the conductant drug.These druge have combined effect of nourishing Yin and eliminating the wind,calming the nerves and restoring pulse,taking care of both tip and root and consistent with pathology.4 The fourth part Clinical study of Yangyinxifengfumai decoction in the treatment of premature ventricualr contraction of insufficiency of heart-YIN and wind-driven Heart network.Purpose of research:To observe the curative effect of Yangyinxifengfumai decoction on premature ventricualr contraction with the syndrome of heart-YIN deficiency and wind-driven heart collaterals.Research methods:140 patients with premature ventricualr contraction who were diagnosed as heart-YIN deficiency and wind-driven heart collaterals syndrome were randomly divided into TCM treatment group(n = 70)and western medicine control group(n=70).The treatment group was given modified"Yangyinxifengfumai Decoction",while the control group received the treatment of metoprolol 25mg twice daily.The course of treatment both were 28 ± 2 days.Compared two groups of patients before and after treatment,clinical curative efficacy,TCM syndrome score,room early times and heart rate variability of 24h dynamic electrocardiogram differences.Results:In these 140 patients,1 case of treatment group and 2 cases of control group were lost.1.Curative effect of TCM syndrome:After treatment,?The total curative effect of the two groups were 89.9%in the treatment group and 72.1%in the control group,the treatment group was superior to the control group,and the difference was statistically significant(P<0.05).?The total score of TCM syndrome was reduced,two groups of patients before and after treatment of their own contrast,the difference was statistically significant(P<0.05);and the treatment group was significantly better than the control group,the difference was statistically significant(P<0.05).?TCM individual symptom scores were improved,and the symptoms of palpitations,being frigt and fear easily,shortness of breath and weakness,being upset,wakefulness,and the treatment group was significantly better than the control group,the difference was statistically significant(P<0.05).2.The number of ventricular premature contraction effect:After treatment,the two groups of patients with 24h electrocardiogram room early times were reduced,two groups of patients before and after treatment of their own contrast,the difference was statistically significant(P<0.05),and the treatment group was not significantly better than the control group,the difference was not statistically significant(P>0.05).;two groups of room early efficacy were,the treatment group 73.9%,the control group 67.6%,the difference between groups was not statistically significant(P>0.05).3.The effect of heart rate variability:Main outcome measures were SDNN,SDANN,PNN50,RMSSD.Two groups of patients before and after treatment of their own contrast,four indicators have increased,the difference of them was statistically significant(P<0.05).After treatment,the treatment group was significantly better than the control group in SDNN,SDANN,and RMSSD index(P<0.05).Conclusion:1.This study shows that Yangyinxifengfumai Decoction can significantly improve the premature ventricualr contraction with syndrome of heart-YIN deficiency and wind-driven heart collaterals in patients with clinical symptoms and signs,indirect evidence of heart-YIN deficiency and wind-driven heart collaterals is one of the pathogenesis of premature ventricular contractions.2.Yangyinxifengfumai Decoction can reduce the total number of dynamic electrocardiogram in patients with ventricular premature contraction.Through its impact on the indicators of heart rate variability,considering the premature ventricular contractions may occur in patients with sympathetic nerve excitability,this decoction can improve the autonomic nervous function by inhibiting the activity of sympathetic nerve and improving the function of pneumogastric nerve,so as to effectively relieve the symptoms of the patients.3.Yangyinxifengfumai Decoction on premature ventricualr contraction in patients with liver and kidney function had no significant effect,non-toxic side effects,with good safety.The innovation points of this paper:1.To summarize the academic thoughts and clinical experiences of Professor WangYongyan on cardiovascular disease.2 Put forward the basic pathogenesis of premature ventricular contraction in heart-YIN deficiency and wind-driven heart collaterals syndrome for the first time.establish Yangyinxifengfumai method,and in accordance with the basic clinical pathogenesis of the disease in the treatment of the disease form of the empirical formula:Yangyinxifengfumai Decoction.3.To further verify the clinical efficacy and safety of Yangyinxifengfumai Decoction which is the empirical formula of Professor WangYongyan in premature ventricualr contraction,and to explore the mechanism of Yangyinxifengfumai Decoction in treatment of premature ventricualr contraction with the syndrome of heart-YIN deficiency and wind-driven heart collaterals,it may provide new treatment methods and new ideas for the research of TCM. |
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