| Research Objective:this article is to dig,arrange and state the academic idea of"reinforcing organ and facilitating bowel movement" and to present and extract syndrome differentiation and medication feature of Professor Yao(Shujin Yao)by exploring his academic thinking origin of "reinforcing organ and facilitating bowel movement".It is also to summarize his clinical experience to treat chronic renal failure with the method of resolving toxin by strengthening the body resistance and reinforcing the kidney.In addition,it is to summarize the medicine law by analysing the inheriting the auxiliary system of the transitional Chinese medicine and to observe the clinical effcacy from fact of treating chronic renal failure with the method of resolving toxin by strengthening the body resistance and reinforcing the kidney.Research MethodTheoretical study and experience summary1.Study classics and document.I study classics and find by hard and thorough search to pursue his academic origin of thought.I also carefully arrange and study his works and academic papers,handouts and manuscript as well as essays published by my teachers relevant to experience summary,review and collect his academic thinking venation and repeated exchange and communicate with teachers to strive for completely and correctly summarize his academic thinking and clinical experience.2.Learn from teacher.I seize all kinds of learning opportunities,such as outpatient service,ward-round,case discussion,nursing studont,academic conference and special class on academic thinking and repeatedly figure out and summarize treatment experience of Professor Yao to put forward questions on study and work so as to discuss academic perspective.I also take notes followed by him,carefully summarize classic case and sum up his academic thinking,differential treatment thinking and medicine law.Experience summary on special diseases.I summarize the differential treatment rule on chronic renal failure treatment with the method of resolving toxin by strengthening the body resistance and reinforcing the kidney through the follow-up,medical case arrangement,clinical observation and medication analysis and discuss with him to summarize his differential treatment rule on chronic renal failure with the method of strengthening the body resistance and reinforcing the kidney.I also count his medical cases on chronic renal failure based on the inheriting the auxiliary system of the transitional Chinese medicine software to summarize his medicine law on chronic renal failure treatment.Clinical research.With forward looking and randomized control methods,I divide 76 subjects into two groups,treatment group with strengthening the body resistance and reinforcing the kidney decoction and benefiting Qi for activating blood circulation detoxification casual and control group on uremic clearance granule.3-Month treatment is a course of treatment.I conduct symptom scoring statistics and inspections on hematocrystallin,blood urea,serum creatinine,glomerular filtration rate,albumin,triglyceride and total cholesterol and compare treatment group with control group.Research resultsTheory and experience summary1.Theoretical origin.Professor Yao's theoretical origin of "reinforcing organ and facilitating bowel movement" derives from classical ancient books,experience of former worthies,family learning accumulation and summary and innovation of personal clinical experience.His academic thinking was born of Huangdi Neijing and Nan Jing,inspired by Shan Han Lun and Jinkui Yaolue.Piwei Lun established his spleen and stomach-centred viewpoint Confucians' Duties to Their Parents enlightened his divided through between facilitating bowel movement and triple warmer.Danxi Xinfa comprehended his unification of reinforcing organ and facilitating bowel movement.Lei Jing consolidated his reinforcing method of balance between Yin and Yang.Shoushi Baoyuan established his through of paying equal attention to apriority and posteriority.Wenbing Tiaobian further clarified his vertical differentiation and divided treatment of triple warmer.Doctors in modern times learn widely from others' strong points.Their flexible elicitations of diagnosis and treatment further detail reinforcement and facilitation.They drew experience from former worthies,complied with the edification of "giving priority of nourishing kidney and Qi to male,nourishing blood and soothing the liver to female,curing indigestion and tonifying spleen to child and moderately reinforcing yin and yang to the elder",integrated years of clinical practice,continuously explored and summarized to finally make the academic thinking of "reinforcing organ and facilitating bowel movement" come into being.Explanation on the academic thinking of "reinforcing organ and facilitating bowel movement".Professor Yao thinks we should be familiar with coronary heart disease based on the "insufficient material foundation" and the low "functional activities" and"fu-organ disease" on "dysmetabolism".2.The "insufficient material foundation" and low "functional activities" show the essence of "viscera deficiency"."Dysmetabolism" causes "fu-organ excess".The deficiency and excess of viscera and fu-organ and rising and falling disorder can assist to analyse the occurrence and development course of disease."Five organs store essence without Qi leaking and six hollow organs digest and transport food and drink without storing essence".Strong function of five internal organs,unblocked fu-organ Qi,fluent Qi function of triple warmer,vigorous healthy qi,pathogenic Qi immunity,sequential rising and falling of Yin and Yang make health body.Or numerous diseases come.Triple warmer is a big Fu-organ in human body,including internal organs of the body and extraordinary Fu-organ.Professor Yao thinks that "an block in body results in blocks in body".Blocks in upper,middle and lower triple warmer is the inevitable result of viscera dysfunction.Either "viscera deficiency" or "sthenia of evil" will make unblock.In order to reach the result that an unblock in body makes unblocks,we reinforce organ by supporting healthy Qi and facilitate bowel movement by eliminating pathogenic Qi based on different positions of viscera in triple warmer.Heart and lung invigoration,smooth upper warmer,spleen and supplementing Qi invigoration,stomach and calm the adverse-rising energy regulation,middle warmer mediation,liver and kidney adjustment and reinforcement,turbid reduction and regulation and lower warmer cleaning can result in effect of pure Yang returns to the five internal organs and turbid yin to the six hollow organs.3.Clinical practice of "reinforcing organ and facilitating bowel movement".Professor Yao gives priory to reinforcing the five internal organs,circulating healthy Qi and centring on spleen and stomach.He also attaches most importance to "main organ and takes the rest as subsidiary role.He pays attention to cultivating and reinforcing nephron.So strong kidney Qi makes organs more powerful.External trouble prevention by reinforcing Lung Qi means to take precautionary measures to prevent from diseases or prevent variation on existing disease.Qi and Yin reinforcement and peaceful mind is to stabilize the great governor of internal organs of the body.Smoothing liver circulation and Qi and blood cultivation pay attention to harmony between Qi and blood.The importance of the six hollow organs circulation is to adjust triple warmer and remove its accumulate sluggish.Both therapy and prescription shall comply with the nature of rising or falling.We should abide by the "harmonious Yin and Yang and rising and falling adjustment" as well as "smoothing triple warmer and Fu-qi circulation" during application.The fact that which is of importance between reinforcing organ and facilitating bowel movement is syndrome differentiation.We should combine both reinforcement and facilitation as well as rise ascend lucidity and descend turbidity based on different features of viscera.Based on the feathers of triple warmer,we should treat triple warmer individually and reinforce organ and facilitate bowel movement through smooth upper warmer,middle warmer mediation,lower warmer circulation and falling.4.Prescription medicine law of "reinforcing organ and facilitating bowel movement".1)Professor Yao focuses on supporting the healthy energy and healthy Qi.He is good at ginsengs,such as American ginseng,red ginseng,radix pseudostellariae and radix codonopsis.He stresses to select different ginsengs based on different illness states.He is good at using empirical formula,"Stilbene Yi sijunzi decoction",to invigorate spleen and supplementing Qi and eliminate dampness through diuresis,"Chensu Sini powder" to ascend lucidity and descend turbidity and "Xiaozhang Liqi decoction" to promote rising by falling.2)Supplementing qi and nourishing yin.He reinforces Lung Qi and mediates upper warmer with "Yupingfeng powder",reinforces Qi and Yin and make mind peaceful with "Shengmai decoction" and mediates upper warmer and circulates lower warmer with "Shengjiang powder".3)Nourishing liver and kidney and simultaneously using heavy prescription and inducing astringency."Four flavours of waist consolidation" is used to strengthen waist and concrete kidney,"four flavours of arresting polyuria" and "four flavour of Xiaobai" to tonify the kidney,reduce urine and secure essence,"Sanjiaoyin"to replenish essence and benefit marrow as well as nourish liver and kidney,"four flavour of depressurization" to nourish kidney and soften liver and to calm the liver,suppressing liver-Yang,relieve palpitation,soothe the nerves and reduce blood pressure with "four flavours of heavy prescription"."Three flavour of diurese"expedites the lower warmer,removes dampness turbidity and eliminate pathogenic Qi and "three flavours of moistening catheter" nourishes blood,tonifies the kidney,moistens catheter and descends the turbid to excrete turbid toxins.4)Empirical Formula Collection is the summary and essence of his family biography and personal experience.These prescriptions can be used to treat relevant diseases during clinical application."Four flavours of expectoration","five flavours of softeniong hard lumps and dispel nodes","Pinghuayin","Three flavours of Hdispersing blood stasis","Three flavors of invigorating the circulation of blood","Postoperative analgesia Yin" and "Sichongyin" are not only widely used to prevent phlegm from forming and stopping coughing,eliminate tumour by softeniong hard lumps and dispel nodes,invigorate the circulation of blood and hdisperse blood stasis,expel wind and dredge collaterals and relieve pain but also to cure various diseases,such as cough and asthma,tumours,coronary heart disease and rheumarthrosis.5)Professor Yao's high-quality powder is the inheritance and development of hereditary experience,which is his characteristic prescription to cure difficult and complicated diseases.For example,"Benefiting Qi for activating blood circulation detoxification casual" is used to cure chronic renal failure,"inducing resuscitation and resuscitation powder" to coma and orifice block,"Hanhua powder of dredging collaterals and tumour elimination" for esophagus cancer and "infantile malnutrition powder" to paediatric stasis.All have outstanding efficacy.Experience summary on special diseases1.Understanding of cause and etiology of chronic renal failure.Professor Yao uses triple warmer theory to dialecticallu cure chronic renal failure.He thinks that its essence is the depletion of lung spleen and kidney and objective the suffusion of water-dampness,turbid toxins and blood stasis to triple warmer.Depletion of lung spleen and kidney determines the occurrence,development and evolution of deceases.Suffusion of water-dampness,turbid toxins and blood stasis to triple warmer is the key of etiology evolution.2.Experience of curing chronic renal failure is divided into triple warmer treatment determination and strengthening the body resistance and reinforcing the kidney,which are used to cure chronic renal failure.1)Strengthening the spleen and stomach,mediating middle warmer and sufficient Qi and blood are essence.Various symptoms shown in disordered middle warmer of chronic renal failure can be concluded to middle warmer syndrome,which is divided into spleen asthenia and dampness retention and damp-heat stasis.Spleen asthenia and dampness retention can be cured by invigorating spleen to eliminate dampness with the formula of strengthening the body resistance and reinforcing the kidney decoction,relieving distension and regulating Qi decoction and three flavours of diurese,whose dosages shall be used based on the situation.The middle energizer dampness-heat can be cured by clearing heat and removing dampness with the formula of Huanglian Wendan Decoction,Zuojin Pill and three flavors of relieving hyperacidity,whose doses shall be used based on the situation too.2)Coordination of the five internal organs is the key to regulate and invigorate the heart and lung and tonify the liver and kidney.The upper warmer is controlled by heart and lung,which is the upper source of hydrosphere metabolism.Disordered hydrosphere metabolism causes blocked upper warmer.So tonifying the heart and lung and smooth upper warmer to consolidate the essence.Upper warmer disease is divided into the loss of control of lung Qi and insufficient heart Qi.Loss of control of lung Qi can be cured by tonifying Qi and securing the exterior as well as phlegm evil by resolving phlegm and disinhibiting water with the formula of Yupingfeng San and four flavours of expectoration,whose doses shall be used based on the situation.Insufficient heart Qi shall be cured by reinforcing Qi and nourishing Yin as well as blood stasis and water-dampness by invigorating the circulation of blood and disinhibiting water with the formula of Shengmai yin,three flavors of hdispersing blood stasis and three flavours of diurese,whose doses shall be used based on the situation.The deficiency of liver and kidney not only causes the deficiency of Yin and Yang-hyperactivity but also the lower warmer disease with loss of control of kidney deficiency,essence escaping,unfavourable lower warmer catharsis and turbid toxins stagnation.Deficiency of Yin and Yang-hyperactivity disease can be cured by calming the liver and suppressing liver-yang with the formula of four flavours of heavy prescription,four flavours of reducing blood pressure and Shengmai Yin,whose doses shall be used based on situation.Loss of control of kidney deficiency disease can be cured by tonifies the kidney and inducing astringency,replenishing essence and filling the marrow and removing dampness and dissolving turbidity.3)During late period of disease,the upper and lower shall be expedited and triple warmer negotiated.The longer the chronic renal failure lasts,the longer the damp turbidity stays,which suffuses triple warmer.Dysfunction of ascending lucidity and descending turbidity causes triple warmer disease with turbid toxins suffusion,which is the inexorable trend this disease develops to during later period.It can be cured by invigorating spleen to eliminate dampness,expediting purity and dredging turbidity,invigorating the circulation of blood and disinhibiting water with the formula of expediting purity and dredging turbidity decoction,three flavours of invigorating the circulation of blood,strengthening the body resistance and reinforcing the kidney decoction and three flavors of diurese,whose doses shall be used based on the situation.4)Strengthening the body resistance detoxication shall runs through the entire treatment of chronic renal failure.Professor Yao thinks the necessary measures taken to cure chronic renal failure is to eliminate the water-dampness,turbid toxins and blood stasis stayed in triple warmer.The depletion of five internal organs is essence and water-dampness,turbid toxins and blood stasis stagnation is phenomenon.Strengthening the body resistance detoxication shall runs through the entire treatment of chronic renal failure.Benefiting Qi for activating blood circulation detoxification casual is his empirical formula to cure chronic renal failure,which is cooperate with decoction.3.Study on medicine law of chronic renal failure.Based on the inheriting the auxiliary system of the transitional Chinese medicine software,I conduct frequency statistics,classified counting and analysis on Chinese herbal prescriptions for 289 prescriptions Professor Yao used to cure chronic renal failure,conclude 29 mode frequencies of prescription medicine he used to cure chronic renal failure and 32 groups of medicine association rule,which complies with his medicine law his students summarized,fully showing his visible experience of medication.There are 13 groups of medical combination with orrelation coefficient among medicines greater than 0.03.Among them,most of medicines used are of high-quality,which reflects the implicit rule of high-quality powder used to cure chronic renal failure.There are 15 groups of key medical combination,which assists to clusteringly deduce 8 new prescriptions.It is the deep digging of his medicine experience.It shows his visible experience while digs implicit experience he used but not be dug.Clinical research1.Objective.I apply Professor Yao's method of resolving toxin by strengthening the body resistance and reinforcing the kidney to clinic for observation and conduct practically clinical observation to achieve knowledge application through the study and summary of his academic thinking of reinforcing organ and facilitating bowel movement in order to well inherit his experience on chronic renal failure treatment.2.Method.select 76 cases of chronic renal failure and use EXCEL random number table at the rate of 1:1 to randomly divide them into observation group(n=38)and control group(n=38)based on their visiting sequence with the forward looking and randomized control research method.I take Professor Yao's treatment methods of strengthening the body resistance and reinforcing the kidney decoction and benefiting Qi for activating blood circulation detoxification casual for treatment group and uremic clearance granule particle for control group to observe each efficacy.Treatment period is 3-month.Symptom score,serum creatinine inspection,urea nitrogen,glomerular filtration rate,blood uric acid,albumin,total cholesterol and triglyceride shall be recorded one,two and three months later respectively before and after treatment to conduct efficacy analysis.3.Result1)Clinical efficacy comparison between two groups.There are 34 cases in treatment group with 9(26.47%),excellent,8(23.53%),effective,13(38.24%),stable and 4(11.76%),no effect.The total effective rate is 91.18%.There are 33 cases in control group with 2(6.06%),excellent,5(15.15%),effective,8(24.24%),stable and 18(54.54%),no effect.The total effective rate is 45.45%.The clinical efficacy compositions of both comparisons have distinctive difference(rank-sum test,P<0.05).Comparison difference between total effective rates of two groups have statistical significance(x~2 test,P<0.05).2)Efficacy comparison on TCM syndrome before and after treatment of two groups.There are 34 cases in experiment completion treatment group with 4(11.8%),cured,8(23.53%),excellent,19(55.88%),effective and 3(8.82%),no effect.The total effective rate is 91.18%.There are 33 cases on experiment completion control group with 0,cured,3(9.09%),excellent,16(48.48%),effective and 14(42.42%),no effect.The total effective rate is 57.58%.The TCM syndrome of both comparisons have distinctive difference(rank-sum test,P<0.05).Comparison difference between total effective rates of two groups have statistical significance(x~2 test,P<0.05).3)Symptom score change comparison of both groups before and after treatment.There is no obvious difference(p>0.05)of improvement on symptoms,such as tiredness,weakness,puffy face and swollen limbs,heaviness limbs,anorexia,nausea and retching,aching lumbus and limp knees,extreme chilliness,dim complexion,lumbago,abdominal fullness and distention and increased number of enuresis nocturna,from subjects on both treatment and control groups before and during one month's treatment.After two and three months' treatment,there is distinct difference of improvement on these symptoms from subjects of both groups,which has statistical significance(p<0.05).There is no obvious difference on symptom score of sticky and greasy in mouth,skin itch,less urine but yellow,excrement not solid and dry and hard from treatment group after treatment,which shows no obvious difference(p>0.05)to improve these symptoms from subjects from both groups.It shows that efficacy of treatment is better that control group on improving tiredness,weakness,puffy face and swollen limbs,heaviness limbs,anorexia,nausea and retching,aching lumbus and limp knees,extreme chilliness,dim complexion,lumbago,abdominal fullness and distention and increased number of enuresis nocturna.There are improvements on these symptoms,such as sticky and greasy in mouth,skin itch,less urine but yellow,excrement not solid and dry and hard,from both groups.However,there is no obvious efficacy difference on both groups.4)Biochemical criterion comparison of both groups.In allusion to indexes,such as serum creatinine,urea nitrogen,glomerular filtration rate,blood uric acid,total plasma proteins,albumin,total cholesterol and triglyceride,the comparison between both treatment groups is P>0.05.Comparative difference has statistical significance(P<0.05)after 3-month treatment in the same group.The comparison is P<0.01 after treatment from treatment and control groups,which shows that the treatment group is better than control group.4.Conclusion1)Strengthening the body resistance and reinforcing the kidney decoction and benefiting Qi for activating blood circulation detoxification casual can obviously improve symptom of chronic renal failure,serum creatinine,urea nitrogen,glomerular filtration rate,blood uric acid,total plasma proteins,albumin,total cholesterol and triglyceride.It has statistical significance compared with control group.Each index is better than that of control group.2)Dialectical treatment on chronic renal failure by Professor Yao's triple warmer theory.He adopts the method of resolving toxin by strengthening the body resistance and reinforcing the kidney with the academic thinking of reinforcing organ and facilitating bowel movement,which not only has effectiveness but also repeatability and referentiability.Research AchievementDuring the 3-year of study,I am honoured to obtain Professor Yao's devoted instruction.I deeply learn and dig his academic thinking through all kinds of ways,such as study on classics and his works,manuscript and handout arrangement,outpatient service with him,consultation of doctors,ward-round,case discussion and question and answer,systematically summarize the academic thinking of reinforcing organ and facilitating bowel movement from its origin to theory,method,prescription and medicine,explore the application of this academic thinking to special diseases and thoroughly conclude and extract the experience of treating chronic renal failure with the method of resolving toxin by strengthening the body resistance and reinforcing the kidney based on the inheriting the auxiliary system of the transitional Chinese medicine,I also conduct clinical control study,obtain the expected efficacy,achieve knowledge application and conclude the effective method to treat chronic renal failure. |
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