Studying The Rules Of Diagnosing And Treatments For Pakan Mugpo Based On Tibetan Medicinal Texts And Clinical Cases

Background: Tibetan medicine is the basis for Tibetan ancestors to accumulate and create rich methods of self-care and treatment in the fight against nature and various diseases,and to learn medical knowledge of neighboring countries and the essence of other ethnic groups.In addition,it summed up the clinical experience of the indigenous medicine,and gradually formed a comprehensive theory of Tibetan medicine,which has been completed as a masterpiece of Tibetan medicine the "Four Medical Books",it was regarded as the standard of Tibetan medicine theory and practice.Among them,the three Nyipa(r Lung,Chipa,and Pakan)are the causes of all diseases,especially for the disease of "Pakan Mugpo" that is a syndrome in which three nyipas and blood and other carriers are concurrently present.It is also a theoretical manifestation of a comprehensive etiology and pathogenesis,clinically.Associated with many diseases.Therefore,it is irreplaceable to cultivate Tibetan doctors' clinical thinking as much as the three major nyipas.The four diseases of "Pakan Mugpo" are highly consistent with the digestive system in Western medicine,and have typical characteristics of digestive diseases in clinical;two pathogenesis,four diseases,and three illnesses of Pakan.The disease period can represent the cause and pathogenesis of all diseases,and it is also called the root cause of all internal diseases.Clinically,in the process of diagnosis and treatment of Tibetan and Western medicine,one of the main reasons why the guiding value cannot be tapped and applied is due to asymmetrical differences in the classification of different medical diseases,such as stomach "Pakan Mugpo" that is simply the same as gastric ulcer,which will affect the diagnosis,the principle of drug use,and the evaluation of clinical efficacy.Objectives:(1)Through literature research,it took a systematically studies from both theoretical and practical perspectives for "Pakan Mugpo".The etiology and characteristics of the "Pakan Mugpo" disease,its pathogenesis and principle,the characteristics of the predisposing factors,and the identification of the disease location were analyzed.The relationship between classification significance,diagnosis and comorbidities and Pakan disease.Explore the relevance of "Pakan Mugpo" disease and blood diseases.Data mining the theoretical basis,common medicines,and treatment characteristics of "Pakan Mugpo" disease in Tibetan literature classics.Summarize the connotation and theoretical characteristics of "Pakan Mugpo" disease in Tibetan medicine.(2)Through clinical cases analysis,clinical data and prescriptions were collected from 314 patients who met the inclusion criteria.The corresponding characteristics of macroscopic appearance and microscopic indicators were analyzed.Microscopic indicators such as the diagnosis of "Pakan Mugpo" disease and gastroscopy,HP,and blood tests were extracted.The characteristics of the clustering between key elements,and analysis of drug prescriptions in clinical prescriptions,provide scientific evidence for the standardization of clinical diagnosis and treatment.Methods:(1)Through literature search,selected the ancient books related to "Pakan Mugpo" disease and its relevant etiology and pathogenesis,syndrome differentiation,symptoms and treatment,drug prescriptions,treatment principles and treatment methods,and to summarize,analyze the conclusion.(2)Through clinical cases analysis,314 cases of "Pakan Mugpo" disease were diagnosed at the Qinghai provincial Tibetan hospital,and clinical diagnostic information,prescription medications,gastroscopic images,and 14C-urea breath test were collected to assist in the diagnosis and using Microsoft Excel 2010 to establish corresponding Database,using SAS8.2 software for analyzing data statistics.Results:(1)The literature study found that the "Pakan Mugpo" disease,which was not mentioned in ancient Indian medicine,it comes originally from the "Four Medical Tantras".Second,although its disease classification belongs to the category of three Nyipa(r Lung,Chipa,and Pakan),it is actually the source of all internal diseases.Third,from the perspectives of "Pakan Mugpo",the disease's etiology and pathogenesis,the disease's position and the symptoms have the polymerization,its essence is a typical syndrome.(2)Clinical cases analysis found that the western gastroscopic test can not be used as a evidence for diagnosing the "Pakan Mugpo" disease.The second is that Tibetan medicine has an effective rate of 98.8% for the treatment of "Pakan Mugpo" disease.The third is the positive 14C-urea breath test is 100%.Fourth,the incidence of occult blood was 12.78%.The fifth found that among the 36 clinical symptoms,seven kinds of typical symptoms have more than 50% of the frequent including the acid reflux,chest-burn,loss of appetite,belching,xiphoid pain,fullness,constipation.Sixth,there are three kinds of formula among 33 kinds of prescriptions used in more than 50% of the frequency,they are namely twenty-one Chongxi,Renqing Mang Jue,twenty-five Tangchen.In addition,the association rules between HP,clinical diagnostic information,and prescription medications were analyzed.