Combination Of Ancient Literature On Encephalopathy And Study On The Effect Of Zishen Yisui Jiannao Recipe On Encephalopathy With Kidney Deficiency And Marrow Deficiency

Background and ObjectiveThe brain marrow theory is the study of the morphological structure,physiological function and pathological changes of the brain and the marrow,and the relationship with the meridian system,internal organs and the external natural environment.The brain and the marrow are "extraordinary organs".In the traditional Chinese visceral system,there is no position of the brain,which causes its function to be gradually replaced by visceral function.However,since the spread of western learning to the east,this independence of the brain has been gradually valued."brain marrow disease"has become a common term used by doctors,but they have different understanding of its connotation.On the one hand,through the study of the ancient literature related to brain marrow theory,this paper sorts out its development context,redefines the brain marrow disease,and clarifies its connotation.On the other hand,the pathogenesis of brain marrow disease is mostly deficiency of kidney and marrow.Professor Chen zhigang,on the basis of years of clinical experience,has formed the experience prescription for treating brain marrow disease:Zishen Yisui Jiannao Fang.Therefore,based on the concept of treating different diseases with the same therapeutic principle,we intend to observe the effect of Zishen Yisui Jiannao Fang on kidney and marrow deficient brain marrow disease.MethodsThis study is divided into three parts.The first part is the study of ancient literature related to brain marrow,collecting and summarizing the literature related to brain marrow theory in ancient books;combing the development of brain marrow theory in ancient times,analyzing and summarizing its development in different periods.In the second part combines the study of ancient literature and the discussion of related problems by modern medical doctors,comprehensively summarizes the theory of brain marrow,including its generation,its relationship with meridian,its function,etc,and proposes the definition of brain marrow disease.The third part is the clinical research,based on the concept of "treating different diseases with the same therapeutic principle",adopt the method of before-and-after design,included in the MSA,PD,PDS,SCA patients who are kidney and marrow deficient type.They were treated with Zishen Yisui Jiannao Fang for 6 months.Before and after treatment,TCM syndrome scores,ADL scores,MoCA scores for all,UMSAS,MSA-NMSS scores in the MSA group,UPDRS scores in the PD and PDS groups,and ICARS scores in the SCA group were compared.ResultsThe first partThe brain marrow theory was imitially summarized in Huangdi Neijing,including the physiology,pathology and treatment of the brain marrow,which laid the foundation for its development in later generations.During the Wei,Jin,Sui and Tang Dynasties,the theory of the brain marrow in Neijing is fully inherited;Sun Simiao proposed to treat the marrow disease from the perspective of hepatobiliary,and created prescriptions for treating marrow diseases from the perspective of marrow deficiency or sufficiency;Enriched prescriptions and drugs for the treatment of marrow disease,including animal medullary lipids.During the Song,Jim and Yuan Dynasties,the main developments of the brain marrow theory included the use of anatomical understanding.For example,Wang Ang proposed the name of"spinal cord".Shengji Zonglu detailed the bone marrow;The prescription for treating marrow disease has further enriched.During the Ming and Qing Dynasties,the traditional "brain governing mind"was continuously developed and Li Shizhen put forward the idea that "Brain is the House of the Original Domination".At the end of the Ming Dynasty,it began to be influenced by Western medicine.Many medical doctors recognized that "brain mastering memory".Wang Qingren formed a complete TCM brain marrow theory and discussed the connection between brain marrow and gro "wth and development of the human body,perception,speech,memory,and improved the physiological functions,pathological changes,clinical treatment and other aspects of the brain marrow.The second partThe marrow generates from congenital kidney essence,and it also needs the rearing of qi and blood.The brain and marrow are called "extraordinary organ" in Huangdi Neijing,independent of the traditional organs.At the same time,the brain marrow is linked to the internal organs by means of the meridian system,such as Stomach Meridian of Foot Yangming,Bladder Meridian of Foot Taiyang,Gallbladder Meridian of Foot Shaoyang,Liver Meridian of Foot Jueyin,Du Meridian,Branche of Kindy Meridian of Foot Shaoyin,Jingjin of Foot Yangming,etc.The normal maintenance of the physiological function of the brain is closely related to the functions like liver governing conveyance and dispersion,heart govering blood circulation,lung corntrolling qi,kidney governing bone and producing marrow,spleen govering digestion and absorption.The function of the brain marrow includes govering thinking,perception,memory,limb movement,speech and the five emotion.All diseases that can cause dysfunctions such as cognitive,speech,audio-visual,and physical activity of patients have mechanisms of brain marrow damage,which can be attributed to the category of brain marrow disease.The third partl.General information:102patients were included,and 15 patients eventually fell off.87 patients completed complete information collection and follow-up.There were 43 cases of MSA,25cases of PD,12 cases of PDS and 7 cases of SCA.The age were 18 to 84 years,and the median is 60(53,67)years old.There were 40 males and 47 females.The course of disease was 1 to 16 years,with a median of 3(2,5)years.2.Pre-treatment scores:All patients had ADL scores of24 to 68,with an average of 44.21±1.18;MoCA scores of 14 to 29,with a median of 24(22,26),a total of 67.82%of patients scored<26 points;TCM syndrome scores 13 to 51,an average of 30.68±8.14 points.Among the sub-items of the TCM syndrome score scale,the gait disorder score is 100%highest,followed by fatigue(94.25%),expression(85.06%),urinary disorder(83.91%),and defecation disorder(81.61%),the remaining sub-items also have different degrees of loss.3.Overall efficacy analysis:After treatment,for all the patients,TCM syndrome scores and its primary and secondary part all decreased(all p<0.05).In group analysis,TCM syndrome scores and its secondary part in MSA patients,TCM syndrome scores and its primary and secondary part in PD patients,TCM syndrome scores and its primary part in PDS patients all decreased(all p<0.05).There was no statistical difference between before and after comparison in the primary part of TCM syndrome scores in MSA patients,the secondary part of TCM syndrome scores in PDS patients,TCM syndrome scores and its primary and secondary part in SC A patients(all p>0.05).To Analyse the sub-items of TCM syndrome scores scale,all patients' expression,fatigue and urinary disorders,dizziness,insomnia,blurred vision,salivation,defecation obstacle scores decreased(all p<0.05);gait disorder score showed an upward trend but the difference was not statistically significant(p>0.05).;there was no statistical difference between the remaining items.The ADL scores of all patients showed an upward trend after treatment,but there was no statistical difference(p>0.05).In the group analysis,the ADL scores of the MSA,PD and SCA groups showed an upward trend,and the ADL scores of the PDS group showed a downward trend,but there was no statistical difference(p>0.05).The MoCA scores of all patients were increased after treatment(p<0.05).In the group analysis,the scores of patients in the PDS group increased after treatment,the difference was statistically significant(p<0.05);There was an increasing trend in MSA,PD,?SCA group,but the difference was not statistically significant(p>0.05).4Further efficacy analysis in groupsIn MSA patients,their URMSRS scores(Parts ?,?,and ?)increased after treatment,but the difference was not statistically significant(p>0.05).The total score of UMSARS-?+?(post-treatment-pre-treatment)has a maximum value of26,a minimum of-14,and a median of 1(-3,6)lower than similar studies abroad.In the UMSARS sub-score analysis,the score of writing and walking in UMBAS-I,body shaking and gait in UMSARS-II increased,the difference was statistically significant(p<0.05).The scores of intestinal function in UMBAS-?decreased,and the difference was statistically significant(p<0.05).There was no statistical difference between the other items.The MSA-NMSS total score of MSA patients decreased after treatment,and the defecation function and sleep symptom scores in the MSA-NMSS sub-item decreased,the difference was statistically significant(all p<0.05),and there was no statistical difference in other sub-items of MSA-NMSS after treatment.The UPDRS-II and UPDRS-III scores of the PD group were lower than before,but there was no statistical difference(p>0.05).There was also no statistical difference in H-Y classification.In the UPDRS sub-item analysis,the salivary secretion score decreased,and the difference was statistically significant(p<0.05);there was no statistical difference in the other sub-items.The UPDRS-? and UPDRS-? scores of the patients in the PDS group decreased,but there was no statistical difference(p>0.05).There was no statistical difference between the UPDRS sub-items before and after the treatment.The total score of ICARS in SCA patients was not statistically different after treatment(P>0.05).In each sub-item score,the score of language disorder increased,the difference was statistically significant(p<0.05);there was no statistical difference between the other sub-items.ConclusionThe brain marrow theory was initially summarized in Huangdi Neijing,but its development was relatively delayed in the later generation.It was not until the late Ming and early Qing dynasties that it was influenced by Western studies and opened up a new stage of development.Wang Qingren's^discussion of "Naosuishuo marks the complete development of the brain marrow theory.Influenced by Taoist thoughts,there has been the understanding of "brain governing mind" since ancient times,which begun to be valued by more doctors since Li Shizhen's theory that "Brain is the House of the Original Domination".Nowadays,most doctors tend to think that "brain governing mind" includes "heart governing mind."Marrow,mainly brain",The generalized brain marrow includes the marrow of the whole body,while the narrow sense is only the marrow of the brain.The marrow generates from congenital kidney essence,and it also needs the rearing of qi and blood.The function ofthe brain marrow includes govering thinking,perception,memory,limb movement,speech and the five emotion.All diseases that can cause dysfunctions such as cognitive,speech,audio-visual,and physical activity can be attributed to the category of brain marrow disease.Zishen Yisui Jiannao Fang can improve the non-motor symptoms of patients with kidney and marrow deficiency brain marrow disease,mainly in improving the two stools,expression,fatigue,dizziness,insomnia,blurred vision,and salivation.And can delay the progression of dyskinesia in brain disease.