| Objective The study intends to research the papers,works and clinical medical records published by Professor Li Jia-geng,focus on the data mining of chronic gastritis medical records,to discuss Professor Li Jiageng’s academic thoughts and experience in the treatment of diseases such as spleen and stomach diseases,and to summarize the clinical syndrome differentiation and treatment ideas,drug use rules and characteristics,so as to better guide the clinical practice and promote the academic thoughts and experiences inheritance of famous and old Chinese medicine.Method Collect the outpatient medical cases of Professor Li Jia-geng from 2011 to 2018(Hubei Hospital of traditional Chinese medicine,Guoyitang of Hubei University of traditional Chinese medicine,etc.);study the published papers and works of Professor Li Jiageng;sort out the experience in mediation,medicine,method,disease,etc.;analyze Professor Li Jiageng’s syndrome differentiation and treatment of chronic gastritis,gastric cancer,gastroesophageal reflux,ulcerative colitis,crone,etc The clinical records of spleen and stomach diseases such as diseases,irritable bowel syndrome and constipation,and 15 kinds of difficult and miscellaneous diseases in internal,external,gynecology,pediatrics and five sense organs departments;the data mining research and analysis of chronic gastritis medical records are focused on: the standardized medical record data is entered into Excel table,and is used after cleaning and sorting Spss20.0 software for frequency analysis,weka3.6 software for cluster analysis,association rule analysis,and then through pajek2.0 complex network software for cluster analysis of core drugs,and draw complex network diagram,showing Professor Li Jiageng’s clinical medication law of chronic gastritis.Result 1.Professor Li Jiageng’s academic thoughts and contributions:(1)advocating Zhongjing,exploring and seeking for concealment: he has edited a large number of works related to Zhongjing from a macro perspective,and summarized Zhongjing’s thoughts from six classics differentiation and treatment as the core of his thoughts,integrating cold and temperature,teaching hundreds of schools,and summarizing Zhongjing’s thoughts from the aspects of theory,method,prescription and medicine;from a micro perspective,he has examined the connotations of "Fu","news" and "removing Zhong" in Treatise on febrile diseases,and verified Wang Shuhe’s life,This paper analyzes the syndrome of Xiaochaihu Decoction,which is not half exterior and half interior syndrome(disease location,qualitative analysis,clinical practice),and discusses the toxic effect of insect medicine,warming dryness medicine(aconite,Pinellia ternata)used by Zhongjing and its taboo.(2)The author points out that 397 is the essence of Zhang Zhong-jing’s syndrome differentiation and treatment,and also the important ideological source of clinical syndrome differentiation and treatment.(3)Tracing the source of medical theory and advocating spatiotemporal mathematics and Physics: expounding Zhongjing theory from the perspective of the book of changes,advocating the unique thought of spatiotemporal mathematics and physics in medicine,expounding physiology,pathology,symptoms,syndrome differentiation,transformation and prognosis,etc.,reflecting the overall thought and the viewpoint of constant motion of traditional Chinese medicine,which is conducive to the cultivation of clinical thinking.(4)The six meridians and the treatment of serious diseases: the treatment of six meridians is fundamental,which is combined with the prescription of the syndrome,the addition and subtraction of the syndrome,the selection of the prescription according to the mechanism and the treatment of the disease.(5)Syndrome differentiation of six meridians,syndrome differentiation of viscera,syndrome differentiation of Wei Qi Ying Xue,syndrome differentiation of Dialectics of Qi,blood and body fluid syndrome differentiation of triple energizer,syndrome differentiation of eight principles,etc.are organically integrated and used in combination with multiple methods.With the integration of cold and temperature,we can learn from hundreds of schools and treat flexibly.(6)To explore the idea of rescuing and guiding according to the situation: To summarize the application of Zhongjing exploratory method in disease diagnosis,exploratory treatment and prognosis judgment;to divide the method of rescuing according to the situation into three parts: guiding according to the condition,guiding according to the position and guiding according to the nature of the disease;to use the method of rescuing and reversing the cause of disease,optimizing treatment and preventing transmission.And use these methods to guide clinical practice,treatment of nasopharynx malignant tumor fester,hematoma and so on.2.Thoughts and experiences of clinical syndrome differentiation and treatment.(1)Emphasizing the differentiation and treatment of six meridians and expanding the application of meridians.(1)Xiaochaihu Decoction plus subtraction in the treatment of acute fever: Based on syndrome differentiation of six meridians,combined with syndrome differentiation and disease differentiation of weiqiyingxue,Xiaochaihu Decoction plus subtraction.According to the syndrome of wind heat invading Wei,Shaoyang Yangming combined with Qi Fen heat excess and Sanjiao pathogenic heat dampness,it is treated with viral hepatitis,cholecystitis,pneumonia,tumor,otitis media,rhinitis,lymphadenitis and other diseases.(2)Meridians mainly cooperate with Pueraria and Uncaria six meridians to treat vertigo: wind,cold,dampness and other evil Qi attack,or phlegm,water,blood stasis stop gathering,or qi,blood,body fluid and yin-yang imbalance in meridians and viscera as the main pathogenesis;advocate six meridians syndrome differentiation as the main,meridians and time prescription cooperate with Pueraria and Uncaria,and increase or decrease with the syndrome.Pueraria 20 g and Uncaria 15 g were used as a pair of drugs to cure many vertigo,safe and effective.(2)This Qi,blood,body fluid,yin and yang can be used flexibly according to time and experience.(1)The main pathogenesis of deafness is Qi stagnation and blood stasis,deficiency of essence and Qi,which involves five internal organs;the main treatment is filling essence,regulating qi,harmonizing blood,harmonizing body fluid;the treatment is based on the empirical formula and the appropriate medication according to age and gender.(2)Treatment of nephrotic syndrome by regulating the essence of viscera: the pathogenesis is closely related to the essence of viscera,blood and body fluid,especially the spleen,kidney and lung.The treatment is based on regulating the spleen,kidney and lung.Liuwei Dihuang Decoction and Yougui Pill were selected to fill the kidney essence;Bazhen decoction was added to replenish the spleen and stomach qi and blood,invigorate the circulation of Zhongzhou;yinqiao powder and Mahuang Decoction were used to relieve the external symptoms and eliminate the pathogenic factors;the methods of soothing the liver and regulating the spleen,nourishing the blood and heart,promoting the circulation of Sanjiao and bladder were used.(3)The treatment of trigeminal neuralgia by regulating qi and blood Yin and Yang: the invasion of external pathogens,stagnation of liver qi,blood stasis and blocking collaterals,or the loss of Yang and hyperactivity of yin and Yang collaterals are the main causes and pathogenesis;the basic treatment is eliminating pathogenic factors and dredging collaterals,and regulating qi and blood Yin and Yang;the common prescriptions are Chaihu Shugan powder,Siwu Decoction and Zhuzheng powder.(4)The treatment of myasthenia gravis with Mahuang Shengma Decoction and the method of reducing hair and increasing Yang Qi: the pathogenesis is closely related to the deficiency of Qi and blood in viscera such as the attack of evil Qi,weakness of spleen and stomach,deficiency of kidney yang,etc.;the main treatment is warming the spleen and kidney,warming the Yang and clearing the heat;the main treatment is Mahuang Shengma decoction combined with Liuwei Dihuang Decoction and Bazhen decoction. (5)Danggui Shaoyao Powder Plus and minus the treatment of dysmenorrhea: stagnation of liver qi,stagnation of Qi and blood stasis,or cold coagulation of blood stasis,or stasis due to deficiency as the main pathogenesis;Shugan Jianpi,Yangxue Tiaojing as the main treatment;Danggui Shaoyao Powder,Sini Powder or Chaihu Shugan powder as the main treatment.(3)Syndrome differentiation and treatment based on the theory of internal and external pathogenic factors: heat,dampness,phlegm,blood stasis and depression are the main pathogenesis.Dampness heat and qi depression are the first diseases,which can cause Qi deficiency,yin deficiency,blood stasis and phlegm obstruction.Clearing away heat and dampness,removing blood stasis and phlegm are the main therapeutic methods.The lung nodule is mainly composed of qingfeire,which is often supplemented and reduced by yinqiao powder or Wuwei Xiaoxiao Decoction;the breast lump is mainly composed of qingzhongjiao damp heat,which is often supplemented and reduced by Banxia Xiexin Decoction.With the syndrome with phlegm,warm yang,loose knot,Jieyu,Huayu and other methods of treatment.(4)Seeking the root of the disease and treating it with multiple methods.(1)He Tiao five viscera therapy for infertility caused by gene defects: five viscera and six viscera can cause infertility,not only kidney;Chinese medicine can cure some gene defects,polycystic ovary syndrome caused by infertility.Treatment is often flexible according to the patient’s physique,with different emphasis.It can be used to treat kidney,liver,spleen and stomach,lung and kidney,spleen and kidney.For example,jiebiao Sanxie is used to treat the lung;Qingre and dehumidification,Yiqi and Jianpi,Liqi and stomach are used to treat the spleen;Shugan Jieyu,Yangxue Tiaojing are used to treat the liver;Yin and yang are used to treat the kidney;blood and fire are used to treat the heart.(2)Elimination method,supplement method and temperature method are the main treatments for coronary heart disease: coronary heart disease is based on deficiency of yin and Yang of Qi and blood,and the heart vessels are blocked by dampness,heat,cold,phlegm and stagnation;xiaobuwen is the main treatment,which includes warming heart Yang,nourishing qi and Yin,eliminating phlegm and blood stasis and depression;Gualou Xiebai Banxia decoction,Shengmai Decoction,Erchen decoction,Wuling powder and Xuefu Zhuyu decoction are selected along with the syndrome.(3)The method of Promoting Yang and invigorating spleen to treat infant colic: the main pathogenesis is depression of middle Qi,stagnation of liver Qi or cold coagulation of liver vein;the main treatment is invigorating qi and Promoting Yang,invigorating spleen and nourishing blood;the main prescription is Buzhong Yiqi pill combined with Baohe Pill.(5)Flexible use of secret prescriptions(1)Treatment of nasopharynx malignant fester by syndrome differentiation: heat,toxin,stasis and obstruction of nasopharynx are the main pathogenesis of nasopharynx tumor and other malignant diseases;three methods,namely,clearing,tonifying and eliminating,are the main treatment methods;trial method,antidote method and taking advantage of the circumstances are flexibly used;Jiedu Huayu decoction and insecticidal quchuang formula are self-made prescriptions,which have better therapeutic effect on nasopharynx malignant fester.(2)Li’s Tuihuang Decoction plus five reduction and three differentiation treatment of jaundice: heat,toxin,dampness,stasis and stagnation are the main pathological factors;heat,toxin,dampness,stasis and stagnation are combined,qi stagnation and blood stasis,liver loss and drainage,abnormal bile secretion and excretion and jaundice are the main pathogenesis;heat release,detoxification,diuresis,stasis elimination and qi circulation are the main treatment methods;Sanjiao syndrome differentiation,weiqiyingxue syndrome differentiation and disease differentiation treatment are combined;Li’s Tuihuang Decoction It is the effective experience party.(3)Jiedu Huayu Decoction treats gout according to the theory of heat,toxin and blood stasis: heat,toxin and blood stasis are the basic pathogenesis of limb joints;detoxification and blood stasis are the main treatment methods;experience prescription "Jiedu Huayu Decoction" is the main prescription,with obvious effect.(6)Prescription medicine should be avoided,increasing efficiency and reducing toxicity:(1)When using medicine,it should be light and smooth,avoid abusing warm tonic,over tonic is toxic,such as ginseng,etc.;do not waste food because of choking,some strong or toxic drugs can also be used as tonic,such as aconite and Asarum can be used as tonic.Use it carefully to increase efficiency and reduce toxicity.(2)Disease experience: small prescription and special medicine are suitable for use,and can increase efficiency and reduce toxicity.(3)It can reduce the occurrence and recurrence of the disease.3.Experience in differentiation and treatment of spleen and stomach diseases(1)Characteristics of syndrome differentiation and treatment of spleen and stomach disease:(1)Treatment of dampness,heat,toxin and blood stasis,taking into account both the specimen and the specimen;(2)Differentiation of tongue,adjusting cold and heat;(3)Treatment of heavy mucous membrane repair,detumescence and muscle growth;(4)Treatment of stomach,spleen and liver as tonic,combined with tonic;(5)Reuse of time,integration of cold and temperature,and integration of hundreds of schools.(2)Examples of experience:(1)Treatment of gastric cancer metastasis complicated with jaundice by deficiency of heat,toxin and dampness and stasis: the main pathogenesis is the combination of Qi,phlegm,stasis and toxin.In the early stage,liver qi stagnation and spleen stomach Yang deficiency are common;in the middle stage,dampness and turbid endogenesis,blood stasis and phlegm coagulation are common;in the late stage,stomach heat and Tianjin injury,Qi and blood deficiency,blood stasis and toxin internal obstruction are main.The main treatment method is to treat Fuzheng and Quxie,clear away heat and dampness,detoxify and remove blood stasis.(2)Xinkaikujiang in the treatment of postoperative complications of gastric cancer: xinkaikujiang is the main treatment method,and Banxia Xiexin Decoction Combined with Huoxiang Zhengqi powder and Danshen Decoction are added and reduced.(3)On the treatment of gastroesophageal reflux based on the principle of deficiency,qi stagnation,phlegm coagulation,blood stasis and fire depression;the main treatment method is to strengthen the body and eliminate pathogenic factors,with the increase and decrease of symptoms.(4)The treatment of old people’s habitual constipation by the combination of qingbuxiao and syndrome differentiation: Yin deficiency liquid drying up,Qi deficiency and blood loss,Yang deficiency and Yin coagulation,gastrointestinal dryness and heat,qi stagnation and food stagnation and obstruction of circulation and descending are the main pathogenesis;qingbuxiao three methods are the main treatment;the treatment includes qingfeire,qingshuire,buyin,Buyang,Buqi,Buxue,xiaoyuxue,xiaoshiji and xiaoyuqi.(5)Treatment of Crohn’s disease with dampness and heat stagnation of the intestine: dampness and heat stagnation of the intestine,weakness of the spleen and stomach,and the formation of deficiency and excess in blood stasis are the main pathogenesis;clearing heat and removing dampness,supplementing qi and strengthening the spleen,activating blood and removing stasis are the main treatment methods;Xijiao Dihuang Decoction and Shihui powder are the main prescriptions.(6)Syndrome differentiation and treatment of ulcerative colitis by the combination of jingshifang: the basic pathogenesis is the deficiency of Qi and blood.Clearing heat and detoxification,removing blood stasis and removing dampness are the main treatment methods,and it is necessary to regulate the Yin and Yang of blood,body fluid,etc.Commonly used prescriptions include Wumei Pill,the root of Chinese pulsatilla decoction,Shihui powder and so on.(7)Wumei Pill can treat irritable bowel syndrome by adding and subtracting: the etiology and pathogenesis can be caused by emotion,diet,fatigue,cold and damp,damp and heat,etc.,which leads to the disorder of intestinal Qi mechanism and the loss of conduction;the common treatment is to soothe liver and spleen,replenish qi and blood,remove dampness and clear heat;Wumei Pill,Huoxiang Zhengqi powder,Tongxie Yaofang,Chaihu Shugan powder,etc.(3)Data mining results of chronic gastritis(1)Among the 719 patients,women were significantly more than men;(2)Epigastric distention,epigastric pain,acid regurgitation and belching were the common complaints;(3)Red tongue,yellow fur and stringed pulse were the main tongues;(4)Qi stagnation,blood stasis,damp heat,blood deficiency and Qi deficiency were the main pathogenic factors;(5)The core syndrome was divided into six types,most of which were spleen stomach damp heat,liver stomach disharmony.(6)Commonly used prescriptions: Banxia Xiexin Decoction,Huoxiang Zhengqi powder;Erchen decoction,Huanglian Wendan Decoction;Danshen Decoction;Chaihu Shugan powder,Xuanfu Daizhe Decoction;Danggui Shaoyao Powder,etc.(7)Commonly used Chinese medicine: raw licorice,tuckahoe,tuckahen,Coptis,Scutellaria,Huoxiang,Peilan,pinellia ternata,Danshen,red peony,Bletilla,chuanxiong,yanhusuo,cuttlebone,etc.(8)Core drug pairs: Peilan → Huoxiang,Baiji → cuttlebone,stir fried malt → stir fried corn bud,citron → bergamot,white peony → red peony,tuckahen → Poria cocos,Coptis → faban pinellia,Scutellaria → Coptis,etc.(9)The core drugs were clustered into four new prescriptions: Huoxiang-Peilan-The root of Chinese pulsatilla-fried Atractylodes Rhizoma-Poria cocos-Fu Shen;Huoxiang-pinellia ternata-Huanglian-Scutellaria-cuttlebone-Baiji;kudzu-Uncaria-Huoxiang-The root of Chinese pulsatilla-Huanglian-Huangqin;Honeysuckle-Forsythia-Dandelion-Huoxiang-The root of Chinese pulsatilla.(10)Syndrome syndrome relationship,syndrome prescription relationship,syndrome medicine relationship: for example,spleen and stomach dampness and heat,such as epigastralgia,epigastric distention,belching,epigastric burning and so on;often treated with Pinellia heart purging Decoction plus Huoxiang,Peilan and so on;mainly used Huoxiang,Peilan,Pinellia ternata,Coptis,Scutellaria and so on.(4)Experience in differentiation and treatment of chronic gastritis(1)Chronic gastritis is based on the weakness of the spleen and stomach,with damp heat and Qi stasis as the standard.(2)The disease is located in the stomach,involving the viscera;(3)Clearing away heat and dampness,soothing the liver and regulating the spleen,removing blood stasis and nourishing blood as the main method;(4)The majority of men are clearing away heat and dampness,while women are also nourishing qi and blood: it is related to life,diet,physiological law,psychological factors,disease transmission factors,etc.(5)With the help of harmonizing,eliminating,tonifying;(6)The combination of Jingshi formula and cold and temperature;(7)The treatment of viscera and viscera simultaneously,with the increase and decrease of syndrome(symptom);(8)Summarized the spleen and stomach disease test formula: Huoxiang,Peilan,FABANXIA,Huanglian,Huangqin,Chishao,Baishao,Danshen,chuanxiong,Baiji,cuttlebone,Chenpi,Buddha’s hand,etc.Conclusion 1.Typhoid academic thoughts:(1)Advocate Zhongjing and explore the hidden;(2)study and explain the great theory and adopt 397 methods;(3)Trace the medical theory and advocate the mathematical theory of time and space;(4)Six classics and righteousness,syndrome and treatment of serious diseases;(5)Typhoid miscellaneous diseases,round machine method;(6)Explore and rescue the adverse,and guide the thought due to snobbery.2.The thought of clinical syndrome differentiation and treatment:(1)Pay attention to six meridians differentiation and treatment,expand the application of meridians;(2)This Qi,blood,body fluid,yin and Yang,and the meridians can be used flexibly;(3)The theory of combining internal and external evils differentiation and treatment;(4)Seek the basis of disease treatment,and distinguish and treat with multiple methods;(5)Use the secret prescription flexibly,and treat both the specimen and the specimen;(6)The prescription should be avoided to increase efficiency and reduce toxicity.3.Experience in differentiation and treatment of spleen and stomach diseases(1)Characteristics of syndrome differentiation and treatment of spleen and stomach disease:(1)Treatment of dampness,heat,toxin and blood stasis,taking into account both the specimen and the specimen;(2)Differentiation of tongue,adjusting cold and heat;(3)Treatment of heavy mucosa repair,detumescence and muscle growth;(4)To pass the stomach,protect the spleen,disperse the liver as the supplement,both the elimination and the supplement;(5)Reuse of time,integration of cold and temperature,and integration of hundreds of schools.(2)Chronic gastritis syndrome differentiation and treatment experience:(1)chronic gastritis is based on the weakness of the spleen and stomach,with damp heat and Qi stasis as the standard;(2)The disease is located in the stomach,involving various viscera;(3)Clearing heat and removing dampness,soothing the liver and regulating the spleen,removing blood stasis and nourishing blood as the main treatment method;(4)Men are more clear of damp heat,women are also nourishing qi and blood;(5)Harmony and facilitation are used,with elimination as the supplement;(6)Meridian is used together,with cold and temperature in the same tune;(7)Viscera are treated simultaneously,with syndrome(symptom)increasing and decreasing.(8)The medicine changes with the syndrome.The innovations of this study are as follows: 1.Summarizing the time and space mathematical view of Professor Li Jia-gengon the combination of typhoid fever and Yijing;exploring and rescuing the adversity,and guiding the typhoid fever according to the situation.2.This paper summarizes the thought of clinical syndrome differentiation and treatment,and the clinical experience of secret test prescription.For example,"Jiedu Huayu Decoction","insecticidal quchuang Decoction" and "Li’s Tuihuang Decoction",to some extent,reflect the characteristics of differentiation and treatment of Professor Li Jia-gengand the characteristics of medication.3.This paper summarizes the characteristics of syndrome differentiation and treatment of spleen and stomach diseases,such as clearing stomach,protecting spleen,dispersing liver,eliminating and supplementing both;paying attention to tongue diagnosis and microscopic examination,and spleen and stomach;paying attention to the characteristics of syndrome differentiation and treatment of spleen and stomach diseases,such as mucous membrane repair;4.Mining out four new prescriptions of core drug clustering of chronic gastritis;summarizing the characteristics of syndrome differentiation and treatment,such as spleen and stomach weakness as the basis,damp heat and Qi stasis as the standard,and harmonizing,eliminating and supplementing. |
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