Experience And Clinical Application Of The Master Of Chinese Medicine-the Differentiation And Treatment Of Rheumatoid Arthritis With Cold Syndrome By Professor Zhou Zhongying

Research purposes:(1)Based on the outpatient medical records of Professor Zhou Zhongying who has been treating rheumatoid arthritis with cold syndrome for many years as the basic data,use data mining and statistical analysis to study the medical case,and explore the thoughts of Professor Zhou Zhongying in treating rheumatoid arthritis、Medicine experience,summarize,sort out,and refine the academic thoughts of Professor Zhou Zhongying in treating rheumatoid arthritis with cold syndrome,in order to facilitate clinical application,and lay a foundation for further improving the curative effect of clinical treatment of rheumatoid arthritis with cold syndrome in Chinese medicine.(2)Using Professor Zhou Zhongying,s main treatment methods and prescriptions for the treatment of rheumatoid arthritis with cold syndrome,observe and study the curative effect and verify the exact effect of the cureResearch methods:(1)Collect and sort out all the outpatient medical records of rheumatoid arthritis with cold syndrome diagnosed and treated by Professor Zhou Zhongying from 1985 to 2014,and select them according to the inclusion and exclusion criteria.Finally,1 14 cases will be included,and a medical records database will be established.Association rules and other methods are used to study the regularity between symptoms,tongue,pulse,pathogenesis,and prescriptions in medical records,and combine analysis with Professor Zhou Zhongying’s clinical experience in rheumatoid arthritis.(2)Adopt the academic thought of Professor Zhou Zhongying for the treatment of rheumatoid arthritis with cold syndrome,and treat 30 cases of rheumatoid arthritis with bi syndrome due to wind cold and dampness.Oral Chinese medicine decoction,one dose daily,30 days as a course of treatment.The pain visual analogue scores(VAS)and TCM syndrome scores of patients were collected before treatment,after 1 month,2 months,and 3 months,and rheumatoid arthritis disease activity was collected before and after 3 months of treatment.The index Disease Activity Score-28(DAS28)and the traditional Chinese medicine symptom evaluation standard are used to determine the curative effect,observe the treatment effect,use Excel2016 and SPSS 24.0 software analysis package to analyze the data before and after treatment,and then analyze the changes in curative effect.Research results:(1)Medical record research A total of 50 patients with r-heumatoid arthritis with cold syndrome,including 10 male patients and 40 female patients,aged 22-69 years old,average 48.07±10.35 years old,with 114 consultations.Symptoms of higher frequency in all consultations were limb pain,fear of coldness,joint stiffness,joint swelling,sweating,chills,poor flexion and extension,joint pain,and fear of wind,accounting for 61.40%,29.82%,20.18%,15.79%,14.91%,13.16%,12.28%,11.40%,10.53%.The main tongue is thin moss,thin greasy moss,dark and light.The main pulse is thin,stringy and slippery.The disease’s location in viscera are mostly in the kidney and liver.The pathological factors are mainly dampness,wind,cold,sputum,and stasis.The disease pathogenesis is mixed,the excess pathogenesis can be summarized as bi syndrome due to wind cold and dampness,phlegm and blood stasis,and the deficiency pathogenesis can be summarized as kidney yang deficiency,liver and kidney deficiency;124 drugs were used in all consultations,of which the type and frequency of rheumatism drugs were the highest,and the drug with the highest frequency was Qingfengteng,followed by the medicine for tonifying deficiency,and the highest frequency was Huangqi.Association rule research shows that the combination with higher symptoms is low back pain and limb pain,aggravation of cold and limb pain,joint deformation and limb pain,limb cold and limb pain,morning stiffness and limb pain,numbness and joint pain,joint swelling and joint pain,joint stiffness and joint pain,uncomfortable flexion and extension and joint pain;the combination of higher degree of tongue image is dark purple and thin greasy moss,little purple and thin moss,Light purple and thin moss,light purple and thin moss,tooth marks and thin moss;the combination with high pulse correlation are thin and stringy,thin and slippery;the combination with high pathogenesis is bi syndrome due to wind cold and dampness,Phlegm and blood stasis obstruction,bi syndrome due to wind cold and dampness and liver and kidney deficiency;phlegm and stasis obstruction and liver and kidney deficiency;the most commonly used drug combinations are guizhi,huangqi,xixin,and chuanwu.(2)Adopt Professor Zhou Zhongying’s academic thoughts of treating rheumatoid arthritis with cold syndrome and the main treatment methods were used to treat 30 patients with rheumatoid arthritis with bi syndrome due to wind cold and dampness.After 1 month of treatment,2 months of treatment,and 3 months of treatment,the VAS scores of patients were significantly lower than before treatment(p<0.01);the DAS28 score of patients after 3 months of treatment was significantly lower than before treatment(<0.01);after 1 month of treatment,2 months of treatment,and 3 months of treatment,the patients had joint pain The score,joint swelling score,joint tenderness score,aversion to wind and cold score,waist and knee softness scores,every TCM symptoms are reduced to different degrees than before treatment;The total scores of TCM syndromes were significantly improved than before treatment(p<0.01);after 1 month of treatment,the total effective rate was 33.33%,10 cases were effective,0 cases were markedly effective,20 cases were ineffective.After 2 months of treatment,the total effective rate reached 96.67%,of which 27 cases were effective,2 cases were markedly effective,and 1 case was ineffective.Compared with the data after 1 month of treatment,the total effective rate was increased,and the difference was statistically significant(p<0.01).After 3 months of treatment,the total effective rate reached 96.67%,of which 18 cases were effective,11 cases were markedly effective,and 1 case was ineffective.Compared with the data after 1 month of treatment,the total effective rate was increased,and the difference was statistically significant(p<0.01)Research conclusion:(1)Professor Zhou Zhongying’s main symptoms of treating patients with RA of cold syndrole are limb pain,fear of coldness,joint stiffness,joint swelling,sweating,chills,poor flexion and extension,joint pain,fear of wind,etc Pain is the most frequency symptom,and the disease always belongs to the deficiency and reflect the excess;the dificiency syndromes are the deficiency of qi and blood,the deficiency of liver and kidney;the excess are reflected by wind,cold,dampness,phlegm,and blood stasis.Mainly treatment include expelling wind,removing dampness,clearing away cold,activating collaterals,resolving phlegm and removing blood stasis,stagnation and collaterals,nourishing qi and nourishing blood,and nourishing liver and kidney.There are many rheumatism drugs on the type of medication,supplemented by qi and blood drugs to help tonifying,especially the us.e of rattan drugs,blood circulation and stasis drugs,phlegm drugs,worm drugs,and the core of the "pathogenesis syndrome" It can be summarized into three principles and basic prescriptions.The pathological factors such as wind,cold,and dampness are cured by expelling the wind,clear away the cold,removing the dampness and activating collaterals;Representatives include Mahuang jia shu tang,wutou tang,yiyiren tang,ma fu xixin tang,Yanghe tang,etc.Pathological factors such as phlegm and blood stasis are used to cure by treat phlegm,remove blood stasis,and remove stagnation,activate the collateral,Representatives include Qing zhou Baiwanzi fang and Tao hong yin.Deficiency of blood and liver and kidney deficiency are the main pathological treatments,such as tonifying,relieving the evil,treating the root cause and the target;main decoction are duhuo jisheng tang,juanbi tang,etc.(2)Using Professor Zhou Zhongying,s ideas for treating rheumatoid arthritis with cold syndrome to treat 30 patients of rheumatoid arthritis with bi syndrome due to wind cold and dampness,After 3 months of Chinese medicine decoction treatment,the patient’s pain level was significantly lower than before treatment,the disease activity was significantly lower than before treatment,the patient’s symptoms were significantly improved,and the quality of life was significantly improved.Observation results show that Professor Zhou Zhongying,s experience in treating rheumatoid arthritis deserves further clinical application.