Real World Study On Prof.Shen Chunti's Academic Thought Of TCM Threshold Treatment Based On Syndrome Differentiation

Objective:1 To discuss the feasibility of the real world study in the inheritance of famous TCM doctors' theory,and explore the standardability of experiment design,data collection and prescription analysis of real world study,so as to set up a model for the inheritance study of famous TCM doctors' theory.2 To explore the scientificity and clinical operability of Professor Shen Chunti's critical syndrome differentiation and treatment theory of "Disease-Syndrome-Type-Treatment",and to deepen the understanding of Professor Shen Chunti's critical syndrome differentiation and treatment theory.3 To study the real world treatment data of chronic bronchitis by Professor Shen Chunti and further interpret the clinical experiences and speculation characteristics of famous TCM doctors.Method:1 Literature research:To provide theoretical basis and method guidance for the inheritance study of famous TCM doctors' theory in the real world,the application of real world study in traditional Chinese medicine and the relationship between real world study and inheritance study of famous TCM doctors' theory were reviewed.2 Academic connotation of critical syndrome differentiation and treatment theory:The connotation of Professor Shen Chunti's theory of "Disease-Syndrome-Type-Treatment" was sorted,and the development process and specific operation of academic ideal were expounded in detail.3 Clinical practice of critical syndrome differentiation and treatment theory:Under the guidance of critical syndrome differentiation and treatment theory,the real world study of chronic bronchitis was conducted,including the consistency study of critical syndrome differentiation of "Disease-Syndrome-Type" in chronic bronchitis and analysis of real world treatment data of chronic bronchitis by Professor Shen Chunti.The clinical operability of Professor Shen Chunti's critical syndrome differentiation and treatment theory of"Disease-Syndrome-Type-Treatment" was verified through the consistency evaluation of different physicians applying the critical syndrome differentiation method.Shen Chunti's academic ideas and characteristics of medication in treating chronic bronchitis were interpreted by analysing real world treatment data of chronic bronchitis by Professor Shen Chunti.4 Network pharmacology research of core prescription:To provide ideas for the in-depth study of the inheritance of famous TCM doctors' experience,the mechanism of Professor Shen Chunti's core prescription in treating chronic bronchitis was studied using network pharmacology.Result:1 Literature research:The real world study is more in line with the clinical characteristics of traditional Chinese medicine,and can better show the diagnosis and treatment characteristics of famous TCM doctors in real world,and reflects the individualization and group characteristics of famous TCM doctors in the process of diagnosis and treatment.2 Critical syndrome differentiation and treatment theory of "Disease-Syndrome-Type-Treatment":The core of Professor Shen Chunti's theory of "Disease-Syndrome-Type-Treatment" lies in the differentiation of basic syndromes(basic information)of diseases firstly,and then the syndromes are classified into different types according to different specific indicators(symptoms).Treatments should be based on the relationship between pathogenic factors and healthy qi of disease and its development trend,and follow three principles:treatment of basic syndromes(diseases),treatment types(syndrome classification)and co-treatment of basic syndromes and types(disease and syndrome types).The basic syndromes have their corresponding basic formulae,and different types also have their corresponding basic formulae.When the basic syndromes and types co-exist,both should be considered.Based on the above understanding,24 critical syndrome differentiation standards of Professor Shen Chunti in pulmonary diseases have been preliminarily arranged.3 Clinical practice of critical syndrome differentiation and treatment theory:The consistency study showed that critical syndrome differentiation had good clinical maneuverability,and there was a high consistency of four diagnostic information discrimination and diagnosis between different physicians and different hospitals.According to the real world data,the core prescription of Professor Shen Chunti in treating chronic bronchitis is:Zhimahuang,Xingren,Huangqin,Zisuzi,Rafuzi,Zhebeimu,Qianhu,Zhiziwan.4 95 active ingredients and 71 targets of core prescription in chronic bronchitis treatment were obtained.Three targeted modules and the topological based hub targets were identified by MCODE and cytohubba algorithm,including EGFR,VEGFA,IL-6,CASP3,MYC,etc.The top 20 hub genes and module targets were mainly enriched in MAPK signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,P53 and TNF signaling pathway.Besides,the GO functions of response to stimulation,cell proliferation,immune system response,regulating cell growth and differentiation,reducing stress and inflammation,regulating immune reaction,and promoting airway remodeling and mucus hypersecretion were enriched by core prescription targets.Conclution:1 The real world study is feasible and worthy of further promotion in the study of the inheritance of the famous TCM doctors' experience.2 Clinical study showned that the core prescription improved the main symptoms of cough,expectoration,asthma and some specific symptoms in patients,and helped to reduce the acute attack of chronic bronchitis.Real world study of chronic bronchitis have shown that the critical syndrome differentiation and treatment theory has good clinical practicability,which reflects the Professor Shen Chunti's speculation characteristics of "accurate differentiation,different treatment of mark and essence,correspondence between prescription and syndrome",and can be used as an innovative method to guide the clinical syndrome differentiation and promotion of TCM.