| Objective:The academic thoughts and clinical experience of the prominent TCM doctors is the fortune of TCM. It is still a express problem how to inherit and propagate the thoughts of the prominent TCM doctors. Professor Yan Huimin, chief physician and doctoral Supervisor of Beijing Children’s Hospital Affiliated to Capital Medical University, is the national five-batch guidance teacher of academic experience inheritance of old experts in TCM. Professor Yan has been working for 40 years and collected plentiful clinical experience about digestive and respiratory system Disease. Through endoscopy, pathology and detection of helicobacter pylori, combined with TCM syndrome differentiation of gastritis peptic ulcer in children, Professor Yan successfully research and development the chinese patent medicine named Weiping Chongji. Based on "diarrhea prescription" of teacher Wang Pengfei, Professor Yan has led team developed yunpizhixie granules to treat diarrhea of spleen deficiency. It had great significance to inherit, excavate, spread and exchange academic thought and clinical experience of Professor Yan Huimin.This study was to explore academic thought origin of Pediatrics of TCM from Professor Yan Huimin, summarize the characteristics and clinical experience. Through case studies of Henoch-Schonlein purpura(HSP) in children combined with Helicobacter pylori(HP) infection, we were trying to find a effective treatment for recrudescent HSP.Method:By following the clinic, we collected patients’ date, summarized the notes, recorded the typical cases in detail. Also we read up again"the Canon of Internal Medicine", "Treatise on Febrile Diseases", "Key to Therapeutics of Children’s Diseases" and "the collection of diagnosis and treatment of pediatric cases". Through retrieval literatures, we made a preliminary summary on the academic thought of Professor Yan. Selected 140 HSP cases combined with HP infection syndrome of endoretention of damp toxin, divided into western medicine and the combination therapy groups, and observe the situation for treatment of HSP recurrence, statistical analysis, trying to find effective way to reduce HSP recurrence.Results:This thesis is divided into three parts.Part Ⅰ Ideological Origins of Yan Huimin’s academic OverviewProfessor Yan Huimin graduated from the Beijing University of Chinese Medicine, worked in Beijing Children’s Hospital of Chinese tradition medicine department for years and advanced studied again in University for one year. Then she followed teacherWang Pengfei, thepediatric King to improveclinical experience. She becamethe first batch heir of academic experience inheritance of old experts in TCM and then followed famous Chinese pediatricians directo rLiu Yunyuan for deep study. Finally, she gradually formed her own clinical experience and treatment characteristics in 40-year medicine career.Part II academic thought and clinical experience of Yan Huimin1.Summary the academic thought and features of teacher Yan Huimin:Teacher Yan paid attention to find the cause of disease and formed the academic thought of wholistic therapy, differentiate treatment and combining diseases with syndromes according to pathogenic factors. Teacher Liu specialized "Treatise on Febrile Diseases" as a model for the combination of syndrome differentiation and disease differentiation. Teacher Yan inherited it and took advantage of modern technology to made an in-depth study about macroscopic and microcosmic syndrome differentiation of gastrointestinal disease and pediatric endoscopic features. Children’s spleen is always insufficient, so teacher Yan more often protected the spleen and stomach. It laid the academic thought of "pay attention to the stomach". Teacher Liu believed that children were not miniature adults. Gradually academic thought of "paying attention to the physiological and pathological features of children" was formed. Pediatrics commonly known as "dumb subjects". Liu’s attention was particularly in the inspection of tongue and was inherited by teacher Yan. Disease among children were always intermingling cold and heat, deficiency syndrome mingling with excess syndrome. Cold and heat medicine were used together in clinic. Also the use of paired herbs was the inheritance of Liu’essence as its joint action to medicine efficacy.2.Summary of Yan Huimin’s clinical experienceTeacher Yan had many effective treatments for common pediatric diseases. Children gastritis were usually due to eating fatty-sweet and oleaginous food, and more common with hot-humid syndromes. Treatment was removing heat to expel damp, regulating qi to chime the middle. Pediatric asthma was oriented in qi deficiency in lungs, spleen and kidney. The su-root of insidous phlegm was the secondary cause. We could treat from lung, spleen and kidney. So the therapeutical principle was invigorating spleen to eliminate dampness, relieve cough and reduce sputum. HSP happened mainly with wind, heat, wet (poison), blood stasis and deficiency with the main syndrome was endoretention of noxious dampness. Therapeutical principle wasdetoxification and promoting urination, promoting the circulation of qi and remove obstruction.Recurrent respiratory tract infection had four types:the disharmony between Ying and Wei type, the lung and spleen Qi deficiency type, the deficiency of both vital energy and yin type, the heat accumulation in lung and stomach type with the treatment of strengthening body resistance and consolidating superficies. The key of functional constipation’s syndrome differentiation was asthenia and sthenia.Heat constipation and Qi-stagnation constipation were sthenia syndrome while cold constipation was asthenia syndrome. It should pay attention to in simultaneous treatment of endosyndrome and exosyndrome, simultaneous tune of liver and spleen when medication. Adenoidal hypertrophy was usually due to phlegm accumulating with stagnant blood, and with the treatment of activate spleen-energy and disperse blood stasis. Treatment of diarrhea due to damp-heat type was eliminating dampness by cooling and invigorating spleen to top diarrhea. Recurrent chalazion, should also nourish blood to restore normal meridians, regulate activities of qi. Obliterative bronchiolitis should open lung and activate closePart Ⅲ Clinical observation of therapy that detoxification and promoting urination, promoting the circulation of qi and remove obstruction on HSP complicated with Hp infection with syndrome of endoretention of damp toxin from Professor Yan HuiminConbined treatment of TCM and western medicine in HSP and Hp infection were reviewed in this paper.Clinical studies designed to investigate the academic experience of teacher Yan in treating HSP combined with Hp infection.This study selected 140 cases of eligible patients with HSP merger Hp infection (internal accumulation of toxic dampness).They were randomly divided into two groups, the control group (Western) and the treatment group (western medicine and Chinese medicine prescription of detoxification and promoting urination, promoting the circulation of qi and remove obstruction). Statistical analysis of clinical efficacy and relapse rate were used to research the clinical experience of teacher Yan.Results:the efficiency and HP darkening ratio of treatment group were same with control group. Long-term follow-up study for two months, the recurrence rate of the treatment group was significantly lower than that of the control group with statistical significance.Conclusion:Detoxification and promoting urination method to treat allergic purpura with helicobacter pylori infection with syndrome of endoretention of damp toxin reduce the recurrence. Detoxification and promoting urination method to treat helicobacter pylori infection with the extension of time is on the decline, and can be a long time to suppress helicobacter pylori.Significance:Through the three years of following professor Yan Huimin’s study and exploring the academic thought, I tried my best to understand the academic thoughts and organize the valuable clinical experience while studing the classics ancient books. First of all, it was an effective method to rescue TCM resources to save, excavate and sort out the academic thoughts and clinical experience of the old Chinese medicine. It was a valuable learning opportunity and an effective way even a shortcut to grow of great significance for young doctors to inherit the academic thought and clinical experience of old Chinese medicine. |
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