| The study mainly discuss the theory system and clinical application of formula corresponding to syndromes from stable angina as the starting point.It will clarify the original content and using method of it, which will promote the level of syndrome differentiation.Theory study1. History of formula corresponding to syndromes (1) The formation of the theory mainly include prototype stage before Han Dynasty, sublimation stage of late Eastern Han Dynasty and the following improving stage; (2) People recorded what them sawn and listened during the medical activities in prototype stage; (3) In sublimation stage, treatise on febrile diseases written by Zhang Zhong-jing found out the relationship between structure fixed prescriptions which used more often and symptoms and signs; (4) Doctors after Han Dynasty repeated and verified the truth of classical prescriptions and the theory of Formula Corresponding to Syndromes.They also developed and improved the theory.2. The connotation of formula corresponding to syndromes (1) There are so many prescriptions in TCM, we should better study classical prescriptions in treatise on febrile and miscellaneous diseases; (2) The connotation of "Zheng" is indication, which is collected from the clinical trials researched on people in Ancient times and plays a great important role in diagnosises.3. The principle of formula corresponding to syndromes (1) Formula-syndrome principle:set prescriptions is choosed when the clinical manifestations of the disease is same to it. (2) Chinese herb-syndrome principle:We should the compositions of the set prescriptions according to the herb-syndrome principle when the clinical manifestations of the disease is not identical to it.(3)Dose-syndrome principle:The effection of the chinese herb varies when the dose is changed. (4) Formula combination principle:Prescriptions are combined when one prescription can not treat the disease only. (5) Associated formula principle:not only the similarities should be grasped, but also the specificity should be distinguished by the formula-syndrome principle and chinese herb-syndrome principle, when the clinical manifestations are the same among several formula. 4.The characteristics of formula corresponding to syndromes (1) It is based on clinical experience and classics; (2) Indication is the connotation of the theory which contains symptom-sign, disease and constitution and manifests formula-syndrome and Chinese herb-syndrome? (3) It manifested as intuitive judgments and jumping characteristics in treating diseases, which pointed out the relationship between the disease and prescriptions.5.The using methods of formula corresponding to syndromes (1) First, choose formula according to symptoms and signs, test and verify them according to herbs then; (2)First, choose herbs according to symptoms and signs, select the formula according to herbs then? (3) Choose herbs and formula according to the fondness of five tastes.6.The therapeutic effect evaluating of formula corresponding to syndromes (1) The effect contains disease, TCM syndromes, symptoms and signs, subjective feelings and so so.Not only the therapitic effect should be achieved, but also the adverse reactions should be diminished the more the better. (2) The taste of the formula represents the correct level of the treatment.(3) Adverse reactions is related to the level of formula not corresponding to syndromes.7.Discrimination between Clinical Medication Based On Pathogenesis and Formula Syndrome (1) Connotation differentiation:The former focuses on the identification of pathogenesis such as Zheng, the latter focuses on the identification of formula-syndrome. Zheng is drew by subjective speculation, which is abstract and uncertain.The formula-syndrome is signs and syndromes, which is objective and certain. (2) Clinical differentiation:The former targets pathogenesis, but the latter targets the formula-syndrome. The most significant difference between them is whether giving attention to the objective evidences of formula utilization. (3) There are certain historical origin and practical realistic reasons in the desalination of clinical medication based on formula syndrome. Syndrome differentiation and treatment degenerates after Ming Dynasty. We did not pay more attention to the shortcomings of it more carefully. (4) Giving attention to the objective evidences of formula utilization is the keys to clinical medication. 8.The research sence of formula corresponding to syndromes contains deepening the thinking mode of Syndrome differentiation and treatment, specificate TCM and challenge the ailments and critical illness.Clinical study1. Objective and sense The clinical study in which stable angina patients diagnosed by turbid phlegm and blood stasis in TCM will accept the treatment of Danlou capsule and Shenshao capsule can reflect the effect of treatment of formula corresponding to syndromes according to the theory study.2. Material and Methods Choose 63 patients according with diagnostic standard in Guang'anmen hospital afflicted to China Academy of Chinese Medical Sciences, Anzhen hospital afflicted to Capital University of Medical, First Affiliated Hospital of Henan College of Traditional Chinese Medicine and Hubei General Hospital. Half of them belong to treatment group (DL group), the others belong to the control group (SS group).The former is treated by Danlou capsule and Shenshao simulation agent capsule, the latter is treated by Danlou simulation agent capsule and Shenshao capsule. Make sure that the age and gender distribution, state of the illness of the four groups not different and comparable by statistical analysis. After four weeks of treatment (one period treatment), observe and compare the symptoms of the patients before and after the treatment, angina curative effect, TCM syndrome curative effect, ECG curative effect, physical and chemical indicators curative effect, blood pressure, Rhythm, Heart rate, Liver and kidney function, Blood glucose and blood lipid.3. Results3.1 Angina curative effect:The curative effect of angina integral in DL group before the treatment is superior to effect after the treatment. The curative effect of angina integral in SS group before the treatment is not significant as the effect after the treatment in statistics.The difference between two groups is not significant in statistics before the treatment, but it is significant in statistics after the treatment, P<0.01. The total effective rate of DL group is78.57%, the other is 42.86%, which indicates that the curative effect of DL group is better than SS group.3.2 TCM syndrome curative effect:The curative effect of TCM syndrome in DL group before the treatment is superior to effect after the treatment, which is the same as the SS group. The difference between two groups is not significant in statistics before the treatment, but it is significant in statistics after the treatment, P<0.01. The total effective rate of DL group is75.00%, the other is 35.71%, which indicates that the curative effect of DL group is better than SS group.3.3 ECG curative effect:The change in DL group is not significant before and after the treatment.Only one aggravated in SS group.3.4 physical and chemical indicators curative effect:The curative effect of physical and chemical indicators curative effectsuch as CRP,sCD40L,MMP-9,MPO in DL group before the treatment is superior to effect after the treatment, which is the same as the SS group. The difference between two groups is not significant in statistics before the treatment, but it is significant in statistics after the treatment.4. Conclusion:The curative effect of formula corresponding to syndromes can not only be reflexed by disease and TCM syndrome in macro-level, but also be reflexed by physical and chemical indicators in micro-level. Angina pector is related to inflammatory cytokines and plaque stability factor, the change of which is good when treated by the theory. It also illustrate that Danlou capsule can inhibit the inflammatory response and stabilize the plaque. |
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