| Professor Lu Zhi-zheng, National Chinese Medical Science Master, a famous Traditional Chinese Medicine (TCM) expert. He was born in TCM family, deep origin, and proficient in Chinese Classical, advocate of spleen and stomach and WenBingXue. He paid great attention to the TCM theory research of inheritance and innovation, and followed the holistic concept of TCM and the meridians and organs for the syndrome differentiation and treatment of syndrome differentiation system principle, formed " hold the central and transport the four sides, refresh the mood and emotion, adjust the ascend and descend of Qi, moisten dryness, carry the diet " system to recuperate academic thoughts of spleen and stomach. Lu Zhi-zheng is one of the founders of the subject, TCM rheumatism (bi syndrome, bi disease). He developed wet disease theory, proposed a "dry bi","postpartum bi" problems, formed dry bi theory, and promoted rheumatism discipline construction. He engaged in medical profession more than70years, had lofty medical ethics. It is important theoretical significance and practical applications to inheritance his academic thoughts and academic spirits.Following the advisor study three years, through my advisor vocal education, watching he treat patients and thinking, analysis of his clinical treating cases and using drugs pricipline, I have analyzed the information such as the mining technology, comb and summarizes the advisor thoughts of the rheumatism diseases treatment of spleen and stomach the theoretical basis. In inheriting my advisor thoughts of spleen and stomach, I would focused on the dry bi theory. I planed to carry out a Randomized controlled clinical trial, took primary Sjogren syndrome patients as the research objects, to evaluate the effectiveness and safety of the supplementing qi and nourishing yin treatment.The first part, Theorical ResearchFirst of the theorical research, Rgulate Spleen and Stomach therapy, academic thought and theory research of rheumatism disorders treatment1Aademic thoughts of Spleen and Stomach as the center of rheumatism disorders onset.According to spleen and stomach as the vital genesis of Wei, Qi, Ying, blood and body fluid; and spleen and stomach as the central of ascend and descend of Qi, he expounded the imbalance of spleen and stomach is the important factor of rheumatism lead to disease. He put forward the spleen and ShiXie initiated to disorder, the spleen and stomach disorders caused liquid dry, and dry bi endogenous. He put forward the relationship of Wei, Qi, Ying and blood damage and woman multiple rheumatism. He put forword the relationship of spleen and stomach disorders and related viscera to express the pathogenesis.2Aademic thoughts of Spleen and Stomach as the center of rheumatism disorders treatment.He put forward adjusting spleen and stomach, balancing Yin and Yang, Fuzhengquxie, upper and lower together cure, for the whole of the fundamental rheumatism treatment way, and they were the keys to the prognosis. He established innovative ideas of Spleen and Stomach as the center of rheumatism disorders treatment.3Study on the "regulating the spleen and stomach" rheumatism clinical experiences.3.1Through the medical record list of spleen and stomach and viscera, facial features and orifices the overall syndrome differentiation, from the holistic thinking " treating based on people ", the holistic syndrome differentiation " hold the central and transport the four sides", I combed the characteristics of my advisor’s ideas on the diagnosis and treatment of spleen and stomach diseases.3.2Through the sorting of the past three years collection of316prescriptions treating rheumatoid diseases, I summarised92different therapeutic principles. Among316prescriptions, the prescriptions of regulating spleen and stomach accounted44.3%.I summarized five methods of regulating the spleen and stomach to treat rheumatism disorders:strengthening the spleen and replenishing the qi, transporting the spleen and stomach, transporting the spleen and gasificating wet, activating spleen healthy transportation, warming the spleen and expelling the cold.3.3In the treatment of rheumatism on medicine experience, I summed up five points. Firtly professor Zhu Zhi-zheng was good at treating rheumatism disorders from triple energizer. And he enjoyed using herbs to choose a gas line above the water source of the lung,to remove the source of wet of spleen, to expel wet from urinate. Secondly he valued of spleen and stomach to eliminating pathogenic factors, and he often using herbs to transport spleen and stomach on the syndrome differentiation basis according to the specific condition, at the same time, he put attention from the diet of spleen and stomach recuperation. Thirdly he claimed dredging collaterals to treat Bi, commonly used the snakes and other insect drugs. Fourthly he often used pair of drugs, and paid attention to drug compatibility. Fifthly he was familiar to the drug by, and paid attention to medicine certificate for meridians.4Clinical features of regulate spleen and stomach treating rheumatism disordors.4.1From the wet treatment of rheumatoid arthritis, Professor Lu Zhi-zheng thought damp and heat is more resistance of rheumatoid arthritis core pathogenesis, which be seen more at active period, and thought treatment should be concerned to spleen and stamoch throughout the whole proccess. I summed up "three steps" of the experience of the spleen and stomach medicine.4.2Professor Lu Zhi-zheng often used regulating Ying and Wei to treat post-partum bi, He thought the disorder of Ying and Wei was important caused point.4.3Professor Lu Zhi-zheng was good at treating gout using transporting spleen and expelling wet. He thought the key point of pathogenesis were spleen deficiency, damp and hot, and comprehensive treatment method was the way to go.Second of the theorical research, Rgulate Spleen and Stomach therapy, academic thought and theory research of Dry-bi treatment1Dry-bi named and more theoretical innovationPast dynasties in ancient books were not a "dry-bi" disorders, and the disease related discussion "dry symdrone","dry disease " from the Huang emperor period to the qing dynasty. On the basis of the certified according to dry characteristics combined with years of the clinical experience, in the1980s, professor Lu Zhi-zheng first named "dry-bi" and put forward of spleen and stomach disorders, five-organs disorders completely all could for dry. Deficiency Qi and Yin hold mechanism for core, long into dry poison for the key chang of dry-bi.2Rgulate Spleen and Stomach therapy, academic thought of Dry-bi treatmentWith years of the clinical experience, professor Lu Zhi-zheng sumed up the causes and mechanism, and put forward rgulating Spleen and Stomach therapy, academic thought of Dry-bi treatment. He thought the treatment should be focused on supplementing qi and nourishing yin, and should pay great attention to the spleen and stomach Yang and 3Clinical treating characteristics and medicine experienceProfessor Lu Zhi-zheng created clinical medicine basic prescription:supplementing qi and moistening dry decoction. The drugs together fully embodies the way of " hold the central and moisten dryness" give priority and " transport the four sides, refresh the mood and emotion, adjust the ascend and descend of Qi, carry the diet "" academic thought.Third of the theorical research, Dry-bi theory has profound influence on traditional Chinese medicine disease and syndrome formation of sjogren’s syndrome and modern research progress.Dry-bi was as a traditional Chinese medicine diagnosis rheumatism disease ’secondary in the early1990s, have been widely applied in clinical. Sjogren’s syndrome has no corresponding problems in Chinese medicine in ancient books, and it is thought belonging to dry-bi category by modern physicians. In2010the State Administration of Traditional Chinese Medicine put Dry-bi into the first batch of TCM treatment clinical pathway, as Chinese medicine therapy rheumatism-of sjogren’s syndrome named TCM diagnosis. The disease of TCM syndrome form riches rheumatism the theoretical connotation, widely used in the country, is the domestic colleague consensus and guide clinical practice.The second part, Clinical researchclinical application research based on professor Lu academic thought of Dry-bi.A randomized controlled clinical trial, took primary Sjogren Syndrome patients as the research objects, was carried out to evaluate the effectiveness and safety of the supplementing qi and nourishing yin treatment. The recults are as follows:1. The main symptoms:The improvement of dry mouth, both groups had curative effect, especially the curative effect of treatment group was more significant. Six months after treatment, the treatment group compared to the control group dry mouth VAS score dropped1.66(cm), and the treatment group worked faster, for one month can be seen obviously improved.The improvement of dry eyes, both groups had curative effect, especially the curative effect of treatment group was more significant. Six months after treatment, the treatment group compared to the control group dry eyes VAS score dropped1.64(cm), and the treatment group worked faster, for one month can be seen obviously improved, which obviously better than the control group.The improvement of debilitation, both groups had curative effect, especially the curative effect of treatment group was more significant. Six months after treatment, the treatment group compared to the control group debilitation VAS score dropped1.44(cm), and the treatment group worked faster, for one month can be seen obviously improved.2. TCM symptoms total score:Both groups can obviously reduce the total TCM symptoms score, the treatment group worked faster, for one month appeared dropped significantly, much better than control group; At the same time the treatment group made very good curative effect of TCM syndrome, with the total effective rate was82.76%.3. Immune indexes:At reducing the level of IgG, after six months treatment, the treatment group IgG level declined obviously, compared with controls no difference. Both groups did not see the obvious curative effect on reducing RF level.4. Saliva flow rate, absorbing ink experiment: In saliva flow rate and improve ink absorption of experimental results, both groups has curative effect, from improving trend on look, the curative effect of treatment group was better.5.In the improvement of ESR, two groups were not obvious curative effect.6.Safety:Treatment group and control group adverse reaction rate were1.72%(1/58),22.41%(13/58) respectively, the treatment group safety more reliable,Lu’s moistenning dry decoction can greatly improve the main symptoms in patients with pSS, also can reduce the immune index level IgG. It proofed TCM medicine can improve pSS condition, and clinical application of safe and reliable. |
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