Wang Shaohua Physicians For The Treatment Of Chronic Kidney Disease, Director Of The Academic Thoughts And Clinical Experience

Based on the theory and clinical practice, this research is to sum up the academic thoughts and clinical experience accumulated by Chief Physician WANG Shao-hua treating chronic renal glomerular disease(chronic nephritis),and study his characteristics and law of clinical prescription.Objective:To summarize the academic thoughts,clinical experience as well as characteristics and law of prescriptions accumulated by Chief Physician WANG Shao-hua treating chronic renal disease and excavate experiential effective recipes,by way of collecting and sorting the ancient and modern literatures,combined with the status of Traditional Chinese Medicine(TCM) treating chronic renal disease.Methods:This research was divided into theoretical research and clinical research.The former was mainly to collect and sort the ancient and modern literatures.The latter was to excavate and analyze clinical data.The clinical data of56cases of chronic nephritis patients treated by Chief Physician WANG Shao-hua in Xinghua Hospital of TCM were sorted and applied to syndrome analysis.A database for prescriptions of Dr.WANG Shao-hua was established by Microsoft Excel and handled via data screening.The contrast study was carried out between recipes and medicines,being analyzed and summarized based on syndrome differentiation. According to statistics requirement, the primitive data in relative prescriptions was pre-disposed, then the descriptive information of the initial prescriptions were disintegrated and transformed into data elements that could be processed by computer to make it normative,accurate and ordered, and then implement the correct expression and reasonable organization of the data.On the platform of Windows XP,a database for Dr.WANG Shao-hua treating chronic nephritis was established by MS Excel,which was mainly to investigate drugs,including nomen proprium,nature and flavour,effects, channel entry and so on.The core drugs of chronic nephritis prescriptions were found by frequency statistics and applied to frequency analysis of four natures, five flavours,channel entry and effects for analyzing characteristics of prescriptions by way of theory on drug properties.Results:The research summarized the viewpoints of Chief Physician WANG Shao-hua on the causes and pathogenesis of chronic nephritis, and summed up the characteristics of nature and flavour,effects and channel entry on drugs commenly used by Dr.WANG Shao-hua via frequency analysis of71kinds of drugs in the first visit prescription of56cases of chronic nephritis patients.The drugs includedShenghuangqi, Dangshen, Baizhu, Shanyao, Shanyurou, Shudihuang, Fuling, Zexie, Guizhi,Fupian,Mahuang,Sangbaipi and so on,which reflected the thought of Dr.WANG Shao-hua treating the spleen,kidney and lung on chronic renal disease.The main effects were to invigorate the spleen.tonify the kidney.activate yang and induce diuresis, indicated for chronic renal disease marked by edema. The prescriptions commonly used were Jisheng Shenqi Wan,Jingui Shenqi Wan,Siwei Tang,Sijunzi Tang,Wuling San,Fangji Huangqi Tang,Zhenwu Tang,Shipi Yin and so on.The first prescription drugs of Dr.WANG Shao-hua were mainly attributive to the lung, spleen and kidney meridians.The forementioned core drugs were attributive to the heart,liver,spleen,lung, kidney,stomach and urinary bladder meridians.It was thus clear that Dr.WANG Shao-hua had the holism of five zang viscera in mind to strengthen healthy qi and eliminate pathogenic factors.Most drugs commonly used by Dr.WANG Shao-hua were sweet,and the secondary was pungent,calm and bitter.The forementioned core drugs were sweet, warm, bitter, tasteless, calm, pungent and hot in nature and flavor.Chronic renal disease was a chronic procedure which required long-term treatment,so the excessive bitter or cold drugs were not suitable in order to avoid impairing the stomach.Conclusion:The research shows that Dr.WANG Shao-hua normally uses the drugs that are sweet,pungent and calm and attributive to the kidney,heart,spleen liver, lung, stomach and urinary bladder meridians to treat chronic renal disease.Though chronic renal disease is marked by deficiency of spleen yang and kidney yang as well as retention of water at the initial stage, the water-dampness can transform into heat pathogen from time to time.To mildly regulate cold and heat is important to select drugs,especially for chronic renal disease with the spleen and stomach in middle jiao involved.As Dr.WANG Shao-hua formulates a prescription,the supplementing drugs are attributive to the spleen and kidney meridians so as to reach the location directly. Dr.WANG Shao-hua follows the olden principle "treating middle jiao is like balance which is not calm if not balance"to select drugs which are slight cold,slight hot and calm for treating middle jiao,while the high hot or cold drugs are seldom used. Dr.WANG Shao-hua usually chooses drugs sweet,pungent and calm to treat renal disease,as the sweet drugs have the characteristics of regulation, relief and tonification,which can tonify the spleen and strengthen the stomach. Pungent flavor has the flowing action while moistening has the cathartic action.The sweet drugs can eliminate the pathogens and support healthy qi.The concerted application of pungent and sweet drugs can activate yang to circulate qi and transform the water-dampness. On the whole,Chief Physician WANG Shao-hua thinks that chronic renal disease is a syndrome of principal deficiency and secondary excess as well as intermingled deficiency and excess.Principal deficiency refers to the impaired function of the lung,spleen and kidney. Secondary excess is marked by retention of water-dampness,transforming into heat-dampness and blood stasis gradually.The treatment principles lie in strengthening vital qi and eliminating pathogenic factors.Treatments to support healthy qi refer to invigorating the spleen,replenishing qi and tonifying the kidney qi,while treatments to eliminate pathogens are to activate yang to circulate qi and promote diuresis with drugs of tasteless flavor.The natures and flavors of drugs are mainly sweet,pungent,calm and bitter.