Study On The Rules Of Syndrome Differentiation And Medication On The Experience Of Famous Veteran Doctors Of TCM In Treatment Of Atrophic Lung Disease

Objective: To explore the etiology and pathogenesis distribution,syndrome element distribution, combination rules, common syndromes and features of atrophic lung disease as well as the medicinal compatibility law adopted by modern famous doctors of TCM through studying and organizing the experience of these doctors in the treatment of atrophic lung disease. Methods: Literatures which met the inclusion criteria were retrieved from the existing“Lung Disease Database of Modern Famous Doctors of Chinese Medicine”and“Lung Disease Database of Journals” for the establishment of “Literature Research Database of Experience of Modern Famous Doctors of Chinese Medicine in Treating Atrophic Lung Disease”.The etiology and pathogenesis distribution,syndrome distribution, combination rules,features of syndrome element distribution of atrophic lung disease as well as the medicinal compatibility law adopted by modern famous doctors of Chinese medicine in treating atrophic lung disease were studied by using SPSS19.0 statistical software with statistical description, statistical analysis. Results: Filtered according to the inclusion criteria and exclusion criteria, “Literature Research Database of Experience of Modern Famous Doctors of Chinese Medicine in Treating Atrophic Lung Disease”was established, including data 412, which contains 166 etiology,244 pathogenesis,256 yndrome,177 kinds of Chinese medicine and 74 prescriptions.1 There are 8 kinds of diseases belong to atrophic lung disease in TCM in this study, the most common one is interstitial lung disease.2 There are 13 kinds of etiology, mainly internal injury(40.2%), infirmity(37.4%), heat evil(19.0%),)sputum(13.2%), external infection(10.9%), dryness evil(9.2%)..Pathogenesis 35 kinds, including deficiency of both qi and yin(13.9%) most frequently,followed by phlegm-heat obstructing lung(9.8%), superficies deficiency(9.0%).3 Syndrome element distribution and combination rule:The pathogenic syndrome elements of cough were mainly composed of yin deficiency(48.0%),qi deficiency(30.9%), sputum(21.1%),heat(18.8%) and yang deficiency(16.0%). The syndrome element of pathogenic location was mainly the lung. The combination rule was dominated by the combination of three syndrome elements and two syndrome elements. For the combination of syndrome elements of disease nature and disease location,the common single syndrome elements of disease nature were yin deficiency,qi deficiency and yang deficiency. The disease locations were mainly the lung,the spleen,the stomach,the kidney and the heart. The combination of two syndrome elements of disease nature were qi deficiency combined with yin deficiency,the sputum pathogen combined with heat pathogen, the sputum pathogen combined with static blood. The disease location was mainly the lung.4 Common symptoms: There are 88 kinds of symptoms, mainly cough,coughing of sputum, short of breath,dyspnea, rapid respiration, oppression in thest, spontaneous sweating, dry mouth,weakness,thin pulse,rapid pulse,red tongue,white fur,thin fur, weak pulse, purple tongue,yellow fur.5 Common syndromes5.1 A total of 25 syndromes,6 kinds of syndromes frequency are common,as follows:deficiency of both qi and yin of lung syndrome,yin deficiency of the lung syndrome,phlegm-heat obstructing lung syndrome, qi deficiency of the lung syndrome,yin deficiency of the lung and stomach syndrome,phlegm with static blood obstructing lung syndrome.5.2 The mainly symptoms in common syndromes:5.2.1 Deficiency of both qi and yin of lung syndromeThe primary symptoms: coughing of sputum,short of breath, dysphoria in chestpalms-soles,spontaneous sweating,night sweatin,thin pulse,weak pulse;The secondary symptoms: cough, dysphoria, hemoptysis, weakness, red tongue, rapid pulse.5.2.2 Yin deficiency of the lung syndromeThe primary symptoms: cough,coughing of saliva, dry mouth,thirst, red tongue, weak pulse,rapid pulse.The secondary symptoms: coughing of sputum, dry throat, scanty fur, thin pulse.5.2.3 Phlegm-heat obstructing lung syndromeThe primary symptoms: cough,coughing of sputum,yellow fur, floating pulse;The secondary symptoms: rapid pulse,thin pulse.5.2.4 Qi deficiency of the lung syndromeThe primary symptoms: pontaneous sweating, spiritlessness, weakness;The secondary symptoms: cough, coughing of sputum, short of breath, poor appetite, light white tongue.5.2.5 Yin deficiency of the lung and stomach syndromeThe primary symptoms: coughing of sputum, a small amount of sputum,hot flashes,sallow complexion,rapid pulse;The secondary symptoms: cough, hemoptysis,chest pain,thin pulse.5.2.6 Phlegm with static blood obstructing lung syndromeThe primary symptoms: chest tightness, white sputum, greasy fur, purple tongue, thin pulse;The secondary symptoms: cough,coughing of sputum, excessive sputum, rapid respiration, poor appetite, red tongue, rapid pulse.6 Analysis on TCM prescriptions6.1 Prescriptions for treatment of atrophic lung disease6.1.1 Common prescriptions sorted according to their level of frequency, were Maimendong soup( 13.7%),Gancaoganjiang soup(11.8%),Yupingfensan(11.2%),Qing zaojiufei soup(5.0%),Zhenwutang(5.0%),Zhigancao soup(5.0%).6.1.2 The common pharmaceutical for atrophic lung disease include Gancao(58.5%), Maidong(41.5%), Kuxingren(37.1%),Huangqi(33.5%),Nanshashen(31.3%), Chanbeimu(28.1%),Baizhu(24.9%),Fuling(24.9%),Banxia(23.3%),Ziwan(23.0%),Dan ggui(20.4%).6.2 Analysis on prescriptions for treatment of primary symptoms6.2.1 Prescriptions for treatment of primary symptomsCough: ①Ziwan,Banxia,Huangqi;②Chuanbeimu,Fuling,Nanshashen;③Kuxing ren,Maidong,Gancao.Coughing of sputum: ①Chuanbeimu, Ziwan;② Banxia, Nanshashen, Fu ling;③Kuxingren, Maidong, Gancao.Short of breath: ①Huangqi, Fuling,Baizhu, Gancao;②Gualou,Jiegeng, Danshen, Nanshashen, Kuxingren, Maidong.Dyspnea:①Huangqi, Gancao;② Baizhu,Chuangxiong, Danshen, Mai- dong.Rapid respiration: ①Dangshen, Huangqi, Baizhu, Fuling, Banxia, Gancao;② Kuxingren, Ziwan, Maidong,Tiandong,Nanshashen,Shengdihuang。Chest tightness:① Danshen, Fuling, Baizhu, Maidong;② Gualou,Jiegeng,Wuweizi,Baihe,Taizishen, Nanshashen;③Huangqi.Spontaneous sweating :①Mahuanggen,Muli,Fuxiaomai;② Huangqi, Baizhu, Fangfeng.Dry mouth: ① Maidong, Nanshashen,Gancao;② Jiegeng, Banxia, Ku Xingren, Dangshen, Huangqi, Huangpin,Shengdihuang.Weakness:① Huangqi, Baizhu, Maidong Gancao;② Kuxingren, Ban 6.2 Canonical correlation analysis between the Symptoms and Medicine①Symptoms(Spontaneous sweating); Medicine(Fangfeng,Fuxiaomai,Huangqi, Muli).②Symptoms(Short of breath, Dyspnea, Chest tightness,Palpitation); Medicine(Baihe,Danshen,Tinglizi,Taizishen).③Symptoms(Coughing of sputum, Cough, Spiritlessness); Medicine(Kuxing ren,Huaju hong,Gancao,Dazao,Huangqi).④Symptoms(Rapid respiration,Dyspnea); Medicine(Chuanbeimu,Chuan xiong).⑤Symptoms(Cough, Rapid respiration, dry mouth, poor appetite, Palpitation); Medicine(Banxia,Huajuhong,Maidong,Nanshashen,Huangqin,Shigao,Danggui).⑥Symptoms(Short of breath, dry mouth, Night Sweating,Fever);Medicine(Huangqi,Jiegeng,Banxia,Gualoupi,Huangqin,Maidong,Shudihaung) 6.3 Prescriptions for treatment of primary syndromesFrequently used prescription and pharmaceutical for common syndromes:6.3.1 Deficiency of both qi and yin of lung syndrome: Maimendong soup, Zhigancao soup; Maidong, Gancao, Banxia.6.3.2 Yin deficiency of the lung syndrome: Maimendong soup; Maidong, Gancao, Nanshashen, Banxia,Beimu,Chuanbeimu.6.3.3 Phlegm-heat obstructing lung syndrome:Qianjingweijing soup;Kuxingren, Chuanbeimu, Gancao,Banxia,Fuling,Huajuhong,Jiegeng,Nanshashen.6.3.4 Qi deficiency of the lung syndrome:Dushentang; Huangqi, Baizhu.6.3.5 Yin deficiency of the lung and stomach syndrome: Fuling, Gancao, Chuanbeimu, Nanshashen,Yiyiren,Pibaye,Haigeke,Maidong,Chenpi,Sangbaipi,Ziwan, Ejiao,Baihe,Banxia,Digupi,Huajuhong,Wuweizi.6.3.6 Phlegm with static blood obstructing lung syndrome:Xiangfuxuanfuhua soup;Banxia,Dangshen,Honghua. Conclusion:1 There are 8 kinds of diseases belong to atrophic lung disease in TCM in this study, the most common one is interstitial lung disease.2 The mainly etiology are injury,infirmity,heat evil. The mainly pathogenesis include deficiency of both qi and yin,phlegm-heat obstructing lung.3 For the main syndrome elements of atrophic lung disease, the element of disease location is mainly the lung while elements of disease nature are mainly yin deficiency,qi deficiency,sputum,heat and yang deficiency. The syndrome element combination of atrophic lung disease is mainly the combination of three elements, and the combination with the highest frequency is yin deficiency,qi deficiency and the lung.4 The common syndromes of atrophic lung disease are deficiency of both qi and yin of lung syndrome, yin deficiency of the lung syndrome, phlegm-heat obstructing lung syndrome, qi deficiency of the lung syndrome, yin deficiency of the lung and stomach syndrome, phlegm with static blood obstructing lung syndrome.5 The frequently used prescription and pharmaceutical for atrophic lung disease are Maimendong soup,Gancaoganjiang soup,Yupingfensan; Maidong,Kuxingren, Huangqi,Nanshashen, Gancao.