Research On The Clinical Experience And The Treatment Of Hidrosis Syndrome Of Professor Wu Shengyuan

[Objective] By clinical observation with the traditional Chinese medicine inheritance system(TCMIS, v2.0.1), collecting and analysing Professor Wu Shengyuan’s clinical records of hidrosis syndrome of recent years to summarize the experience and the principles of his herbal prescriptions in diagnosing and treating hidrosis syndrome.[Method] According to the standard cases of hidrosis syndrome, which were treated by Prof. Wu Shengyuan, the clinical data were computed and analysed by TCMIS, which summarized Prof. Wu Shengyuan’s experience in treating the hidrosis syndrome and the composing principles of herbal prescriptions.[Result] The statistical analysis is based on prescriptions for 98 cases who had 256 clinical visits. Frequencies of herbs and associated rules among herbs included in the database are computed and analyzed: 16 herbs pairs are commonly used, 33 herb combinations and 9 new prescriptions were obtained from the database. Prof. Wu Shengyuan’s experience in treating the hidrosis syndrome and the composing principles of herbal prescriptions are preliminarily summarized.[Conclusion] Based on data analysis, this study applies the traditional Chinese medicine inheritance system(TCMIS, v2.0.1), collects and summarizes the experiences and principles of Professor Wu’s herbal prescriptions in treating hidrosis syndrome. The research result includes two main parts:Part one: Research on Professor Wu ’s clinical experience and treatment principals of hidrosis syndrome with TCMIS(V2.0.1).From the recorded 98 cases of hidrosis syndrome who had 256 clinical visits, the eight major identified TCM patterns are Ying and Wei in disharmony, spleen and lung Qi deficiency, heart blood deficiency, kidney Yang deficiency, damp heat fumigation, Yin deficiency and fire blazing, heat in the up burner and cold in the lower burner, Qi deficiency and blood stasis. The major patterns are deficiency(Ying and Wei in disharmony, spleen and lung Qi deficiency, heart blood deficiency, kidney Yang deficiency), a total of 207 clinical visits and accounting for 80% of all cases. Simple excess has one type, damp heat suffocating with 19 clinical visits and accounting for 8%. A mixture with deficiency and excess has three types(16 clinical visits with Yin deficiency and fire blazing, 11 clinical visits with heat in the up burner and cold in the lower burner, 3 clinical visits with Qi deficiency and blood stasis), a total of 30 clinical visits and accounting for 12%. The patterns identifying result is highly consistent with the frequency of herbal applications. Among them, the patterns of Ying and Wei in disharmony and spleen and lung Qi deficiency are most common. Both types have respective 76 and 50 clinical visits which is consistent with Professor Wu’s conclusion of basic pathogenesis for hidrosis syndrome "Yin and Yang are imbalanced, Ying and Wei are in disharmony."Analysed from the prescriptions and principal of herbal application, Professor Wu’s commonly used prescriptions for treating hidrosis syndrome are mostly from the classics. Such as Guizhi decoction, modified Guizhi Fuzi decoction, Yupingfeng granules, Guipi decoction, Longdan Xiegan decoction, Qianyang Fengsui pills. 78 kinds of herbs are used in the prescriptions, reflecting the concentration of herbal application and the accuracy of diagnosis. 30 herbs are used more than 40 times: among them four most frequently used are Guizhi, Huangqi, Baizhu and Baishao, reflecting the principle of treatment of regulating Ying and Wei.The commonly used herbs include 10 herbs for tonifying, 2 herbs for warming the internal, 4 herbs for clearing heat and eliminating dampness, 3 herbs for tonifying spleen and digesting food, 4 herbs for astringent function, one herb for regulating Qi, one herb for drying dampness and transforming phlegm, 5 herbs for relieving the external; in total 8 types. This reflects the treatment principle for hidrosis syndrome "Supporting the upright Qi and eliminating the pathologies, treating both symptoms and root”, which should be always followed. The specific methods are "To relieve the external, clear the damp heat, warm the Yang, regulate Qi and blood, make the deficient fire decent, dispel the blood stasis and harmonize the spleen and stomach", to reach the state of "Ying and Wei are perfectly harmonized, Yin and Yang are in perfect balance. "Part two: Summary of Professor Wu’s clinical experience of treating hidrosis syndromeSweating is a normal physiological phenomenon, but a significant amount of long-term sweating is beyond the range of body’s physiological regulation which reflects certain pathological changes, and has a tremendous impact on the patient’s physical and mental health, as "Jing liquid escapes with the sweat", "Blood reduces because of sweating", "Qi escapes with the sweat" or even "Yang disappears because of sweating" etc. Modern medicine has no specific disease name for sweating, only regards it as an associated symptom for certain diseases, such as hyperthyroidism, rheumatic fever, autonomic dysfunction, tuberculosis, hypoglycaemia and shock or as an indicator for certain diseases. Besides modern medicine has no particular effective methods for excessive sweating, most time the treatments are limited to symptomatic way.Chinese medicine diagnoses the hidrosis syndrome from symptoms and conditions and has the advantage of an integrated system for regulation. Professor Wu Shengyuan is a famous Chinese medicine doctor in Yunnan Province, the first successor generation of Wu Peiheng’s supporting Yang academic school in Yunnan, one of the second and fifth national old Chinese medicine experts – supervisor of TCM academic inheriting, who enjoys special allowance from the State Council. He has been a TCM doctor for 55 years, not only inherited academic ideas and experiences of well applied Sini decoction from his father, the famous physician Mr. Wu Peiheng, who cured many chronic diseases, but also developed his own unique ways of diagnosis and treatment for external disease, rheumatism Bi syndrome, digestive disease, hidrosis syndrome, insomnia and other difficult internal diseases.In treating perspiration, Professor Wu unifies all sweating problems like spontaneous sweating, night sweats, cold sweats, shivering sweating, manic sweating, profuse sweats and other abnormal sweating with "sweating patterns" for diagnosis and treatment. He divides the cause of sweating into external and internal, which is closer to clinical practice. He summarizes the basic pathogenesis for hidrosis syndrome as "Yin and Yang are imbalanced," which means "Either Yin loses its function of retaining, or Yang loses its function of protecting." That is to say the root cause of sweating is always the imbalance of Yin and Yang.Based on the summary that "Yin and Yang are imbalanced" as the basic pathogenesis for hidrosis syndrome, the master always follows the rule of “Supporting the upright Qi and eliminating the pathologies, treating both symptoms and root". It needs to be tonified when deficient, according to different causes of disease to tonify Qi, warm yang, nourish blood, lubricate Yin, regulate Ying and harmonize Wei; It needs to be eliminated when in excess, to clear damp heat or transform damp cold, tonify Qi and promote blood circulation, dispel stasis and unblock the collaterals; With heat in the up burner and cold in the lower burner, or with mixed heat and cold, it should be treated by clearing heat in the up burner and warm the lower burner, leading fire back to its original place. In short, "When the pathogenic factors are at external it should be relieved, when it has heat it should be cleared, when yang is deficient it should be warmed, Qi and blood should be regulated, when there is blood stasis it should be dispelled, when there is deficient fire it should be subdued, spleen and stomach should be harmonized." The tonifying method is used for sweating due to spleen and lung Qi deficiency and external is not solid, applied with modified Guizhi decoction and Yupingfeng granules; For sweating due to yang deficiency and external not solid, should be applied with method of warming yang, choosing Guizhi with Fuzi decoction combined with Yupingfeng granules; For Ying and Wei in disharmony, regulating Ying and Wei, choosing formulars of modified Guizhi decoction combined with Yupingfeng granules; Method of nourishing blood is used for sweating due to heart blood deficiency or heart and spleen deficiency, formulars are Guipi decoction and Buzhongqiqi decoction; Method of clearing damp heat mainly used for sweating due to damp heat steaming, choosing formulars of modified Longdanxiegan decoction or Wendan decoction; For sweating caused by yin deficiency and fire blazing, applying nourishing Yin, with formulars of modified Danggui Liuhuang decoction; If Shaoyin is heated then Huanglian Ejiao Jizihuang decoction should be applied; For heat in the up burner and cold in the lower burner and deficient yang floating at surface is treated with method of warm subduing. It has the symptoms of night sweats or spontaneous sweating, aversion to cold, sore and painful gums, mouth and tongue ulcers, no taste in the mouth and no thirst, pale tongue and white coating, deep thin and weak pulse, choosing formulars of Qianyang Fengsuipills combining Yupingfeng granules and Guizhi decoction; Method of removing blood stasis used for patterns of Qi stagnation or Qi deficiency, selecting Taohongsiwu decoction or Buyanghuanwu decoction according to different causes.By treating hidrosis syndrome, the master prefers to use classical prescriptions of Guizhi decoction and Guizhi adding Fuzi decoction, traditional prescriptions of Yupingfeng granules, Guipi decoction and Wendan decoction, or a combination of classical and traditional prescriptions,and good at applying herbal pairs(Huangqi with Guizhi; Fuzi with Guizhi; Shengjiang with Dazao; Shengjiang with Banxia; Daotihu with Fuxiaomai; Huanglian with Lianxin; Zhi Yinsuke with Zhi Yuanzhi; etc.). These prescription formulars are precise and appropriate, with simple addition and subtraction and the effect is obvious. In particular, after many years clinical proves by Prof. Wu, Zhi Yinsuke and Daotihu’s function of sweat astringent should be further promoted.