| This thesis is composed of three parts:literature review, TCM syndrome research and experience summary. Literature review is divided into two parts, Chinese and western medicine, systematically stating the research progress of functional dyspepsia, such as the concept, pathogenesis, clinical treatment. TCM syndrome research use themethods of social network, retrospect the cases of out-patients, finding and discussing the characteristics of traditional Chinese medicine of functional dyspepsia. At last, from two aspects of theoretical basis and treatment characteristics, summarized Professor Li Zhenhua’s experience in treating functional dyspepsia from liver-based theory.The main contents of TCM syndrome research are as follows:Objective:To summarize the characteristics of TCM syndrome differentiation and the law of syndrome, through the analysis of TCM syndromes, syndrome elements, symptoms of patients with functional dyspepsia.Methods:1.According to the diagnostic criteria of functional dyspepsia in Rome III, the inclusion and exclusion criteria are set up.2.According to the characteristics of the symptoms of functional dyspepsia, which belongs to "stomachache", "noisy", "fullness", "indigestion" in the trational Chinese medicine.The basis of TCM syndrome diagnosis is divided into two aspects:the first is the consensus, that is, officially published materials, guidelines, expert advice,by the state, association and others; the second is Professor Li Zhenhua’s empirical diagnosis.In order to avoid interfering the statistical results, only take the first diagnosis.3.In the digestive department of Xiyuan Hospital of China Academy of Chinese Medicine Sciences, collecting the cases of the out-patients, then screening, sorting out their names, gender, age, diagnosis of traditional Chinese medicine, Chinese medicine syndromes, symptoms and other information.4.The frequency of syndrome types and syndrome elements in all cases are summarized, and the general characteristics are analyzed, and the data are processed secondly according to these characteristics.5.The data after secondary processing are formed symptom matrix through the process of Bibexcel software, and file are stored as txt format, then the file are imported into Ucinet software, formed the file ended with.##h. Import##h file into the Ucinet software again, getting the degree centrality, between centrality, cohesive subgroup graph, internal density table, and getting the social network graph of symptoms after importing##h file into NetDraw software. And according to the graphs, tables and data, analyse the characteristics of the data after secondary processing.Results:1.Collected 239 cases initially,106 cases were involed in the research finally,74 cases were analysed secondly.2.There were 22 syndromes in 106 cases, including liver-stomach disharmony, spleen deficiency and damp-heat, spleen deficiency and qi stagnation, stagnated heat in liver and stomach, yin deficiency and qi stagnation, liver-stomach qi stagnation, spleen deficiency and dampness resistance,liver depression and spleen deficiency, spleen-stomach deficiency, liver-stomach yin deficiency, qi and yin deficiency, spleen-stomach damp-heat, spleen-kidney yang deficiency, damp-heat qi stagnation, liver-spleen disharmony, yin deficiency inner heat, stagnation of phlegm-heat, fire excess from yin deficiency, dampness and qi stagnation, cold-heat complex, qi stagnation and blood stasis, stagnation of qi due to depression of the liver. The percentage of "liver-stomach disharmony" was significantly higher than the othersExtracted the syndrome elements in accordance with location factor and nature factor, location factors included liver, stomach, spleen, kidney, "liver" take the largest proportion of 4 location factors by 36.00%; nature factors included qi stagnation, depression, heat(fire), dampness, yin deficiency qi deficiency, yang deficiency, phlegm, cold, blood stasis, "qi stagnation or depression" take the largest proportion of 10 location factors by 37.27%.3.Based on the particularity and importance of liver in TCM syndrome differentiation of functional dyspepsia, these data were processed secondly with "liver" element.There were 12 syndromes in the data, including liver-stomach disharmony, spleen deficiency and qi stagnation, stagnated heat in liver and stomach, yin deficiency and qi stagnation, liver-stomach qi stagnation, liver depression and spleen deficiency, liver-stomach yin deficiency, damp-heat qi stagnation, liver-spleen disharmony, dampness and qi stagnation, qi stagnation and blood stasis, liver depression and spleen deficiency.There were 65 symptoms in the data, including big belly, poor sleep,belching, acid reflux, poor emotion, anorexia, heartburn, epigastric discomfort, epigastric pain,lateral thorax fullness, dry mouth, thin stool, chilly, dry stool, fatigue,chest tightness, early satiety, semiliquid stool, inhibited defecation,bitter taste,reduced time of defecation, spontaneous perspiration,flowing pain all over the body,backache,nausea,sticky stool, weight loss,dizziness, fart too much,hate cold food, cold hands and feet,amnesia,palpitation,dry lips, defecation many times,hard-soft stool,abdominal distension,sense of eyewinker in the fauces, unfixed dry and thin stool,thirsty,epigastric burning,vomit,aphtha,excess of saliva,night sweat,sweet taste,edema of lower extremity,dryness of eye, hotness in back,pharyngalgia,dry pharynx,aversion to cold, feeling of fullness in the head, feeling of fullness in the eye, shortness of breath, acne, have a desire for pressure and warmth, halitosis, pectoralgia, micturition, feeling heat in the mouth and nose, sour taste, noisy in the stomach, alopecia, bowel sound.According to the social network graph of 65 symptoms, produced by NetDraw software, found 22 core symptoms in all, they were big belly, epigastric pain,epigastric discomfort, early satiety, lateral thorax fullness,chest tightness, anorexia,nausea, acid refluxi heartburn, belching, chilly, poor emotion, dry mouth, bitter taste, poor sleep, fatigue, semiliquid stool,thin stool, inhibited defecation, dry stool, reduced time of defecation.The syptoms presented 3 types of qi stagnating in upper-jiao or qi upward, qi stagnating in middle-jiao and disordered stool due to gas barrier.4.Among all the degree and between centralities of 65 symptoms, calculated by the Ucinet software, the values of gastrectasia were significantly higher than other symptoms, all top five were gastrectasia, sleeping badly, belching, acid reflux and poor emotion in two sets of data.5.In the analysis of cohesive subgroup, a subgroup composed of 19 symptoms, the first group, had the strongest internal density, includingbelching, acne, backache, cold hands and feet, poor emotion, sticky stool, fart too much, big belly,halitosis, excess of saliva, sweet taste, poor sleep, hard-soft stool, flowing pain all over the body, epigastric burning, edema of lower extremity, anorexia, chilly, spontaneous perspiration. The symptoms had two characteristics, one was a typical manifestation of qi stagnation, another was the pathogenic dampness affected the disease.Conclusion:1."liver" plays an important role in the etiology and pathogenesisof functional dyspepsia.2.For functional dyspepsia due to "liver", gastrectasia, sleeping badly, belching, acidreflux and poor emotion have higher diagnostic value, qi stagnation is manifested in san-jiao, including upper-jiao, middle-jiao, lower-jiao, pathogenic dampness is a important factor in the change of disease. |
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