| Li Bainian, director of Chinese medicine, Nanjing University of Chinese Medicine adjunct professor, five, fourth of the country's traditional Chinese medicine experts academic experience to guide the teacher. Anorectal Department of traditional Chinese medicine clinical and teaching work in the more than 50 years, specializes in diagnosis and treatment of anorectal disease, treatment on the function constipation, high complex anal fistula, ring mixed hemorrhoids, anal defects, stricture, incontinence diseases have very high attainments. Founded open exclusion therapy in the treatment of high complex anal fistula, and the development of a "long acting analgesic", "Kuijie enema", "alum yellow fire hemorrhoids liquid" and other common agents for more than 20. Published more than 30 papers, won the Provincial Institute of traditional Chinese medicine excellent paper award, the Nanjing Municipal Science and technology paper award. Four achievement won the provincial and municipal scientific and technological progress second prize, organized the compilation of textbook of anorectal disease handout ","the doctor of traditional Chinese medicine disease diagnosis standard anorectal part, edited the anorectal disease treatment and research"and guidance for the preparation of the diagnosis and treatment of anal fistula with a new viewpoint".Objective:To explore the formation process of Professor Li Bainian's academic thought, summarize Li Lao's academic thought and clinical experience, to inherit and carry forward the unique academic thought and clinical diagnosis and treatment technology of Professor Li Bainian, which not only make the post scholars benefit, but also benefit the majority of patients. Selection of Li Lao experience of old and clinical practice, summed up the Yiqirunchang decoction, clinical observation and research were carried out. Through the observation and analysis of Yiqirunchang Decoction in treating spleen deficiency gas weak constipation clinical effect and influence on spleen deficiency syndrome, clinical Spleen Qi is weak constipation treatment to provide reference.Methods:through the review of Li Lao finishing medical process, work experience and the obtained achievements, finishing three years with teacher notes, typical medical cases, diagnosis and treatment of technical guidance, difficult cases of exchange of experience and so on. The reading tutor of papers and books, comprehend Li Laoshi's academic thought and clinical experience and collected the data of diagnosis and treatment of teacher, medicine, read the relevant literature, induction, finishing Li Laoshi's academic thoughts and clinical experience, carries on the system summary. At the same time, will meet the spleen qi is weak type constipation patients were randomly divided into control group and treatment group, with 30 cases in each. Treatment group using Yiqirunchang Decoction for treatment, the control group with oral administration of lactulose oral liquid. All patients were treated for 4 weeks. After the group of two groups of patients with stool characteristics, defecation frequency, defecation time, difficulty degree, spleen deficiency symptoms and other integral records, and statistical observation of two groups of patients before and after the treatment of constipation symptoms and syndrome of spleen deficiency syndrome, comparison and analysis of the treatment effect of two groups of drugs.Results:Li Bonian's academic thought formation attributed to three aspects:first, source in the medical classics by long-term grind of TCM theory, familiar with the classic medical books, such as Huangdi Neijing, Shanghan Lun, "synopsis of prescriptions of the Golden Chamber", "surgical authentic"; second, source to the teacher to teach, Lao Li attended in Jiangsu Province Chinese medicine school class in traditional Chinese medicine, when school teachers are from Jiangsu Province, the country's doctors, draw the different sects medical experience the essence of; third, the source in the clinical practice of many years of hard. After a long period of theory combined with practice and clinical practice, formed its own unique academic thinking. Li Laoqin learn to ask, is skilled in the practice, set the length of the famous, pay attention to traditional Chinese medicine and Western medicine combined with and skilled in the treatment of functional constipation, high complex anal fistula, ring mixed hemorrhoids, inflammatory bowel disease, anorectal refractory disease.Syndrome differentiation and treatment of asthenia type constipation:Li Laoli after years of clinical practice that chronic functional constipation is caused by deficiency secret. The main pathogenesis is weakness of the spleen and stomach, Qi and blood deficiency, Jin xiekui virtual. Tone correction virtual, focusing on the spleen and stomach, Li Lao think spleen and stomach for the day after tomorrow"," the source of Qi and blood biochemistry ", weakness of the spleen and stomach, acquired dystrophy is the fundamental deficiency constipation. The disease is located in the large intestine, which is related to the spleen and stomach, and is closely related to other organs, no matter which dirty damage will involve the spleen and stomach. So he attaches great importance to strengthen the spleen and stomach, stressed that any deficiency constipation patients, nursing care of the spleen and stomach; Runchang Tongfu, qi stagnation, Li Lao think deficiency constipation is the deficiency in the standard empirical, accompanied by qi stagnation, treatment must pay attention to protect the body upright, avoid diarrhea through Fu, potency of carboxylic fierce products, to prevent the injury is, so commonly used Runchang pass, Li Qi Tong Zhi medicine; regulating the spleen and lung, lifting, and lung and large intestine, Li Lao on spleen based, pay attention to conditioning lung, often with Xuanfei, Runfei of goods, inside and outside Tongzhi, complement each other.Anal fistula of academic thought and experience summary:Li Lao in the treatment of anal fistula of the core idea is to protect the anal function, Li Lao thought not to anal fistula in pursuit of high cure rate, ignoring the protection of anal function and effect of anal incontinence on the quality of daily life of patients far more than anal fistula. Surgery, and the optimal operation scheme, well-designed stellate incision, reduce tension, deep should be curved or hemispherical, horseshoe anal fistula by main and auxiliary incision, keep skin bridge and tunnel exclusion counterparts drainage. Completely remove the vital hidden sinus and accurately ascertain the really inside the mouth. During the operation, the virtual line, after the surgery to reduce the cavity, granulation tissue growth close to the rubber band, has played a fixed role and then use a one-way control of tight line, rubber band to start cutting, the lower end of the lining protection in situ tissue integrity, tissue cutting and repair direction from the proximal to the distal, thereby reducing the degree of sphincter injury. In accordance with the "medicine line, intestinal muscle with long, in principle not only complement".The academic thought and experience summary of hemorrhoids:the first choice of conservative treatment of hemorrhoids, hemorrhoids treatment should be to improve symptoms, reduce pain, prevent and delay the recurrence of the main. Li Lao paid special attention to external therapy, the use of suppositories, dressings, herbal fumigation sitz bath, physiotherapy instrument etc.. Second choice of minimally invasive surgical treatment of hemorrhoids, for surgical treatment, but also to consider treatment of small injury, such as Barron ligation, eliminating hemorrhoid injection, hemorrhoidal artery ligation and. Adhere to the concept of minimally invasive treatment of hemorrhoids, Li Lao believes that the concept of minimally invasive surgery is the patient's pain and postoperative complications of pain, put in the first place in the work of diagnosis and treatment. Minimally invasive treatment is not only minimally invasive methods and equipment, but also the operation of the soft manual, operating techniques, such as skilled. Focus on living habits conditioning:the occurrence of hemorrhoids and daily life is closely related, even surgical treatment, it may be repeated, therefore, Li Lao believes that active prevention is consistent with the concept of disease prevention.Clinical observation and analysis of treatment, two groups of patients with clinical symptoms were significantly improved in the treatment of 2 weeks, the two groups of patients with no significant difference in the treatment effect. After 4 weeks treatment, the curative effect of the treatment group was significantly better than that of the control group (P<0.05); the frequency of defecation and the syndrome of spleen deficiency syndrome in the treatment group was significantly better than that in the control group (P<0.01). Through clinical observation and analysis of curative effect of Yiqi Runchang Decoction "in the treatment of Spleen Qi is weak constipation, the effect is significant, the overall treatment effect of effectively improve the patients, improvement of spleen deficiency syndrome of traditional Chinese medicine has obvious superiority, curative effect is exact, it is worth clinical promotion. |
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