From The Perspective Of The Action Link, The Author Discusses The Connotation Of "small Gas, Micro-drink" In The "Golden Dragonfly"

This paper mainly discusses three aspects:literature review,theoretical research and experimental research.Literature review:Both of Linggui Zhugan Decoction and Shenqi Pill are included in Essentials from the Golden Cabinet "People's shortness of breath sand mild fluid retention should be relieved by urination,and Linggui Zhugan Decoction and Shenqi Pill can both treat them.The similar original text is considered as the model of "different treatments to the same disease" in Essentials from the Golden Cabinet.The later generations generally use Linggui Zhugan Decoction and Shenqi Pill to treat cardiac diseases.The research mainly focuses on the functions of Linggui Zhugan Decoction and Shenqi Pill in treating diseases such as chronic cardiac failure and hypertension in clinical application,while in experimental research it generally discusses the mechanism of action on cardiac diseases of these two prescriptions from the perspective of RAAS system and inflammatory factor.There are abundant clinical practice and relatively solid experimental research of Linggui Zhugan Decoction and Shenqi Pill in treating cardiac diseases and they could relieve shortness of breath and mild fluid retention.However,the research of the connotation of various treatments to the same disease is still not enough.Theoretical research:?Through analyzing the discussion of "different treatments to the same disease" in The Yellow Emperor's Inner Classic and Essentials from the Golden Cabinet,the interpretation of the original text by medical masters in successive dynasties and the research result of different treatments to the same disease in recent years,it is found out that the connotation of different treatments to the same disease based on different treatments to the same disease with different patterns is not complete,and different treatments to the same disease with same patterns may exist while the solid evidence of different treatments to the same disease with same patterns is still not complete.?Modern doctors achieve great curative effects of cardiac failure from the perspective of fluid retention evil,so this experiment selects cardiac failure as the representative model of "shortness of breath and mild fluid retention".Experimental research:This paper selects cardiac failure as the representative model of "shortness of breath and mild fluid retention" carrying out empirical research of the connotation of "different treatments of the same disease".There are two major parts of it:Part One Comparative Study on "Different Treatments of the Same Disease" of the Functions of Linggui Zhugan Decoction and Shenqi Pill in Treating Rats with Cardiac Diseases as ModelsObjective:To observe the differences between the intervention effect on rats with chronic cardiac failure of Linggui Zhugan Decoction and Shenqi Pill.Method:30 healthy SD rats were selected and induced by abdominal aortic banding to establish rat models with chronic cardiac failure.Another 10 rats were selected to give sham operations.Two weeks later,mode rate were randomly divided into ?model group ?Linggui Zhugan Decoction group ?Shenqi Pill group,and they were given intragastric administration of Chinese medicine for 4 weeks.Model group and sham operation group were given purified water and the other treatment groups were given corresponding Chinese medicine.Four weeks later,the pulmonary function and arterial blood and qi of those rats in every group were tested.Results:Test Result of Pulmonary Functions and Qi and Blood AnalysisCompared with the sham operation group,FVC,FEV1/FVC of the model group were all decreased(P<0.05),and PH,PaO2,SaO2 of arterial blood were all decreased(P<0.05),while PaCO2 was increased,indicating that the model rats had cardiac dysfunction.Compared with model group,both of pulmonary functions and arterial blood and qi were improved in rats in Linggui Zhugan Decoction group and Shenqi Pill group(P<0.05).There was no significant difference in the pulmonary functions and arterial blood and qi between Linggui Zhugan Decoction group and Shenqi Pill group(P>0.05),indicating that both of these two formulas could improve cardiac functions of rats with cardiac failure,which means they could treat "shortness of breath"and there was no significant difference in functions of these two formulas.Conclusion:Linggui Zhugan Decoction group and Shenqi Pill group could both improve the cardiac functions of rat model with chronic heart failure without significant differences in effects.That is to say the connotations of "different treatments to the same disease" might exist.Part Two Connotation Research on "Different Treatments of the Same Disease" of Linggui Zhugan Decoction and Shenqi Pill in Treating Rats with Cardiac Diseases as ModelsObjective:To explore the mechanism of Linggui Zhugan Decoction and Shenqi Pill in improving chronic cardiac failure from the perspective of action sites,and provide experimental references for connotation research on "Different Treatments of the Same Disease".Method:The establishment and drug injection were the same as part one.Rats were randomly divided into ?Shenqi Pill group ?Linggui Zhugan Decoction group ?model group ?sham operation group.The pulmonary functions,arterial blood and qi and haemodynamics parameters were tested;Myocardial pathology(HE staining)was observed.The urination for the duration of 24 hours of rats with metabolism cage was collected and the concentration of Na+?K+?Cl-in rats' urination were tested with automatic analyzer.The concentration of AQP2 in urination was tested with ELISA method,and the concentration of PRA,Ang?,ALD in serum,inflammatory factors and CRP were tested with ELISA method.ResultsTest Result of Pulmonary Functions and Qi and Blood AnalysisCompared with the sham operation group,FVC,FEV1/FVC of the model group were all decreased(P<0.05),and PH,PaO2,SaO2 of arterial blood were all decreased(P<0.05),while PaCO,(P<0.05)was increased,indicating that the model rats had cardiac dysfunction that is called "shortness of breath".Compared.with model group,both of the pulmonary functions and arterial blood and qi were improved in Linggui Zhugan Decoction group and Shenqi Pill group(P<0.05),indicating that these two formulas could improve the cardiac functions of rats with chronic cardiac failure.There was no significant difference in the pulmonary functions and arterial blood and qi of Linggui Zhugan Decoction group and Shenqi Pill group(P>0.05),indicating that both of these formulas could improve shortness of breath,which meant they could "treat same disease with different methods".Test Result of Concentration of Na+K+ and Cl-in urination and the concentration of AQP-2Compared with sham operation group,the urination of rats in model group was decreased(P<0.05),and the concentration of Na+ and Cl-were decreased(P<0.05).The concentration of K+ and AQP2 were significantly increased(P<0.05)indicating that there exist water fluid retention in model rate.Compared with model group,the urination of rats in Linggui Zhugan Decoction group and Shenqi Pill group were increased(P>0.05).The concentration of Na+and Cl-were significantly increased(P<0.05),and the concentration of K+ was significantly decreased(P<0.05).The concentration of AQP2 in Shenqi Pill group was decreased(P<0.05),indicating that these two formulas could improve water fluid retention of model rats.The comparison on the ion in urine of rats in Linggui Zhugan Decoction group and Shenqi Pill group showed no statistical significance(P>0.05),indicating that Linggui Zhugan Decoction and Shenqi Pill had no significant difference in the effect of improving water fluid retention of model rats.Test Result of Concentration of PRA?Ang??ALD in SerumCompared with sham operation group,the contents of PRA?Ang??ALD in arterial blood were increased in model group(P<0.05),indicating that the RAAS system was activated in the rat models with cardiac failure.Compared with model group,PRA and ALD of rats in Linggui Zhugan Decoction group and Shenqi Pill group were decreased(P<0.05)and there was no significant decrease of Ang?(P>0.05),indicating that both formulas had such actions as decreasing the generation of PRA and ALD as well as inhibiting the activating of RAAS system.Compared with Linggui Zhugan Decoction,ALD of rats in Shenqi Pill group was decreased significantly(P<0.05),indicating that both of these formulas could inhibit the activating of RAAS system by inhibiting the generation of ALD,but Shenqi Pill had more significant actions.Test Result of the Concentration of inflammatory factors(IL-6?IL-10?IL-18?IL-1?)and CRP in serumCompared with sham operation group,IL-6?IL-10?IL-18?IL-1?pand CPR in serum of rats in model group were all increased(P<0.05),indicating that the inflammatory factors of model rats with cardiac failure were activated.Compared with model group,IL-6?IL-10?IL-18?IL-1? in serum of rats in Linggui Zhugan Decoction group were all decreased(P<0.05),while those in Shenqi Pill group were decreased(P<0.05).Compared with Linggui Zhugan Decoction group,IL-10 and IL-18 of rats in Shenqi Pill group were increased((P<0.05),indicating that Linggui Zhugan Decoction had actions in the link of lowering IL-10 and IL-18 in serum,so as to inhibit inflammatory response.The pathological observation of cardiac muscle tissue Sham operation group:normal size and shape of myocardial cell and cardiac muscle fibers in alignment.The transverse diameter of myocardial cells in model group increased,while the cardiac muscle fibers got thicker with disordered arrangement and fracture.The nucleus got bigger with disordered form,while the nucleolus got densely stained with changed interstitial proliferation.The changes of HE staining in Linggui Zhugan Decoction group Shenqi Pill group were similar to model group,and there was no significant difference in pathological changes between two groups.Haemodynamics ParameterCompared with sham operation group,the heart rate(HR)and the maximum contraction rate(+dp/dtmax)of internal pressure in left ventricle of rats in model group were significantly decreased(P<0.05),while the left ventricular end-diastolic pressure(LVEDP)was significantly increased,indicating that the vasomotor functions of rats in model group were not complete.Compared with the model group,the HR and the maximum contraction rate(+dp/dtmax)of internal pressure in left ventricle of rats in Linggui Zhugan Decoction group were significantly increased(P<0.05),while LVEDP was significantly decreased(P<0.05).HR,left ventricle systolic pressure(LVSP)and the maximum contraction rate(+dp/dtmax)of internal pressure in left ventricle in Shenqi Pill group were significantly increased(P<0.05),indicating that both of Linggui Zhugan Decoction and Shenqi Pill could improve haemodynamics of model rats.The comparison between Linggui Zhugan Decoction group and Shenqi Pill group(P>0.05)indicated that Linggui Zhugan Decoction and Shenqi Pill had effects on improving the incompetence of diastolic and systolic functions of model rats,but the difference in effects was not significant.Conclusion:Both of Linggui Zhugan Decoction and Shenqi Pill can improve the cardiac functions of model rats and there was no significant difference in their actions.That is to say "different treatment of same disease with same pattern" exists,and the connotations may be that two formulas had actions on different links of chronic cardiac failure...