Professor Yao Nai Li's Diagnosis And Treatment Ideas And Clinical Experience In Treating Spleen Deficiency Syndrome

Purpose:This study is conducted on medical records of spleen deficiency patients collected during clinic observation.On the one hand,it summarizes professor Yao's diagnosis and treatment experience in the differentiation and treatment of spleen deficiency,and exploit the strategies and thinking in it,providing precious study materials for the inheritance and development of prestigious traditional Chinese medicine(TCM)doctors' clinical experience.On the other hand,based on the clinical cases,this research analyzed professor Yao'sdiscriminatory analysis on spleen deficiency syndrome structure from multiple aspects including the four diagnostic information,treatment,medication law,to verify and validate if theory study docks clinical study,and to provide further exploration of the hierarchical structure of spleen deficiency with directions.Methods:From October 2015 to January 2018,during professor Yao's attendance in hospital,there were 78 clinical cases collected that were diagnosed with spleen deficiency.88 medical records in total.In addition,cases of spleen deficiency were collected cases from Guang'anmen Hospital outpatient information system database and used as retrospective study data.From February 2008 to September 2015,726 patient cases,a total of 3839 clinical records were collected,referring to the case inclusion criterion and exclusion criterion.According to the law of the People's Republic of China national standard terminology of traditional Chinese medicine clinical diagnosis and treatment,all case datum were logged in accordance with the unified standardization into EXCEL,imported through Medical Integrator Studio,details standardized to get structured datum,and then the datum were analyzed using BusinessObjects.804 cases of spleen deficiency were studied mainly by mathematical statistical methods,including complex network analtical method and correlation analysis,among which,frequency distribution of TCM disease diagnosis,TCM syndrome diagnosis,symptoms,tongue condition,treatments were computed,sex,taste and return,via of Chinese medicine for treatment were analyzed,in order to explore professor Yao's academic thoughts in the differentiation and treatment of spleen deficiency,and to preliminaryly explore and analyse the hierarchical structure of spleen deficiency.Results:The clinical strategies and thinking of professor Yao's treatment of spleen deficiency syndrome were summarized.Professor Yao thinks,in the process of TCM diagnosis and treatment,precise differentiation determines the efficiency of treatments afterwards,and cognition of syndrome's hierarchical structure is the key factor to achieve accurate differentiation.To take spleen deficiency as an example,professor Yao stressed that its syndrome hierarchical structure should be analyzed from the etiology and pathogenesis,relationship with disease,the relationship between with the viscera and channels,with the relationship between qi and Yin and Yang,and the important role of tongue condition in syndrome differentiation needs to be emphatically analyzed.By studying cases of spleen deficiency diagnosed by professor Yao,The study included 804 patients.The maximum age is 87,the minimum is 5,and the average is 50.44±13.10.There were 411 males and 393 females.There were statistically significant differences between men and women,P<0.05,and women were older than men.It was found that common clinical manifestation of spleen deficiency were loose stools(1151,29.31%),sleep less(1066,27.15%),the stomach bilges(1064,27.09%),anorexia(801,20.40%).fatigue(630,16.04%).Common tongue coating is dark red tongue(1867,47.54%).light and dark tongue(846,21.54%),tongue and teeth marks,(654,16.65%),fat and big tongue body,(565,14.39%),white greasy tongue coating(597,15.20%),thin white(593,15.10%)coating on the tongue,yellow greasy(463,11.79%)coating on the tongue,tongue coating thin yellow(418,10.64%),It's different from national standards,the clinical common pulse condition of pulse condition(1480,37.69%),pulse condition heavy string(869,22.13%),pulse condition heavy fine(694,17.67%),pulse condition weak(371,9.45%).Spleen deficiency syndrome is mainly distributed in liver,stomach,meridian,heart and lung,except spleen.Among them,the most vulnerable organ is liver(43.82%).Second,the second is the stomach(19.95%).The third is the meridian(5.84%),which also leads to lung,kidney,gallbladder,intestine and so on.Cases of patients with spleen deficiency diagnosis evidence contains disease sex,namely the number of cases of clinical factors accounted for 31.67%of the total number of clinical,from the perspective of the false or true spleen deficiency is given priority to with virtual,disease always belong to mark this virtual to real,factors of syndrome.And from the point of view was not diagnosed with fever of rendering account for 19.47%of the total number of clinical,including property for thermal diagnosis for 646 times,accounting for 86.48%of the total number of clinical,and attribute for cold diagnosis is only 68 times,accounting for 9.1%of the total number of clinical,explains the research samples of spleen deficiency cases,the disease is significantly less cold fever distribution more.The corresponding TCM diseases of spleen deficiency syndrome include constipation,stomachache,gastric ruffian,stomach distention,diarrhea,and pain.In this study,common western medicine diseases include chronic gastritis,chronic atrophic gastritis,gastrointestinal dysfunction,fatty liver,etc.Common treatment methods were to strengthen the spleen,stomach,liver,humidity and heat.Commonly used drugs were poria,atractylodes,licorice,coptis,prepared pinellia tuber.The nature and flavour of commonly used drugs were bitter,sweet,pungent,warm and calm.The channel tropism of the medicine is spleen,lung,stomach,liver and heart.The commonly used drugs for patients with stomachache and spleen deficiency syndrome were poria,coptis,prepared pinellia tuber,licorice,atractylodes,fritillary bulb,curcuma zedoary,costustoot,radix pseudostellariae,white peony root and codonopsis.Commonly matched pair of medicine for the treatment is atractylodes and poria cocos,coptis and tuckahoe.atractylodes and coptis,poria and prepared pinellia tuber,poria and licorice,costustoot and atractylodes.The commonly used drugs for chronic atrophic gastritis patients with spleen deficiency are poria cocos,pseudostellaria root,pinellia,rhizoma coptidis,atractylodes,radix glycyrrhizae,magnolia officinalis flower,vinegar rhizoma zedoariae,honey liquorice etc.Commonly matched pair of medicine for the treatment are atractylodes and poria cocos,pachyrhizae and tuckahoe,tuckahoe and vinegar curcuma.Conclusions:1.In the aspect of syndrome differentiation,Professor Yao's believed that the core symptom of spleen deficiency syndrome are loose stools,bloating,loss of appetite,tired and fatigue.There are many factors influencing sleeping,and the relationship between spleen deficiency and sleepless remains to be studied,Professor yao pointed out that spleen deficiency are complex and accompanied by various syndrome is various.So distinguishing the spleen deficiency needs to comprehensive information,such as the image of sublingual collaterals.2.In terms of medication,the core prescription is poria,atractylodes,licorice,pseudostellaria heterophylla,rhizome.Because the data can't fully show the treat-characteristics of Dr.Yao,so the data has been verified by himself and the distinctive medicines are salvia miltiorrhizae,endothelium corneum gigeriae gali,fritillary bulb and curcuma zedoary.3.As for therapy,the Professor Yao's treatment of spleen deficiency is focuses on invigorating qi and invigorating spleen.The proportion of liver and spleen and spleen and stomach is larger than that of patients with diseases,so it is necessary to take into account the common diseases of the viscera and diseases in the study of liver and stomach.There are many patients with spleen deficiency and thermal or spleen deficiency,so there is a certain bias in the treatment of heat.In the syndrome of spleen deficiency syndrome and syndromes,the pathogenesis transformation of the pathological products,such as dampness,turbidity,turbidity,qi stagnation and blood stasis,is very common in clinic.Therefore,in the process of clinical diagnosis and treatment of spleen deficiency syndrome,various related factors should be comprehensively analyzed,such as pathological products and certificates.Besides,it is necessary to combine the cold and hot disease basis,not to isolate the cold and heat.4.Generally,Professor Yao paid attention to the relationship between spleen deficiency syndrome and zang-fu meridian and qi and blood Yin and Yang in the treatment of spleen deficiency syndrome,so as to master the spleen deficiency syndrome form a general view.Emphasis on the role of gasification and the importance of regulating air conditioners in treatment.Syndrome and puts forward research must begin from basic syndrome,and the second is to pay attention to study individual specific syndromes due to complex and varied clinical patients,patients are multiple syndrome complex syndrome,so it is important to pay attention to the basic pathogenesis,or a combination of specific diseases,step-by-step,hierarchical accurate differentiation,provide the basis for clinical medication.