Study On Clinical Experience About The Treatment Of Hypertension From Warming Through Therapy Used By Professor Guo Lizhong

[Objective]Through long-term clinical with architect,supervisor from finishing the medical record of clinical diagnosis and treatment of high blood pressure disease,summarizes the mentor warming through method treating hypertension disease characteristics and clinical features,pathogenesis regularity,and dialectical points,and carries on the analysis summary to send party administration law,explore tutor's clinical experience in the differentiation and treatment of hypertension by warming through method,rich therapeutics of traditional Chinese medicine,so as to further improve the clinical effect of the treatment of hypertension.[Method]The original data of this paper were from all the outpatient medical records of the tutor from December 2012 to December 2018.The hypertension medical records of the period were recorded into"Medcase V3.2 data record system of Chinese medicine pulse records of warehouse public consultation".The data were screened strictly according to the inclusion and exclusion criteria.R language 3.1.3 data processing system,combined with Mcrosoft Excel 2016 frequency analysis.[Results]A total of 110 cases and 330 diagnoses met the requirements,including 67 males and 43 females,accounting for 60.91%and 39.09%respectively.The patients were distributed in all ages,with the maximum age of 80 years old and the minimum age of 26 years old,accounting for more than 25%(30.91%)and 60-69 years(25.45%)respectively.Clinical symptom amounts to 118 kinds in all,total frequency is 1826 times,among them frequency exceeds 20%to be dizziness(35.15%),lack of power(28.79%),poor sleep(25.45%),stiff neck(21.82%),gastric distension(20.30%)in order;There were 31 kinds of tongue images in total,with a total frequency of 833 times,among which the ones with a frequency of more than 20%were pale red tongue(30.00%),dark tongue(28.79%),thin white tongue(22.73%),greasy white tongue(22.12%)and edge tooth marks(21.82%);There were 16 pulse types,and the cumulative frequency was 752 times,in which the frequency of more than 25%was successively the tight pulse(53.33%),the smooth pulse(34.24%),and the thready pulse(27.27%);There were a total of 81 pathogenesis,and the cumulative frequency was 678 times,among which the frequency of more than 10%was cold and wet stagnation(24,85%),wind-phlegm up-disturbance(16.67%),cold and wet medium obstruction(15.45%),the spleen kidney Yang deficiency(14.85%),obstructed qi and blood(10.00%),wind and yang disturbance(9.70%).For the pathogenesis of cold-dampness stagnation and pestilence of qi and blood,the warming through cold-dampness method was applied,in which the symptoms with a frequency of more than 28%were dizziness(34.92%),fatigue(29.63%)and stiff neck(28.04%)successively.The tongue images with a frequency of more than 22%were dark tongue(28.57%),light tongue(26.46%)and thin white tongue(22.75%).The pulse-forms with a frequency of more than 30%were successively compact pulse(56.08%),smooth pulse(33.33%),and veinule(30.69%).Chinese herbal medicines with a frequency of more than 44%are processed main licorice(96.58%),ginger(91.88%),cassia twig(91.03%),cinnabaris tuckahoe with pine(78.21%),pinellia(70.09%),rhizoma atractylodis(54.70%),fructus amomi(49.57%),rhizoma acori graminei(44.02%)in sequence.In view of the wind phlegm(wind Yang)disturbance and so on pathogenesis uses the warming through wind quenching method,in which the frequency exceeds 25%the symptom successively is dizzy(41,35%),the sleep difference(27.82%),the lack of power(25.56%);The tongue images with a frequency of more than 25%were dark tongue(27.82%)and lightly coated white tongue(27.82%).The pulse condition with frequency more than 22%was successively tight vein(52.63%),smooth vein(40.60%)and chord vein(22.56%).Chinese herbs with a frequency of more than 45%are processed main licorice(97.73%),cinnabaris tuckahoe with pine(94.32%),pinellia(89.77%),ginger(84.09%),cassia twig(74.43%),gastrodia edata(69.32%),rhizoma acori graminei(64.77%),and raw thizoma stractylodis macrocephalae(46.02%).For the pathogenesis of spleen-kidney Yang deficiency and cold-dampness resistance,the reverse method of warming stomach with descending was applied,and the symptoms with a frequency of more than 23%were followed by gastric distension(35.35%),dizziness(34.34%)and fatigue(32.32%).The tongue images with a frequency of more than 29%were respectively white greasy coating(30.30%)and dark coating(29.29%).The pulse patterns with a frequency of more than 37%were successively tight(58.59%),fine(37.37%)and deficient(37.37%).Chinese herbs with a frequency of more than 45%are processed main licorice(94.39%),ginger(91.59%),prepared monkshood(87.85%),fructus amomi(84.11%),raw thizoma stractylodis macrocephalae(75.70%),cassia twig(69.16%),pinellia(62.62%),fructus amomi rotundus(48.60%),cinnabaris tuckahoe with pine(48.60%),and clove(46.73%),respectively.[Conclusion]1.Middle-aged and elderly men are the majority of the patients with hypertension treated by the mentor with the method of warming through.2.The main clinical manifestations that are applicable to the treatment of hypertension by the warming through method are dizziness,fatigue,poor sleep and stiff neck;Pale red or dark tongue,moss thin white or white greasy,edge tooth marks;The pulse is tight and smooth.3.The pathogenesis suitable for the treatment of hypertension by warming through method includes cold-dampness stagnation,wind-phlegm or wind-yang disturbance,spleen-kidney Yang deficiency,cold-dampness medium obstruction,etc.4.The three main methods for the differentiation and treatment of hypertension from warming through are warming through cold and dampness,warming through wind quenching and warming stomach with descending.The pathogenesis of cold and dampness is cold and dampness stagnation,qi and blood obstruction,etc.Clinical features include dizziness,weakness,stiff neck,dark tongue,thin and white coating,tight and smooth pulse,etc.Commonly used formula:Guizhi Decoction combined with Erchen Decoction plus or minus.The pathogenesis of this method is wind-phlegm(wind-yang)disturbance,etc.Clinical characteristic includes:giddy,poor sleep,lack of power,tongue is dark,moss is thin white,pulse is tight string is slippery;Commonly used formula:Guizhi Decoction combined with Banxiabaizhutianma Decoction plus or minus.The pathogenesis of the method is spleen and kidney Yang deficiency,cold and dampness,etc.Clinical features include:stomach distension,dizziness,fatigue,dark tongue,moss white greasy,pulse thin tight;Commonly used ingredients:Fuzilizhong Decoction combined with cassia twig,clove,fructus amomi and pinellia.