Research On Academic Thought Of Treating TA And Moderncl Inical Application Of Fu Qing Zhu's Gynecology

Objective: 1.The study intends to summarize Fu Shan's academic on prevent miscarriages by the further learning the original work.2.Adopting data mining technology,this paper,from the perspective of EBM(evidence-based medicine),explored the clinical application of various agents and the drug use patterns,to expand the clinical used range of Fu shan' prescriptions.3.Evaluated comprehensively the clinical efficacy of Fu's treatment of TA(threatened abortion),to provides EBM basis for clinical using andianertian decoction,and to enrich the content of Fu Shan' academic,providing a documentary basis for future research.Methods: the section is divided into three parts:1.The academic idea: Using electronic search to collect the cademically literature,original works and note books of Fu QingZhu's Gynecology TA Sections published in the CNKI,Wanfang,VIP,since these libraries built(-2019).By dealing with the collected data the paper Summarized systematically Fu Shan' academic idea of prevent miscarriages from four angles,including the etiology,pathogenesis,prescription compatibility characteristics,traits of prevent miscarriage,using drugs regularity and so on.2.The Clinical application study:taking prescriptions are named as keywords,electronically collect the clinical application literature of Fu Shan's prevented miscarriages prescriptions in published periodical of four databases(CNKI,VIP,Wanfang and Superstar database),time:-2019.Epidata software was used to extract information from the literature conformed the inclusion and exclusion criteria.Finally,forming a literature database of clinical application of prevent miscarriages prescription.After the data were normalized,Excel software was used to record diseases treated by each prescription and characteristics of literature bibliometrics.3.Evidence-based medicine system evaluation:By the second part analyzing,it was found that Fu Shan' anti-abortion prescriptions was still used to prevent miscarriage.Base on the number of andianertian decoction clinical trials ranking first,a meta-analysis was conducted on the validity of anti-abortion.After evaluating the evidence-based medicine quality of 16 clinical trials,on the basis of inclusion andexclusion criteria,9 RCTS were brought into study.Bias risk assessment,literature heterogeneity test and meta analysis were performed with RevMan5.3 software.Results:1.Academic thoughts:In terms of etiology and pathogenesis,Fu Shan soothing the fetus takes deficiency of qi and blood as its root,deficiency of kidney as its foundation,deficiency of spleen as its core,deficiency of liver and blood as its concurrently,heat syndrome at both ends of the virtual and real,blood stasis syndrome include asthenia and sthenia.In the treatment of TA,Fu Shan take attention to the liver,spleen and kidney,strengthening the kidney and keep the fetal safety,strengthening spleen and replenishing qi,do not forget to regulate the liver;expert in invigoration and scorn attacking pathogen,remove blood stasis meanwhile consideration to invigorating qi,the five elements restrain have unique application.In the formula,the quantity of the medicine is simplified,to make good use of the pair-herb,corner herb,there are ancient and flexible.On the good use of warm herb and careful use of cold herb,make good use of special herb that can treat extra-channels disease,dare to use pregnancy contraindications,pay attention to drug processing.2.Clinical research:a total of 50 clinical application literature were included,Divided into 24 clinical trials and 26 clinical experience literature.There are 1 core journal paper,13 technology core papers,6 papers with the support of the fund.96% of the literature were from medical institutions above the county level.These literature cover 6prescriptions,including andianertian decoction 35 papers,jieyu decoction 9 papers,yuantugutai decoction 3 papers,zhuqibulou decoction 2 papers,runzaoantai decoction1 paper and 1 fuqizhiti decoction paper.A total of 18 TCM(traditional Chinese medicine)diseases and 8 western medicine diseases are involved.The clinical application of andianertian decoction is the most frequent,mainly used for the treatment of TA.The second is jieyu decoction,which was mainly used in mental diseases.The zhuqibulou decoction is used to cure various gynecological bleeding syndrome.The literature amount of the other three prescriptions was 1,and no further application was found.Except andianertian decoction and jieyu decoction,the otherprescriptions were used less frequently,and the results of medication analysis were not significant,so the analysis was not made.3.Evidence-based medicine:A total of 16 RCT samples of an dian ertian decoction were systematically evaluated,and the results were generally of low quality.Because of the lack of randomization,hidden and blind method,interventions to the low level of standardization,lack of drug combination rules,the treatment time is not unified,outcome measurement method is not unified,lack of security considerations,follow-up record is less,the final performance for clinical trials of incomplete test design,test of the low level of methodology,test report of the quality objective enough.A total of 1035 patients were included in the 9 eligible randomized controlled clinical trials of andien ertian decoction.Meta-analysis results showed that RR=1.18,95%CI=[1.13,1.24],Z=6.63,P<0.0001.Conclusion:1.Mr.Fu shan's academic thought of maintaining the fetus was based on the inheritance and innovation of the predecessors' experience.The etiology and pathogenesis were mainly deficiency,followed by fever and both stasis.The characteristics of maintaining the fetus include the regulation and treatment of liver,spleen and kidney,the maintenance of qi and blood,and the application of five elements.The compatibility of the prescription is simplified and appropriate,the use of the sword and the heart of the harp.Formed a unique characteristics of its own system.2.The application of the miscarriage prevention formula by modern doctors not only inherits the essence of the original work,but also makes a certain breakthrough.On the premise of accurate syndrome differentiation,it is not only used for gynecology,but also for internal medicine and pediatric diseases.3.The original prescription of Fu Shan's miscarriage prevention and dose of all prescriptions were reserved,and most of the newly added prescriptions were for symptomatic treatment.4.The results of Meta analysis showed that the efficacy of andian ertian decoction in miscarriage prevention was better than that of western medicine alone.However,due to the low quality of clinical research,high risk of bias and large heterogeneity,more high-quality RCT support is needed to provide evidence-based medical evidence for the clinical use of the prescription.