The Study On Clinical Characteristics And Regulations Of Medicine Usage Of Famous Veteran TCM Physicians In Treating Bi-syndrome

Objective:The study sorts out the effective medical cases of Famous Veteran TCM Physicians including Wang Weilan,Jiao Shude,Lou duofeng and Li Jiren,using the software of traditional Chinese medicine inheritance support system(TCMISS)to input and excavate,and analyzes the regulations of medicine usage and the principles of formula formation of several physicians from the aspects of drug use frequency,core combination and so on.At the same time,compare and sort out the clinical characteristics of the four Physicians,and to find their common points for induction and generalization from the aspects of etiology,pathogenesis,syndrome differentiation and treatment through literature research in order to get the clinical academic system of treating arthralgia and clinical syndrome with the support of theory and data.It is helpful to expand the thinking and method of traditional Chinese medicine in treating Bi syndrome,and provide reference for clinical syndrome differentiation and treatment.Methods: 1 data miningChoose four TCM physicians who have made great achievements in the research and treatment of Bi syndrome,including Wang Weilan,Jiao Shude,Lou duofeng and Li Jiren,by looking up the list of the first batch of 500 Famous Veteran TCM Physicians in China.Take "name of the physicians(such as Wang Weilan)+ Bi syndrome" "name of the physicians(such as Wang Weilan)+ experience" "name of the physicians(such as Wang Weilan)+ Medical Records" as the key words,successively search the literature of four physicians in treating Bi syndrome in the database of CNKI,Cqvip and Wanfang,screening and selecting effective medical cases.Then,establish the prescription database and complete the data mining work such as frequency and cluster analysis through TCM inheritance auxiliary platform system(v2.5)to obtain the frequency of drug use,the four Qi and five flavor of drug,the meridian tropism,drug combination and potential new prescriptions.2 Literature researchUsing the method of philology,take academic thoughts of four TCM physicians,included in the research scope,in treating Bi syndrome as the main statistical object of literature,look up their disciples' works,periodicals,reports,etc,collect and sort out the clinical experience from the aspects of etiology,pathogenesis,syndrome differentiation and treatment methods.And finally find out the common ideas of syndrome differentiation and treatment and their distinctive academic views and clinical experience through observation and comparative analysis.3 Summary of academic systemUsing the method of summary and induction,combine the results of the first two parts and summarize the clinical characteristics and medication rules of the four physicians in treating Bi syndrome,including their understanding and development of the etiology and pathogenesis of Bi syndrome,ideas and experience in syndrome differentiation and treatment,as well as commonly used drugs,drug pairs and potential new prescriptions.So as to form a complete academic system with theoretical and data support to systematize and simplify the complex diseases.Results: 1 The part of data miningThis study included 99 prescriptions of Professor Wang Weilan,92 prescriptions of Professor Jiao Shude,101 prescriptions of Professor Lou duofeng and 92 prescriptions of Professor Li Jiren.Data mining and analysis of common drug combinations and potential new prescriptions are carried out with the support of TCM inheritance auxiliary platform system(v2.5).It is found that there is a common rule in the use of traditional Chinese medicine by the four physicians: the four Qi of the medicine are mainly warm,cold and flat,the five tastes are bitter,pungent and sweet,and most of them are due to the three meridians of liver,spleen and kidney.The main categories of drug efficacy are: antirheumatic drugs,deficiency-nourishing drugs,antipyretic drugs,stasis-dissolving drugs,relieving drugs,detoxification and insecticidal drugs,liver-pacifying and wind-extinguishing drug,interior-warming drug and Qi regulating drug.Most of the commonly used drug combinations have the functions of harmonizing Ying and Wei,warming yang and dredging channels,removing wind and dampness,clearing away heat and resolving surface,nourishing yin and clearing heat,searching wind and removing collaterals,activating blood and supplementing blood,benefiting qi and strengthening spleen,strengthening muscles and bones.And 12 potential new prescriptions for Bi syndrome were found out.2 The part of literature research(1)Etiology and pathogenesis: The four physicians all think that the causes of Bi syndrome include the internal causes such as imbalance of Qi and blood,deficiency of internal organs,and external evils such as wind,cold,dampness and heat.In addition,Mr.Wang attached great importance to the syndrome differentiation of Qi and blood,and emphasized the role of phlegm and blood stasis in Bi syndrome.Mr.Jiao added the meaning of " Bi syndrome is caused by the mixture of evil Qi " and pointed out that kidney deficiency is the main cause of Wang Bi.Mr.Lou advocated that Bi syndrome must coexist with "deficiency,evil and stasis".Mr.Li attached importance to the relationship between collaterals and Bi syndrome and pointed out that external evil,internal evil and toxic evil were equally important.(2)Syndrome differentiation and typing: The syndrome differentiation in Bi syndrome by four physicians is based on the factors causing arthralgia including wind,cold,dampness,heat,deficiency,phlegm and blood stasis and there are different emphases in clinical practice.Mr.Wang is good at combining disease differentiation with syndrome differentiation,using different dialectical methods in different Western Medicine Diseases.Mr.Wang was the first to establishe the name of "Wang Bi" and its different types.Mr.Lou adopts the syndrome differentiation method of "three causes and three syndromes",taking cold and heat as the class,undering the three major syndromes of “vital Qi deficiency,pathogenic factors and phlegm and blood stasis”,and there are orders under the class,which has a clear level.Mr.Li focuses on syndrome differentiation of cold and heat and focuses on "deficiency,phlegm and stasis" in chronic rheumatism.(3)Treatment: The whole thought of the four physicians is to combine strengthening and cultivating the body with removing pathogenic factors and dredging collaterals.Mr.Wang's treatment concept of Bi syndrome extends the idea of combining disease differentiation and syndrome differentiation,and treats various Western medical diseases under the category of Bi syndrome from different angles and he takes “supplement” as the fundamental and takes "communication" as the purpose.Mr.Jian obeys the treatment rules of invigorating the kidney,dispelling cold,nourishing the liver and strengthening the tendons for various arthralgia syndromes.Mr.Lou established the principle of "strengthening the body,removing pathogenic factors and unblocking collaterals",and he was good at medicine according to the department.Mr.Li determined the main prescription for the treatment of cold Bi and heat Bi respectively and treated it with "deficiency,phlegm and blood stasis" as well.According to many years of clinical practice,four physicians have created a large number of self-made prescriptions.3 The part of summary of academic systemBi syndrome always belongs to the syndrome of deficiency Ben and excessive biao,so clinical syndrome differentiation and treatment of Bi syndrome can be started from two aspects,which is deficiency and reality.The treatment of Bi syndrome from deficiency includes deficiency of Yang Qi,deficiency of Yin blood,deficiency of collaterals and viscera,and the treatment of Bi syndrome from reality includes differentiation of cold,heat,wind,humidity,phlegm and blood stasis.The most commonly used drugs of the four physicians are mainly those for dispelling wind and dampness and dispersing cold,followed by tonic drugs,including tonifying qi and blood,warming and Tonifying Kidney Yang as well as the product which can promot blood circulation and remove blood stasis.The most commonly used single drug is Cassia Twig,White Peony,Angelica,Astragalus,Caulis Spatholobi,liquorice,Achyranthes Bidentata,Anemarrhena,etc.The use of drug pair includes the complementary drug pairs which have the fanctions of Tonifying Qi and blood,clearing away heat and dampness,removing wind and pain,removing phlegm and blood stasis and the opposite drug pairs which have the fanctions of reinforcing while reducing and tonifying while dredging.Conclusion:(1)According to the four physicians,in addition to the external evils such as wind,cold,dampness and heat,the maladjustment of Qi and blood circulation caused by the deficiency of vital energy is also an important reason for the onset of Bi syndrome;the deficiency of liver,spleen and kidney is the root cause of chronic rheumatism and persistent obstinate rheumatism;the main reason for the stagnation of channels and collaterals caused by the combination of internal and external evil Qi,phlegm and blood stasis is the main reason for the non recovery of Bi syndrome.Four physicians first identified deficiency and excess,cold and heat,then identified evil Qi and partial victory,and finally identified pathological products.The overall treatment idea is to combine strengthening and cultivating the body with removing pathogenic factors and dredging collaterals.(2)The prescriptions of four physicians for Bi syndrome are mainly warming and tonifying,and most of the drugs belong to the three meridians of liver,spleen and kidney.Prescriptions of Mr.Wang and Mr.Li prefer to use both cold and warm,and Mr.Lou and Mr.Li tend to use drugs more peacefully.Mr.Wang is good at using insect and snake drugs to quickly dredge collaterals and remove Bi;Mr.Jian often used herbs of warming kidney and helping yang to invigorate kidney and dispel cold;Mr.Lou often took care of the spleen and stomach with the products of invigorating the spleen and benefiting the stomach;Mr.Li likes to use rattan and insect drugs to get rid of wind and dampness,relax muscles and activate collaterals.(3)Through the combination of sorting out clinical experience and mining effective medical cases,the results are in line with the clinical practice of famous and old Chinese medicine,which is reasonable and credible.At the same time,more potential drug use rules can be found.By summing up and sorting out the thinking of syndrome differentiation and treatment and the law of potential prescription of four physicians,the academic system of treating Bi syndrome with "Xu" and "Shi" as the breakthrough point is obtained,which makes the complex Bi syndrome systematized and simplified.