| Under the guidance of my mentor's tutor,Cao Wei,the chief physician,this paper makes an in-depth discussion on the treatment of rheumatic diseases with traditional Chinese medicine by using literature retrieval method,modern pharmacological research and traditional Chinese medicine theory,and makes an interpretation and experience summary on the application of aconite and aconite in Treatise on Febrile Diseases and synopsis of the golden chamber.At the same time,Professor Cao Wei is treated with Aconite aconite The analysis and summary of the treatment of Bi disease mainly includes the following two parts:1.Literature miningTaking the items of Fuzi and Wutou in Shanghanlun and jinkuiyaolue as the main research objects,the office software Microsoft is used Excel 2016 established a database,used bibliometric analysis method to systematically evaluate the clinical application of Fuzi and Wutou in Shanghanlun and jinkuiyaolue,used descriptive analysis,calculated frequency,composition ratio,and summarized the clinical symptoms,prescriptions,usage,dosage,poisoning or adverse reactions and treatment methods of Zhongjing's clinical application of aconite and Aconitum in bed The basic law of aconite and Aconitum can provide basis for further clinical application.64 items were retrieved,including 35 prescriptions and 4 prescriptions.In Shanghanlun and the main body of the entry,36 articles related to the clinical application of Fuzi were retrieved,33 of which were the prescription of Fuzi,involving 20 prescriptions,23 of which were in the main body of jinkuiyaolue,22 of which were descriptions of Fuzi prescriptions,21 of which appeared,6 of which were repeated prescriptions,with 35 prescriptions in total.Aconitum does not appear in Treatise on febrile diseases.5 articles in Treatise on prescriptions of synopsis of the Golden Chamber correspond to 5 Wutou prescriptions,and the total Wutou prescriptions are entries.Wtcszw is used for aconite and aconite.There are 55 drugs used in compatibility with aconite,and the top ten drugs used in compatibility with Aconite are licorice,dried ginger,Cinnamon Twig,ginger,Atractylodes macrocephala and jujube,peony and ginseng,ephedra,Poria cocos,asarum and Fangfeng.There are 5 prescriptions of Aconitum,which are all mentioned in the decocting method to be mixed with honey.The other drugs used in the compatibility with Aconitum are Paeonia,astragalus,liquorice,ephedra,Fuzi,dried ginger,chishi,shujiao,pinellia,asarum,Poria,Guizhi,ginger and jujube,totaling 14 flavors.There are 23 articles using raw aconite in Fuzi,38 articles using processing methods,and 4 different processing methods are used in 5 articles of Aconitum,including 2 times of "cannon","peeling","boiling off the skin,no mouth","mouth,two liters of honey,one liter of frying out the aconite".Aconite is mainly used to treat a variety of cold or yang deficiency diseases.Sini decoction is mainly used to treat Shaoyin disease.Aconite is mainly used to treat a variety of pain diseases.In clinical application,the conversion standard of "one or two modern 9g" can be used.In the case of reasonable compatibility and standardized decoction,high-dose decoction can ensure its safety.According to the original records,the vertigo reaction is the performance of Aconitum,which should be differentiated from the toxic reaction.Zhongjing should be cautious about the use of toxic drugs such as Fuzi and Wutou.First,we should consider the patient's physique.If the healthy qi is sufficient,it can be slightly increased.If the body is weak,it should be reduced.Second,we should gradually increase the dosage from a small amount,so as to know.Third,we should pay attention to the development of the disease and the evil spirit.We can increase the dosage slightly to attack disease.Among the prescriptions of Fuzi and Wutou,there are nine prescriptions,such as SNT and GZFZT,which refer to body pain or joint pain,which is consistent with the symptoms of rheumatism.It can be used in the treatment of rheumatic arthralgia.However,after literature retrieval,its clinical application and related research are limited.2.Data miningBased on 125113 prescriptions of traditional Chinese medicine in outpatient department of Rheumatology and Immunology Department of Guang'anmen Hospital,Chinese Academy of traditional Chinese medicine from January 2017 to December 2019 as the original data.It includes general information(age,gender),visit time,diagnosis of traditional Chinese and Western medicine,prescription number,prescription drug,dosage form and dosage.Fuzi,Chuanwu and Caowu prescriptions were taken as the main research objects,and the relevant information of clinical application was obtained by analyzing the prescriptions.It can be seen from the data mining of outpatient prescriptions in our department that Fuzi,Chuanwu and Caowu are widely used in rheumatoid arthritis,ankylosing spondylitis,gout,osteoarthritis,postpartum rheumatism and other diseases.The use proportion of Fuzi is 5.56%,Chuanwu is 0.69%,and Caowu is 0.59%.As the core drug in many representative prescriptions of Rheumatology,the use frequency is too low.Before the age of 50-60,the use rate of Fuzi,Chuanwu and Caowu was higher in female patients than in male patients,while after the age of 50,the use rate of male patients was higher than in female patients.There is a certain correlation with gender and age,which is related to the predisposition of diseases and the decline of vital energy in different age groups without gender.The dosage range of Fuzi is 3-30g,of which 10g,9g and 6g are the main ones,which are within the scope specified in the Pharmacopoeia;the dosage range of Chuanwu is 3-30g,mainly 8-10g,which is far more than 1.5-3g specified in the Pharmacopoeia.At present,the prescription of our department mainly focuses on the use of granules,Chuanwu and Caowu 8g mainly use granules,12g and 15g and higher doses mainly use bulk decoction pieces,which is related to the doctor's understanding of different dosage forms.As for whether the same dosage in different dosage forms has different efficacy,further evaluation is needed.Through the analysis of complex network,it is concluded that Fuzi and Chuanwu Caowu are commonly used in outpatient clinic,among them,Fuzi and Chuanwu Caowu can be used as substitutes,even in combination,and they are compatible with kidney yang warming,qi activating and blood activating drugs.Fuzi's prescription also includes WMW,Wutou's prescription and BXW.Fuzi's prescription is often used in combination with Shengmai Yin and Simiao pill.It can be used to treat patients with deficiency of both qi and Yin,as well as patients with damp heat of lower Jiao.The combination of Chuanwu Caowu prescription can be seen that it is mainly used for the patients with both exterior asthenia and sweating,and the patients with deficiency and excess mixed with upper Jiao dry heat and lower Jiao slippery discharge. |
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