Experience Inheritance Of TCM Treatment Of Immune Thrombocytopenia In The Department Of Hematology And Oncology, Dongzhimen Hospita

OBJECTIVE:Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine was established in 1958.Professor Li Yinglin began working in Dongzhimen Hospital in the 1960s,under the guidance of the famous physician Mr.Qin Bowei,and participated in the first Western Chinese learning class in China.After completing his studies,he began to serve as the head of the Blood Group of the University of Internal Medicine,engaged in blood disease research,and had nearly 50 years of experience in diagnosis and treatment of blood diseases.From the 1970s to the 1980s,Professor Chen Xinyi inherited the experience of Li Yinglin’s predecessors,Continue to engage in clinical treatment work in the blood group,and improve the diagnosis and treatment theory of blood diseases;From the 1980s to the 1990s,Professor Li Dongyun studied with the senior Chen Xinyi and was assigned to the Blood Group of Dongzhimen Hospital after graduation,developing modern medical theory of hematology.The Department of Hematology and Oncology of Dongzhimen Hospital was officially established in 1993.During many years of clinical practice,the department has treated a large number of patients with hematological diseases,formed a unique theoretical system with three generations of "Li Yinglin Chen Xinyi Li Dongyun" as the core in the treatment of hematological diseases,and accumulated rich clinical experience,which is urgently needed to be inherited and sorted out.The purpose of this study is to organize the theoretical system for the treatment of ITP with the three generations of "Li Yinglin Chen Xinyi Li Dongyun" as the core,summarize and summarize their unique experiences and academic ideas,maintain integrity and innovation,and provide reference for subsequent inheritance and reorganization work.METHODS:1.Data mining partCollect and sort out relevant medical records and electronic prescriptions from the medical record room of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine since the 1960s,as well as prescriptions recorded in the outpatient and clinic of Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine from 2020 to 2022,and summarize the prescriptions for treating ITP for three generations represented by"Li Yinglin Chen Xinyi Li Dongyun",Using IBM SPSS Statistics 23 and IBM SPSS Modeler 18.0,we conducted data mining such as general data analysis,frequency statistics,association rules,and cluster analysis on medical record prescriptions that meet the Napoli standard.In combination with relevant publications,daily teacher learning,and academic conferences,we summarized and sorted out the unique experience and inheritance advantages of ITP.2.Qualitative interview researchBased on the results of ITP data mining in the early stage,individual interviews with famous traditional Chinese medicine practitioners were conducted to establish research topics and research objects,prepare an interview outline(see appendix for details),determine interview precautions,organize the content of the interview text,and submit it to the interviewed famous doctors for review and modification.The quality of the interview was checked to make up for the shortcomings caused by the simple use of data mining methods,Make the experience of famous doctors more authentic and convincing.Through qualitative interviews with relevant famous doctors,the valuable experiences of three generations in medical ethics,academic origins,differential treatment methods,and core medication were summarized as supporting evidence and materials for this study.RESULTSs:1.In the first part of the study,a total of 436 prescriptions for the treatment of ITP in three generations were included,including 82 prescriptions by Professor Li Yinglin,involving a total of 129 traditional Chinese medicines;Professor Chen Xinyi’s prescription included a total of 107 prescriptions involving 128 traditional Chinese medicines;Professor Li Dongyun has 247 prescriptions involving 176 traditional Chinese medicines.In terms of drug use frequency,Professor Li Yinglin ranked among the top ten in terms of drug use frequency:Angelica sinensis,Astragalus membranaceus,Rehmannia glutinosa,Ligustrum lucidum,White peony root,Ganoderma lucidum,Radix Pseudostellariae,Eclipta,Rhodiola,and Poria cocos;Professor Chen Xinyi ranked the top ten in terms of medication frequency:Dioscorea nipponica,Astragalus membranaceus,Rubia cordata,ass hide glue,Panax notoginseng,turmeric,liquorice,salvia miltiorrhiza,paeonia lactiflora and agrimony;Professor Li Dongyun ranked among the top ten in terms of medication frequency:astragalus,rehmannia,agrimony,rubia,caulis spatholobi,atractylodes macrocephala,notoginseng,achyranthes bidentata,pachymen,and red peony.In terms of the four Qi and five flavors and meridian tropism,Professor Li Yinglin’s four Qi medicines are mainly sweet and bitter,while the five flavors are mainly calm and warm.The meridian tropism is the highest in the liver meridian,followed by the kidney meridian.Professor Chen Xinyi mainly uses sweet and bitter four qi,warm and calm five flavors,with the liver meridian accounting for the highest proportion,followed by the lung meridian.Professor Li Dongyun mainly uses sweet and bitter four qi,warm and calm five flavors,and the liver meridian accounts for the highest proportion of meridians,followed by stomach meridians.In terms of association rules,the core drug pairs obtained by Professor Li Yinglin are"Huangqi Danggui","Raw Dihuang Danggui","White peony Danggui","Ligustrum lucidum seed Danggui","Huangqi raw Dihuang","Raw Dihuang white peony","Ligustrum lucidum seed Eclipta",etc;The core drug pairs obtained by Professor Chen Xinyi are "Chuanshanlong-Astragalus","ass hide glue-madder","turmeric-panax notoginseng",etc;The core drug pairs obtained by Professor Li Dongyun are "Huangqi Radix Rehmanniae","Huangqi Herba Agrimoniae","Agrimoniae Agrimoniae","Rubia Rubra Agrimoniae",and "Atractylodes Macrocephalae Agrimoniae".In terms of cluster analysis,Professor Li Yinglin has extracted four new prescriptions,which are:①Ligustrum lucidum-Eclipta-Ganoderma lucidum-Schisandra chinensisPseudostellaria heterophylla-Tuckahoe,②Astragalus membranaceus-Rhodiola-Salvia miltiorrhiza-Phellodendron,③Lycium barbarum-Psoralea corylifolia-Chuanxiong,④Angelica sinensis-Rehmannia glutinosa-Paeoniae alba-Radix Paeoniae Rubra-GuijiaCaulis spatholobi-ass hide glue.Three new prescriptions of Professor Chen Xinyi were extracted,namely:①Dioscorea nipponica-Astragalus-Rubia cordifolia-Panax notoginseng-ass hide glue-Curcuma longa-liquorice,②Salvia miltiorrhiza-Agrimoniae pilosa-prepared ground-Angelica sinensis-Radix paeoniae alba,③ Shengdi-Buffalo horn-Forsythia suspensa-thin bamboo leaf-tangerine peel-Saposhnikovia divaricataSpatholobus spatholobi-Codonopsis pilosula.Three new prescriptions of Professor Li Dongyun have been extracted,which are:①Astragalus membranaceus-Shengdi-Herba Agrimoniae-Rubia rubra-Atractylodes macrocephala-Caulis spatholobi-Panax notoginseng-Achyranthes bidentata-Fulin,②Yujin-Chuanxiong-Acorus tatarinowiiBupleurum chinense,③Selaginella-Anemarrhena asphodeloides-Honeysuckle-Fangfeng-Red peony.2.In the second part,based on the results of data mining,qualitative interviews are conducted according to the interview outline,and the interview voice is transcribed into text.The interview recording is ultimately transcribed into about 15000 words of text.Based on the grounded theory,text coding is carried out,and on this basis,comparisons and integrations between the original text and the primary code are repeatedly carried out to conduct hierarchical coding.Finally,four primary codes are summarized,namely,the path to academic research,differentiation and treatment methods,core prescriptions,and scientific research development.Under the four primary codes,a total of 21 secondary codes are summarized,including a total of 6 secondary codes by Professor Li Yinglin,namely,the path to scientific research Treatment based on differentiation of symptoms and signs,prescription based on differentiation of symptoms and signs,medication with combination of symptoms and signs,acute ITP;Professor Chen Xinyi has a total of 10 secondary codes,which are:academic origin,medical ethics,teaching and educating people,treatment based on differentiation of symptoms and signs,treatment based on stages,leveling and leveling,medication based on differentiation of symptoms and signs,targeted medication for the organs,and chronic ITP;Professor Li Dongyun has a total of 5 secondary codes,which are:integrity and innovation,repeated practice,teaching by example,focusing on intractable ITP,and focusing on overall thinking.CONCLUSIONR:The main academic ideas of treating ITP for three generations are as follows:1.Syndrome differentiation system:Professor Li Yinglin first proposed the syndrome differentiation method of "three syndromes and four types".Professor Chen Xinyi creatively proposed the theory of treating ITP from the spleen and using "leveling" to "leveling".Professor Li Dongyun followed the treatment principles of "holistic" and "valuing patient quality of life";2.Medication characteristics:Professor Li Yinglin emphasizes supplementing qi and nourishing blood in the treatment of ITP,while Professor Chen Xinyi combines the immune mechanism of the disease and emphasizes the core treatment principles and prescriptions of regulating immunity;Professor Li Dongyun’s theory of governing the harmony between form and spirit embodies humanistic care everywhere,laying the foundation for subsequent research on difficult to treat ITP.