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This paper summarized the clinical experience of XU Fengqin in the treatment of hypertension in the elderly. It is believed that the basic pathogenesis of hypertension in the elderly is liver and kidney depletion， and the key is ascendant hyperactivity of liver yang and spleen failing to transport. Therefore， the theory of “combination of disease and symptoms” is put forward that the four common clinical symptoms of hypertension in the elderly， including morning hypertension， non-dipper hypertension with abnormal circadian rhythm， postprandial hypotension and orthostatic hypotension， should be differentiated and treated with prescription in accordance with the characteristics of the corresponding pathogenesis. Specifically， the pathogenesis of morning hypertension is mainly liver-kidney yin deficiency and ascendant hyperactivity of liver yang， for which the treatment method of enriching liver and boosting kidney， calming the liver and subduing yang is suggested， and Qingxuan Jiangya Decoction （清眩降压汤） in modifications can be used. For non-dipper hypertension with abnormal circadian rhythm， the pathogenesis is mainly phlegm-dampness obstruction and clear yang failing to ascend， and treatment method should be dissolving phlegm and dispelling dampness， calming the liver and extinguishing wind， with Banxia Baizhu Tianma Decoction and Modified Honglong Xiahai Decoction （半夏白术天麻汤合加味红龙夏海汤） in its modifications. Regarding postprandial hypotension and orthostatic hypotension， the pathogenesis is mainly spleen-stomach depletion and clear yang failing to ascend， and thus the method of supplementing the center and boosting qi， raising yang and lifting the sunken is advised with Buzhong Yiqi Decoction （补中益气汤） or Yiqi Congming Decoction （益气聪明汤） in the modifications.
ABSTRACT
The grading of evidence is an important factor in clinical decision-making. The current evidence grading system based on western medicine is limited in the clinical practice of traditional Chinese medicine （TCM）， therefore we propose the solutions to the development of grading system for TCM interventional evidence， following the international evidence grading standards， taking into considerations of the unique characteristics of TCM practice， based on the Grades of recommendation， assessment， development and evaluation （GARDE） evaluation system， and integrating with grading system regarding TCM classical literature and empirical evidence from modern famous doctors. The evidence from classical literature is suggested to be evaluated from three aspects including source of ancient medical records， comprehensive of treatment details， and the inheritance. The qualification of famous doctors， content integrity， and inheritance of experiences will be used to evaluate the evidence from famous doctors' experience. The multi-sourced evidence such as TCM classical literature， experience of modern famous doctors， and modern researches is mainly integrated in a qualitative way， and the overall level of evidence of TCM interventions will be graded consistently with the GRADE system based on modern research. The evidence from classical literature and modern famous doctors' experience will be assessed and considered as supplementary evidence， which will make the evaluation of clinical evidence more objectively and comprehensively， thereby guiding clinical practice further.
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Objective:Analyze the composition of Tongzhifang，regularity of modified prescriptions based on outpatient medical records of national famous Chinese medicine practitioner Professor YU Ying-ao for the treatment of epilepsy as well as data mining， and summarize the clinical experience of Professor YU in diagnosis and treatment of epilepsy， in order to provide the reference basis for the traditional Chinese medicine treatment epilepsy. Method:Based on the data of outpatient medical records of Professor YU for epilepsy diagnosis and treatment，this study conducted standard patient follow-up，clinical data collection，pretreatment and mining analysis，and was confirmed through expert interviews. Liquorice 2.3 data mining platform and SPSS 17.0 were used for data management and statistical analysis. Result:A total of 1 219 medical records of 243 cases were completely collected. As a result， Professor YU Ying-ao's Tongzhifang for epilepsy was based on ancient prescription Baijinwan，in which Shenglongchi and Ostreae Concha enhance tranquilizing and hyperactivity-subduing effects，Citri Reticulatae Pericarpium，Armeniacae Semen Amarum，Arisaema Cum Bile and Bambusae Caulis in Taenias eliminate phlegm and free channels， Salviae Miltiorrhizae Radix et Rhizoma and Persicae Semen promote blood circulation to remove blood stasis， and the 10 herbs were meticulously composed and well compatible. According to the small sample data，the total effective rate of patients with tetany type epilepsy taking this prescription for 3 months and 6 months was 80% （P<0.01）， with no adverse reactions. As for the dosage of Tongzhifang，the dosage for adult pills is generally 3-6 times that of decoction prescriptions，and the dosage for children's pills is generally 5-10 times that of decoction prescriptions. Under the guidance of the combination of disease differentiation and syndrome differentiation，epilepsy at the acute phase was treated with additionally Hupomo 1.5-3 g，the ratio of Curcumae Radix to Alumen is usually 4∶1， severe convulsion was treated with additionally Uncariae Ramulus Cum Uncis， Bombyx Batryticatus and Pheretima， epilepsy due to trauma was treated with additionally Typhae Pollen， Eupolyphaga Steleophaga， Carthami Flos and Radix Paeoniae Rubra； constipation was treated with additionally Cannabis Fructus； fatigue was treated with additionally Astragali Radix； dyspepsia was treated with additionally Galli Gigerii Endothelium Corneum； and irritability treated with additionally Gentiana scabra Bunge. Conclusion:The composition of Professor YU's Tongzhifang for treating epilepsy with Qianzhen Zhixian Huatan Tongluo method is relatively stable. Modified prescriptions are based on syndrome differentiation. Clinical experience and dosage range of decoction prescription and pill prescription for adults and children are available.
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[Objective]Summarize the Professor GUO Lizhong's experience of treating depression with strengthening Yang-Qi, providing a new perspective for the treatment of depression. [ Methods]Through observing and recording the clinical work with Professor GUO, organizing medical records, prescriptions and collecting lecture materials, theses and writings, analyzing its dialectical ideas, prescription and medication; by retriving ancient TCM books and analyzing famous TCM doctors' academic thoughts, to summarize Professor GUO's point of treating depression academic ideas and prescription drugs by strengthening Yang-Qi. That choosing Sini soup combined with Guipi soup and Tianjing soup receives good effect. [Results]Professor GUO Lizhong's thought mainly originates from classical works, such as "Internal Classics", who thinks that Yang-Qi deficiency is the root cause of depression, the essence and blood deficiency are the key links, frivolous virtual fire is its incentive, treatment of wanning or diving Yang-Qi is the first, then support essence and Yang-Qi. Two cases of depression returned to normal work and life after treatment of warning and diving Yang-Qi and supporting essence and Yang-Qi. [ Conclusion ]lt's unique of Professor GUO's experience in the treatment of depression, it is worthy of further study and experience of the dialectical ideas and election of prescription clinical value. To take GUO's experience for treating depression from the "Yang weakness, essence and blood deficiency, Yin fire up", and apply his rule can markedly relieve depression patients' clinical symptoms and obviously improve patients' life quality.
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[Objective] Professor ZHANG Xiaosu treating childbearing anovulatory uterine bleeding academic thought and experience is summarized.[Methods] The clinical records of Professor ZHANG Xiaosu in the treatment of anovulatory uterine bleeding were studied. The experience and characteristics of ZHANG's treatment of the disease were summarized from the aspects of etiology, pathogenesis, treatment and prescription.[Results] For anovulatory uterine bleeding, Professor ZHANG Xiaosu believes that the disease of kidney deficiency, liver Qi stagnation is an important link in the pathogenesis, with "kidney, liver" for the treatment of law, urgent then treating the symptoms, treating the original for slow disease, at the same time stage of treatment, combination of traditional Chinese and western medicine, psychological counseling.[Conclusion] Professor ZHANG Xiaosu treats anovulatory uterine bleeding from the liver and kidney dialectical treatment, for ovulation disorders of uterine bleeding patients with the theory of guidance, in favor of young Chinese medicine students to study, promote the treatment of the disease and the development of Chinese medicine cause.
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[Objective] To sum up Pro.SONG Kang's clinical experience in treating idiopathic pulmonary fibrosis.[Methods] By following the teacher,summarize the theory and method of the teacher's treatment of idiopathic pulmonary fibrosis.[Result] Pro.SONG Kang according to studying collateral disease theory,thinks that "pulmonary collateral blockage" and "deficiency of collateral"are the basic pathogenesis of idiopathic pulmonary fibrosis,will belong to the" Feibi "," Feiwei ",often with purgation-tonifying to treat the idiopathic pulmonary fibrosis,specific treatment of dissipating phlegm and removing blood stasis,invigorating lung and spleen,nourishing yin and tonifying kidney,aims at the main symptoms,composing prescriptions reasonably,and combining with western medicine treatment according to the illness,and achieves great therapeutic effect in clinic.[Conclusion] Pro.SONG Kang's treatment of idiopathic pulmonary fibrosis has significant curative effect,the clinical experience and prescription drug is worthy of further research and study.
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Objective] To sum up the academic ideas and clinical experience of Zhou Fuming's old Chinese medicine in treating gout arthritis. [Method] From the clinical treatment,coping the teacher's prescription drugs, collecting the clinical information of the teacher, research and discuss Zhou Fuming old doctor of traditional Chinese medicine academic ideas and clinical experience in gouty arthritis treatment, to summarize the traditional Chinese medicine of gouty arthritis in dialectical characteristic, and for proven cases. [Result] Gouty arthritis in TCM is called arthromyodynia, physical weakness and disease blocking main and collateral channels are the basic pathogenesis. Zhou Fuming old Chinese medicine puts forward first identifing the main symptoms, then identifing secondary symptoms, to make clear major and minor, virtual and real, the site of disease treatment tips, with objective to reach strengthening the physique and driving away the disease and clinical cure. The listed medical case carried out teacher Zhou's academic experience, whose curative effect was satisying. [Conclusion] Zhou Fuming old Chinese medicine treatment of gout arthritis effect was remarkable, has the value of popularization and application.The clinical dialectical thought and medication principle are worth in-depth study and exploration.
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Objective] To explore the professor Xie Jingri fromthe theory of liver and spleen in the treatment of chronic atrophic gastritis treatment and medication,in order to further understand the relationship among the liver,spleen and stomach. To broaden the thinking,to improve the clinical curative effect of chronic atrophic gastritis. [Method] With factor liver main spleen transportation as the theoretical basis,from the perspective of the relationship between five zang-organs and six fu-organs,with clinical basis for the case of professor Xie Jingri about the theory of liver and spleen in the treatment of chronic atrophic gastritis is discussed for collection. [Results] Professor Xie Jingri putting forward the theory of liver and spleen in the treatment of chronic atrophic gastritis has profound historical origin,there are documentaries, rules on the use of drugs to people,both focus on the overall,with the evidence-based medicine,and attention to detail,judge of modern,pathogenesis. For chronic atrophic gastritis has opened up a more effective treatment. [Conclusion] Through the elaboration of treatment of chronic atrophic gastritis treatment,medication and typical cases,make the theory of liver and spleen for stomach more clear train of thought,on the theory of liver and spleen theory,improve the efficiency of clinical treatment of chronic atrophic gastritis.
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Objective To explore the medication rules of national TCM masters’ treatment for phymatosis. Methods The prescriptions for phymatosis of national TCM masters were collected to build a database. The methods of association rules with apriori algorithm and complex system entropy cluster were used to achieve frequency of individual herbs, frequency of medicine combinations, association rules of herbs and core medicine combinations. Results In the prescriptions for phymatosis, Chinese medicinal herbs with the highest frequency were Astragali Radix, Pinelliae Rhizoma, Poria, Herba Oldenlandiae, Rehmanniae Radix Exsiccata, and so on. Medicine combinations with the highest frequencywere Atractylodis Macrocephalae Rhizoma-Poria, Citri Reticulatae Pericarpium-Poria, Atractylodis Macrocephalae Rhizoma-Codonopsis Radix, and Poria-Codonopsis Radix. The medicine association rules of confidence coefficient 1 were Sparganii Rhizoma→Curcumae Rhizoma, and Moutan Cortex, Persicae Semen→Paeoniae Radix Rubra. The new prescriptions composited by “Curcumae Rhizoma, Sparganii Rhizoma, Manis Squama, Prunella Spica, Dipsacus Asperoides”, or “Paridis Rhizoma, Adenophorae Radix, Gleditsiae Spina, Sargassum, Laminariae Thallus”. Conclusions Chinese medicinal herbs used in the prescriptions of national TCM masters for the treatment of phymatosis were often with the actions of invigorating the spleen and benefiting qi, clearing away heat and toxic material, and promoting blood circulation to remove blood stasis, which were complied with the medication rule of treating both the incidental and fundamental aspects in TCM.
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Objective] To explore Ma Dazheng professor Chinese medicine treatment for the treatment of leukorrhagia. [Methods] Ma ’s treatment of gynecological disease discusses perspectives and clinical experience in terms of academic pathogenesis, treatment, therapies, their basic prescription compatibility and subtraction of the common CD features are summarized.[Results] Ma Dazheng professor applied lishi, tonifying spleen qi, kidney spleen, heat detoxification treatment, heat treatment and water as the main syndromes, pixu(spleen deficient), spleen kidney Yang deficiency type and the wet poison down, had clinical curative effect. [Conclusion] Ma Dazheng professor according to the characteristics of the patients in the process of treating leukorrhagia, syndrome differentiation and treatment, obtained the clinical accuracy and good curative effect, the gynecological clinical diagnosis and treatment had a good guiding significance, worthy of our in-depth study and understanding.
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Objective To explore the medication rules of state medical master Yan Zhenghua from the prescriptions. Methods After analyzed by the statistical report module and the data analysis module, the method of data-mining that including association rules and apriori algorithm was used to analyze the frequency of Poria and drug combination, the association rules between drugs and core drug combinations in Pro. Yan’s prescriptions via a database based on Traditional Chinese Medicine (TCM) inheritance assist system. Results The prescriptions containing Poria were commonly used to treat vertigo, stomachache, diarrhea and other syndromes. The highest frequently used drugs were Pericarpium Citri Reticulatae, Radix Paeoniae Rubra, Radix Salviae Miltiorrhizae, Parched Semen Ziziphi Spinosae, and Caulis Polygoni Multiflori. The most frequently used drug combinations were “Pericarpium Citri Reticulatae, Poria”, “Radix Salviae Miltiorrhizae, Poria”, and“Poria, Parched Semen Ziziphi Spinosae”. The drug association rules that the confidence coefficient was more than 0.9 were “Carina→Oyster”, “Poria, Carina→Oyster”,“Oyster, Caulis Polygoni Multiflori→Carina”, and“Rhizoma Atractylodis Macrocephalae→Poria”. Conclusion The drugs in the prescriptions containing Poria that built by Pro. Yan mostly had the effects of regulating the flow of qi, relieving uneasiness of body and mind, and cooling the blood, which reflected the clearly thought when Pro. Yan made the prescriptions.