Xu Peng age of academic thought and clinical experience medication regularity of the treatment of chronic gastritis
|School||Beijing University of Traditional Chinese Medicine|
|Course||Chinese medical science|
|Keywords||Harmonizing and transformation method Chronic gastritis Traditional Chinese medicine therapy Medication rule Xu Pengling|
Objective:Chief Physician Xu Pengling had gradually generated a unique theoretical system about medication and syndrome differentiation. In order to apply and carry on the medication features of his harmonizing and transformation method for treating the spleen-stomach diseases and trace the theory root of the medication features, we systematically summarized his medication and clinical features of syndrome differentiation, observed the effects of medication compatibility for corresponding syndromes, explored his medication rules through normalized systematic clinical observation, and evaluated the clinic security. At the same time we approached the history of mediation and syndrome differentiation from the viewpoint of heritage, summarized Professor Xu’s clinical treatment characteristics and made them repeatable application principle to benefit the clinical use in the future. This study was to summarize the academic thinking, syndrome differentiation, clinical experience, medication rules and the inheriting method of the famous veteran TCM doctors, doing the research on the academic thinking of the famous veteran TCM doctors and treatment method as the main line, analyzing and digging Professor Xu Pengling’s medication rules for treatment of chronic gastritis to explore the inheriting methods of experiences of famous veteran TCM doctors.Methods:1. Discuss the academic origin of the harmonizing and transformation theory of Professor Xu Pengling from the view of in heritage.①Summarize the Professor Xu’s academic thinking that we should pay attention to regulate the spleen and use harmonizing and transformation method when treating diseases.②We concentrated and refined the theory about the harmonizing and transformation theory from Inner Canon of Yellow Emperor, Treatise on Febrile Diseases, and Variorum on Synopsis of Golden Cabinet, abstracted the core content, and especially refined Professor Xu’s unique understanding and originality creativity on the related theory, which included the related statements about property and flavor in Inner Canon of Yel low Emperor and its guiding significance for clinic, about the harmonizing and transformation theory in Treatise on Febrile Diseases and Variorum on Synopsis of Golden Cabinet, the significance of the compatibility of medication property and flavor in the clinical application.③We summarized the features and experience of the academic thinking of Xu Gongyan from his students to authenticate the harmonizing and transformation theory of Professor Xu from syndrome and diseases in clinic. 2. Summarize the Professor Xu’s academic thinking and unique treatment experienceWe summarized the Professor Xu’s academic thinking that treating spleen-stomach could regulate the five-zang organs and the importance of harmonizing and transformation method. We also collected and dig the clinical experience, including the clinical observation and summarization on chronic gastritis by using harmonizing and transformation method, the unique experience on treating chronic diarrhea, vertigo and oral ulcer, application of tongue inspection and summarization of characteristics of medication, all of which aimed to represent the Professor Xu’s academic thinking and unique experience systematically.3. Researching and digging Professor Xu Pengling’s medication rules for treatment of chronic gastritisWe collected 212 typical medical cases and 436 Clinic visits from Professor Xu treating chronic gastritis, established Access 2000 databases, and used frequency analysis of statistical frequency of single herb applications, by Weka3.4, data analyzing software to analyze the compatibility of medication rules. Mutual information analysis was used to get two-dimension frequency relationship, which was to obtain the establishment of inter-related factors such as drug targets and baseline data correspondence between physical and chemical indicators that the calculation of the binary-related drugs frequency relationship, and then calculate the mutual information simplifies the herbs used for chronic gastritis and compatibility features.Results:1. The sources of Xu Pengling’s academic thinkingProf. Xu inherited a lot from his father, Xu Gongyan, who was good at regulating the spleen-stomach, and addressed the treatment principle of "easy, convenient, cheap and effective" with a few herbs, big dose and good effect. Xu Gongyan also was good at using harmonizing and transformation method by the five flavors and believed that harmonizing and transformation method could cure the symptoms caused by dampness and phlegm through normalizing the metabolism of water, grain and essence.Prof. Xu did a lot of research on the classics, especially Inner Canon of Yellow Emperor and Treatise on Febrile Diseases, the followed the thinking of harmony from Inner Canon of Yellow Emperor. Prof. Xu believed that Zhang Zhongjing, the author of Treatise on Febrile Diseases, mentioned the "harmonizing" with a wide meaning, which aimed to maintain the balance o f qi-blood, yin-yang and organ-meridian. Zhang Zhongjing used the flavor theory to regulate the deficiency and excess, which originated from Inner Canon of Yellow Emperor, in which demonstrated the thinking of balancing and harmonizing.Professor Xu emphasized "the harmonizing prescription made could harmonize the "unharmony". Because of combined pathogenic factors, if we wanted to identify the amount of cold and heat, excess and deficiency of the body, dryness and dampness of zang-fu organs, the methods should be flexibility, harmonization should be the total therapeutic target, and many kinds of combined treatments were used according to concrete syndrome differentiation in clinic. He expanded and inherited the medicine theories and methods of ancient famous doctors, claimed harmonization was the therapeutic essence and transformation was for treatment, which meant that through transportation and transformation and engendering transformation methods we got the effect for regulating yin and yang、qi and blood、zang-fu organs、cold and heat、deficiency and excess. The harmonizing and transforming fomula could regulate them to keep harmonization. The research showed that the harmonization and transformation method advocated by Professor Xu embodied the high-level unity of principle and flexibility of TCM therapeutic principle, had an extensive application and complicated indications, which indeed was an effective therapeutic method widespread used in clinic.2. Prof. Xu’s academic thinking and unique experience of diagnosis and treatmentProf. Xu’s academic thinking could be demonstrated in two aspects. The first aspect is, Prof. Xu’s addressed that spleen governed the rest organs. He paid much attention on ascending the spleen qi and descending stomach qi to maintain the qi dynamics to follow the nature law. Tonifying the post-heaven and regulating the spleen-stomach could treat the five-zang organ diseases. The second aspect is, the principle of seeking the root of the diseases was followed all the time. And he also stressed regulating the functions of organs by using harmonizing and transformation method to maintain the balanced status of yin-yang, qi-blood, interior-exterior and deficiency-excess.Prof. Xu was good at tongue inspection for treating spleen-stomach diseases, and argued that the tongue fur should be focused on for the shout-term patients, the tongue body for chronic illness and tongue color for identifying the cold or heat. The tongue inspection could give strong clinic evidence for spleen-stomach syndrome differentiation through the concept, location, cold-heat, prognosis and transformation of the diseases. Prof. Xu’s harmonizing and transformation method had been proved to be effective for treating chronic gastritis, chronic diarrhea and oral ulcer through clinical observation, which had improved clinical symptoms, with good follow-up effect, and no adverse reactions. Based on the combination of the features of spleen-stomach and syndrome differentiation, the harmonizing and transformation method applications may be better clinical treatment options.Prof. Xu addressed the prescription of easy, convenient, effective and cheap with a few herbs, guiding by harmonizing and transformation method. And Prof. Xu had a very unique understanding about the features of glycyrrhizae, evodiae, picrorhizae and ginger. Accompanied with other herbs, glycyrrhizae could only transform sour-sweet into yin, but also spicy-sweet into yang; not only clear heat and tonify the deficiency but also prevent spleen-stomach damage caused by too many cold herbs. Prof. Xu was good at using ginger. The entire deficiency requiring warm the middle would get the ginger and involved, for which the spicy-sweet would transform into yang, preventing from dryness. When using picrorhizae, tongue inspection and physical constitution would be so important. No matter qi stagnation, phlegm, dampness or stasis, it should be used.3. The clinical research on the medication rule about Professor Xu Pengling treating chronic gastritisFor 212 patients,436 prescriptions used,93 kinds of Chinese medicinals applied, totally used for 3661 times. In the 93 kinds of Chinese herbs used, there were 12 kinds of herbs with usage rate of which was more than 30%, for example Rhizoma Pinelliae, dried ginger, fresh radix astragali, Fructus Evodiae, Radix Glycytthizae, Fructus Chebulae, Herba Cistanches, magnoliae cortex and Raidix Paeoniae Alba. The common couplet medicinal were Fructus Evodiae and Rhizoma Pinelliae used in pair, dried ginger with Fructus Chebulae, Fructus Evodiae with Rhizoma Coptidis, Radix Glycytthizae with Fructus Chebulae and dried ginger, et al. The compatibility methods like warming middle-jiao and drying the dampness, acrid and sweet in flavor transforming into yang, acrid medication for dispersion and bitter medication for descending, combination of cold and heat, and combination of tonic and purgative effect, were the most common medical prescriptions. The basic decoctions used by Professor Xu for chronic gastritis were Pinelliae Decoction for Purging Stomach-Fire, Left Metal Pill and Astragalus Decoction for tonifying middle-jiao.Conclusions:Professor Xu Pengling believed that treating the spleen-stomach could harmonize the five-zang-organ, and the harmonizing and transformation method advocated by Professor Xu Pengling meant the combination of harmonizing method and transformation method. It not only could regulate yin and yang、qi and blood、zang-fu organs、cold and heat、deficiency and excess, also imply transportation and transformation and engendering transformation. The etiology and pathogenesis causing chronic gastritis is related to imbalance of yin-yang and qi-blood. This method could balance yin-yang and harmonize qi and blood, make the spleen and stomach functions recover to make the disease gradually improving. Professor Xu applied acrid and sweet in flavor transforming into yang, acrid medication for dispersion and bitter medication for descending, combination of cold and heat, and combination of tonic and purgative effect for harmonization to treat chronic gastritis.The Prof.Xu’s treatment for chronic gastritis was harmonizing and transformation, which meant harmonizing yin and yang, modifying the organs, adjusting deficiency-excess, regulating the qi dynamics as key method. And its medication should represent the thinking of spicy-warm, spicy-sweet and bitter-cold, the combination of five flavors with reducing-reinforcing, cold-heat, which would open the mind for us to treat the chronic gastritis. The harmonizing and transformation decoction is a combined formula based on modification of Pinelliae Decoction for Purging Stomach-Fire, Left Metal Pill, Astragalus Decoction for tonifying middle-jiao, which could be the basic formula for chronic gastritis. The therapeutic menthod of Professor Xu for chronic gastritis, like harmonizing and transforming yin-yang, treating deficiency by tonification and treating excess by purgation, regulating qi movement and so on, provide the methodology reference about the study on treatment for chronic gastritis with traditional Chinese medicine. Based on the characteristics of spleen-stomach and syndrome-differentiation, harmonizing and transformation could be a better treatment method for chronic gastritis.