Dissertation
Dissertation > Medicine, health > Chinese Medicine > TCM Internal Medicine > Modern medicine, internal diseases

Xu heart,such as clinical research summary of academic thinking and clinical experience and three-parameter Tongmai mixture treatment Chest

Author ChenJiaXing
Tutor XuXinRu
School Beijing University of Traditional Chinese Medicine
Course Integrative clinical cardiovascular and cerebrovascular
Keywords Xu-xinru Experience summary Sanshen Tongmai Heji Disease of chest stuffiness and pains
CLC R259
Type Master's thesis
Year 2011
Downloads 27
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1.Professor Xu Xin-ru:Academic Thoughts OriginProfessor Xu Xin-ru, who was born in December 1924, was a native of Shanghai and graduated from Shanghai Tongji university medical college, and then assigned to Beijing. From 1959 to 1961, for responsing to our party’s call of "Western medicine learn from traditional Chinese medicine (TCM) to improve medical health of China" , she participated in the first class named "Western learn from Chinese medicine" and systematically studied TCM for nearly three years. Professor Xu Xin-ru is an expert of combining traditional Chinese and western medicine, who was the earlist famous expert graduating from the famous university in our country. From graduated in 1962 until now, she has always been working in Beijing hospital of TCM in participating in clinical practice, scientific research, and education. After retiring from work, she continued to work in an expert outpatient service, the special consultation clinic and educational work, and so far, she has been practicing medicine in nearly 60 years. Professor Xu Xin-ru is skilled in the treatment of cardio-brain vascular disease. She is a state-level old doctor of traditional Chinese medicine, was awarded the "national march-eighth red-banner pacesetter title".Professor Xu Xin-ru was born in a family of TCM. Her greatgrandfather often gathered herbs personally to treat patients. Her maternal grandfather Jiang Zi-mei and her maternal uncle Jiang Yu-fu were both the famous dortors in the area of Jiangsu and Zhejiang provinces. They have learned from Fei Bo-xiong, a famous doctor from Menghe. Her mother Jiang Yu-qing also learned from her grandfather and grasped the key therapeutical ideas of her family. Professor Xu Xin-ru has accepted the edification of the family predecessors very early in her childhood.Professor Xu Xin-ru was a diligent and hard working expert. Because of the work affairs, she used to extensively learn from doctor Yao Zheng-ping, Guan You-bo, Wang Wei-Ian, Wang Hong-shi and Wang Da-jing, etc, for the excellent experiences of clinical practices and finally founded the "nourish Qi and Yin, and activating blood" treatment theory, and formed Sanshentongmai TCM formula which has been confirmed to be effective in the treatment of Xongbi. Meanwhile, she established the Xiefeilishui theory in the treatment of heart failure initiatively and developed a heart-failure formula called Xinshuai compound formula in the clinical practice. In the long-term practical process, professr Xu achieved mastery through a comprehensive study of the subject, and put all the theories from famous pactitioners together and took the best and formed her own characteristics at the basis of inheritance and research of the predecessors’ theory. Professor Xu Xin-ru always paid great importance in the principles of "holistic thinking" and "syndrome differentiation" and emphasized the "cure will ask its origin" in her clinical practice. At the same time, at the influnce of her family origin, professor Xu Xin-ru has paid much attention to the gentle compatibility of medicinal prescriptions and the adjustment of qi and blood of the patients in the treatment of disease and rarely used Chinese herbs with great toxicity.Xiongbi and Xintong are two terms in TCM which are belonging to the terms of coronary heart disease (CHD) in the western of medicine. It is commonly seen in patients with cardiovascular disease and is one of the leading causes of death in our society. Epidemiological studies have shown that the morbility of CHD has gradually increased each year in our country, and the morbility and mortality are both the head of the disease line in Beijing.Professor Xu Xin-ru has formed an unique TCM diagnostic and therapeutic thoughts in the treatment of Xiongbi (CHD) at the basis of decades of clinical practice and theory. Based on the modern technologies such as truthfully collection, originally save, systematically organization, the study was aimed to investigate the academic origin, academic thoughts, clinical experience, and the speculative characteristics of professor Xu Xin-ru in her treatment of Xiongbi (CHD) with her therapeutical theory "nourish Qi and Xue, activating blood" in the clinical practice. Finally, generalize the thoughts, methods, and experiences of her treatment of Xiongbi. And meanwhile, generalize the academic achievements and experiences in the treatment of heart failuer, dizziness, palpitation, insomnia and myocardial bridge,etc in TCM clinical practices. The purpose of the work above is to provide more benefit in the inheritence of experiences of professor Xu and made more younger doctors acknowledge the thoughts and methods of her clinical practice and help more people of our society.2. Arrangement and research of academic thoughts and clinical experience of professor Xu Xin-ru2.1 Xiongbi and Xintong (coronary artery disease, CHD)Professor Xu Xin-ru is the academic leader of cardiovascular department, Beijing hospital of TCM, capital university of medical sciences. She proposed the unique therapeutic theory of TCM "nourishing qi, nourishing yin, and activating blood" in the treatment of patients with xiongbi and xintong (CHD) and acquired excellent effect in clinical practice. And then, she developed Sanshentongmai herbal prescription, which were made up of astragalus membranaceus, radix pseudostellariae, radix scrophulariae, salvia miltiorrhiza, radix paeoniae rubra, white paeony root, aesculus chinensis bge, rhizoma corydalis, radix bupleuri, etc., and put it into clinics under the theory of "nurish qi and yin, activating blood". All of the above she has done combined a strengthening health with dispersing pathogenetic factor to come to a reasonable compatibility and the significant effect. 2.2 Xinshuai bing (heart failure, HF)Previously, many famous doctors or experts used to treat HF under the theories of "nourishing qi, warming yang, and promoting diuresis". Based on long-term of clinical practice and reviewing ancient literatures, professor Xu proposed the "xie lung and promote diuresis" theory in the treatment of HF. She thought that deficiency of vital energy, blood stasis, and water stasis were the basic pathological mechanisms involved in HF in TCM, so she founded the "nourish qi, warming yang, and promote diuresis" in treatment of HF and made Tinglidazaoxiefei prescription as the main formula to form a series of TCM prescriptions. She added astragalus mongholicus when qi deficiency and Shengmai San when qi and yin deficiency, added root of common peony and fruit of princesplume ladysthumb when it is in blood stasis. The theory of "xie lung and promote diuresis" often used in the water attacking the heart and Drink water shoot lung. Based on the xinshuai series of formulas, professor Xu has developed herbal suppository in the treatment of HF, which is another innovative work of pro. Xu in her TCM clinical career.2.3 Xuanyun bing (vertigo)Professor Xu thought that, from TCM point, vertigo refered to the syndromes that include dizziness and swirl. It usually stopped when closing the eyes, and aggreviated when being in a motor or a boat and can not stand upward. Sometimes, it usually accompanied with nausea and vomiting, sweating, even faint and other symptoms, In mordern medicine, vertigo can be caused by a series of disease such as hypertension, hypotention, Meniere’s syndrome, central dizziness, peripheral vertigo, neurasthenia, menopausal syndrome, cervical spondylosis, cerebral blood deficiency, etc.2.4 Xinji (palpitation)Professor Xu considered that the TCM term "palpitations" can be divided into two clinical syndromes called fright (xinji) and timidity (zhengzhong). Fright (xinji) usually related to more emotional factors, such as flash meet fear, anger, sorrow. It often occurs paroxysmally, with light condition and excess TCM syndrome. While timidity (zhengzhong) often brought about by the deficient condition after long-term disease and the injuried mind. It usually lasted for a very long time and can not be easily controlled. More attention should be paid in estimating whether the pulse is in order, fast or slow, in order to guide TCM syndrome differentiation. Palpation was divided in to deficient syndrome and excess syndrome. The deficient syndrome was qi and yin deficiency, heart yang deterioration, while excess syndrome was blood stasis, etc.2.5 Bumei (insomnia)Professor Xu considered that insomnia were a series of disorders which included hardness to sleep, wake up easily, or awake all night as the main symptoms, or of dreams. The main mechanisms of insomnia were the unbalance of yin and yang, qi and xue, which caused the disfunctions in the mind and spirit. It included two TCM syndromes:deficiency and excess. The excess syndrome were often shown as easily being interupted, hepatic disfunction, excessive diet, much heat and phlegm. While deficient syndrome can be concluded as disharmony of heart and kidney, water and fire, excessive working, injuried blood and qi, and deficiency of heart and spleen. Therefore, nourish spleen and kidney, refresh heart and slam down were both important methods for treatment of insomnia.2.6 Myocardial bridgeCoronary artery and its branches often traversed across the surface of the heart and in the epicardial fat or deep face. When a coronary artery was packaged by the myocardium, this myocardial can be called the myocardial bridge and this specific coronary artery was called mural coronary artery. The myocardial bridge may be related to the onset of coronary heart disease of local factors and also can cause myocardial ischemia. But now, in modem medicine, many treatment methods such as operation and drug medication can be applied in treatment of patients with myocardial brige or atherosclerosis plaques near the myocardial bridge. But both of these methods were poor effective and usually with wide range injuries. There was no literatures published in terms of myocardial bridge in acient times. But there are more and more patients who were suffered with myocardial bridge in clinical practice. Based on its characteristics, professor Xu thought that myocardial bridge can be defined as the TCM syndrome "disfunction of jin and muscularconstricture" and nourish blood tending medicte should be applied in relieving symptoms that were caused by repressing of the coronary artery, and finally to control the symptoms.2.7 Sweat syndromeProfessor Xu considered that sweat syndrome was more commonly seen in patients with yin deficiency and yang excess, and yin not gathering yang. Patients with sweat syndrome often had symptoms such as hot fever, sweat out, so the treatment method should be based on balancing yin and yang, inhibiting liver and nourish yin. Because sweat was the fluid of the heart, much sweating may cause deficiency of the blood and the healthy atmosphere, so the Chinese medical herbs which have the characteristics of nourishing qi and yin should be added. It is of importance to add herbs with nourishing qi characteristics when patients are in the qi deficiency condition. It is not always the qi deficiency syndrome when sweating after moving, and inner hot can also cause sweating. Patients of qi deficiency often exhibit sweating after moving. The kidney qi deficiency syndrome often accompanied with lumbar debility and sweat more under the waist, so Chinese herbs with nourishing qi and yin should be added. Patients of lung qi deficiency are often easily to catch a cold. Patients with the syndrome of inner hot often showed symptoms such as dry mouth, thirsty, sweat out, red face, drink much, so adding nourishing yin product to prevent yin injury.2.8 Academic experience of professor Xu in treatment of CHD:clinical study.In our clinical trial,110 patients with CHD are randomly divided into two groups, and respectively administered with Sanshentongmai compound prescription and normal western medical treatment. The observational indexes included main symptom scores, main symptom total scores, and accompanied symptoms scores. The results showed that the main symptom scores, main symptom total scores, and accompanied symptoms scores were significantly decreased compared to the pre-treatment. The symptoms of chest distress, degree of chest pain, chest pain frequency, consumed nitroglycerin, palpitation, and fatigue are both relieved in Sanshentongmai treatment group compared to those in the normal medical treatment group. The therapeutic view of "nourishing qi and yin, activating blood and promoting circulation", which is founded by professor Xu, is confirmed to be effective in treatment of Xiongbi (coronary artery disease) in clinical practice. Objective:To observe the clinical effect of Sanshen Tongmai Heji in the treatment of coronary atherosclerotic heart disease(CHD). Methods:Cornary atherosclerotic heart disease patients were randomly divided into 2 groups.The patients in the control group (52 cases) received conventional western medicine treatment, the Sanshen Tongmai Heji group (58 cases) received conventional western medicine treatment plus Sanshen Tongmai Heji. The follow-up underwent for 4 weeks.The changes of clinical symptoms and ECG were observed. Results:The symptom score decreased significantly after treatment. Better clinical effects were observed after treatment, there are 40 cases indicated excellent efficacy(68.96%),18 out of 58 had good efficacy(31.03%), total effective rate is 100%. Besides that, it can also relieve the symptoms compared with Western medicine group (P<0.05).Conclusion: Sanshen Tongmai Heji can significantly improved clinical effects of CHD patients and improve the quality of life for the patients.

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