The Literature Research Of Syndrome Differentiation And Treatment Characteristics Of Arthralgia Syndrome And Syndrome' S Element Rules Of Four Rheumatism

Backgrouds:Arthralgia Syndrome is studied early in Traditiona Chinese Medicine (TCM), which is matched with some of rheumatoid disease such as rheumatoid arthritis (RA), gouty arthritis (Gout), osteoarthritis(OA) and so on in Modern Medicine. Literature has played a great role in the phylogeny of TCM. Not only the number of rich, also which accumulate a lot of experience on the syndrome differentiation and treatment of Arthralgia Syndrome, The experiment of curing Arthralgia Syndrome by the Physicians of the are practical and effective. They also have influences in the curing methods of Arthralgia Syndrome to the physicians of later ages.Objectives:On the basis of previous studies, this study aims at collection and studies of syndrome differentiation and treatment of Arthralgia Syndrome in ancient medical books, which tend to generalize syndrome differentiation characteristic and evolutive rule. Another, Extracting syndrome element from the Published literatures of Arthralgia Syndrome, and includes the TCM syndrome in them, exploring the syndrome differentiation current situation in the perspective of syndrome element, for further improving the accuracy of syndrome differentiation and better guiding TCM to play a role in Arthralgia Syndrome clinical diagnosis and treatment.Methods:1. Literature comment. Based on the summarization of the academic thoughts and clinical experiences of famous ancient and modern physicians, this study collects and studies medical literature, case histories, medical discussions and descendant interpretations of their academic thoughts from 《Inner Canon of the Yellow Emperor》,《Synopsis of the Golden Chamber》, Two Jin-Southern and Northern Dynasty, Sui-Tang Dynasty, Song-Jin-Yuan Dynasty, Ming-Qing Dynasty and Modern times, so as to generalize their knowledge and sum up syndrome differentiation characteristic and rules with commenting.2. Statistical analysis. By integrated retrieval method, the main database Guangzhou University of Chinese Medicine, combined with VIP Medical database, access the literature which include rheumatoid arthritis, gouty arthritis, ankylosing spondylitis and osteoarthritis have published in2000——2011in China. With reference to inclusion and exclusion criteria,collect the eligible documents, extract syndrome element and establish database, entrying the data area such as pattern of syndrome, frequency to analyse by statistical software, include the literature syndrome element and the percentage frequency distribution of descriptive.Results:The part of Literature Research1.《Inner Canon of the Yellow Emperor》 laid theoretical basis of Arthralgia Syndrome. It is for the first time to propose pathogenesis of this disease that is winds cold and dampness combined with internal factors.2.《Synopsis of the Golden Chamber》 is the development time of syndrome differentiation and treatment. Zhang Zhongjing's awareness on etiology and pathogenesis of disease is deeper than before. He emphasizes the dampness and deficiency of liver and kidney. Although the pathogenesis theory of phlegm and blood stagnation is not fully formed, it had an initial germination.3. The Wei-Jin and Sui-Tang Dynasty is period of deepening combination of theory and clinical practice. The physicians complemented the etiology and pathogenesis of toxin and identified dispelling wind and activating blood, clearing heat to cool the blood and detoxify and other rules, with founding so many prescriptions such as decoction of rhinoceros horn.4. Song and Jin-Yuan Dynastyn is an comprehensive development and innovation period of Arthralgia Syndrome. The doctors are mainly used visceral pattern identification syndrome differentiation theory to deepen the theoretical system of this disease. There were four famous physicians who had new breakthrough in diagnosis and treatment. The View of dampness-heat, deficiency of spleen and stomach, blood-heat and phlegm-dampness had a profound effect on later generations. 5. The Ming-Qing Dynasty is a mature and perfect period of syndrome differentiation and treatment system of Arthralgia Syndrome. As the school of epidemic febrile disease was born, the doctors in China began to perfect the dampness-heat and summerheat as the pathogenesis. The theory that meridian and collateral was prosperous made doctors pay more attention to deficiency of liver and kidney. As the blood stasis theory of mature, doctors had begin to attach importance to the pathological product, especially the key role of phlegm and blood stasis in the condition changes.6. In modern times, the combination of traditional Chinese and Western medicine is the main measure of diagnosis and treatment for Arthralgia Syndrome. The theory system has been continuously enriched and clear. Some of rheumatology physicians put forward new perspectives combining with the development of modern medicine. Professor Lou Duofeng proposed the new theory called deficiency evilstasis. Academician Wang Yongyan also advanced another theory which emphasize the syndrome differentiation and treatment with collaterals. In addition, with more and more syndrome type of the disease, we are entering into a standardized and objective orbit gradually.The part of Syndrome's Element from Modern Literature1. The number of literature met the inclusion criteria is339, including the number of RA has119, AS has71, Gout has90and OA has59. Clinical research type has192, Syndrome analysis type has47, Experience summary type has100.2. After the criterion of syndrome's names, distribution of syndrome's types of these four kinds of disease is as follows. RA has51syndrome's types in total with eight common syndromes, including wind cold dampness bi-complex syndrome, phlegm and blood stasis syndrome, liver-kidney yin deficiency syndrome, dampness heat bi-complex syndrome, wind dampness heat bi-complex syndrome, cold dampness bi-complex syndrome, cold-heat complex syndrome, dual deficiency of qi and blood syndrome. AS has44syndrome's types in total with five common syndromes, including cold dampness bi-complex syndrome, liver-kidney yin deficiency syndrome, dampness heat bi-complex syndrome, kidney yang deficiency syndrome, blood stasis bi-complex syndrome. Gout has43syndrome's types in total with six common syndromes, including dampness heat bi-complex syndrome, phlegm and blood stasis syndrome, blood stasis-heat resistance winding syndrome, liver-kidney yin deficiency syndrome, phlegm blocking syndrome, wind dampness heat bi-complex syndrome. OA has52 syndrome's types in total with five common syndromes, including liver-kidney yin deficiency syndrome, qi stagnation and blood stasis syndrome, cold dampness bi-complex syndrome, blood stasis bi-complex syndrome, wind cold dampness bi-complex syndrome.3. After the statistical analysis, distribution of syndrome's elements of location in these four diseases is as follows. RA has five syndrome's elements of location in total, including bones, kidney, liver, spleen and stomach. AS has five syndrome's elements of location in total, including bones, kidney, liver, lung and spleen. Gout has five syndrome's elements of location in total, including bones, kidney, liver, spleen and gallbladder. OA has six syndrome's elements of location in total, including bones, kidney, liver, spleen, lung and stomach. Bones, kidney, liver and spleen can be found in these all four diseases above.4. After the statistical analysis, distribution of syndrome's elements of nature in these four disease is as follows. RA has thirteen syndrome's elements of nature in total, including dampness, heat, cold, wind, blood stasis, phlegm, yin deficiency, yang deficiency and qi deficiency are common syndrome's elements. AS has fourteen syndrome's elements of nature in total, including dampness, heat, blood stasis, cold, yang deficiency and are common syndrome's elements. Gout has twelve syndrome's elements of nature in total, including dampness, heat, blood stasis, phlegm, cold, wind and toxin are common syndrome's elements. OA has thirteen syndrome's elements of nature in total, including dampness, blood stasis, cold, yin deficiency, qi stagnation, yang deficiency, phlegm, heat are common syndrome's elements. Dampness, heat, blood stasis, cold, yin deficiency, phlegm, yang deficiency, wind, qi deficiency and blood deficiency can be found in these all four diseases above.5. The. combination form of syndrome's elements in these four kinds of disease include single syndrome's element and multi-syndrome's elements, multi-syndrome's elements include single location and nature syndrome's element, single location and multi-nature syndrome's elements, multi-location and single nature syndrome's elements. The combination form of three syndrome's elements is the most common. The combination form of two and four syndrome's elements followed by.Gonclusion:1. Literatures reviewed shows that:Through the ages, syndrome differentiation of Arthralgia Syndrome undergoesed a change from outside to inside, simple to complex, shallow to deep, intuitive to abstract, leaving behind a valuable information to younger generations. In syndrome differentiation, Neijing focused primarily on wind, cold and dampness. Zhang Zhongjing focused on dampness more than before and emphasized on liver and kidney deficiency for internal. The doctors added toxin evil in Sui and Tang Dynasties. The physicians of Jin and Yuan Dynasty were the courage to breakthroughs and innovations, who advanced deficiency of spleen and stomach, damp-heat and phlegm. The expert of epidemic febrile in Qing Dynasty studied Arthralgia Syndrome with damp-heat mainly adding blood stasis and qi deficiency later. With further research and specification in modern, system of syndrome differentiation is more clarity after appearance of deficiency, evil and stasis and differentiation from collaterals which can specified in a specific direction for the future research. In treatment, from a simple acupuncture treatment and herb treatment to combination, also developing the Dao-yin and fumigation and other methods. The formulations added cream, pill, powder gradually not only decoction. The beginning of Chinese and Western medicine combined with the treatment from nearly one hundred years.2. Modern literature study shows that:We have the unified understanding of Arthralgia Syndrome today by some following points. First, the researchers combine Arthralgia Syndrome with Rheumatic autoimmune diseases. Secondly, most of researchers have the comprehensive and profound understanding of the etiology and pathogenesis of Arthralgia Syndrome, including evils, deficiency and pathological product. Evils include wind, cold, damp and heat. Deficiency involves organs including kidney, spleen and liver. Pathological product refers to phlegm and blood stasis mainly. Third, the studies of syndrome type are still in its infancy, Lack of uniform standards and norms. With the number and achievements of studies, it is insufficient to support the clinical application and research.3. The study of syndrome's types and syndrome's elements shows that: the number of syndrome's types is so large and complex, but its distribution is scattered. In contrast, the number of syndrome's elements is less than types. The main position elemnts are bones, liver and kiedney. The root of Arthralgia Syndrome is deficiency of liver and kidney, at the same time, the tip is damage of bones. The main nature elemnts are dampness, heat and blood stasis. We can speculate wet evil and blood stasis is the main pathological changes of the paralysis disease from this. This shows combination of that can syndrome's elements cover most of the information of disease.4. The law of combination form shows that three syndrome's elements is the most. The same are yin deficiency+liver+kidney, dampness+heat+bones, blood stasis+bones which can reflect the nature of Arthralgia Syndrome.With simple classification and flexible combination, the syndrome's element can reflect the characteristics of the disease also the complexity and variability of clinical syndromes. In practical application, it will solve the the key point easily.