| Professor Gao Zhongying, born in a family specializing in traditional Chinese medicine (TCM), has studied medication since his childhood and acquired the proficiency in internal medicine, gynecology and pediatrics. As one of 500 eminent TCM experts identified by the National Ministry of Health, he is also among the second, the third and fourth batch of national successor mentors. With 58 years of experiences in clinical medicine, teaching and research work, he has served as the director successively in the Research Departments of Traditional Chinese Internal Medicine and TCM Formulas in the TCM School of Capital Medical University. By studying the principles of medical science, Professor Gao has became a master on classical medical books, and created the "five-organ reinforcing method", which breaks traditional theoretical concepts and expands the meaning of reinforcing method. Clinical evidences have shown that, Professor Gao can achieve effective treatment with precise and appropriate prescription. He has rich clinical experiences in applying pure Chinese medicine to treat chronic gastritis. This study consists of three parts.PartⅠreviews origins of Professor Gao Zhongying’s academic thoughts. Based on methods of interview and analytical induction, origins of Professor Gao’s academic thoughts are summarized, finishing his heritage genealogy and heritage status, while excavating the formation process of his academic thoughts and clinical experiences, clearing the relationship of each professional school of TCM related to Professor Gao Zhongying’s the spleen and stomach field, excavating and finishing Professor Gao’s academic thoughts of spleen and stomach in the TCM classic works. The study included Professor Gao’s road to success, medical family tradition, Beijing traditional Chinese medicine project "Passing Heritage 3+3" and his workstation of Chinese traditional medicine experts are presented. Introducing such medical ancient classics as Nei Jing from which Professor Gao has derives the academic thoughts concerning spleen and stomach are exhaustively researched, and the well-know ancient medical scholars such as Zhang Zhongjing, Li Dongyuan, and Ye Tianshi. The relationship of various TCM schools specialized in stomach and spleen, including Shi Jinmo, Wei Shuhe, Dong Jianhua, Guan Youbo, Li Qiangou. Their different ways to inherit tradition and make creation are clearly defined..PartⅡ, Gao Zhongying’s academic thoughts and clinical experiences are finished and studied. His academic thoughts embodied in the study of the clinical formula rules, this part from five aspects describes the "five-organ reinforcing method" respectively, the rules of Clinical formula, special viewpoints of formula, his spleen and stomach theory, and his therapy on respiratory diseasesFirstly, a deep analysis is made on Professor Gao’s theoretical and academic thoughts of reinforcing five internal organs, which exactly reflects the compatibility rule in combining herbs to reinforce the Qi, blood, Yin and Yang and is an essential and compliance principle for replenishing the deficiency of five internal organs. The followings are extracted from Professor Gao’s theory:the deficiency of five internal organs doesn’t mean the deficiency of blood, Yin and Yang, but means different emphasis according to the physiological characteristics of the five internal organs and their pathological features. The reinforcing of spleen, lung and kidney focuses on Qi, Yang and Yin. The reinforcing of heart and liver can also strengthen the Qi, blood, Yin and Yang.In his years of pharmacology teaching, Gao Zhongying, based on his extensive reading of medical classics and rich teaching experiences, points out the disadvantage of the present formula teaching and puts forward his unique views. Apart from teaching, he did lots of clinical works combining with the theories, and makes great efforts to reach the top level of formula study which refers to find out the rules of clinical medicine.Professor Gao Zhongying not only absorbed many insights in the theories but also makes innovation in dealing with spleen and stomach diseases. His spleen and stomach academic thoughts originated from the Nei Jing, and differentiation form Zhang Zhongjing, and Li Dongyuan summarized all of them. In the Qing Dynasty, Ye Tianshi proposed the academic concept of separately treating the spleen and stomach with an emphasis on nourishing the stomach Yin, making a supplementary to Li Dongheng’s theory of focusing more on treating spleen than on treating stomach and focusing on warming than on nourishing Yin. Professor Gao concentrates on studying ancient theories on the spleen and stomach but doesn’t blindly obey them. He has put forward his own insights that the production of stomach Yin originates from the Qi transformation of middle burner. Spleen Yang represents the entire digestive function, while the spleen Yin includes the digestive fluid and lubricating fluid (saliva, esophagus lubricating fluid, gastric juice, intestinal juice, etc.) in upper and lower digestive tracts. As a part of the spleen Yin, stomach Yin (fluid) is the digestive fluid sublimated from body fluid by spleen Yang. When the gland of gastric mucosa atrophies, the stomach yin is short of production, the essential way is that the spleen should be reinforced to promote the source. Professor Gao has gradually formed his own unique theoretical system. In the treatment of chronic gastritis, he also has unique insights and clinical experience. From the physiology & pathology of spleen and stomach as well as the etiology & pathogenesis of chronic gastritis, he proposes the theory that most chronic gastritis are the deficiency of the root and the excess of the branch, its core pathogenesis lies in the spleen insufficiency and stomach dryness, so the treatment should focuses on reinforcing the spleen Qi, nourishing Yin and moistening the dryness, and combining the differentiation of syndromes and diseases. Its core ideas:(1) the spleen deficiency and stomach dryness are the basic pathogenesis of chronic gastritis; (2) the spleen deficiency is the inevitable result of weakening digestive function; (3) the stomach dryness is the characteristics of chronic gastritis; (4) the spleen deficiency and stomach dryness are the reasons for Yang and Yin deficit of chronic gastritis; (5) reinforcing the spleen and moistening the stomach are the basic treatments to chronic gastritis. Syndrome Differentiation Classification is the basis of treating chronic gastritis. It also emphasizes attribution of spleen deficiency and stomach dryness, combined with endoscopic mucosal swelling, ulceration, atrophy observed, so as to make correct herbs selection to obtain good effect.Professor Gao Zhongying has quite rich diagnosis and treatment experiences, covering internal medicine, surgery, gynecology and Pediatrics, especially specialized in various digestive system and respiratory system diseases such as chronic atrophic gastritis, gastro-esophageal reflux disease, ulcerative colitis, chronic intractable cough, allergic rhinitis and allergic asthma. He also shows originality in gynecological medicine, with the outstanding characteristics of "emphasizing Chong, Ren while thinking about Yangming", "stressing to regulate menstruation and removing blood stasis", "descending Yangming in harmony and regulating menstruation" and "preferring warm herbs and keeping uterus warm first". Besides, he has achieved very good clinical effect with warm herbs in the treatment of hypertensive disease and recurrent oral ulcer and with Tingli pill in children cough and asthma.PartⅢClinical research on Professor Gao’s academic experiences In order to better study and inherit Professor Gao’s academic thinking of spleen and stomach, and improve the level of clinical treatment, this research has summed up and mined his clinical medication rules in treating chronic gastritis from multiple perspectives. By entropy clustering technology of complex systems, mine Professor Gao’s formula data, and discuss the rules of formula which have good effects in the treatment of chronic gastritis.Methods:First, apply entropy clustering methods with Epidata 3.1 database platform to deal with formula data, and draw conclusions. Search for the formula laws behind the database mainly from the three aspects. The first aspect referred to the single herb, and it was mainly achieved through the frequency method; the second aspect referred to the analysis on couplet herbs, mainly through mutual information and association rules, etc., to discuss the commonly used couplet herbs for spleen & stomach diseases and initially reveal the formula rules; and the last aspect referred to the combination laws of many herbs, which were discussed through the entropy clustering of complex systems, clustering analysis, principal component analysis and factor analysis. These three aspects mutually supplemented and corresponded with each other, revealing Professor Gao Zhongying’s formula laws together.Meanwhile, the software Pajek for complex networks was applied in the process. It not only provided a set of fast and efficient algorithms for analyzing complex networks, but also presented a visual interface to facilitate the understanding on the structural characteristics of complex networks from a visual point of view. Through an analysis on the commonness of Professor Gao’s formula, we found the compatibility structure that reflected formula thinking and core clinical features, thus supporting the arrangement of Professor Gao’s experiences.Results:Through the above-mentioned methods, we analyzed and screened 730 formulas in the database, and found 30 herbs most frequently used in the treatment of chronic gastritis. By applying the method of modified mutual information, we got 94 commonly-used herbs with correlation coefficients of above 0.05; and through entropy clustering method of complex systems, we found 11 core combinations. Entropy clustering method of complex systems was used to build the association among 80 herbs commonly used for treating chronic gastritis, and 122 associations were obtained. We draw out the classified graph of complex network nodes of herbs commonly used for chronic gastritis. According to statistics, cuttlebone had the highest frequency of 355, trichosanthin 347, heterophylla 324, bulbus fritilariae 300, atractylis ovata 296, pinellia rhizome fermented mass 244, rhizoma zedoariae 201, endothelium corneum gigeriae galli 196, amomum villosum 144, radish seed 142, paeonia lactiflora pallas 126, rhizoma coptidis 125, evodia rutaecarpa 116, baked ginger 94, forsythia 80. This result is completely in line with clinical practice, and they are essentially Professor Gao’s commonly used herbs for chronic gastritis. Combining the above result of complex network with clinical practice, we can draw the following conclusions:We have summed up the following prescriptions by combining the network data with clinical observations:the basic formula for chronic superficial gastritis:heterophylla (or codonopsis), atractylis ovata, cuttlebone, thunbery fritillary bulb (or fritillary), trichosanthin, endothelium corneum gigeriae galli, forsythia and pinellia rhizome fermented mass. The basic formula for chronic atrophic gastritis:heterophylla (or codonopsis), atractylis ovata, cuttlebone, thunbery fritillary bulb (or fritillary), trichosanthin, root of straight ladybell, ophiopogon root, polygonatum, yam, dendrobium and astragalus.Innovative concept:In summing up the professor’s experiences, we have gradually formed our own ideas and introduced innovative concept to the theory of chronic gastritis treatment, namely, we proposed a further subdivision based on Professor Gao’s theory that the core pathogenesis of chronic gastritis lies in the deficiency of spleen and dryness of stomach. According to the development and evolution of chronic gastritis, the deficiency of spleen is always there, and the dryness of stomach can be divided into two phases, the first of which is chronic superficial gastritis with excess heat of stomach dryness, and the second phase is the chronic atrophic gastritis with deficiency heat of stomach dryness.The related basic research has been with Tsinghua Information Science and Technology (raise) National Laboratory the Ministry of bioinformatics research, to carry out "Based on Bioinformatics and Metabolomics of Cold and Heat Syndrome of Chronic Atrophic Gastritis Markers of Network Research," and has been approved.Based on Professor Gao Zhongying’s basic formula for treating chronic gastritis, we have made breakthroughs in clinical medication by modifying the formula according to patients’ different symtoms.For instance, herbs for reducing fever (such as skullcap, dandelion, etc.) can be appropriately added to treat reddening and swelling of mucosa or Hp infection; and patients with cold-heat jumble can also use appropriate dose of Zhang Zhongjing’s decoction of tuber pinellia for removing the heart-fire. Moderate to severe superficial gastritis or atrophic gastritis can adopt more herbs for invigorating blood circulation and eliminating stasis such as salvia miltiorrhiza and rhizoma zedoariae, etc. to contribute to the reversion of gastric atrophy. For patients with moderate to severe dysplasia, more forsythia and fritillaria should be additionally added with herbs for softening hard lumps and dispelling nodes, such as raw oysters, spina gleditsiae, selfheal, etc. to enhance efficacy; and anti-cancer drugs (such as Herba Oldenlandiae, Herba Scutellariae Barbatae, etc.) can be early used for intervention to prevent gastric cancer.Applying the reinforcing spleen and tonifying the stomach decoction we made to treat 46 cases of the chronic superficial gastritis comparing to the control group treated by conventional western medicine drugs, the total effect rate, main symptoms, the pathological changing condition under gatroscopy are obvious difference between two groups (P＜0.05,P＜0.01.) The related academic paper already have been published Chinese Journal of Integrated Traditional and Western Medicine on Digestion In order to better study and inherit Professor Gao’s academic thinking of spleen and stomach, and improve the level of clinical treatment, this research has summed up and mined his clinical medication rules in treating chronic gastritis from multiple perspectives. By entropy clustering technology of complex systems, mine Professor Gao’s formula data, and discuss the rules of formula which have good effects in the treatment of chronic gastritis. Methods:First, apply entropy clustering methods with Epidata 3.1 database platform to deal with formula data, and draw conclusions. Search for the formula laws behind the database mainly from the three aspects. The first aspect referred to the single herb, and it was mainly achieved through the frequency method; the second aspect referred to the analysis on couplet herbs, mainly through mutual information and association rules, etc., to discuss the commonly used couplet herbs for spleen & stomach diseases and initially reveal the formula rules; and the last aspect referred to the combination laws of many herbs, which were discussed through the entropy clustering of complex systems, clustering analysis, principal component analysis and factor analysis. These three aspects mutually supplemented and corresponded with each other, revealing Professor Gao Zhongying’s formula laws together.Meanwhile, the software Pajek for complex networks was applied in the process. It not only provided a set of fast and efficient algorithms for analyzing complex networks, but also presented a visual interface to facilitate the understanding on the structural characteristics of complex networks from a visual point of view. Through an analysis on the commonness of Professor Gao’s formula, we found the compatibility structure that reflected formula thinking and core clinical features, thus supporting the arrangement of Professor Gao’s experiences.Results:Through the above-mentioned methods, we analyzed and screened 730 formulas in the database, and found 30 herbs most frequently used in the treatment of chronic gastritis. By applying the method of modified mutual information, we got 94 commonly-used herbs with correlation coefficients of above 0.05; and through entropy clustering method of complex systems, we found 11 core combinations. Entropy clustering method of complex systems was used to build the association among 80 herbs commonly used for treating chronic gastritis, and 122 associations were obtained. We draw out the classified graph of complex network nodes of herbs commonly used for chronic gastritis. According to statistics, cuttlebone had the highest frequency of 355, trichosanthin 347, heterophylla 324, bulbus fritilariae 300, atractylis ovata 296, pinellia rhizome fermented mass 244, rhizoma zedoariae 201, endothelium corneum gigeriae galli 196, amomum villosum 144, radish seed 142, paeonia lactiflora pallas 126, rhizoma coptidis 125, evodia rutaecarpa 116, baked ginger 94, forsythia 80. This result is completely in line with clinical practice, and they are essentially Professor Gao’s commonly used herbs for chronic gastritis. Combining the above result of complex network with clinical practice, we can draw the following conclusions:We have summed up the following prescriptions by combining the network data with clinical observations:the basic formula for chronic superficial gastritis:heterophylla (or codonopsis), atractylis ovata, cuttlebone, thunbery fritillary bulb (or fritillary), trichosanthin, endothelium corneum gigeriae galli, forsythia and pinellia rhizome fermented mass. The basic formula for chronic atrophic gastritis:heterophylla (or codonopsis), atractylis ovata, cuttlebone, thunbery fritillary bulb (or fritillary), trichosanthin, root of straight ladybell, ophiopogon root, polygonatum, yam, dendrobium and astragalus.Innovative concept:In summing up the professor’s experiences, we have gradually formed our own ideas and introduced innovative concept to the theory of chronic gastritis treatment, namely, we proposed a further subdivision based on Professor Gao’s theory that the core pathogenesis of chronic gastritis lies in the deficiency of spleen and dryness of stomach. According to the development and evolution of chronic gastritis, the deficiency of spleen is always there, and the dryness of stomach can be divided into two phases, the first of which is chronic superficial gastritis with excess heat of stomach dryness, and the second phase is the chronic atrophic gastritis with deficiency heat of stomach dryness.The related basic research has been with Tsinghua Information Science and Technology (raise) National Laboratory the Ministry of bioinformatics research, to carry out "Based on Bioinformatics and Metabolomics of Cold and Heat Syndrome of Chronic Atrophic Gastritis Markers of Network Research," and has been approved.Based on Professor Gao Zhongying’s basic formula for treating chronic gastritis, we have made breakthroughs in clinical medication by modifying the formula according to patients’ different symtoms.For instance, herbs for reducing fever (such as skullcap, dandelion, etc.) can be appropriately added to treat reddening and swelling of mucosa or Hp infection; and patients with cold-heat jumble can also use appropriate dose of Zhang Zhongjing’s decoction of tuber pinellia for removing the heart-fire. Moderate to severe superficial gastritis or atrophic gastritis can adopt more herbs for invigorating blood circulation and eliminating stasis such as salvia miltiorrhiza and rhizoma zedoariae, etc. to contribute to the reversion of gastric atrophy. For patients with moderate to severe dysplasia, more forsythia and fritillaria should be additionally added with herbs for softening hard lumps and dispelling nodes, such as raw oysters, spina gleditsiae, selfheal, etc. to enhance efficacy; and anti-cancer drugs (such as Herba Oldenlandiae, Herba Scutellariae Barbatae, etc.) can be early used for intervention to prevent gastric cancer. Applying the reinforcing spleen and tonifying the stomach decoction we made to treat 46 cases of the chronic superficial gastritis comparing to the control group treated by conventional western medicine drugs, the total effect rate, main symptoms, the pathological changing condition under gatroscopy are obvious difference between two groups (P＜0.05,P＜0.01) The related academic paper already have been published Chinese Journal of Integrated Traditional and Western Medicine on Digestion... |
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