| Objective"Wang Xu Gao Medical Records" and "Wu Ju Tong Medical Records" is more popular in modern times later valued two medical case, these two main medical case is not only a record of the treatment process, but also in the two physicians Throughout his life comprehend practice resulting theoretical framework under. And two physicians are detailed record of every treatment process, Wu Ju Tong even up to four or five diagnostic records, and some patients can one day a diagnosis, careful treatment. Save blindly blindly drugs plus drugs, diagnosis and treatment of both before and after the judgment is based, and therefore all clinical study and research significance of medical records. In two physicians Medical Records as comparative studies, a clearer understanding of the development of Chinese medicine, empirical academic ideological consistency surname Changes in clinical practice, that is, from the Nei Jing era caused Treatise on the era, the development to the Qing temperature disease era thinking on the changes of exogenous disease, whether the disease is also true in the other, whether to become a universal value on the era, is worth exploring.Papers from two physicians Biography and academic evolution of departure by doctors studying medicine background and history, and to reflect the thinking in the medical technology, but also the formation of important academic process. Also compare two medical case writing characteristics and differences, as well as medical case and the overall number of cases of drug type and frequency statistics, has two doctors understand drug habits and characteristics. By Wang Xu gao standard "Liver Ways in 30" and Wu Ju Tong "early disease liver depression, chronic illness into the network" concept, the actual analysis of medical records of medication status, showing the true face of the most hair cut herbs. Select jaundice, accumulation, vertigo and four stroke syndromes, for medical case and Wang Xu Wu gao Ju Tong Department of liver disease compared the combination of Western medicine comparative cognition, Nei Jing, Zhang Zhongjing Qing Dynasty era of the two physicians certified academic point of view and medication differences from their "medical door tips" and "cronyism disease book" theoretical framework extends to medical records content, to detailed analysis and comparison study two doctors the four liver syndrome characteristics and the similarities and differences of the clinical cases, the in liver syndrome summed up the four core clinical applications.MethodsMedical History Document traditional medical case studies and original research method of combining sorting through different versions of the original medical records and a lot of repetitive reading, two physicians and other reference works, then by "Chinese Medical Classics" electronic books "China academic Journal (online version)," Chinese excellent Master thesis, etc., by a wide deep study by two physicians in clinical practice to its final operating comprehensive academic ideological essence of his life practice. Wang Xu gao and deep Wu Ju Tong Medical Records content and repetitive a lot of reading, can appreciate the academic certificates do not speak standard Chinese medicine stresses disease, like headache, dizziness, stroke Jieke move from the liver wind syndrome, but it is also different diseases under the spirit of traditional Chinese medicine. Analysis in a lot of reading, two other scholars and doctors academic argument medical case studies, but also enrich the important reference of this study.Data sources and academic point of view the formation process of the present dissertations, with a spreadsheet (EXCEL) software to count two doctors Medical Records number of cases, the number of drugs, the proportion and habits. Although medicine is profound, but the "Compendium of Materia Medica" recorded more than eighteen hundred of herbal medicine, the ancient physicians, no one can make use, drug habits take medical case statistics for two Doctors Qing liver syndrome in medical practice, the whichever is the most clinically used drugs, traditional Chinese medicine as a depth of choice to study medicine.Finally by jaundice, accumulation, dizziness and stroke four liver Medical Records collection, comparison and analysis to support the theoretical basis of Wang Xu gao-Liver Ways in 30, and two physicians and clinical characteristics of the diagnosis and treatment, as the development of the Liver Syndrome history, clinical guidance past with the future educational.ResultsAccording to the research methods, this thesis summarizes the following results:(A) medical records commonly used drugsWang Xu gao Liver Ways in 30 described 30 kinds Liver laws and prescriptions, there are four types of liver syndrome, prescription 12, lists 112 drugs flavor. Liver syndrome type 4 were liver Treatment, Treatment of liver wind, cold anger Treatment of liver and other liver deficiency syndrome and treatment. They include drugs, if after deducting cross syndromes repeat medication 19 flavor, drug Wang actual Liver Ways in 30 enumerated 93 flavor.According to Wang Xu gao governance principles Ways in 30 liver, liver two statistical Medical Records liver syndrome drug use frequency statistics. "Wang Xu gao medical case, " the total number of 364 kinds of drug use category, the top five drugs respectively, to yellow (190), Angelica (168), white peony root (133), licorice (131) and Radix (129). Wang Xu gao drug based on the classification of function, to yellow can Xifeng Yang, Liver, Bugan yin; Angelica can liver, enrich blood; TGP can Xifeng Yang, earth-wind, slow liver, (earth) vent wood, of the liver, liver convergence, Bugan yin, or to vent liver drug plus heat and cold; licorice can be earth-wind, diarrhea child; Radix earth-wind energy, clean golden wood. To interpret from yellow, angelica, white peony root three drugs, the first re Dafa Liver yin, liver and kidney homologous and water is not Han wood-based concept. The total number of "Wu Ju-tong’drug use category is 266 species, licorice (347), Citrus (302 times), Radix (182), to yellow (173), white peony root (165) the highest rates. Wang Xu gao compared with the first heavy licorice, orange peel, is the first real spleen liver Zhongjing governance concept based.(B) evidence-based analysis:five of liver syndrome of drug use1. Liver Treatment:Wang Xu gao:Almond (128), wood (65), sweet (61), fumarate (58) timesWu Ju Tong:Almond (251), turmeric (103), inulin (101 times), sweet (86), white cardamom (86 times).2. Treatment of Liver Wind:Wang Xu gao:Dan (79), Uncaria (70), abalone (59) per reference (55), horns (49).Wu Ju Tong:Dan (143), the reference element (84), mint (66), horns (43), chamomile (37).3. Treatment of angerWang Xu gao:Radix (106), berberine (90 times), (Black) Gardenia (74), leaves (64), skullcap (53).Wu Ju Tong:skullcap (162), forsythia (161), berberine (110 times), Alisma (68), Radix (48).4. Cold liver and other liver deficiency syndrome and treatment:Wang Xu gao:Semen (59), cinnamon (42), medlar (34th), Cistanche (26), Eucommia (25).Wu Ju Tong:Shu (Sichuan) pepper (65), cinnamon (26), Ruddle (9), Chuan Xiong (8), plum (8).(C) Selection and analysis of four liver syndrome1. Jaundice:Modern medicine is part of the liver jaundice jaundice system disorders, Chinese medicine is considered a kind of yellow jaundice is a condition of the disease, often with yellow body, yellow eyes, yellow urine clinical features. Although the "Q · thorn hot papers":"liver fever who first yellow urine, abdominal pain lying, body heat, " noted jaundice syndrome liver disease, but there are five Chinese medicine is said jaundice associated with the five internal organs, non-exclusive in the liver. Wang Xu gao jaundice door included only medical case six cases, none of the liver and jaundice syndrome, but not in the liver by the so-called syndrome of jaundice, jaundice seen in Chinese medicine is not necessarily a liver syndrome.Jaundice, a disease, Wu Ju Tong is not documented in the "Wu Ju Tong Medical Records", but it listed in the "warm Diseases identified. " Wu Ju Tong in five do not have a negative Dan jaundice jaundice are all hot and humid that also criticized Yu Jia Yin Huang Zhongjing for a license does not deal with criticism, to the Yellow River is without the Zhongjing. But Luo Fu Qian, the yin and yang forces identified, praised Canada, this same thinking and Wang Xu gao. Wu jaundice syndrome, summed syndrome Ordinance 35, a total of 12 square prescription treatment. Taming the first weight three diagnostic directions: First, the first trial jaundice hair and no hair, that small convenience and unfavorable; it is easy to cure jaundice and intractable, that thirst of mouth and thirst. Second, re-examine stasis of the stomach due to the heat, or because of outside and, within reason, or hair, or because the food valley, intoxicated or solid alcohol, color or because workers have been with Xuxue, yellow sweat into the water; the third is subdivided not up and down the list, to make an on Sheng heat, Yu who urinate difficult; and in the virtual virtual table, except for hot hiccup, fire caused by robbery yellow. Wang Xu Treating relatively high contrast delicate lot.2. accumulateThe accumulation of pathogenesis is mainly derived from blood stagnation caused by the cause of many affectionate governance issues, securities found in "chest", "branch under the heart", "belly", "sash", "intestinal membrane original" and other parts of the occurrence of swelling hard pain problems. Wang Xu gao think liver controlling dispersion and the main blood collaterals, liver failure Chang vent, or depression, or hyperactivity, prone to cause improper air transport and blood disorders. Liver qi stagnation or blood disorders, bleeding or pain, or to disease product lump in the abdomen, it is also often one of the accumulation of liver syndrome ring, only one certificate of non-liver disease and is usually caused by refractory card. Medical Records respect, "Wang Xu gao Clinical medical books eds" in Liu’s "selection ring River Cottage Medical Records" and the party till Xia made the "Wang Xu gao Clinical Medical Records" Jie accumulate door "accumulation gate" chapter, each included 31 and 30 case. In twenty-six years Guangxu edition Liu Bao Yi Jiang Yin Liushi medical books in the "Central Cottage Creek Medical Records" is summed up as "Jia addiction door" only 10 cases."Wu Ju Tong Medical Records · Clinical accumulate" a total of nine cases, the accumulation of disease characteristics, treatment guidelines and precautions Wu in "medical healing book · Zhengjia theory" brief description. To Wu, the accumulation and Zhengjia name is the same disease in different diseases with the treatment should not be too triangular, Curcuma, Yang final end, safflower attack stasis drug rule, not suitable for long-term use him for the medical treatment. Its pathogenesis is imaginary evil is real and stagnation, the ancient cloud "Tang who finishes it. " Not Jiufu. "Pills who also slow" to gradually grind chronic illness. Wu Again, where the disease for a long time into the plot into the disease, its treatment should not slow swing, pill should not soup. Therefore, under the condition to be treated for a long time, Wu will continue with Dan slow retrogradation of disease through until symptoms of the illness.3. VertigoFrom the liver vertigo, from the era from Canon, "Q" that starts from liver depression, dizziness, and then fire Yang Kang, raised within the wind of vertigo, somewhat empirical "all the wind out of dizzy, all belonging to the liver, " meaning; "coffin" is considered to dizziness from lack of blood and marrow empty so to dizziness, biased deficiency "on the virtual dizzy" meaning. Wang Xu gao vertigo medical records a total of 37 cases since the "liver wind pyrophlegm door" chapter read, "Jing said:the virtual is dizzy Danxi cloud: no sputum no dizzy pathogenesis theory, saying:all the wind out of dizzy, all belonging liver, vertigo is not true, wind and phlegm three infestation. "Ming Wang has a disease of the vertigo pathogenesis and Treating the heavy place. No dizziness and kidney, spleen as well as liver wind phlegm. "Q" to talk about the liver, "coffin" empty talk, coupled with Zhongjing Zhu Zhenheng clear stand "cover no sputum can not be too dizzy" in theory. Wang found that the liver is the spindle with vertigo, still follow the five elements theory, the cause must end phase and only non-thinking.Wu Ju Tong Medical Records total of seven cases of vertigo, which "dizzy run," the word to represent the vertigo were 6 cases, Yang wind dizzy move within only one case. Most of the former six cases referred to dizzy run, Wu Zun is Zhongjing vertigo of words. But in fact, Wu Wu Medical Case On one case of liver syndrome, dizziness, and many more phlegm to dizzy as the main etiology and pathogenesis, Yang wind dizzy moving within the substance nor medication liver syndrome.4. StrokeThe term stroke begins Zhongjing still in use. In the previous era to all kinds of names Nei Jing, consciousness disorders can be divided into "violent Jue," "thin Jue", "big Jue", "fried Jue," "strike servant", as well as hemiplegia of "dried up" "partial wind", "stroke", "dumb", "Rush" and other titles. With the development of stroke Treatment history, is false stroke is the cause of the foundation, but before the Tang and Song dynasties, and except for the wind into mainstream thinking, after Jin and Yuan, gradually within the main wind Treating thinking. In the wind to the pathogenesis attributed to the liver who have liver wind, anger, reverse liver, liver blood deficiency and so on. Wang in "Medical door tips·stroke" chapter that is the first sentence that "a stroke syndrome, mostly liver wind Shangni", directed liver is run by a stroke of the certificate, its certificate, except with the "Q · to larger theory of truth ":" all the wind out of dizzy, all belonging to the liver, "the cloud" dizzy ", the more emphasis on" sudden faint servant, crooked mouth drooling, hand-foot-fail "and" out "card. Wang reminded the ancients for stroke has been discussed quite complete, also have their own different opinions, nothing more than the wind from the outer to the Xiaoxuming decoction; wind from endogenous to put out in the wind; gas or words clip, clip fire, phlegm, etc., even if the stroke Jingyue also presents non-customs wind, is due within the virtual essence, as long as the virtual internal warming can, but Wang advised that Liyan party or on a medical student who must believe, but not all letter, only the light of and with the permit rule. Treatment experience, Wang concise, basic prescription for the antelope, Tianma, orange, Breit, Uncaria, Fu Shen, Huang Zhu; Zhu Li, ginger. There are language Jian who sent under Su Pill; there is resistance awakened closed, tongue paste strong God who, under treasure of Dan; phlegm, bile star plus. But on the stroke of Clinical Medical Records chapter classification, on the side of Liu Ershi version significantly different, Fang version only classified as "stroke" 17 cases; Liu’s edition is divided into "the throttle" three cases and "inner damper" 6 Example; co-edited version is divided into "classes in the door" 11 cases, the other points listed in the "anger qi liver wind door" 63 cases; in short, said Liu’s stroke, stroke, internal wind, stroke and liver class wind of the other, and the party’s known as a stroke (the door), but otherwise liver wind pyrophlegm (door).About stroke or have real class, the wind outside or inside of the other wind, Wu Ju Tong in the medical case points in great detail, Wu disease into the wind the wind outside and inside the wind, the wind outside the "sun stroke" label, in the wind by the "stroke" and "liver wind" is marked. That is true, said the wind outside sun stroke, stroke, stroke inside the wind that is the class that is a stroke or liver wind. Do the symptoms, the kind of stroke, will slow vertical shape, belong to the wind ruffles the elephant, "coffin" that of Rush; the true stroke, shape will Spasm, is six evils of the evil from the outside in. Therefore, belongs to a class of liver syndrome of stroke, Wu Ju Tong has one win and is considered a negative characteristic, such as "no to kidney Liver, Yang alone on the solitary" or "virtual earth liver insult" is hybrid virtual and real organs diseases. The rule is that "B Kuei-homologous", "real homemade wind", "golden wood construction," three kinds of the rule is. Wu Ju Tong on the stroke on the bed of governance, can be said to define the concept of confusion since ancient times, to later set a clear diagnosis and treatment guidelines.ConclusionWang Xu gao and post-doctors are all in the Qing Wu Ju Tong, there are theoretical writings of medicine and clinical diagnosis and treatment of medical records, through internal and specializes in deep Zhongjing doctrine, then by the Qing Ye Tianshi Febrile Diseases, said the impact is not confused Ideological differences both typhoid fever and febrile disease theory, but also in the medical case inclusive, give full play to the role of education and guidance on the development of Chinese medicine physicians generations past with the future.Wang Xu gao Liver Ways in 30 summarizes the development of liver syndrome of traditional Chinese medicine for thousands of years Treatment principles and implementation of the clinical diagnosis and to become part of the implementation process in the liver syndrome hair cut herbs, a very important guideline, but also before or since those important guidance. But listed therapies and drugs, are not fully applied in the medical case, namely Liver Ways in 30 recommendations are theoretical, clinical diagnosis and treatment, and pathogenesis are certified by a single non-composite, so the judge will there are huge differences in the proportion of treatment is chosen on. The drug administration is also true, such as yellow, angelica, white peony root, licorice and wheat, winter Medical Records drugs are more than one hundred times, five columns of liver syndrome medication. With respect to the liver and other liver deficiency cold syndrome and treatment of fine Xin Wangshi only five times, goat Wang more unused.Wu Ju Tong "early disease liver depression" and "chronic illness into the network, " two words throughout Wu medical case, the base core theory Treatment of liver syndrome. Liver syndrome can also be interpreted as the beginning of the disease to liver failure catharsis and Yu, Yu-long chronic illness qi stagnation of blood in the network. Emotional Yu Nu liver syndrome occurs is the starting point, since the lesions raw anger, liver wind, Chongfan take his dirty insult regeneration and the card or certificate. Treatment, fewer patients with early disease and more chronic illness, Wu case the phrase "primary liver catharsis, liver disease can not...... catharsis liver blood, is also the main network of blood, so whoever Liver governance network" can Description of Key liver. In addition, although the cloud liver depression or anger, but a "charitable spirit can not eliminate anger, do not take medicine," it is stated that, medication is not a cure liver first method, but emotional. Yu Nu is not removed, can not medication, it is different from the treatment of liver syndrome Wu Wang place.Wang Xu gao Liver Ways in 30 stressed liver, liver wind, anger with the three different names belong to the pathogenesis of partial changes, Wu Ju Tong stressed Yu Nu liver injury, liver qi stagnation, chronic illness into the network, the cause of migraine belong disease. Treatment of liver syndrome of the face, should be combined with two physicians summarized theoretical framework, and medical case Remainding basic concepts and thinking, is to give the true mass of clinical diagnosis and treatment of liver syndrome.In this paper, there are room for further complete place, one is unable to complete the implementation of liver syndrome of drug statistics, difficulty is that few drugs can be attributed to a single liver syndrome drug, this drug Tropism of taste, whereas the statistics can not be accurate. Second liver syndrome is only a collation with the concept in medicine, and can not be only in "Internal Medicine" (10,15,16) of hypochondriac pain, jaundice, accumulation, bulging with five kinds of headache disorders as a certificate of induction Hepatology, it can not only permit the election of jaundice, accumulation, dizziness and stroke four cards as a representative. Therefore, there are many medical cases of liver syndrome in other chapters could not be listed in the selection analysis, this paper is missing the point, yet scholars continue to study and discussion in order to complete the desired content of liver Medical Records. |
PDF Full Text Request