The Summarization Of HanMingXiang’s Academic Ideology And Clinical Experience On Diagnosing And Treating Chronic Cough And Dyspnea Thought To Use Warm Therapy

Objective:To systemically summarize the methods and experience of warm therapy that Prof HanMingXiang used in the diagnosis and treatment of chronic cough and dyspnea, to train the ability of differentiation diagnosis, to understand the system in detail, to further develop all his methods, to enriching content of chronic cough and dyspnea therapy according to traditional Chinese medicine, and to explore new modes of study famous doctors’clinical experience.Methods:To record and organize clinical cases of the tutor using warm therapy in treatment of chronic cough and dyspnea. Through the medical records of 234 cases of chronic cough and dyspnea, To observe the distribution regularities of sex, age and initial diagnosis. To apply digital platform of independent research and development of Chinese academic experience in the First Affiliated Hospital of Anhui University of traditional Chinese medicine. Collect the information of patient in differentiation, treatment, prescription and so on. Set up the Case collection database of HanMingXiang’Studio, to analyses using frequency of Chinese medicine and the curing method of each syndrome type to refine the core prescription. To select the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine’ 60 patients of acute exacerbation of chronic obstructive pulmonary disease of the phlegm retention in the lung syndrome, randomly divided into the treatment group and control group respectively 30 cases. The both groups are given the same basic treatments, such as anti-infection, relieving asthma and even mechanical ventilation if appropriated.The treatment group was added shiziwenfeitang, and control group added mucosolvan,30mg, IV twice a day for ten days. To observed the changes of the evaluating scores in the symptoms of Cough, expectoration, dyspneae, pulmonary function and the levels of neutrophil elastase> epithelial growth factor receptor、interleukin-17A、hypoxia Inducible Factor-la, and then to compared the treatment effect.Results:Prof HanMingXiang considered chronic cough and dyspnea belong to chronic inflammatory airway diseases, such as asthma、chronic obstructive pulmonary disease and so on, which are longer course of disease, recurrent, refractory. The pathological factor is phlegm and retained fluid, excess of yin dues to yang insufficiency, asthenia in origin and asthenia in superficiality. Department of pulmonary disease easy to repeated attacks in the cold season, lung enjoying warm and disliking cold is the major reason. Yang deficiency is exogenous pathogenic factors, phlegm blocking in the airway, patients occurs cough and dyspnea.Prof HanMingXiang considered treatment about chronic cough and dyspnea includes, wenyanghuayin, xinwensanhanxuanfei, wenyangquyu, ganwenbufeijianpiyishen.The reason for the patients in acute attack with chronic inflammatory airway diseases not all due to infection, allergy, cold stimulation and other factors are closely related. The effect of warm therapy is exact to in treatment of chronic cough and dyspnea. Dialectical points is cold, heat, deficiency, real, location and simultaneous phenomenon of chronic cough and dyspnea.According to the clinical pathological characteristics of phlegm and retained fluid, cough and dyspnea, the evolution of the position of the lung spleen and kidney, and the theory of Lung enjoying warm and disliking cold, we put forward the four methods of warm therapy use warm therapy to treat phlegm and retained fluid, firstly, wenfeisanhan, jiebiaojuanyin. Reason of recurrent of phlegm and retained fluid, cough and dyspnea is infection, Treatment is waisanfenghan neijuantanyin, such as sheganmahuangtang, Xiaoqinglongtang. Secondly, wenpiyiqi peitushengjin. "Phlegm coming from spleen, the lung being the utensil for storing phlegm", phlegm and retained fluid dues to excess of yin due to yang insufficiency, we emphasis on warm therapy, not simply from the lung, but from wenpiyiqi. Strengthening earth to generate metal, to reduce the source of phlegm, such as huangqijianzhongtangN enchanting> lingguizhugantang> liujunzitang. Thirdly, wenshenhuayin, naqipingchuang. One of the main causes of phlegm and retained fluid, cough and dyspnea is kidney yang deficiency. The lung being the upper source of fluids, regulating fluid a passage, the kidney controlling water metabolism, store the essence of five zang-organs and six fu-organs, deficiency of the kidney, disturbance in functioning of qi, chest tightness and asthma. Treatment is wenshenhuayin naqipingchuang. Such as chinkuei shin chewan pills, Decoction for Strengthening the Spleen-yang, buffeting. Finally, wenyangxingyu, huatanzuiyin. All vessels converging in lung, lung regulating visceral activities, deficiency syndrome of the lung, xinqi xinyang is weak and tired, blood stasis. Initial stage, sputum; later stage, blood stasis, phlegm and blood stasis harm yangqi, vicious cycle. Blood coagulation in cold, blood flow is smooth in hot, yangqixuruo, can’t to warm blood, endogenous blood stasis, lead to cough and asthma.Treatment is wenyangxingyu,huatanzhuyin. Such as yanghetang、 taohongsiwutang, tinglidazaoxiefeitang.Prof HanMingXiang considered location about chronic cough and dyspnea is lung. Seven methods of treating lung is xuan lung, su lung, wen lung, qing lung, run lung, lian lung, bu Iung.Syndrome characteristics of cold syndrome is leng、dan、qin、xi、qin、bai. Using warm therapy, treatment according to syndrome differentiation, comprehensive application the therapy of wenxuan、wensan、wenbu、wenhua.The data from 234 (male 98 cases, female 136 cases) chronic cough and dyspnea patients, including 0-40 years old,77 cases, accounting for the total number of 32.46%; 41-60years old, 74 cases, accounting for the total number of 32.13%; 61-75 years old,70 cases, accounting for the total number of 29.51%; more than 75 years old,13 cases, accounting for the total number 5.9%. Top three diseases of chronic cough and dyspnea are syndrome of wind-cold attacking lung 27%、phlegm dampness stagnation 25%、lung kidney two deficiency 21%.Core prescription is blackberrylily rhizome、ephedra、aster、flos farfarae、pericarpium citri reticulatae、decursivum、cynanchum glaucescens、poria cocos、the tuber of stemona、 Schisandra chinensis. Top ten Chinese medicines is respectively pericardium citric reticulate 192、poria cocos 189、aster 174、flos farfarae 172、almond 151、liquorice 144、the tuber of stemona 142、ephedra 132、Schisandra chinensis 129、Astragalus membranaceus 119. Top ten type of drug paired frequency distribution is pericarpium citri reticulate, poria cocos, correlation coefficient 23.60828; flos farfarae, almond, correlation coefficient 20.36355; aster, almond, correlation coefficient 19.369; aster, the tuber of stemona, correlation coefficient 18.24397; almond, ephedra, correlation coefficient 17.92094; flos farfarae, ephedra, correlation coefficient 16.94005; flos farfarae, the tuber of stemona, correlation coefficient 16.80149; aster, ephedra, correlation coefficient 16.69092; Schisandra chinensis, blackberrylily rhizome, correlation coefficient 15.4311; cynanchum glaucescens, the tuber of stemona, correlation coefficient 15.4311. Warming lung and resolving phlegm, anti asthmatic is major treatment.Clinical data of shiziwenfeitang to treat Patients with acute exacerbation of chronic obstructive pulmonary disease, the total effective rate was 93.33% in the treatment group, the total effective rate was 76.67% in the control group, the treatment group was better than the control group (P<0.05). There was no difference of syndrome integral between the two groups pretherapy (P>0.05), the two groups post-treatment symptoms were significantly improved (P<0.01). There was no difference in treatment group with the control group about cough, expectoration,dyspnea (P>0.05), however, poor appetite, abdominal distension, shortness of breath, mouth sticky improved P<0.05, P<0.01). There was no difference of pulmonary function between the two groups (P>0.05) before and after treatment. The levels of NE, IL-17A, EGFR and HIF-1α decrease in both groups after treatment, the levels of IL-17A and HIF-la significantly decreased in the treatment group (P<0.05).Conclusion:Prof HanMingXiang used warm therapy to treat Cough, expectoration, dyspnea based on the theory of Lung enjoying warm and disliking cold, the results of data reanalysis showed academic thought of Prof HanMingXiang use warm therapy to treat chronic cough and dyspneas. Clinical research showed both siziwenfeitang and mucosolvan can improve clinical symptoms, but siziwenfeitang has its unique advantages at the amelioration of some symptoms, such as anorexia、abdominal distension and so on. Siziwenfeitang showed the effect of warm therapy is exact to in treatment of chronic inflammatory airway disease, which eregulate the expression of neutrophil elastase、 epithelial growth factor receptor、interleukin-17A、hypoxia Inducible Factor-1α,and effectively improve airway inflammation and mucus hypersecretion of the patients with COPD, the effect of warm therapy is exact to in treatment of chronic inflammatory airway disease.